Indian Health Care Sector

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Varoon Shekhar
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Re: Indian Health Care Sector

Post by Varoon Shekhar »

[quote="Varoon Shekhar"]https://timesofindia.indiatimes.com/cit ... 351718.cms

I read the PM from a forum moderator just today! I totally overlook private messages on this forum. Anyway, I was being quite sarcastic and disgusted with all these accidents on Indian roads. It's not good, of course, that anyone of any occupation dies. I was thinking of India's poor doctor to patient ratio, and how such horrific accidents and losses of doctors are going to hurt.
Kashi
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Post by Kashi »

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the path to universal health coverage in India: Overcoming the challenges of stewardship and governance
Public spending on healthcare in India is [..] just over 1% of gross domestic product (GDP)
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), approved by the Indian government in March 2018, is an ambitious reform to the Indian health system that seeks to provide financial health protection for 500 million of the most vulnerable Indians and halt the slide of the 50–60 million Indians who fall into poverty annually as a result of medical-related expenditure.
Indian government approved the ambitious AB-PMJAY in March, 2018. The scheme, colloquially referred to as “Modicare” after Indian Prime Minister Narendra Modi, aims to build on existing schemes to provide publicly funded health insurance cover of up to 500,000 Indian rupees (over US$7,000) per family per year to about 100 million families (500 million people, 40% of India’s population) . The scheme builds on the previous programs outlined above (for example, the National Health Mission still forms the basis of primary care under the new program) and has been designed to be implemented to either take over or operate alongside state-based programs, but has a broader remit in terms of the services covered and the amount of coverage that each individual is entitled to. The government has so far allocated 100 billion rupees (almost US$1.5 billion) to the program for 2018–2019 and 2019–2020 . Currently, the country spends about US$64 per person on healthcare, two-thirds of which is privately financed by user fees. As such, current UHC initiatives in India centred on AB-PMJAY alongside state-based programs such as those in Andhra Pradesh, Telangana, Tamil Nadu, Karnataka, and Kerala represent, as a whole, one of the most ambitious ever health and, one could argue, poverty-alleviation programs ever launched.
Eligibility for the scheme is determined based on deprivation criteria measured in the 2011 Socio-Economic Caste Census. There is no limit to the number of family members covered, and benefits will eventually be India-wide (if all states and union territories sign up to the program). This means that a beneficiary will be allowed to take cashless benefits from any public or empanelled private hospital across the country. State health authorities will lead the implementation of the AB-PMJAY, and states are free to continue to provide existing programs alongside the national program or integrate them with the new scheme. States will also be able to choose their own operating model to either use the expenditure to pay a private insurance provider to cover services, provide services directly (as elected by Chandigarh and Andhra Pradesh, for example), or a mix of the two (as in Gujarat and Tamil Nadu). Expenditure under the program will also be shared between the central and state governments in a prespecified ratio depending on the legislative arrangements and relative wealth of the states, with the Indian government covering between 60%–100% of expenditure.
The AB-PMJAY offers a unique opportunity to improve the health of hundreds of millions of Indians and eliminate a major source of poverty afflicting the nation. There are, however, substantial challenges that need to be overcome to enable these benefits to be realised by the Indian population and ensure that the scheme makes a sustainable contribution to the progress of India towards UHC.
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Re: Indian Health Care Sector

Post by Vips »

Indian device for cancer fight gets USFDA’s ‘breakthrough’ tag.

The US Food and Drug Administration (FDA)’s Centre for Devices and Radiological Health has designated a medical invention by a Bengaluru-based scientist as a “breakthrough device” in the treatment of liver, pancreatic and breast cancers.

Cytotron, developed by Rajah Vijay Kumar, aids in tissue engineering of cancer cells, altering how specific proteins are regulated to stop these cells from multiplying and spreading.

“We are pleased to inform you that your device and proposed indication for use meet the criteria and have been granted designation as a breakthrough device,” states a communique from the FDA wing to Shreis Scalene Sciences, the company that had taken the device to the US.

Cytotron is intended to cause degeneration of uncontrolled growth of tissues. “It is indicated for treating protein-linked, abnormally regenerating disorders such as neoplastic disease, and allowing extended progression free survival, with pain relief, palliation, improved quality and dignity of life,” says the letter.

Kumar had developed Cytotron at the Centre for Advanced Research and Development, which is headquartered in Bhopal, after nearly 30 years of research into cellular pathways and interactions with specifically modulated fast radio bursts.

“It is a great feeling that after so many years of hard work, against all odds, an institution like the USFDA is designating our work as a breakthrough in the treatment of three types of cancers,” Kumar said.

New technologies in the battle against cancer have generally been hard to come by. It’s even rarer for an Indian device to get breakthrough status in the US. The Centre for Devices and Radiological Health is responsible for pre-market approval of all medical devices in the US, ensuring they are safe for use and effective.

“The devices will all be made in India, given that there are hardly any imported components. And our American partner will take the device to the US. Cytotron is already an approved medical device and is in use in the UAE, Mexico, Malaysia and Hong Kong, among others,” Kumar said.

How it works

Generically known as rotational field quantum magnetic resonance, Cytotron uses fast radio bursts (FRB), high energy and powerful short radio bursts in which both electric and magnetic components of the electromagnetic signals are "circularly" polarised.

FRBs are produced when a radio signal travels through a powerful instantaneous magnetic field on its path to the target. “FRBs can be used to communicate with the cellular command and control, to up or down regulate a specific protein or gene,” Kumar said in a statement.

He added: “In cancer cells, Cytotron does two things: First, it alters the protein pathways of a pro-apoptosis protein called p53 via p21 inducing programmed cell death in the cancer cells. Second, exposure to Cytotron stops metastasis by inhibiting the epithelial mesenchymal transition cells, responsible for spread of cancer; 90% cancer patients die due to metastasis.”
Vips
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India plans to snatch away China’s control over drug market; what it is doing to supply globally.

India plans to ramp up production of pharmaceutical ingredients and become an alternative supplier for global drugmakers hit by factory shutdowns in China due to the coronavirus outbreak. The Indian government has aggressively begun implementing a policy to ramp up local output and emerge as an alternate to China, according to people familiar with the plan who asked not to be identified as discussions are not public yet. The so-called “China-plus one” strategy involves identifying essential drug ingredients, providing incentives to domestic manufacturers and reviving ailing state-run drugmakers, they said.

The deadly coronavirus, which shut down vast swathes of the Chinese economy before becoming a pandemic, snapped global supply chains as factories in Asia’s largest economy fell silent. For India — world’s single-largest exporter of generic drugs — this triggered raw material shortages and exposed its dependence on Chinese imports. The south Asian nation relies on bulk ingredients from China to manufacture a fifth of the global supplies of drugs that are off patents.

Highly Dependent
Bulk Drug | % imported from China

Paracetamol- 100%
Metformin- 100%
Amoxicillin- 90-95%
Ampicillin- 100%
Ciprofloxacin- 100%
Ibuprofen- 80-95%

India imports almost 70% of its bulk drugs and intermediates – the chemicals that make a finished drug work — from China. A number of these are sourced from Hubei province, where the pathogen first emerged in late-December. Of the total $3.56 billion imports of such products in 2018-19, China’s share was $2.4 billion, according to information presented in the Indian parliament.

The current crisis also gives an opportunity to India to challenge China’s stronghold on supplying basic drug ingredients.

After announcing a 140-billion-rupee ($1.8 billion) fund last month for setting up three drug manufacturing hubs, the government has identified 53 key starting materials and active pharmaceutical ingredients (APIs) whose output will be boosted on priority, the people said. These include fever-medicine paracetamol and antibiotics such as penicillin and ciprofloxacin.

Discussions are also underway on the viability of reviving on loss-making state-owned drugmakers Hindustan Antibiotics Ltd. and Indian Drugs and Pharmaceuticals Ltd. to speed up this process and ensure affordable medicines, the people familiar said.

“Indian bulk drug manufacturers could grow income by $3.3 billion if they expand capacity and global supply as the virus outbreak disrupts China’s pharma sector,” Mia He and Jamie Maarten, analysts with Bloomberg Intelligence wrote in a March 16 note.

Essential Medicines
Of the 373 drugs listed under India’s national essential medicines list, some 200 are imported as APIs, mostly from China, Dinesh Dua, chairman of Pharmexcil, an export promotion council under the trade ministry, told Blomberg over phone.

Sudhir Vaid, chairman and managing director, Concord Biotech Ltd, said the government should support local companies by giving low cost power, subsidies and faster approvals. It takes as long as three years to get approvals, Vaid said.

“If the government goes full throttle with the monetary help in one cluster, it can become a success in two years,” Pharmexil’s Dua said. “In five years, we can replicate that model throughout the country.”
vimal
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Re: Indian Health Care Sector

Post by vimal »

^^ I'm glad GOI woke up after the virus otherwise they were sleeping on the helm for years.
yensoy
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Re: Indian Health Care Sector

Post by yensoy »

There has to be a 2% "health security tax" on all API imports, and this money used to support domestic production. WTO be damned, just like WHO.
Karan M
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Re: Indian Health Care Sector

Post by Karan M »

Discussions, discussions, discussions. What happened to MOF's much ballyhooed plan to make a plan to take away export share from China. Did it even ever get completed?
Rishirishi
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Re: Indian Health Care Sector

Post by Rishirishi »

vimal wrote:^^ I'm glad GOI woke up after the virus otherwise they were sleeping on the helm for years.
Not only GOI, but the whole world has woken up. Even EU countries between them are blocking supply of things like protection masks, sanitizers etc. Germans placed an 30 000 pcs order of ventilators with a domestic company. This essentially blocked sale to other EU countries. Several advanced economies found that they were not able to manufacture even simple stuff.
Governments world over are rethinking import from China strategy. Expect a lot more local production in all countries.
Vips
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Under-5 mortality rate halved from 2000 to 2017.

Two scientific papers on child survival published on Tuesday by the India State-Level Disease Burden Initiative depicted a significant decline 49% in the under-5 mortality rate (U5MR) between 2000 and 2017, but it pointed out inequality between states and wide variations between districts.

While there is a variation of 5-6 fold in the rates between states, there is also a variation of 8-11 fold between districts, noted the report published in the Lancet. The initiative is driven by the Indian Council of Medical Research and the Public Health Foundation of India, among others.

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The findings show there were 1.04 million under-5 deaths in 2017, down from 2.24 million deaths in 2000 Most under-5 deaths in UP, Bihar comes second Neonatal deaths in India have gone down from 1.02 million deaths in 2000 to 0.57 million deaths in 2017. Neonatal mortality rate (NMR) has dropped by 38% in India since 2000. Sixty-eight per cent of under-5 deaths in India are attributed to child and maternal malnutrition, whereas 83% of the neonatal deaths to low birth weight and short gestation.

The highest number of under-5 deaths in 2017 were in UP (312,800, which included 165,800 neonatal deaths) and Bihar (141,500, including 75,300 neonatal deaths). U5MR and NMR were lower with the increasing level of development of the states. In 2017, there was a 5.7-fold variation in
U5MR ranging from 10 per 1,000 live births in the more developed state of Kerala to 60 in less-developed UP, and a 4.5-fold variation for NMR ranging from 7 per 1,000 live births in Kerala to 32 in UP.

“The research paper has shown that India has made positive strides in protecting the lives of newborns over the last two decades,” Niti Aayog member V K Paul said
ricky_v
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Re: Indian Health Care Sector

Post by ricky_v »

Stats from 2018
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ricky_v
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Re: Indian Health Care Sector

Post by ricky_v »

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sreerudra
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Re: Indian Health Care Sector

Post by sreerudra »

Gentlemen

Do any of you know id the India HealthStack has an 112 API or 108 API?
I am hoping to find some more details.
Thank you in advance.
VKumar
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Re: Indian Health Care Sector

Post by VKumar »

How about opening one AIIMS level hospital in every district HQ?
Also if we open one in each developing country it will be a great projection of soft power. Maybe alongwith an IIT and an IIM too!
sreerudra
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Re: Indian Health Care Sector

Post by sreerudra »

Does anyone know India HealthStack has 108 integration?
sreerudra
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Post by sreerudra »

Does anyone know have additional information on Modi's Govt is creating a National Health ID?


https://economictimes.indiatimes.com/in ... 290784.cms
Hiten
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Re: Indian Health Care Sector

Post by Hiten »

BARC's DRHR has made a Sleep Apnea Device

https://www.spansen.com/2020/09/calling ... -barc.html

there should be separate thread to track oddities coming out Organisations setup to pursue something totally different

another BARC product, bitter gourd juice & banana cake
https://www.spansen.com/2020/04/barc-go ... itter.html
Vips
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Re: Indian Health Care Sector

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Zydus ‘wrapping up Phase-III trials of three-dose vaccine.

Zydus Cadila is optimistic that its three-dose plasmid DNA vaccine, ZyCoV-D, will offer sustained immunity with longer antibody response. The company expects to launch the antidote “very soon”, even as it completes the advanced Phase-III clinical trials and submits data to the drug regulator for review.

The Covid-19 vaccines presently in India are two-dose vaccines, and Zydus did encounter questions on the economics and logistic complexities involved in a three-dose vaccine. The company, however, stayed the course with its three-dose vaccine, and even indicated that it would be among the most affordable ones. The vaccine will be administered without a needle, intra-dermally.

Unlike most vaccines, which use a needle to inject the vaccine into the tissue, ZyCov-D will be administered without a needle, but using intra-dermal injection that will push the substance into the dermis.

Sharvil Patel, Managing Director, Zydus Cadila, said, “Currently, we are a three-dose regimen which we believe is more suitable for our vaccine and which will give a wider immune response and longer antibody response which we have seen in our data.”

Zydus is also conducting trials on a two-dose vaccine. “If the data are equally good, we will look at it,” said Patel ruling out any delay in the first project due to the trials on the two-shot vaccine.

As India’s second indigenously-developed vaccine, ZyCoV-D will be affordable, reiterates Patel.

“Currently, we are focussing on completing the Phase-III clinical trials and submitting the outcomes. We will decide the pricing of the vaccine closer to the launch,” said Patel.

In an earlier interaction with BusinessLine, Cadila Healthcare founder and pharma sector doyen, Pankaj Patel, had hinted at an affordable price for the company’s vaccine. “It is a trying time for the world. We have to ensure that we help people, more than looking at some quick bucks,” Patel had told this paper.

Ready for variants
ZyCOV-D is developed using a new technology platform that uses non-replicating and non-integrating plasmid-carrying gene of the virus SARS-CoV2. The platform, with improved vaccine stability and lower cold chain requirement, will be easy to transport to any corner of the country. It can also be modified in just a couple of weeks if the virus mutates. In January 2021, the company had received the Indian regulator’s nod to start Phase-III clinical trials for the vaccine on close to 30,000 volunteers. The vaccine was found to be safe, well-tolerated and immunogenic in the Phase I/II clinical trials conducted in 2020.

Throughout the pandemic, Zydus has ensured access to affordable treatment options. It has priced the much-in-demand Remdesivir at ₹899 for a vial, compared to others pricing it at ₹2,450-3,000.
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Re: Indian Health Care Sector

Post by vijayk »

Reposting from other thread ...

I think this pandemic and abdication of responsibility by many states and simply blaming center calls for a Nation Health Service kind of setup.

1. NHS will manage hospital infra. Start with 2/3 major hospitals run by NHS in every district.

2. One medical college per hospital

3. Insurance coverage under LIC

4. Provide NHS to negotiate with doctors to use the infra for surgeries for nominal fees.

5. Completely independent infra like oxygen and necessary drugs and ability to negotiate with pharma.

6. Independent audits by forum of external doctors/state/center officers including judiciary?
Vips
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216 cr vaccine doses to be available in 5 months between Aug-Dec, enough to cover all: Centre.

As states grapple with a shortage of coronavirus vaccines, the Centre Thursday said that over two billion doses will be made available in the country in five months between August and December, enough to vaccinate the entire population.

V K Paul, Member (Health), Niti Aayog, also said the Russian anti-Covid vaccine Sputnik V is likely to be available by next week.

With the domestic supply falling short to meet the huge demand, several states and Union Territories including Delhi, Maharashtra, Karnataka and Telangana have decided to opt for global tenders for procurement of anti-coronavirus shots.

Acknowledging the crunch, Paul said vaccines are important "but it takes time" to produce and make them available. "We are passing through a phase when supply is finite."

Several Indian states are reporting an acute shortage of vaccines, even as coronavirus cases surge across the country.

"This is why we prioritised. Which is why (when) free vaccines were given by the government of India, their focus was on vulnerable age groups. We have to keep this mind," he said at a Health Ministry briefing.

However, the officer said that by the end of the year there will be enough vaccine doses in the country to inoculate the entire population.

"Over two billion doses will be made in the country in ve months (August to December) for India and for the people of India. Vaccine will be available for all as we move forward," Paul said, adding that the number is likely to be ramped up to three billion by the rst quarter of the next year.

He said that the estimated 216 crore doses that are likely to be produced between August and December include 75 crore doses of Covishield and 55 cores doses of Covaxin. Further, Biological E is expected to produce 30 crore doses, Zydus Cadila 5 crore, Serum Institute ofIndia 20 crore doses of Novavax, and Bharat Biotech 10 crore doses of its nasal vaccine, while Gennova will make available 6 crore doses and Sputnik V 15.6 crore doses, he said.

The vaccine candidates of Biological E, Zydus Cadila, Gennova, Bharat Biotech's nasal vaccine are in various stages of clinical trials.

On the procurement of vaccines from Pfizer, Moderna and Johnson & Johnson, Paul said the government is in touch with these firms through the Department of Biotechnology and the Ministry of External Affairs.

"We asked formally whether they would like to send doses to India, manufacture in India, we will nd partners. They said they will talk about vaccine availability in Q3 (quarter 3). We have intensified this process with Moderna, Pizer and J&J and we hope they will come forward," Paul said. "This is happening at the highest level," he stressed. "We invite (them). They make vaccines here, make it with our companies through technology transfer. Under the new strategy, that channel is open and we will support in every possible way," he said.

On vaccination drives in other countries compared to India, Paul cited the examples of the US, Germany and France where the entire population has not received the single dose of vaccine yet.

The government has already said that India is the fastest country globally to reach the landmark of administering 17 crore doses in 114 days.

Paul also defended the Centre's vaccination policy, which several states have criticised.

Many opposition-ruled states have been opposing the policy which mandates them to procure vaccines, nationally and internationally. Opposition states chief ministers too have been demanding free vaccines for all. Delhi Chief Minister Arvind Kejriwal said the fact that the states are "left to right" with one another in the international market for Covid vaccines portrays a "bad" image of India.

Replying to such criticisms, Paul said, "States wanted flexibility. It (the vaccination policy) was in that response. There was also a demand that there should be (availability of doses) in the private sector," he said.

"Any vaccine that is approved by the WHO, FDA can be imported to India. They can get an import license in two days. Who is stopping them?" he added.

He said that so far 35.6 crore vaccine doses have been either procured or are in the process of procurement by the Centre. Giving a detailed break-up, he said under the PM-Cares Fund, 6.6 crore (5.6 crore Covishield and 1 crore Covaxin) doses have been procured and utilised, while 1 crore Covishield doses have been received and utilised under the Gavi COXAV facility. Under phase II, 12 crore (10 crore Covishield and 2 crore Covaxin) doses are being procured, he said, adding of these, 86 per cent doses have been received while the rest are expected by the end of this month.
Under phase III, he said, 16 crore (11 crore Covishield and 5 crore Covaxin) doses are being procured. The supply for these doses will begin from May 21 and continue through July.

Separately, 16 crore additional doses are in the pipeline which are being procured directly by the states and private hospitals, he said. "So, overall, 51.6 crore doses are being procured.
vijayk
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Post by vijayk »

https://swarajyamag.com/magazine/how-aa ... lth-policy
How Aadhaar Can Help Shape India’s Health Policy
However, without a unique identification like the Aadhaar, it will be practically impossible to design and implement the CRVS. In essence, the CRVS registers every birth and death, and issues birth and death certificates. It compiles and disseminates data on these vital statistics. Given that it also provides information on causes of death, the CRVS could play an important role in setting priorities and shaping health policy in India.

The single-biggest challenge to India’s health policy is non-availability of regular and reliable data on health outcomes, in particular on deaths. A lot can be learnt about the quality of life from death. In a large and diversified country like India, where health needs differ from state to state, and, within a state, from district to district, there is, unfortunately, no quantitative and disaggregated measure of health outcome that can be the basis of framing and assessing health policy. As a result, in spite of the best efforts of the government, there is little or no evidence whether health policies are having any intended effects. Perhaps due to lack of good data, there is no political pressure on elected representatives to address health issues at the local level. Another inconvenient truth is that lack of basic health data disproportionately affects the weaker and vulnerable sections of society – women and children.

Historically, the government attempted to address this issue with the civil registry system (CRS), which goes back almost 50 years, with the passage of the Registration of Birth and Death (RBD) Act in 1969, under which every birth and death was to be compulsorily registered. It was envisaged that CRS would be “…the unified process of continuous, permanent, compulsory and universal recording of the vital events (births, deaths, stillbirths)”. Though there has been considerable improvement in the civil registration scenario in the country since the passage of the RBD Act, it is far from complete, and there is significant variation across regions and socio-economic groups.
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Re: Indian Health Care Sector

Post by vera_k »

Not looking good on this front.

Gujarat government has not built a hospital in 25 years, says Congress
In a recent reply in the Assembly, the Gujarat government admitted that only 16 district hospitals in the state had CT scan machines, an instrument critical to the fight against Covid and many other serious conditions.

Only one district hospital — in a state with 33 districts —has an MRI machine, the state government added.
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Post by vijayk »

We need a National Health Council just like GST Council
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Re: Indian Health Care Sector

Post by Vips »

Zydus Cadila likely to seek EUA for its ZyCoV-D vaccine in 7-8 days.

Pharmaceutical major Zydus Cadila has told the Centre that it could apply for emergency use authorisation (EUA) for ZyCoV-D vaccine in the next seven-eight days.

It will be the second indigenous Covid-19 vaccine to apply for such authorisation. It will also be the world's first DNA vaccine against coronavirus.

"Zydus Cadila has told the government that it could apply for emergency use authorisation for ZyCoV-D vaccine in the next seven-eight days," a government source said.

ZyCoV-D is a DNA Covid vaccine, which carries the genetic code for that part of a virus that triggers the immune system of the body.

Niti Aayog Member (Health) Dr VK Paul told ANI that Cadila has enrolled more than 28,000 volunteers for their phase three study.

"We are hoping that they will apply in near future. Most of their study is complete. They have enrolled more than 28,000 volunteers in their phase 3 study. We expect they will submit the results very soon. We are hopeful of this vaccine because it would be the world's first DNA vaccine. We are very proud of their work," he said.

The vaccine is being developed with support from the Centre's National Biopharma Mission as part of the Biotechnology Industry Research Assistance Council, Department of Biotechnology.

India has approved three vaccines against COVID-19 -- Covaxin (Bharat Biotech), Covishield (Serum Institute), and the Russian Sputnik V.

Covishield has been developed by AstraZeneca and Oxford University.

ZyCoV-D, the second indigenous vaccine after Bharat Biotech's Covaxin, is a three-dose vaccine -- to be administered at day 0, day 28, and day 56. The company has said it is also working on a two-dose regimen of this vaccine.

The stability data of the vaccine candidate showed that ZyCoV-D can be stored at 2 to 8 degrees Celsius for long-term use and 25 degrees Celsius for the short term.
Vips
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Re: Indian Health Care Sector

Post by Vips »

India's ‘warm’ vaccine shows results against all variants of concern.

The ‘warm’ vaccine formulations developed by scientists at IISc and biotech firm Mynvax result in antibodies that neutralise all current SARS-CoV-2 variants of concern, an independent evaluation of the formulations done by CSIRO, Australia, — the agency that had done animal tests for the Oxford-Covishield vaccine candidate last year — has shown.

The findings have been published (on Thursday) in the peer-reviewed ACS Infectious Diseases journal and will pave the way for clinical development leading to human trials. The published study was led by Prof Raghavan Varadarajan from IISc and TOI first reported about the vaccine in November 2020.

As per the paper, researchers have shown the formulations triggered a strong immune response in mice, protected hamsters from the virus, and remained stable at 37°C up to a month and at 100°C for up to 90 minutes — living up to its “warm vaccine” tag.

Most vaccines require refrigeration to remain effective — Oxford-AstraZeneca must be kept between 2-8°C; Pfizer requires specialised cold storage at -70°C.

The IISc-Mynvax vaccine has been designed by genetically engineering a domain of the S-Protein of the SARS-CoV-2 virus, called the Receptor Binding Domain (RBD), which attaches itself to the Ace2 receptor on the surface of target cells in the human respiratory tract. This enables the virus to enter the body and cause the infection. S-Protein of the virus is about 1,300 amino-acids long but the vaccine focuses only on a string of 200 amino acids.

Variants of concern & human trials

Explaining about the next course of action, Varadarajan said they had applied to the Government for grants/funds for the Phase-I/II and Phase III human trials in India.

“We would require at least Rs 30 crore for the trials and at this moment, all I can say is that funding has been applied for,”

Varadarajan told TOI, adding that the formulations had resulted in antibodies that neutralise SARS-CoV2 variants of concerns as shown by the pseudo-viral assays done at the CSIR-IMTech in India, and also that the results from the live virus tests by CSIRO were very encouraging.

CSIRO played a key role in evaluating the formulations against all current SARS-CoV-2 variants of concern. “CSIRO scientists at the Australian Centre for Disease Preparedness in Geelong contributed to the study by assessing vaccinated mice sera (blood samples) for efficacy against key coronavirus variants, including the Delta variant currently spreading globally including in Sydney,” CSIRO said in a statement shared with TOI.

Prof SS Vasan, CSIRO’s Covid-19 project leader and co-author, said the vaccinated mice showed a strong response to all variants of the live virus. “Our data shows that all formulations tested result in antibodies capable of consistent and effective neutralisation of the Alpha, Beta, Gamma and Delta SARS-CoV-2 variants of concern,” he said.

Vasan told TOI in an exclusive telephonic interview: “CSIRO will continue to work with the IISc to develop therapeutic applications that will complement vaccination strategies. The lack of safe, effective and affordable therapies that specifically targets this virus is an urgent and unmet need.
Vips
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Re: Indian Health Care Sector

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Big ambitions for India’s contract research firms.

IN BRIEF
India’s contract research organizations (CROs) are no longer just low-cost compound synthesizers. Over the past 15 years, they have asserted themselves as world-class chemistry-service providers. Now, the country’s top CROs are setting up labs in the West, fostering global teams, and courting biotechnology companies. The goal of their executives is nothing less than becoming integrated partners for global drugmakers and going head to head with China as the world’s powerhouse drug discovery partner.

Amid the economic turbulence and supply chain upsets of the past 2 years, big pharmaceutical companies have been quietly moving some of their drug discovery projects from research outsourcing partners in China to partners in India.

The diversification effort started before the pandemic, says Ramesh Subramanian, chief commercial officer at Aragen Life Sciences, one of India’s leading contract research organizations (CROs). “What we’re seeing is a significant focus from companies on diversifying their geographical footprint,” he says. “It goes both ways: companies that are fully ensconced in India look to China for diversification. Companies that are fully ensconced in China look to India.”

But India is the clear winner in the drive to diversify, executives in the country say. Pharmaceutical companies have historically been more invested in China—Asia’s largest market and home to the world’s largest CRO, Shanghai-based WuXi AppTec—and are now expanding into India. And China’s tensions with the US are helping fuel the shift.

Hyderabad, India–headquartered Aragen is already profiting. The company, which employs 3,200 people, just celebrated its best year yet, Subramanian says, and local reports peg the company’s value at $1 billion. Formerly known as GVK Biosciences, the company recently rebranded as Aragen, the name of its US subsidiary. The change was motivated in part by a desire to appeal to a customer base that is almost exclusively Western, according to Subramanian.

Western drug companies have been looking seriously at India for research help since 2005, when the country started to comply with the Agreement on Trade-Related Aspects of Intellectual Property Rights, or TRIPS, a globally recognized intellectual property pact, says Nailesh Bhatt, CEO of the US specialty pharmaceutical company Vgyaan. The new law roused the drug industry’s interest in India for cheap access to highly qualified scientists and the potential for selling patented drugs in India, Bhatt says.

Part of the industry is still low cost, Bhatt says, but India’s largest CROs have evolved since then from cut-rate service providers to powerhouses for high-quality chemistry and biology serving the Western market. “The evolution of the Indian drug discovery services has been quite drastic,” Bhatt says. “If you look at the number of contract development and manufacturing organizations (CDMOs) that were in India in the late 2000s versus what is there now, the clear winners have really emerged.”

Now, India’s top CROs and CDMOs are asserting themselves on the global stage. They are courting biotechnology companies by setting up satellite labs in the US and Europe. And they are hiring managers with Big Pharma or chemical experience. Their goal: go head to head with China while becoming less of an assistant and more of a partner for their drug industry customers.

Image
Syngene International offers drug discovery biology services at its facility in Bangalore, India.

WESTERN STANDARDS

Jonathan Hunt, the CEO of Syngene International, says the window of India’s operating cost advantage is narrowing. The country’s successful CROs have had to keep up with globally recognized processes, quality standards, and operating models to compete in the world market. State-of-the-art facilities and top-notch teams are not compatible with offering low-cost services, he says. But if India’s cost advantage is fading, the country’s place in the outsourcing industry is holding firm, Hunt says.

Founded in 1993 by Biocon, a leading Indian drug company, Syngene is one of the Indian CROs that have moved beyond the rote performance of research tasks and into fuller discovery collaborations.

Hunt credits the company’s success in part to a relationship with Bristol Myers Squibb that dates back to 1998. Syngene established a dedicated research facility for the US drugmaker in 2009. Earlier this year, Syngene announced the addition of a 4,600 m2 lab to the facility. The company will additionally add 200 researchers to the facility’s staff as part of an extension of the contract with Bristol Myers Squibb.

There aren’t many places on the planet where you can access that volume of young talent regularly - Jonathan Hunt, CEO, Syngene International

The partnership, Hunt says, has committed Syngene to processes and quality standards that are equal to global ones. In hindsight, this commitment was key to Syngene’s success with future clients. “From day 1, we gained a well-founded reputation that if you go inside our walls in Bangalore, our operations reflect the quality and safety standards that you find in the global markets,” he says.

If Indian companies’ cost advantage is narrowing, what still sets them apart from CROs in the West is the benefits of the country’s population of more than 1 billion. Syngene has more than 5,400 employees, of whom 87% are scientists. “There aren’t many places on the planet where you can access that volume of young talent regularly,” Hunt says.

Large pharmaceutical companies turn to India to fill a gap between the type of R&D that they need and the number of people at their companies who are qualified to do it, Aragen’s Subramanian says. His company has around 1,600 people dedicated to drug discovery. “Scale is something very tough to reproduce. And companies’ needs evolve dramatically. You might need x number of people today and twice as many tomorrow,” he says.

Not all of India’s drug discovery talent is local. Western scientists have long been hires at companies like Syngene and Aragen. And increasingly, the top CROs are hiring outside managers with large pharmaceutical or chemical experience.

One example is Marcel Velterop, president of drug discovery and CDMO services at the Bangalore, India–based CRO Jubilant Biosys. Velterop held positions with DSM and Dr. Reddy’s Laboratories before joining the CRO. And before Hunt, who is British, was appointed Syngene’s CEO in 2015, he was an executive at AstraZeneca.

Vgyaan’s Bhatt says the recruitment of such leaders proves companies are serious about playing the global field. “They need credibility, leadership expertise, and a real global perspective if they want to be able to sit with the head of R&D at AstraZeneca or GSK [GlaxoSmithKline] and say, ‘Not only should we work for you; we should be partners in drug discovery,’ ” he says.

Hunt, who lives in Manchester, England, and travels between the continents when COVID-19 restrictions allow, says his appointment represents not a strategy to increase Syngene’s ties with Western customers but rather the global nature of top-tier CROs. Most of Syngene’s clients are from outside India. “It’s no surprise that your talent base and your leadership increasingly represent the geographical spread and diversity of the customers in the industry,” he says.

WESTERN FOOTHOLDS
To Syngene, the company’s geographic presence doesn’t need to mirror this diversity. The firm has been strengthening its sales staff in key markets like the US and UK, but all its discovery and manufacturing facilities are in India. While Hunt says Syngene is open to establishing a base in the West, he says the absence of one “hasn’t held us back so far.”

Other Indian CROs consider a site in the West necessary if they are to form more integrated relationships with their clients—especially relationships that extend beyond preclinical drug discovery and encompass the manufacturing of drug candidates that might enter clinical trials. “At some point, not having a site in the West was really hurting us,” says Tuneer Ghosh, global head of chemistry, manufacturing, and controls business development at Sai Life Sciences.

Hyderabad-based Sai opened a development and manufacturing site in Manchester, England, in August 2020. Despite challenges posed by the pandemic, the site was a success. Less than 6 months after opening, Sai announced plans to double its head count and expand the site to offer active pharmaceutical ingredient (API) production, particle science and engineering, in silico modeling, and flow chemistry. A further expansion later this year will add a kilogram-scale lab that follows good manufacturing practice (GMP) standards.

Located in Alderley Park, a former country estate that is now a 160-hectare life sciences center, Sai’s site in Greater Manchester has opened new opportunities with UK- and European Union–based drug companies and biotechs, Ghosh says. “Historically, Sai has been doing really good business with large pharma in the West, but for critical projects, which need speedy delivery, or for complex chemistry, they would still look to CDMOs that are closer to them.”

Echoing other executives in India, Ghosh says that some customers are nervous about taking their intellectual property to CROs or CDMOs in India but are happy to hire a team in the UK. Last year, Sai began working with a drug industry client that has a policy of not outsourcing the synthesis of new chemical entities to India. The Manchester site, Ghosh says, “gave us a direct cutting edge. We had been trying to get into that big pharma for several years.”

The Manchester team comes mostly from Big Pharma and Western CDMOs, creating a cultural link to customers, says Dean Edney, Sai’s global head of process R&D. Edney, who came to Sai after 26 years at GlaxoSmithKline, divides his time between Manchester and Hyderabad when the pandemic doesn’t thwart travel.

Image
Sai Life Sciences opened this development and manufacturing site in Manchester, England, in August 2020.

Sai Life Sciences opened this development and manufacturing site in Manchester, England, in August 2020.
Sai wants to create teams on two continents that can tap into each other’s expertise. The talent pools in Manchester and Hyderabad are different, Edney says, and the transfer of knowledge is “absolutely key” in Sai’s strategy to build a global organization. The plan to expand into flow chemistry in Manchester, for example, will be aided by the team in Hyderabad, where flow-chemistry experience is more readily available. And once travel is possible again, team members will rotate between sites.

Sai is not the only Indian CRO that sees advantages to a Western base. In 2014, before the rebranding, GVK Biosciences acquired the US CRO Aragen. Officially, the rationale was to get involved on the biologics side of the drug industry. But Subramanian says GVK was also keen to gain access to US-educated talent and strengthen its relationships with Western pharma.

Similarly, Kolkata-based TCG Lifesciences established a US subsidiary, TCG GreenChem, earlier this year. It currently occupies 5,000 m2 of laboratory space across sites in Ewing, New Jersey, near Princeton, and Richmond, Virginia. TCG GreenChem’s CEO, Chris Senanayake, who previously worked at Boehringer Ingelheim, Sepracor, and Merck & Co., became the chief science officer of TCG Lifesciences in 2019 before founding TCG GreenChem.

The idea, Senanayake says, is to make TCG GreenChem the drug development engine for TCG Lifesciences and its clients, with innovation spearheaded in the US and most manufacturing done in India. If used well, this system will allow TCG Lifesciences to engineer complex molecules at low cost, he says.

Newer, smaller CROs are also taking this approach. Naresh Jain founded NJ Bio with the aim of leveraging India’s R&D expertise and bringing it to the US. “The expertise in CRO work, large-scale manufacturing, and APIs that India has grown over the last decades is stronger than that in the US now,” Jain says.

The cost of labor is still an incentive for an Indian base, he says: the annual price of employing a scientist in India is as low as $30,000, compared with $180,000 in the US. India’s chemists “produce similar results, if not better,” Jain says. But he also speaks highly of chemists trained in the US who bring a more innovative approach. Working together on sites in India and the US, the two sides bring a lot of value for NJ Bio’s clients, Jain says. “Whenever you mix two different cultures, it’s very refreshing. Diversity brings innovation.”

Founded in 2019, NJ Bio occupies about 3,200 m2 of a former Bristol Myers Squibb facility in Princeton. Jain also helped to launch an affiliated company, Amar Chemistry, in Mumbai, India, around the same time. Between its sites in India and NJ, the CRO specializes in bioconjugation, nucleotide chemistry, custom synthesis, biomolecular nuclear magnetic resonance, and flow chemistry. Jain’s ambition is to grow it into one of the largest niche-expertise CROs in the US.

To achieve this, NJ Bio has to convince its potential clients that it is safe to entrust their intellectual property (IP) to a team that works partially out of India, Jain says. “When we try to sell our services to most clients, their main concern is their IP,” he says, as US companies are nervous about sending sensitive information to other continents. NJ Bio’s model gives clients the option to get early-stage work done in India and later-stage work in the US. “For example, a compound that requires a 25-step synthesis has the first 10 steps done in India and the other 15 in the US,” he explains. “Clients are much more comfortable with this model.”

Miles Congreve, chief scientific officer at the biotech firm Sosei Heptares, is an example of such a client. He is used to working with Asian CROs on drug discovery but draws the line at the manufacturing of drug candidates under GMP standards.

“We would struggle with using Indian and Chinese groups for GMP just because you can more easily audit sites in the West,” he says. “You don’t want an issue with manufacturing that you don’t have control over.” This is a common hurdle for CROs that want to become one-stop shops offering both research and manufacturing services.

If Syngene, for example, had a site near Sosei Heptares’s base in Cambridge, England, then Congreve would consider the company a one-stop shop, he says. As it is, Sosei Heptares employs a jigsaw puzzle of CROs and CDMOs, picking them for different projects according to their individual strengths and locations.

Once you start getting professional investors, I think the doors will open wide for India - Ramesh Subramanian, chief commercial officer, Aragen Life Sciences

Last year the biotech worked with six CROs on designing inhibitors of the SARS-CoV-2 main protease to find an oral drug for the treatment of COVID-19. Syngene supported chemical synthesis, enzyme inhibition screening, and characterization of pharmacokinetic properties of key compounds. UK-based Domainex and Croatia-based Fidelta contributed to assay development and screening. Piramal Pharma and WuXi contributed to the synthesis work alongside O2h Group, a CRO based in India and Cambridge, England.

O2h is Sosei Heptares’s biggest external team and receives a budget of more than $1 million each year. Run by the Indian British brothers Sunil and Prashant Shah, O2h was built on a premise similar to NJ Bio’s. “We saw the strength in chemistry that India had in the early 2000s and the emergence of the biotech scene in Cambridge and put those two observations together,” Prashant Shah says.

The brothers geared their business to help start-up biotech companies from the get-go. Besides drug discovery services, they offer seed funding and incubation support, as well as mentoring and connections to clients in the vibrant Cambridge scene.

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All of Syngene International's research facilities are in India, including this one in Bangalore.

“Having a presence in the UK was essential for building those relationships with customers and supporting them with their drug discovery requirements,” Prashant Shah says. The advantage of doing most of its chemistry and biologics in India, he says, is the ability to scale up a project quickly.

Sosei Heptares started working with O2h in 2008. It was the first CRO the young biotech hired. Would the relationship have been this successful if O2h had only had a site in India, or only in the UK? “That’s a good question,” Congreve says. “It was certainly a factor in the beginning because I liked being able to go to their office in Cambridge and visit the site. But today we work with companies where we’ve never even seen their site.”

COZYING UP TO BIOTECHS
To India’s CROs, courting biotechs like Sosei Heptares is arguably the biggest part of their business plans, and the biggest motivation behind setting up shop in the West. “Yes, we are absolutely going after biotechs,” Sai’s Ghosh says. When biotechs stopped partnering with Big Pharma firms for all their promising compounds and began taking some drugs to market themselves, Sai changed its business model to cater to them, he says.

Like NJ Bio, O2h, TCG, and Aragen, Sai is leveraging its multiple sites to provide biotechs with speed, infrastructure, support, and reassurance that their IP is secure and in a familiar setting. Besides the Manchester site, Sai has placed business development representatives in Massachusetts, San Francisco, and European hubs like Barcelona.

The focus on biotechs also gives CROs a chance to shake off their reputation as rote makers of compounds. Rather than settle into the service role often expected by big drug companies, CROs can enjoy relationships that are more symbiotic, as young companies take help from experienced contract research partners to craft their strategies for drug development.

The desire for more equal client relationships runs through all of India’s most successful CROs, although none go as far as to say that gaining access to intellectual property is a part of the plan. Syngene’s Hunt says the leap from providing simple, repeatable chemistry tasks to doing integrated drug discovery is natural for the industry. “We’re just a biotech company in disguise,” he says. “We don’t need to own the IP, but we create IP in a way that’s indistinguishable from a biotech or pharma.”

The difference may be indistinguishable, but it continues to be important. CROs typically charge their customers for an agreed-upon number of full-time equivalent (FTE) employees. Under an FTE contract, the client pays the CRO a fixed amount without regard for the project’s eventual success or failure.

Some Indian CROs are keen to establish risk-sharing agreements with their customers under which they receive less money than in a straight FTE contract but qualify to earn royalties if their contribution helps the customer launch a new product.

But biotechs tend to be skeptical of these contracts, which rely on the CRO’s providing input that is worth its share of the profit. “True risk means true money on the table, and sometimes the CROs overvalue the input they can give,” says Robert Boyle, the CEO of Sentinel Oncology, a biotech in Cambridge, England, that outsources all its chemistry research. Sentinel has done one risk-sharing agreement, with O2h, in the 16 years since its foundation. Sentinel paid for five FTE chemists. O2h provided another five for free and took a share of royalties in the program.

The Indian Advantage
Although Boyle was happy with the project, he is not convinced that CROs can cross the bridge from being a set of helping hands to becoming a true partner for biotechs. “It’s a different business model. Contract research was driven by being a cost-efficient, professional outsourcing arm,” he says. “I can see more risk sharing as some CROs try to differentiate themselves as a one-stop shop, but I think it’s proven hard to get that off the ground.”

Indeed, Boyle still sees the financial advantage of Indian CROs as their main draw. “It would be very hard for us to suddenly flip to a UK chemistry service provider who would want to charge $200,000 for an FTE agreement when we pay $75,000 in India,” he says. “That’s a lot of money for a young biotech.”

True risk means true money on the table, and sometimes the CROs overvalue the input they can give -Robert Boyle, CEO, Sentinel Oncology

ECLIPSING CHINA
If money is the deciding factor for biotechs, China’s CROs are as competitive as India’s. Sentinel uses both, and Boyle says he has no preference for doing business with one or the other, although he says working with Chinese firms can be hampered by the language barrier.

Industry watchers name language as China’s biggest hurdle for contract research dominance. India, with its English-savvy population, has the upper hand. And while it’s not challenging for big corporations to employ translators or local staff, smaller companies, such as most biotechs, will struggle to create a partnership with a Chinese CRO, TCG’s Senanayake says. “Communication is the only downside to China. This is where we can differentiate ourselves and support the biotech industry.”

If India’s CROs have ever had a chance to eclipse China’s, this is the time. Political tensions between the US and China and the drive to reclaim the manufacturing supply chain by the pharmaceutical industry and government during the pandemic highlight the extent to which China dominates the world’s supply of pharmaceutical chemicals. These tensions have tempted some potential customers to edge away from the contract research giant.

But although some business may move to India, the shift doesn’t seem to be making a visible dent in China’s prominence. WuXi, for one, recently forecast its net profit for the first half of 2021 to increase by more than 50% from a year ago. Another leading Chinese player, Pharmaron, said its profit shot up 140% in the first quarter of 2021 from last year.

Aragen’s Subramanian is optimistic that India will gain more business from China in the near future. The ingredient missing to propel India’s contract research industry to the top is investment, he says. And here, private equity companies are beginning to fill the gap.

Last year, the Carlyle Group took a 20% stake in Piramal Pharma, a CDMO headquartered in Mumbai. In November, Syngene signed a 5-year agreement with the drug discovery and development subsidiary of Deerfield Management, a venture capital firm. And Goldman Sachs took a significant stake in Aragen this year. Subramanian says there are “several other deals that we know are in the works.”

One of the things that differentiated China from India when research outsourcing took off between 2001 and 2010 was China’s access to government-provided capital, Subramanian says. Without it, Indian companies were unable to scale in the same way. “The science was always there. The talent was always there. What was lacking was financial capital,” he says. “Once you start getting professional investors, I think the doors will open wide for India.”

Sosei Heptares’s Congreve expects consolidation over the next decade, with at least some of India’s star players being bought by or acquiring companies that will give them wider global reach. It would be good news for their clients, Congreve says. “It’s attractive to work with companies that are widening their network so you can access their services around the world,” he says. “Clearly, in another 10 years from now, there will be huge corporations that have swallowed up others as part of a group.”

And financial machinations aside, O2h’s Prashant Shah adds that Indian CROs themselves have become “extremely confident” in their ability to drive the country’s industry forward. “They’ve got very strong balance sheets. They can invest and make decisions and move quite aggressively to take up new opportunities across the entire pharmaceutical landscape,” he says. “India is genuinely a powerhouse in terms of its capabilities now.”

Snapshots of some of India’s leading CROs

Aragen Life Sciences
▸ Founded: 2001
▸ Employees: 3,200
▸ Sales: $160 million
▸ Sites: Bangalore, Hyderabad, and Vishakhapatnam (India), and California (US)
▸ Services: Discovery, development, and manufacturing of small molecules, and discovery and development of large molecules

O2h group
▸ Founded: 2003
▸ Employees: 500
▸ Sales: $12 million
▸ Sites: Ahmadabad (India) and Cambridge (England)
▸ Services: Integrated drug discovery; synthetic chemistry; biology; absorption, distribution, metabolism, and excretion; process R&D; and scale-up

Sai Life Sciences
▸ Founded: 1999
▸ Employees: 2,200
▸ Sales: $105 million
▸ Sites: Bidar and Hyderabad (India), Massachusetts (US), and Manchester (England)
▸ Services: Discovery, development, and manufacturing of drug substances

Syngene International
▸ Founded: 1993
▸ Employees: more than 5,400
▸ Sales: $304 million
▸ Sites: Bangalore, Hyderabad, and Mangalore (India)
▸ Services: Research, development, and manufacturing across modalities, including small and large molecules, antibody-drug conjugates, and oligonucleotides

TCG Lifesciences
▸ Founded: 2001
▸ Employees: More than 1,000
▸ Sales: Not disclosed
▸ Sites: Hyderabad and Kolkata (India) and New Jersey (US)
▸ Services: Drug discovery, commercialization, and manufacturing

Note: Sales figures are for 2020.
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Re: Indian Health Care Sector

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Reliance Life Sciences seeks nod for vaccine trial.

Reliance Life Sciences (RLS), part of India’s largest conglomerate, is expected to start Phase I clinical studies of its indigenous Covid-19 vaccine soon, reports Rupali Mukherjee. The Subject Expert Committee, which advises the drug regulator on vaccines and new drugs, reviewed the company’s application and is learnt to have recommended it for approval on Thursday.

A formal nod to conduct trials of the two-dose jab is expected over the next few days, sources told TOI.

The vaccine under development is a recombinant protein-based Covid-19 vaccine, and is expected to be launched by the first quarter 2022. The company started the development process last year, with the vaccine entering the pre-clinical stage in October.

The vaccine is being developed at the company’s Navi Mumbai facility, and is expected to be “competitively priced”.
Vips
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Re: Indian Health Care Sector

Post by Vips »

Bill Gates: 'For the next pandemic, we’ll have gigantic mRNA factories in India.
For the next pandemic, we will make sure we have gigantic mRNA factories in India and the rest of the developing world to achieve our 100-day goal of being able to make vaccines for everyone.
Strong emphasis on mRNA vaccines only. Ammo for the conspiracy theorists.
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Re: Indian Health Care Sector

Post by A Nandy »

https://swarajyamag.com/news-brief/make ... first-time
Union Health and Family Welfare Minister Mansukh Mandaviya said on 4 October that a "Make in India" drone was used to transport Covid-19 vaccine over an aerial distance of 15 kilometres in 12 to 15 minutes from the Bishnupur district hospital to Loktak lake, Karang island in Manipur for administration at the Public Health Centre.

The Health Minister said: “India is home to geographical diversities and drones can be used to deliver essentials to the last mile. We can use drones in delivering important life-saving medicines, collecting blood samples. This technology can also be used in critical situations. It may prove a game-changer in addressing the challenges in health care delivery, particularly health supplies, in difficult areas.”
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Re: Indian Health Care Sector

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Maternal mortality ratio improves to 103, India may hit global goal of 70 in advance.

India’s maternal mortality ratio (MMR) improved to 103 for the period 2017- 19, but the ratio has worsened in states such as West Bengal, Haryana,
Uttarakhand and Chhattisgarh, according to official data just released.

With the MMR continuing to drop for the third year running, India looks set to achieve the sustainable development goal of bringing it to 70 well
before the target year of 2030. The ratio was 122 in 2015-17.

MMR, a key health system indicator, is the number of maternal deaths per 100,000 live births during a given period. India’s MMR was about 556 in
1990 and 254 in 2004-06.

Populous states like UP, Rajasthan and Bihar showed huge improvement, helping India stay the course of steady improvement. The decline in the ratio in these three states from 2016-18 is by 30, 23 and 19 points, respectively, though from very high levels.

Despite significant improvement, Assam, Uttar Pradesh and Madhya Pradesh, in that order, continue to be the states with the highest maternal mortality ratio (MMR). West Bengal showed a shocking increase of 10 points in MMR, jumping from 98 to 109.

While the sudden jump might be surprising, the state has seen a steady worsening over the last three surveys. Chhattisgarh and Uttarakhand show marginal worsening, while Punjab after worsening in the last survey has improved in the latest one. Haryana has joined the club of worsening states.

In the list of three states with the lowest MMR, Telangana replaced Tamil Nadu to join Kerala and Maharashtra. Barring Karnataka at 83, the southern states and Maharashtra have the lowest MMR in the country, ranging from 30 in Kerala to 58 in Andhra Pradesh and Tamil Nadu. After stagnating or showing marginal worsening, Kerala’s MMR has improved dramatically from 43 to 30, recording very high improvement in maternal health between two consecutive surveys, an achievement that is considered difficult when a state has already achieved a low level.

Many developed countries have successfully brought down MMR to single digits. Italy, Norway, Poland and Belarus have the lowest MMR of two, while it is seven in both Germany and the UK, 10 in Canada and 19 in the US. Most of India’s neighbours — Nepal (186), Bangladesh (173) and Pakistan (140) — have a higher MMR. However, China and Sri Lanka are way ahead with MMRs of 18.3 and 36 respectively.
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Re: Indian Health Care Sector

Post by Cyrano »

Just wow!
Hope they go all out to protect their IP and knowhow. And Govt mandates that any hospital using public funds should by Bharatiya products only whenever available.

https://www.financialexpress.com/health ... 4578/lite/
Delhi’s Rajiv Gandhi Cancer Institute gets first indigenously developed Surgical Robotic System, SSI-Mantra
SS Innovations claims that it is the first company in South Asia to launch this machine SSI Mantra.
According to the company, it is an advanced surgical robotic system that has more and better features and applications than existing Surgical Robotic Systems and is much less expensive.
Ashokk
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Re: Indian Health Care Sector

Post by Ashokk »

How a Rs 200 vaccine may soon save 2 lakh lives
It’s a major achievement for India. Last week, the government announced the launch of Cervavac — the country’s first indigenously developed vaccine for prevention of cervical cancer — which is expected to hit the market by the end of 2022.
The quadrivalent human papillomavirus vaccine (HPV) is developed by the Pune-based Serum Institute of India (SII) and the department of biotechnology. It is modestly priced in the range of Rs 200-400. At present, there are two foreign-made vaccines available in India — the quadrivalent vaccine Gardasil Merck, priced at Rs 2,800 per dose and bivalent vaccine Cervarix from GlaxoSmithKline, priced at Rs 3,299 per dose.
This comes as a major relief as cervical cancer is the second-most prevalent type of cancer in India. It also accounts for nearly one-fourth of the world’s cervical cancer deaths, despite being largely preventable.
Speaking at the sidelines of the event on September 1 in New Delhi, Adar Poonawalla, CEO of SII said the vaccine will help make the country self-sufficient in curbing female mortality caused by cervical cancer. The vaccine trials for Cervavac commenced in September 2018 across 12 sites in the country. The phase two/three clinical trial was completed with the support of the department of biotechnology, in which it showed 90% efficacy and prevention. SII now plans to make 200mn doses — first the vaccine would be given in India and only after that it will be exported to other countries.
Vips
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Re: Indian Health Care Sector

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India's 1st indigenous MRI machine is here, thanks to Allahabad University professor and team.

In a major breakthrough, scientists at New Delhi's Inter-University Accelerator Centre (IUAC), led by its director and Allahabad University’s adjunct professor, Prof Avinash Chandra Pandey, have successfully developed India’s first superconducting magnet system used in MRI machines for whole-body clinical scanner.

At present India depends on 100% import for MRI machines which cost exorbitantly. The IUAC has developed a 1.5 Tesla (T) superconducting MRI magnet system, which is like the heart of the MRI machine. This will not only make India produce cheaper indigenous MRI machines, but also put it in the league of select countries which produce these machines. At present, China is the biggest exporter of MRI machines to India.
The MRI machine is used to take images of any body part (head, joints, abdomen, legs, etc.) for detection of diseases by providing precise contrast resolution in any imaging direction.

"This is nothing less than India making its own cryogenic engine, or state-of-the-art weaponry. Having our own indigenous MRI machine would not only cut the cost of the equipment but will also provide access to this vital diagnostic technique to those who today cannot afford the same because of its high cost,” says renowned radiologist Padma Shri Dr Harsh Mahajan. He is former president of the Indian Radiology & Imaging Association (IRIA) and also the consultant to International Atomic Energy Agency (IAEA), Vienna, Austria. He has also served as the honorary radiologist to the President of India.

Talking to TOI over phone, IUAC director Prof Pandey, said: “In India, there are 1.5 MRI machines per million population whereas in developed countries it is more than 10 MRI per million. India needs a large number of MRI machines in the next few years which is only possible through indigenous manufacturing, thereby providing easy and cheaper healthcare access to the people.”

Pandey further said the horizontal tube in an MRI machine through which the patient enters, known as the bore, contains a strong magnet from front to back. This magnet is the most important component of an MRI system.

“The entire system provides an incredibly strong and large, stable magnetic field. And to generate such powerful magnetic fields that are tens of thousands of times greater than the Earth's own magnetic field, MRI scanners use high-strength permanent magnets in which the magnetic field cannot be dissipated,” he said.

At present, MRI machines' processes are quite high as the scanners are built around massive superconducting magnets. A single unit of 1.5 Tesla MRI machines costs around Rs 5-6 crore and Rs 9-11 crore for a single unit of 3 Tesla capacity. Refurbished 1.5 T Siemens Magnetom Symphony Closed MRI Scanners are sold for Rs 1.75 crore to Rs 3 crore in India.

“As compared to this, the MRI machines that could be manufactured in our country using our technology would be much cheaper. This would also help India export these units to other countries and thereby provide easy and cheaper healthcare access to the people, especially those of the third-world nations,” said Pandey. The development will also bring down the exorbitant price of the MRI tests, he added.

“A few Indian industries are willing to build commercial MRI magnets using this indigenous technology. This along with cryogen-free technology and artificial intelligence will lead to lighter and cheaper whole-body scanners which can be mounted on a mobile van for rural healthcare in the future,” said Pandey, who has been associated with the AU's department of physics for 22 years and is heading IUAC for the past four years.

“Superconducting MRI magnet is one of the most complex diagnostic equipment which gives the highest level of clarity in imaging. The indigenous development of India's first whole body 1.5T magnet by IUAC will place India in the elite league of MRI manufacturing countries”, says renowned radiologist and former professor of SGPGIMS, Lucknow and at present principal director, Radiology Fortis, Gurugram, Dr Rakesh Kumar Gupta. In addition, the commercial production of such indigenous development will substantially reduce the import dependency, he added.
Vips
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Re: Indian Health Care Sector

Post by Vips »

India's Maternal Mortality Ratio dips to 97 in 2018-20 from 130 in 2014-16.

The Maternal Mortality Ratio has declined from 130 per lakh live births in 2014-16 to 97 per lakh live births in 2018-20, according to a special bulletin released by the office of the Registrar General of India.

According to the data, Assam has the highest Maternal Mortality Ratio (MMR) of 195 while Kerala has the lowest of 19 per lakh live births. Union Health Minister Mansukh Mandaviya attributed the improvement in the country's MMR to the Narendra Modi g...

Union Health Minister Mansukh Mandaviya attributed the improvement in the country's MMR to the Narendra Modi government's various healthcare initiatives.

Maternal mortality in a region is a measure of the reproductive health of women in the area. Many women of reproductive age die due to complications during and following pregnancy and childbirth or abortion, the Special Bulletin on Maternal Mortality in India 2018-20 said. The present bulletin provides the level of maternal mortality for the period 2018-2020.

According to World Health Organisation, "Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes."

In a tweet, Mandaviya said, "Significant decline in the Maternal Mortality Ratio from 130 in 2014-16 to 97 per lakh live births in 2018-2020. The various healthcare initiatives of PM Narendra Modi Ji's government to ensure quality maternal and reproductive care have helped tremendously in bringing down MMR."

According to the Special Bulletin on Maternal Mortality in India 2018-20, Assam, which has the highest MMR, is followed by Madhya Pradesh with MMR of 173 per lakh live births and Uttar Pradesh 167.

Kerala, which has the lowest MMR, is followed by Maharashtra 33 and Telangana 43, the data revealed.

One of the key indicators of maternal mortality is the Maternal Mortality Ratio which is defined as the number of maternal deaths during a given time period per 1,00,000 live births during the same period.

Target 3.1 of the Sustainable Development Goals set by the United Nations aims at reducing the global maternal mortality ratio to less than 70 per 1,00,000 live births.

The Office of the Registrar General of India under the Ministry of Home Affairs, apart from conducting the Population Census and monitoring the implementation of the Registration of Births and Deaths Act in the country, has been giving estimates on fertility and mortality using the Sample Registration System.
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Re: Indian Health Care Sector

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India confers Padma Vibhushan (second-highest civilian award) to Dilip Mahalanabis for pioneering the use of ORS that saved many lives globally. He demonstrated the effectiveness of ORS while serving in refugee camps during 1971 Bangladesh liberation war.
He was a pediatrician known for pioneering the use of oral rehydration therapy to treat diarrheal diseases. Mahalanabis had begun researching oral rehydration therapy in 1966 as a research investigator for the Johns Hopkins.
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saip
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Re: Indian Health Care Sector

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Are there any Physicians practicing in India on this board? Are Physicians required to renew their registrations periodically, if so who should be contacted? My wife is thinking of offering her services, pro bono, through a free clinic in AP. Psychiatry is her specialty. She has practiced in India and USA. TIA.
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Re: Indian Health Care Sector

Post by Amber G. »

Exciting news from IIT Kanpur
.
IITK has licensed a groundbreaking Gene Therapy technology to Reliance Life Sciences. This will lead to significant advancement in developing treatments for many hereditary eye diseases. This breakthrough is likely to potentially improve addressing genetic disorders in ways never seen before.
Developed by Prof. Jayandharan Rao & Mr. Shubham Maurya from the Dept of BSBE, the patented technology involves using Adeno-associated virus (AAV) based gene therapy vectors which are optimized for their gene delivery potential by modifying amino acids in the viral coat protein. Will put more details - or check out other news media.
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Re: Indian Health Care Sector

Post by Cain Marko »

Posting this here because i really am wondering why India ranks so low on this:
https://worldhappiness.report/ed/2023/w ... -2020-2022

Even nepal, lanka and bd rank higher. Finland and the Nordics consistently top this.

I was trying to understand the methods used to see if these skew the results somehow. Haven't reached any conclusion yet. Perhaps the maths and stats gurus here can please take a look?

AmberGji, please take a Dekko.
This is related to wellbeing after all.
...........xxx..........

Okay, so i took a deeper look into this, and here is what I found that disadvantages countries like India in such studies:
1. The study chooses 6 factors upon which "happiness" is based. Out of these 6, 3 are heavily focused on first world strengths like PCI, social and physical infrastructure. This automatically puts poorer countries at a disadvantage. As though happiness is an economic outcome, despite the many psychology studies that price otherwise!
2. On non economic factors like freedom to make personal choices (might be related to locus of control), India ranks pretty darned well. Easily amongst the top 15!
3. Such reports are used as data points by world bodies like the UN to encourage, "unhappy" countries to follow the models of the western, happy countries. This not only perpetuates the myth that happiness is heavily dependent of material wealth, but also sidelines the wisdom of poorer nations as unworthy of emulation.
This is all the more jarring considering the brutal colonial histories of these "happy" countries.
I'm going to write a paper to debunk this garbage!
But maybe I'm reading things incorrectly. What do forumites think?
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Re: Indian Health Care Sector

Post by Atmavik »

I think Salvatore Babones exposed such ranking systems . His theory is that data is collected by Indian origin academics who have to show India/Modi in a bad light so they can lecture us for if Indians start deciding for themselves then these jholawalas shop will be shut . Hong Kong of all places ranks higher on press freedom than India . SL ranks better than us on Hunger index and a few months later we have to ship rice and wheat. These institutions have discredited them selves
Cain Marko
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Re: Indian Health Care Sector

Post by Cain Marko »

Atmavik wrote:I think Salvatore Babones exposed such ranking systems . His theory is that data is collected by Indian origin academics who have to show India/Modi in a bad light so they can lecture us for if Indians start deciding for themselves then these jholawalas shop will be shut . Hong Kong of all places ranks higher on press freedom than India . SL ranks better than us on Hunger index and a few months later we have to ship rice and wheat. These institutions have discredited them selves
Hmm, you may have a point. I need to dig deeper because I do intend to write a paper/article on this. But I have to really sort out their methods for this.

Even Pakistan ranks higher on this "happiness index". Fascinating.
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