Indian Health Care Sector

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Gaurav_S
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Re: Indian Health Care Sector

Post by Gaurav_S »

Anyone who hasn't watched Satyameva Jayate yet should see the show. At least the one that discussed malpractices by doctor in India is worth watching.

IMO, all this drama by doctors about asking Aamir to apologize is utter BS. The show was very well covered and is targeting only doctors who involve themselves in corrupt and illegal stuff. Even if doctors decide to sue Aamir then its not going to gain much momentum in their favour as mango people will only support Aamir.

All shows are available on YouTube.
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Re: Indian Health Care Sector

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Indian Hospitals Documentary from Aljazeera: 4 part series

http://www.youtube.com/show/indianhospital?s=2012
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Re: Indian Health Care Sector

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Why our food is making us fat
We are, on average, 3st heavier than we were in the 60s. And not because we're eating more or exercising less – we just unwittingly became sugar addicts

http://www.guardian.co.uk/business/2012 ... ing-us-fat
It's the food we eat. More specifically, the sheer amount of sugar in that food, sugar we're often unaware of.

The story begins in 1971. Richard Nixon was facing re-election. The Vietnam war was threatening his popularity at home, but just as big an issue with voters was the soaring cost of food. If Nixon was to survive, he needed food prices to go down, and that required getting a very powerful lobby on board – the farmers. Nixon appointed Earl Butz, an academic from the farming heartland of Indiana, to broker a compromise. Butz, an agriculture expert, had a radical plan that would transform the food we eat, and in doing so, the shape of the human race.

Butz pushed farmers into a new, industrial scale of production, and into farming one crop in particular: corn. US cattle were fattened by the immense increases in corn production. Burgers became bigger. Fries, fried in corn oil, became fattier. Corn became the engine for the massive surge in the quantities of cheaper food being supplied to American supermarkets: everything from cereals, to biscuits and flour found new uses for corn. As a result of Butz's free-market reforms, American farmers, almost overnight, went from parochial small-holders to multimillionaire businessmen with a global market. One Indiana farmer believes that America could have won the cold war by simply starving the Russians of corn. But instead they chose to make money.

By the mid-70s, there was a surplus of corn. Butz flew to Japan to look into a scientific innovation that would change everything: the mass development of high fructose corn syrup (HFCS), or glucose-fructose syrup as it's often referred to in the UK, a highly sweet, gloppy syrup, produced from surplus corn, that was also incredibly cheap. HFCS had been discovered in the 50s, but it was only in the 70s that a process had been found to harness it for mass production. HFCS was soon pumped into every conceivable food: pizzas, coleslaw, meat. It provided that "just baked" sheen on bread and cakes, made everything sweeter, and extended shelf life from days to years. A silent revolution of the amount of sugar that was going into our bodies was taking place. In Britain, the food on our plates became pure science – each processed milligram tweaked and sweetened for maximum palatability. And the general public were clueless that these changes were taking place.

There was one product in particular that it had a dramatic effect on – soft drinks. Hank Cardello, the former head of marketing at Coca-Cola, tells me that in 1984, Coke in the US swapped from sugar to HFCS (In the UK, it continued to use sugar). As a market leader, Coke's decision sent a message of endorsement to the rest of the industry, which quickly followed suit. There was "no downside" to HFCS, Cardello says. It was two-thirds the price of sugar, and even the risk of messing with the taste was a risk worth taking when you looked at the margin, especially as there were no apparent health risks. At that time, "obesity wasn't even on the radar" says Cardello.

But another health issue was on the radar: heart disease, and in the mid-70s, a fierce debate was raging behind the closed doors of academia over what was causing it. An American nutritionist called Ancel Keys blamed fat, while a British researcher at the University of London Professor John Yudkin, blamed sugar. But Yudkin's work was rubbished by what many believe, including Professor Robert Lustig, one of the world's leading endocrinologists, was a concerted campaign to discredit Yudkin. Much of the criticism came from fellow academics, whose research was aligning far more closely with the direction the food industry was intending to take. Yudkin's colleague at the time, Dr Richard Bruckdorfer at UCL says: "There was a huge lobby from [the food] industry, particularly from the sugar industry, and Yudkin complained bitterly that they were subverting some of his ideas." Yudkin was, Lustig says simply, "thrown under the bus", because there was a huge financial gain to be made by fingering fat, not sugar, as the culprit of heart disease.

The food industry had its eyes on the creation of a new genre of food, something they knew the public would embrace with huge enthusiasm, believing it to be better for their health – "low fat". It promised an immense business opportunity forged from the potential disaster of heart disease. But, says Lustig, there was a problem. "When you take the fat out of a recipe, food tastes like cardboard, and you need to replace it with something – that something being sugar."

Overnight, new products arrived on the shelves that seemed too good to be true. Low-fat yoghurts, spreads, even desserts and biscuits. All with the fat taken out, and replaced with sugar. Britain was one of the most enthusiastic adopters of what food writer Gary Taubes, author of Why We Get Fat, calls "the low-fat dogma", with sales rocketing.

By the mid-80s, health experts such as Professor Philip James, a world-renowned British scientist who was one of the first to identify obesity as an issue, were noticing that people were getting fatter and no one could explain why. The food industry was keen to point out that individuals must be responsible for their own calorie consumption, but even those who exercised and ate low-fat products were gaining weight. In 1966 the proportion of people with a BMI of over 30 (classified as obese) was just 1.2% for men and 1.8% for women. By 1989 the figures had risen to 10.6% for men and 14.0% for women. And no one was joining the dots between HFCS and fat.

Moreover, there was something else going on. The more sugar we ate, the more we wanted, and the hungrier we became. At New York University, Professor Anthony Sclafani, a nutritionist studying appetite and weight gain, noticed something strange about his lab rats. When they ate rat food, they put on weight normally. But when they ate processed food from a supermarket, they ballooned in a matter of days. Their appetite for sugary foods was insatiable: they just carried on eating.

According to Professor Jean-Marc Schwarz of San Francisco hospital, who is currently studying the precise way in which the major organs of the body metabolise sugar, this momentum creates "a tsunami" of sugar. The effect this has on different organs in the body is only now being understood by scientists. Around the liver, it coalesces as fat, leading to diseases such as type-2 diabetes. Other studies have found that sugar may even coat semen and result in obese men becoming less fertile. One researcher told me that, ultimately, perhaps nothing needs to be done about obesity, as obese people will wipe themselves out.

The organ of most interest, however, is the gut. According to Schwarz and Sclafani, the gut is a highly complex nervous system. It is the body's "second brain", and this second brain becomes conditioned to wanting more sugar, sending messages back to the brain that are impossible to fight.

The Sugar Association is keen to point out that sugar intake alone "is not linked to any lifestyle disease". But evidence to the contrary appears to be emerging. In February, Lustig, Laura Schmidt and Claire Brindis of the University of California wrote an opinion article for the journal Nature citing the growing body of scientific evidence showing that fructose can trigger processes that lead to liver toxicity and a host of other chronic diseases, and in March, the New York Times reported a study that had been published in the journal Circulation, which found that men who drank sweetened beverages most often were 20% more likely to have had a heart attack than those who drank the least. David Kessler, the former head of the US government's most powerful food agency, the FDA, and the person responsible for introducing warnings on cigarette packets in the early 90s, believes that sugar, through its metabolisation by the gut and hence the brain, is extremely addictive, just like cigarettes or alcohol. He believes that sugar is hedonic – eating it is "highly pleasurable. It gives you this momentary bliss. When you're eating food that is highly hedonic, it sort of takes over your brain."
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Re: Indian Health Care Sector

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Chennai firm rolls-out a new version of cancer-fighting robot
The Maxio series of robots designed and developed by Perfint Healthcare Corporation bring to the oncologist's table a wholly integrated planning, navigation and site-targeting system for CT-guided tumour ablation.

The Maxio's cancer-fighting capabilities come in most handy in interventional oncology, especially tumour ablation that is rapidly turning an effective alternative to surgical treatment of cancer. In fact, tumour ablation is in many cases the go-to option for oncologists faced with inoperable or inaccessible tumours, and this holds especially true in the case of liver cancer patients of whom barely 20 per cent are suited for surgery.

With visualisation, planning and needle placement key to delivering thermal or other energy beams to blast the tumour, the Maxio helps clinicians perform the ablation procedure safely and with consistent quality outcomes.

According to Perfint founder-CEO Nandakumar Subburaman, the company's goal was to create a solution that would make life-saving ablation procedures available to a greater number of cancer patients. “To do that, we realised that the complex techniques used by interventional radiologists would have to be made simpler and more predictable. That's what we've done with Maxio,” he said.

According to Perfint, Maxio combines tumour visualisation in 3D view-fields and during the planning stage, clinicians can see the tumour and surrounding structures, determine the best approach to reach the site and choose the appropriate number and type of energy probe. The robot will also help visualise the estimate ablation volumes and determine the sequence of probe placement.
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Re: Indian Health Care Sector

Post by Gaurav_S »

Aamir appears before House panel, pitches for generic medicines

OTOH Aamir Khan's generic prescription shocks medical experts

BTW, there were some talks about having some SMS system like this to check fake medicines. Not sure what happened to this. Just talks?
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Re: Indian Health Care Sector

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UN: India likely to miss MDG on maternal health
With one maternal death reported every 10 minutes, India is likely to miss the Millennium Development Goal (MDG) related to maternal health, a latest United Nations report says. While there is an improvement from maternal death in every six minutes in 2010 to 10 minutes now, the MDG target in this respect is unlikely to be met, the report said.

At present, the Maternal Mortality Rate (MMR) of India is 212 per one lakh live births, whereas the country’s target is 109 per one lakh live births by 2015.

Maternal deaths are defined as the number of women who die during pregnancy or within 42 days of the termination of pregnancy. India has reduced MMR significantly from 437 per one lakh live births in 1999 to 212 now

India has done better on infant health, and is well within reaching the MDG of reducing IMR to 42 per 1000 live births. As per the latest estimates, India’s IMR stands at 47. India’s progress on the MDG of combating HIV/AIDS, malaria and TB is also satisfactory.

India needs to focus on Assam, Bihar, Madhya Pradesh, Uttar Pradesh and Rajasthan, where the MMR is still high.

As many as 237 million Indians are still living in hunger though India has managed to meet the first MDG of reducing people in extreme poverty by half between 1990 and 2015.
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Re: Indian Health Care Sector

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Medicos rejoice: 3,595 fresh MBBS, 1,442 PG seats created

http://post.jagran.com/medicos-rejoice- ... 1341137092
Aspiring medical students can now look forward to an expanded medical education sector as 3,595 more MBBS seats have been created this year.

Of these, the Medical Council of India (MCI) has given its approval to 2,400 fresh MBBS seats in 20 new medical colleges and 1,195 additional seats in existing medical colleges across the country, sources said.

These new seats come close on the heels of 300 additional MBBS seats created through six new AIIMS-like institutes in as many states from September this year.

Medical students have also reasons to cheer now, as the MCI has created 1,442 new post-graduate seats, with 1,326 MD/MS seats in various existing medical colleges and another 116 super-speciality seats for DM/MCH.

Among the new medical colleges approved by MCI now, include nine in the government sector and 11 private ones. Among the states in which new medical colleges will come up include Andhra Pradesh, West Bengal and Gujarat (where the government-run Medical Education and Research Society will set up the medical college).

The MCI last year had created 4,452 fresh MBBS seats in 21 new medical colleges and additional seats in existing medical colleges in the country. The new seats approved by MCI would help correct the existing imbalance in the availability of public health resources, Health Ministry officials said.

With their coming into operation, the overall availability of MBBS seats in India would rise to 45,464 and the number of medical colleges in the country would rise to 355. As per Health Ministry figures, there were a total of 41,569 MBBS seats in 335 medical colleges across India till date, excluding the new 300 seats in six AIIMS-like Institutes. However, MCI data reveals that there were a total of 40,525 MBBS seats till now (before fresh approval of seats).

The additional seats would boost Health Ministry's commitment to improve the doctor patient ratio in the country from a poor 1:2000 to 1:1000 by 2021. By 2021, the plan is also to take the overall availability of MBBS seats to 80,000 from the present 41,569 and of PG seats to 45,000 from 22,194 seats till now (excluding the new PG seats created). The aim is to tide over doctors' shortage currently pegged at around 8 lakh.

Government data shows that 66 percent of the existing 335 medical colleges and 69 percent of the existing MBBS seats are presently located in Kerala, Karnataka, Andhra Pradesh, Tamil Nadu, Maharashtra, Gujarat, Rajasthan and Goa.

Central India has only 5 percent share each in medical colleges and undergraduate medical seats while eastern India, comprising Bihar and West Bengal, which feature among the five most populous states, have 10 percent of India's medical colleges and just 9 percent MBBS seats

North India with the most populated state Uttar Pradesh is no better with only 17 percent medical colleges and 16 percent of MBBS seats available. The northeast has 3 percent share each in medical colleges and MBBS seats, reflecting the skewed availability of resources.
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Re: Indian Health Care Sector

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India eyes 'free medicines for all' plan

Bit old news but worth. All i can say is hope that end user gets "some" benefit if not full benefit.
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SC to start final hearing on Novartis’ case on Sec 3(d) of Patents Act on August 22

http://pharmabiz.com/NewsDetails.aspx?aid=69953&sid=2
The final hearing on the controversial case on Sec 3(d) of Indian Patents Act will begin in the Supreme Court on August 22. In this high-voltage case, Novartis is challenging Section 3(d) of India's Patents Act which prohibits 'evergreening' - the practice of multinational pharmaceutical companies to extend their patent terms by making small and trivial changes to existing molecules and thereby preventing manufacture of generic drugs.

In this Special Leave Petition (SLP), the Swiss pharma major is challenging the decision of the Intellectual Property Appellate Board (IPAB) which rejected its appeal for a patent on the beta-crystalline form of imatinib mesylate, an anti-cancer drug.

The case was pending in the court for quite some time. It was listed before the Supreme Court on 17 October 2011, but was adjourned to January 17, 2012 for final hearing. However, due to other cases being scheduled around the same time, the hearing of Novartis’ SLP and other related petitions was preponed to November 29, 2011. The case was listed for hearing on November 29 before a Division Bench of the Supreme Court, comprising Justice Aftab Alam and Justice Ranjana P Desai, which again adjourned the matter to February 28, 2012.

But once again, the case was rescheduled for March 28 as the Mumbai terror attack trial in the Supreme Court has been running later than anticipated, and Justice Aftab Alam, who has been hearing the Mumbai attack case, is also part of the two-judge bench that will hear the Novartis case. Now, the final arguments will begin on August 22, 2012.

The Supreme Court case, between Novartis and the government of India, is the final act in a legal battle that stretches back to six years over India's future capacity to produce low-cost generic medicines for its people, and for patients in other developing countries.

Novartis patented the molecule imatinib in 1993. After the signing of the WTO TRIPS agreement by India in 1995, Novartis filed another patent application on the mesylate salt form of imatinib in 1998 at the Indian patent office. In 2005 India amended its patent law to comply with the WTO TRIPS agreement but also included Section 3(d), an important health safeguard that does not allow companies to get patents on new forms of old medicines.

Novartis’ application was rejected by the Indian patent office on several grounds including that the application claimed a new form of an already existing medicine. The company then sued the Indian government, cancer patients and several generic companies in order to get its patent monopoly on imatinib mesylate by getting Section 3(d) knocked out of the patent law.

Simultaneously, Novartis pursued a separate appeal of the denial of its patent application on Glivec arguing that it met the standards of India law. When its administrative appeal failed, Novartis appealed again, this time to the Indian Supreme Court to try and change the interpretation of Section 3(d). In essence, Novartis wants section 3(d), which requires stringent evidence of proof of significantly enhanced therapeutic efficacy if a modification of an existing pharmaceutical entity is to receive new patent protection, to be reinterpreted to allow routine “ever-greening” of minor modifications to existing medicines resulting in additional 20-year patent monopoly.
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India suspends doctors over foetal 'sex tests'
Twelve Indian doctors have been suspended for allegedly conducting prenatal sex tests, a practice banned to stop the abortion of female foetuses that has widened India's gender gap, officials said Tuesday.

The physicians were suspended on Monday from practising medicine following a court order, said Archana Johri, an official of the Rajasthan Medical Council watchdog.

"Five of the doctors were found guilty of sex determination practices while the remaining seven violated other provisions of the Pre-conception and Prenatal Diagnostic Techniques Act," she told AFP in Rajasthan state capital Jaipur.

In New Delhi, the Indian Medical Association condemned the alleged violations by the doctors in Rajasthan.

"It is a deplorable practice and we condemn it," Association Secretary D.R. Rai told AFP.

A study published last year in The Lancet said sex selection of foetuses in India led to 7.1 million fewer girls than boys up to age six, a gender gap that had grown by more than a million in a decade.

The 1996 law designed to prevent the use of ultrasound for prenatal sex tests is widely flouted in India, according to the study by researchers led by Prabhat Jha of the Centre for Global Health at the University of Toronto.

India's prime minister Manmohan Singh last year labelled the practice of aborting female foetuses a "national shame" and ordered policy planners to increase efforts to stamp it out.

Married women in India face huge pressure to produce male heirs, who are seen as breadwinners while girls are often viewed as a burden to the family as they require hefty dowries to be married off.

India has launched an array of schemes to change attitudes towards girls, including offering cash incentives for families not to abort them, but many have had little impact
http://news.ninemsn.com.au/world/850104 ... -sex-tests
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Re: Indian Health Care Sector

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India's Health Sector Faces Many Challenges: Prathap Reddy
WASHINGTON: Observing that the country's healthcare sector faces many challenges, a top Indian corporate leader has emphasised on the need of greater co-operation between India and the US in this area to transform healthcare delivery through Information Technology.

"The three biggest challenges India faces in the healthcare sector are: the paucity of hospital beds for people (1 bed for 1050 people, as against 1 bed for 250 people in the US); the lack of skilled health human resources; and the rise in both infectious and non-communicable diseases," Dr Prathap Reddy, chairman of the Apollo Group of Hospitals said.

Speaking at an interactive session, 'US and India: Innovating Health Care' organised jointly by the Confederation of Indian Industry (CII) and the Center for Strategic and International Studies (CSIS), Reddy pointed out that India is facing alarming numbers of cases of heart disease, cancer and diabetes.

For example, the number of diabetes cases in India, earlier projected at 36 million by 2020, has already surpassed 75 million. Soon, one out of every 5 diabetic patient in the world will be Indian, he said.

Reddy called the healthcare challenge 'solvable', and a key area where the US and India can work together. In particular, he emphasised the need for new tools to transform healthcare delivery, such as through Information Technology and lauded the ongoing efforts in the US to digitize healthcare data through Electronic Medical Records, while hoping that such techniques would be brought to India as well.
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5 States Join Together to Formulate Common Policies for Drug Procurement
The alliance is expected to bring down the across-the-counter costs of drugs and make them more accessible to the common man. This came about at a meeting of heads of the central drug procurement agencies of Rajasthan, Gujarat, Karnataka, Tamil Nadu and Kerala held here {Thiruvananthapuram}.
The aim is to curb the unethical practices of non-state players who form cartels to thwart government’s attempts to provide drugs at cheaper rates to the common man.
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http://pharmagossip.blogspot.com/2012/0 ... y-big.html
Professor Lofgren explains why Big Pharma hates Indian pharma

Pharmaceutical companies putting health of world's poor at riskIndia is often called the pharmacy of the developing world, which is no great surprise as more than 50% of its $10bn annual generic medicine production is exported.
But the domestic drug industry behind India's role as global pharmacist stands to emerge rather poorly from the free trade agreement (FTA) that Europe is proposing for India. In late-stage negotiations over the terms of the long-awaited agreement, the EU is calling for intellectual property rights enforcement that goes well beyond India's obligations as a member of the World Trade Organisation and would make it all but impossible for generic drug manufacturers in the country to continue in their present structure.This could delay the introduction of cheaper medicines in India and elsewhere at a time when the global financial crisis has already put the squeeze on life-saving medicines across the world (last year the Global Fund to Fight Aids, Tuberculosis and Malaria cancelled its 11th funding round due to the crisis).
Yet protests on the streets of Delhi against the unfair terms of the EU-India FTA have been little noticed in the west, where such agreements are increasingly being promoted as a route out of domestic crises. For European leaders, they represent a foreign policy counterpart to calls for a growth pact at home. In a recent editorial, however, the former EU high representative for foreign and security policy, Javier Solana, all but admits that a similar agreement that Europe is tying up with Peru and Colombia may be "denying their weaker citizens [human] rights in favour of the interests of business".
In India, such fears are perilously close to being realised, because the EU-India FTA negotiations are not the only way in which the health of Indian citizens is coming under attack from Europe. In an effort to boost falling profit margins in the west, and to prise open more profitable markets elsewhere, European pharmaceutical companies are also chipping away at India's judicial system
.
Next month, the supreme court of India will hear final arguments in a long-running case between Swiss pharmaceutical giant Novartis and the Indian government. Novartis is seeking extended intellectual property protection for a marginally modified anti-cancer drug, Glivec, for which the original patent has run out. This is a practice known as evergreening, seen by many as an unfair way for pharmaceutical companies to maintain artificially high drug prices in developing markets. That is certainly the view of the Indian government, which, in 2005, inserted a clause into its intellectual property law deliberately intended to prevent the practice.
That clause has proven to be a literal lifesaver many times since, and it ensured that Novartis's original case was thrown out of court in 2006. But Novartis has filed new litigation in an attempt to breach India's legal defences. The final ruling is next month and there is every chance Novartis may succeed. If it does, other pharmaceutical companies will be able to impose higher prices on drugs in India too.
The Novartis case coincides with a third major assault on India's pharmaceutical industry: the final spear in a triple-pronged attack on its generic drug manufacturers by the west.
This involves the attempt by German pharmaceutical company Bayer to revoke the recent granting of a compulsory licence for an Indian firm, Natco Pharma. The licence was to produce a cheaper version of its anti-cancer drug Sorafenib. Bayer does not manufacture the drug in India, and imports in such small volumes that only a tiny fraction of potential patients could benefit. For its brand, Sorafenib, Bayer has charged Indian patients about $69,000 for a year of treatment, an unaffordable amount for most Indian households. Under the licence, Natco will sell the same medicine at 3% of this price, while paying a licence fee – and still make a profit.
But now Barack Obama's administration has weighed in on behalf of Bayer's battle for continued monopoly pricing. Testifying before the House of Representatives subcommittee on intellectual property on 27 June, the deputy director of the US Patent and Trademark Office said US officials are "constantly being there on the ground" pressuring the Indian government to desist from compulsory licensing.
It is not only Indian patients who stand to suffer from this triple-pronged attack. So, too, will charities such as Médecins Sans Frontières, which relies on Indian generic producers to supply 80% of the antiretrovirals it uses around the world. As MSF spokeswoman Leena Menghaney puts it, India is "literally the lifeline of patients in the developing world". In 2006, MSF launched an international campaign against Novartis, signed by half a million people, including Archbishop Desmond Tutu and the author John le Carré, to get Novartis to drop their pursuit of what the campaign argues is exploitation.The campaign may not have reckoned on the scale of the assault under way, however. It is not only the pharmaceutical industry that needs to be addressed but the continued and ruthless lobbying by western politicians to secure the profitability of their own industries.
We ought to be asking why governments in the rich world still seem happy to checkmate the lives of poor people to save their political skins. And why the pharmaceutical industry sees India as such a threat. Could it be that they detect the whiff of real competition?
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http://www.telegraph.co.uk/news/worldne ... -cost.html

Hard to believe it is possible to die for not paying a bill less than $4. As a physician I consider this murder. The imbecile CM of Punjab considers it "unfortunate." And this is in a govt run hospital.
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Pharma majors named in clinical trial death list

http://business-standard.com/india/news ... st/481274/
Drug majors such as Novartis, Pfizer, Bayer Healthcare, Bristol Mayer Squibb, Sun Pharmaceutical and Dr Reddy’s Laboratories were allegedly involved in clinical trials in which 438 persons died in 2011, according to confidential government data reviewed by Business Standard.

While the companies argue they follow the global standards, experts point at the absence of sound regulations as the main culprit. Although the number of deaths in clinical trials has been growing through the years, it fell in 2011 from the previous year mainly because of flat growth in the clinical research market in India.

Data available with the office of the Drugs Controller General of India (DCGI) for 2011 show 57 deaths during clinical trials conducted by Novartis, 32 in trials by Quintiles, 20 each in the case of Pfizer and Bayer, 19 for Bristol Mayer Squibb and 10 for MSD Pharmaceutical.

Among domestic companies, nine persons allegedly died during the clinical trials of drugs developed by Sun Pharma, three in trials by Jubilant Clinsys and one in the case of Dr Reddy’s Labs. Jubilant has, however, said there were no deaths reported in 2011 that could be attributed to participation in clinical trials conducted by it.

Most other pharma companies argue while trials are conducted on patients suffering from serious diseases with limited or no treatment options, it is inappropriate to blame deaths on clinical trials.

“... patients who participate in clinical trials are by definition those who already have a pre-existing medical condition, which could be mild or serious, acute or chronic. Therefore, the death of a patient in a clinical trial could occur due to a variety of reasons, including those unrelated to the trial,” says Shoibal Mukherjee, chief medical officer, Quintiles India, and head, Asia Medical Sciences Group. Quintiles is a leading US-based clinical research organisation (CRO), which conducts clinical studies on behalf of pharma companies.

According to Novartis and MSD India, there have been no deaths due to drugs during clinical trials conducted by them in 2011. Dr Reddy’s Labs says though there was one mortality reported in a trial in 2011, it was not related to the study drug.

Sun Pharma said its trial was on advanced breast cancer patients, in whom the disease had progressed to the terminal stage. “In all cases, compensation has been paid and one is under process,” it said.

According to submissions by the government in the Parliament, despite 668 deaths during clinical trials in 2010, compensation was paid in only 22 cases, that too mostly as low as Rs 1.5 lakh. Bayer, currently conducting 600 clinical trials worldwide, says it adheres to globally harmonised standards.

Experts indicate flimsy regulations are resulting in deaths during clinical trials. “In India, clinical trials can be conducted anywhere with a medical supervision. There are no minimum criteria for a trial site. Even a doctor in his private clinic is eligible to do a trial,” says Anoop Mishra, chairman, Fortis-C-DOC centre for diabetes and metabolic diseases.

According to a medical practitioner in a hospital, to undertake trials, companies often look for doctors who can quickly get more patients for their drug to be tested and complete the study faster. Most pharma companies generally hire a CRO to conduct trials for them, which in turn enrolls doctors. Some drug makers directly approach doctors to conduct trials.

Many companies are learnt to be paying hefty sums to doctors for trials. “The amount varies depending on the company, the drug and the trial duration,” a medical practitioner said.

While companies claim they seek ethics committee approvals for each participating site, experts point towards the lack of credibility attached to these panels. According to Sanofi Aventis, which reported three deaths in trials where the treating physicians felt it ‘could’ have been due to the drug itself, any death, irrespective of its cause, is reported to health agencies and to the concerned ethics committee for review.

Recently, the Supreme Court had expressed concerns over allegedly illegal clinical trials. However, according to a Pfizer spokesperson, standards applicable to trials in India are no different from those in the US, the EU or elsewhere.
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Premium for group health insurance may rise by 50%

http://timesofindia.indiatimes.com/busi ... 244091.cms
Premiums on group health insurance could rise by up to 50% as the finance ministry has told all public sector insurance companies to stop giving discounts on such policies.

The instruction, issued by the department of financial services to the chairman and managing directors of the four government insurers, talks about the strategy to be strictly adopted with immediate effect. It seeks to stop providing discounts on any policy where combined ratio, or the cost of a policy to the insurer, is more than 100%.

The combined ratio refers to costs on insurance claim, management expenses, commission to agents and to third party administrators (TPAs) and any other expenses that may have been incurred in servicing a policy. According to the directive, all expenses are to be factored into pricing the products, hence the potential surge in premiums.
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Chronic Lifestyle Disorders Plague IT Workforce
Around 55 per cent of young workforce engaged in India’s information technology (IT) and IT enabled services (ITeS) sector are stricken with lifestyle disorders due to unhealthy eating habits, hectic work schedules, tight deadlines, irregular and associated stress.
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At a feverish pace
Coming out of denial mode after three decades, the Uttar Pradesh government has got its act together to deal with brain fever that results in the death of hundreds of children and disables a large number annually, particularly in the Poorvanchal region. When implemented fully, the measures can ensure that children enjoy their basic right to live and live a healthy life.

With funds flowing from the Centre under the National Programme for Prevention and Control of Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES), announced in December on the recommendation of a Group of Ministers (GoM), several initiatives are being taken in Gorakhpur. The town is considered the epicentre of the disease because of a large inflow of cases from the neighbouring districts, States and even Nepal. {That's why a large country like India surrounded on all sides by small countries who look up to India for economic needs, should be strict with border controls and illegal immigration. These smaller countries are also lax with vaccinations etc. due to various reasons}

Earlier the focus was on treatment but now it is on prevention,” {a mission-mode approach is needed} K.Ravindra Naik, Commissioner of Gorakhpur and Basti – the worst affected – divisions in the State, told The Hindu , adding that it would take a little more time to show the impact on the ground but things were moving.

On its part, the State government has made it mandatory for all paediatricians employed in all government hospitals to serve in the four districts of Gorakhpur for one month by rotation between July 15 and November 15 when the AES cases peak.

The district administration will also provide an ambulance at the Community Health Centre level to ferry children with fever, irrespective of the nature of fever, for treatment. All cases of fever are to be reported to the administration and in case a JE positive case or AES patient is reported, a team will virtually isolate the village until it is declared safe. The area is fogged, people are asked not to use water from shallow hand pumps and lessons given on personal hygiene and sanitation.

“We have enhanced surveillance through a fever tracking system and any repeat of a JE positive or AES case from a village is considered a criminal negligence. Action was recently taken against 27 auxiliary nurse midwives for failing to report fever cases and the message has gone down,” Mr Naik said.

“But we are prepared for it and it is a good sign that people are responding. People are reporting fever cases to ANMs, ASHAs and health officials which are monitored on a daily basis.”

Dr. R. N. Singh, chief convenor of Encephalitis Eradication Movement that spearheaded the campaign to check the disease, says that mass vaccination done in 2010 controlled JE in 2011 and there were no JE cases. “All deaths were from entero-virus or fever from unknown causes. But JE cases have already been reported this year. Of the 145 deaths, 12 are from JE because single dose vaccination can prevent it only for one year. A second dose after one year can provide full protection,’’ Dr Singh explained.

As of now, JE vaccination is given along with routine immunisation. However, its coverage is doubtful because all cases admitted to BRD Hospital or those dead did not have a history of JE vaccination.

Another challenge for the local administration was shifting of piggeries from residential areas due to stiff resistance from the owners. This, too, has been met with some success as one-third of the piggeries have been moved out. Pigs are carriers of the encephalitis virus.
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Photographic cholesterol testA noninvasive approach to total cholesterol determination

http://www.eurekalert.org/pub_releases/ ... 081712.php
Researchers in India have developed a total cholesterol test that uses a digital camera to take a snapshot of the back of the patient's hand rather than a blood sample. The image obtained is cropped and compared with images in a database for known cholesterol levels.Writing in the International Journal of Medical Engineering and Informatics, N.R. Shanker of the Sree Sastha Institute of Engineering and Technology and colleagues describe how they have developed a non-invasive way to test cholesterol levels in patients at increased risk of heart disease. Their approach is based on the creation of a large database of cholesterol levels recorded using standard blood tests and linked to a standardized photograph of the hand for each patient; cholesterol is concentrated in the creases of one's fingers. They developed an image-processing computer program that compares the image from a new patient with the thousands of entries in the database and matches it to a specific cholesterol reading.Measuring the amount and type of cholesterol circulating in the blood is an important risk factor in cardiovascular disease. Excess cholesterol not used by the body in making hormones and building cells is laid down on the inner wall of arteries as a waxy plaque, which can reduce the normal flow of blood potentially causing heart problems and increasing the risk of cerebral stroke. Total cholesterol is a useful early indicator, although more detailed testing that distinguishes between the HDL high-density lipoprotein) and LDL (low-density lipoprotein) and triglycerides are needed for a more accurate health assessment of patients found to have high total cholesterol. It is LDL, so-called "bad" cholesterol that contributes to the formation of arterial plaques, atherosclerosis. The presence of different total levels of cholesterol can be revealed through image analysis of the skin.A non-invasive and inexpensive method for cholesterol screening would allow this risk factor be determined in much larger patient populations without the need for costly and inconvenient blood tests. The team will also soon publish details of the extension of this work to classifying cholesterol type using their approach.
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Southern figures have helped pull up the national health indicators: Ghulam Nabi Azad - The Hindu
Speaking at the inauguration of the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) super-speciality hospital on the Victoria Hospital premises {in Bengaluru} on Saturday, Mr. Azad said the maternal mortality rate, infant mortality rate and total fertility rate in southern States have helped make the national figures presentable internationally.
Mr. Azad also inaugurated the generic drugs store at the Kidwai Institute of Oncology on Saturday morning. The drugs sold there will cost half of the marked price.
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Towards a safe delivery
A long-neglected subject in the State, the Haryana government has finally woken up to address the critical issue of healthcare for women and children, besides taking steps to tackle the skewed sex ratio in the State that has recorded the worst sex-ratio among all other States.
“What is unique is that we set up 469 delivery huts in the rural areas to provide safe and better delivery facilities to the rural women and more than 1.75 lakh deliveries have already taken place,’’ Dr. Rakesh Gupta, managing director (Haryana), National Rural Health Mission, said.

Another initiative has been the launch of free ambulatory services for pregnant women, BPL and emergency patients. The fleet of 335 ambulances is fitted with GPS and easily accessible by dialling a toll free number. Also, 17 Advanced Life Support (ALS) ambulances have been pressed into service. In addition to this, nearly 14,000 Accredited Social Health Activists (ASHAs) have been hired on honorarium basis.

Doctors, however, are concerned over the large number of anaemic pregnant women who undergo delivery. This, they claimed, is causing infant mortality despite best efforts. To check the problem, reverse tracking of such pregnant women coming to district hospitals is done.
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Pilot health project hit by lack of specialists, Health Minister Azad
Implementation of the Centre’s ambitious pilot project, National Programme for Prevention and Control of Cancer, Hypertension, Diabetes, Cardiovascular Diseases and Stroke, in the 100 identified districts has been hit owing to lack of specialists.

He said that the project was launched in July 2010 in the light of the increasing incidence of non-communicable diseases in the country.

“But it is unfortunate that lack of specialists and human resources to conduct the screening has ensured that the implementation of the project is not up to the mark. We are now looking at partnerships with private hospitals to complete this project and extend it to the national-level.”
It looks like that this is another half-baked and not-well-planned health initiative. There is a huge shortage of doctors, especially specialists of any kind, in this country. How did the health minister expect to find specialists for such a mammoth project ?

I feel that we do not need specialists to detect hypertension and diabetes among rural folks. All that it needs are simple measurements and tests which can be carried out by nurses and lab technicians. Simple questions put forth to rural folk during these tests can screen people for cancer or cardiovascular diseases as well. Or, specialists in town and cities can sift through these answers (to carefully designed questions) or ECGs etc and these people alone can go for further evaluation. This can lessen the burden on the specialists nd eliminate this lack of specialists syndrome. Some cases may be missed in the process but still this alternative is worth taking, I believe.
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Delhi hospital hires bouncers to deter attacks
Working in an Indian hospital can be dangerous. In April, a week before DDU hired the bouncers, friends of an emergency-room patient punched a doctor in the face and broke his nose before going on a rampage with hockey sticks, swinging at windows, lights, furniture and medical staff.

The medical staff at DDU, a government hospital, had faced nearly one attack a month and had gone on strike 20 times over six years demanding better security. Since the hospital replaced its middle-aged, pot-bellied guards with bar bouncers, bodyguards, and wrestlers sporting muscles and tattoos, "there hasn't been a single incident," said Dr. Nitin Seth, the doctor who was injured in April.
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"There is a huge shortage of doctors, especially specialists of any kind, in this country"

Yes, it does look like very few young people in India are choosing medicine as a career. Don't the people and the government realise that this could have serious consequences later on. It has already impacted the country. Interestingly among ethnic Indians in North America, a large portion of the younger generation do want to become doctors.
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Novartis case opens in SC

http://www.business-standard.com/india/ ... sc/486164/
Swiss pharmaceuticals major Novartis on Tuesday began its argument in the Supreme Court, asserting its right to a patent for cancer drug Glivec, with the government, four Indian firms and the Cancer Patients Aid Association on the opposite side.Novartis has appealed against the Intellectual Property Appellate Board’s decision to refuse a patent for the medicine.

Novartis counsel Gopal Subramanian stated the company had faced a lot of criticism on the fact that a month’s supply of the drug was priced at Rs 1.20 lakh and, therefore, it wasn’t affordable for many people in the country. He, however, said there was a patients’ assistance scheme through which 80 per cent of blood cancer victims were given free medicine. He also said the company wasn’t recording huge profits, as alleged.

The bench, headed by Aftab Alam, asked when the company was giving the drug free to some patients, why didn’t it cut its price to ensure it was available to a greater number of patients. The judges said the high prices would also harm rival manufacturers.

The company’s counsel said he would consult Novartis on reducing the price of the life-saving medicine, adding the firm was ready to undertake to ensure the assistance scheme for patients was continued even after the litigation was over.

Authorities say Glivec is not a new medicine, but an amended version of a known compound. The Intellectual Property Appellate Board’s ruling had stated such an amended version was not eligible for a patent, according to Section 3(d) of the Patent Act.

On Tuesday, the Novartis counsel said though the name of the compound used might be available in journals, the company’s research had enabled the modification for treatment. “It is like the difference between carbon and diamond — though both are carbon; there is substantial difference in use,” he said.

He added the medicine, with a cost of $800 million in research, was a breakthrough. It is registered in 35 countries. If India didn’t grant it a patent, it would have international implications, as Indian companies also approached foreign patent offices for registration of their products, he added. Also, a patent was valid for 20 years, and much of this had already been lost in litigation in the appellate board and the Madras High Court, where seven petitions had been moved, he said.

While patient groups and health activists have raised concern on patenting such an incremental innovation, saying this would lead to ‘evergreening’ of patents, impacting the affordability of medicines, Novartis says it cannot be accused of ‘evergreening’. “The beta crystal form of imatinib mesylate is the active ingredient of the Glivec medicine. No other drug comprising imatinib was available anywhere in the world before Glivec was launched. Scientists at Novartis developed the mesylate salt of imatinib and the beta crystal form of imatinib mesylate to make it suitable for patients to take it in a pill form to deliver consistent, safe and effective levels of medicine. This process resulted in a viable drug which revolutionised cancer treatment,” said Novartis India Vice-Chairman & Managing Director Ranjit Shahani.

The Novartis counsel said the company wasn’t as concerned about the pricing of the drug, as on clarity of Indian law on patents. “Anyone investing would like to know about the patent protection available in this country,” he said, adding, “The purpose of this case is vindication of honour.”

Shahani says the outcome of the case would determine future investments in drug development in India. “Knowing we can rely on patents in India benefits the government, industry and patients, because research-based organisations would know if investing in the development of better medicines for India is a viable long-term option,” he says.

The Supreme Court’s verdict would also be significant because it might have implications on other drugs as well.

If the court decides in favour of Novartis, there is a possibility that various old cases, in which patents were denied on the basis of Section 3 (d), would be reopened. Besides, there are many drug patent applications from global companies for drugs not made in India so far, generics for which are available. Then, it is possible a large number of new patent applications could be made here,” says Amit Sengupta of Jan Swasthaya Abhiyan.
SC again asks Novartis to cut cancer drug price

http://ibnlive.in.com/news/sc-again-ask ... 966-3.html
The Supreme Court on Wednesday once again asked pharma company Novartis to scale down the price of its cancer drug Glivec, made from compound imatinib mesylate.

The court suggested the price cut saying that the company's scheme for providing the drug free to poor patients was complicated.The court said : "Rs 1.2 lakh per month is too high to afford a treatment."

An apex court bench of Justice Aftab Alam and Justice Ranjana Prakash Desai told Novartis counsel Gopal Subramanium Wednesday that its proposal on poor patients was a "complicated scheme for identifying those who are entitled to be given (free medicine) and those who can afford paying 80 days of annual cost of Glivec".

Justice Alam said that the end result of the any commercial venture was profit or loss and what mattered was "rupaiya, aana and paisa", thereby, telling that whatever scheme for poor it might have, at the end of the day, Novartis' business transactions meant financial results.

The court said this when Subramanium submitted an undertaking by Novartis stating that if it was granted patent for Glivec then it would continue its programme of providing free of cost or subsidised Glivec to the eligible patients.

Novartis filed the affidavit in pursuance to a query by the court Tuesday whether the pharma company would continue with its scheme of providing free or subsidised medicine to poor and needy patients if it was granted patent of Glivec.

The court's query was in context of its observation that Novartis had no legal obligation of providing subsidised or free Glivec to the needy patients.

The court on Tuesday asked Novartis to earn the goodwill of the people and establish its bonafides by reducing the medicine's price.

Novartis affidavit said: "In the event of patent being granted to petitioner, Novartis in India, undertakes to continue this programme till July 2018 and subject to there being no further regulatory price control/direction in relation to said (Glivec) product."

Novartis told the court that there were about 41,794 CML patients in India, out of which 15,690 were being treated by Glivec.

Of the 15,690 patients, 15,155 patients received Glivec free of cost, 370 patients were availing a discount plan and only 165 patients were paying the maximum amount, which was equal to 80 days of annual treatment.
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Apollo to setup 30 tele-medicine units in Africa - BusinessLine
Chennai, Sept. 13:

Apollo Hospitals has signed an agreement with AfroIndia Medical Services to set up 30 tele-medicine units in East and West Africa. This will pave way for availability of tertiary and quaternary healthcare to patients resulting in cost, effort and time benefit, says an Apollo press release. Prathap C. Reddy, Chairman, Apollo Hospitals Group, inaugurated the first three units at Lagos, Port Harcourt and Abuja in Nigeria through video conferencing in the presence of his Eyitayo Lambo, Health Minister of Nigeria.The telemedicine centres will facilitate doctors in several African countries to interact with specialists at Apollo. A feature of this service is the provision of electronic virtual house visits and remote domiciliary care.
We have an urgent need to increase explosively these telemedicine facilities in rural India itself to overcome reluctance of doctors and specialists to work in rural areas and also the woeful lack of doctors & specialists.
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Ranbaxy to setup another manufacturing plant in Malaysia
The company will invest $40 million in this project that will provide employment to over 200 people. It will be Ranbaxy’s second manufacturing facility in Malaysia.

“In addition to serving the local market, the facility will also export products to markets such as Asean, West Asia, Europe, Sri Lanka, China and other select countries,” Arun Sawhney, Chief Executive Officer and Managing Director of Ranbaxy said.
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India's first indigenous vaccine to prevent Japanese encephalitis

Biological E. Ltd today launched the county’s first indigenous vaccine JEEV to tackle Japanese encephalitis.

Priced at Rs 985, the vaccine will be available in the private domestic market. In due course, it will be exported, according to Mahima Datla, Senior Vice-President of the company.

Technology for the vaccine has been obtained from the Austrian vaccine maker Intercell. The Austrian company produces a vaccine targeted to provide protection to travellers from Europe, Australia, US etc., to regions, where the Japanese encephalitis is prevalent.

“We have indigenised the technology and developed an inactivated vaccine targeting children and adults in India, where the infection is high,’’ she told newspersons here.
The Government imports small quantities of a ‘live' vaccine from China. The problem is severe as lakhs of people get infected by the virus annually.

Inactivated vaccines are considered to have better safety profile compared to live vaccines, she said.

JEEV is a second generation inactivated vaccine. Its safety has been established in trials and is licensed by the Drug Controller General of India.
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http://newindianexpress.com/editorials/ ... 606253.ece?
India’s high child mortality rate a national shameBy The New Indian Express

14th September 2012 12:10 AM

The ‘Child Mortality Estimate Report 2012’ released by the UNICEF shows India in a poor light. It led the whole world by recording deaths of 16.55 lakh children under the age of five in 2011. Among the five countries that accounted for more than 50 per cent of such deaths, India’s figure was more than the combined figures of Nigeria, the Democratic Republic of Congo and Pakistan. Though China has the world’s largest population, it is far behind India in child mortality. For a country that claims to have crossed the threshold of development, these figures should serve as an eye-opener.

India is one of the few countries in the world that has a centrally-funded programme aimed at reducing, if not eliminating, infant mortality. Known as the Integrated Child Development Services (ICDS), it was launched on the birth anniversary of Mahatma Gandhi in 1975. It sought to provide integrated services for development of children below six years, expectant and nursing mothers and adolescent girls living in the most backward, rural, urban and tribal areas. Tens of thousands of crores of rupees have been spent on running the ‘anganvadis’ where such services are to be provided. Alas, most of the deaths have also occurred in areas where ICDS is supposed to be present.

In a vast majority of cases the deaths could have been averted if timely medical care was given. In fact, the main functions of the ‘anganvadis’ include monitoring the health of the infants and their mothers, providing them nutritive food and vitamin supplements. Unfortunately, many of them lack women trained in nursing and childcare. Worse, they are not given adequate food materials and medicines. Pneumonia, diarrhoea, malaria and diphtheria are some of the diseases that take a heavy toll of children’s lives. These are easily curable diseases for which doctors’ services are a must. Until the ICDS is strengthened with better medical input, India will continue to have the ignominy of topping the world in child mortality.
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Reacting on the high number of under-five deaths, WHO’s India representative Nata Menabde said, “Given the size of the population, absolute numbers will always be high in case of India. This should not overshadow the fact that the country has made significant progress in the field of health.”
This is always the case with India. They do not publish it properly. they choose only numbers which is always in millions due to sheer population size for next 50 years or more.
look at the graphs shown and see the progress made over years.

child mortality indicators
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Post by nakul »

^^^

Till we get hospitals in all places, the govt should team up with Ayurvedic experts and educate the populace about the beneficial effects of cow urine. This is something even the remotest villagers can make use of. But going by Acharya Balkrishna's treatment, I would be smoking some heavy stuff.
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Post by krisna »

^^^^
I agree that we have a long way to go, but we are going in the right direction.
It can be accelerated definitely.
No other country has achieved what we have done in the last 60 odd years.(Not an empty boast-one can check it on internet)
The defeatist and apologist attitude of ddm is shocking. Of course being brought up on a diet of leftists influence, it is too much to ask for.
aam sdre thinks bad of our own country due to improper statistical lies.
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Post by Varoon Shekhar »

Am I being overly distressed when reading about recent incidents like the one in Orissa, and in Delhi. One doctor is stabbed, and another is killed. The loss of an honest, hard working individual in any area of work( including construction labour) is a tragedy. But India has a shortage of doctors, and it cannot afford this nonsense. When these things occur, doesn't it significantly affect the overall health care system? Is India churning out enough doctors to offset these losses? Really awful incidents, and doesn't reflect well on Indians, who are supposed to know better.
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http://timesofindia.indiatimes.com/busi ... 483182.cms
ime Minister Manmohan Singh may just have signalled his willingness to keep the doors open for large pharma players to run their business in India. Sources told TOI that at last Friday's Cabinet meeting, when FDI in retail and aviation were cleared, a minister raised the issue of pharmaceuticals, suggesting that there was need to ward off attempts to impose restrictions on foreign capital flowing into the sector
Not sure how to assess the impact - IMO, The cost of medicine will sky rocket if the Western Pharma companies are provided full access.
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'Super-spreading', key in dengue transmission - N.Gopal Raj in The Hindu
Super-spreading, where one infected person passes on a disease to lots of others, could be an important factor driving dengue transmission in places where the mosquito Aedes aegypti carries the virus, according to research published recently .

The female mosquito feeds on human blood and subsequently lays her eggs inside containers holding water that are found in and around homes. The eggs hatch into larvae, which grow and turn into pupae, finally maturing into adults. Studies have found that most of the mosquitoes in each locality typically come from just a few containers and houses, termed ‘super-producers.

Since mosquitoes were concentrated in only a couple of homes in each locality, an infected individual in those houses or in their immediate vicinity was likely to get bitten and pass on the virus to a large number of mosquitoes. Those mosquitoes, in turn, would go on to bite other people, thus spreading the disease.

The study indicated that dengue transmission “depends heavily on events where an infected person infects many mosquitoes,” Dr. Padmanabha told this correspondent. Such people were the super-spreaders. In contrast, most people with the virus would not infect many mosquitoes.

Increased human density led to more possibilities for disease spread through both human-to-mosquito and mosquito-to-human transmission. Greater human density in a particular area would increase the frequency of dengue-infected visitors. “We found that even small variations in human density can have a very big effect,” Dr. Padamanabha said. “A mosquito where you have low human density has much less capacity to transmit than in an area where there is high human density.”’
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Artificial Heart comes to India with a Price tag of Rs. 1 crore
Bandra's Asian Heart Institute recently completed training its team of doctors to implant the device in patients of heart failure. End-stage heart disease, wherein the heart loses its ability to pump oxygenated blood into the body, is currently almost means a death sentence for the patient. The lifesaver that runs on rechargeable batteries, however, will come at varying costs. At the AHI, it will cost a whopping Rs 1 crore.

Experts say with incidence of heart failure increasing by 2 million annually and heart transplants being a distant dream in the country, this technology could be the way forward.

In 10-15% of patients, the original heart recovers and the device is then removed.

AHI would be the first facility in western India to offer the transplant. Recently, Bangalore's Narayan Hrudalaya too got the green signal to start the programme. Earlier in 2008, it had performed artificial heart transplants in four patients. The programme however, had to be aborted due to the global meltdown in 2009 that led to the closure of the company making the device. Now, technology has changed drastically. The device used for transplants in 2008 is all but obsolete, replaced by newer ones which are sleeker and better.
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Keeping Rabies on a Tight Leash - N.Gopal Raj in The Hindu
WHO estimates that more than 55,000 people die of rabies every year, with more than 95 per cent of those deaths occurring in Asia and Africa.

India accounts for a large proportion of the world’s rabies cases. A detailed WHO-sponsored assessment carried out in 2003 by the Association for Prevention and Control of Rabies in India (APCRI) estimated that there were more than 17,000 “furious rabies” cases in the country annually. With an addition of 20 per cent to take into account paralytic or atypical forms of the disease as well, the total number of rabies deaths each year was put at about 20,000.
Injecting the vaccine into the skin (known as intradermal vaccination), instead of into the muscle, allowed a lower dose to be used, thus lowering the cost of vaccination
Reducing the country’s burden of rabies required a consistent and well thought-out strategy to take proven interventions, targeted at humans as well as the dog population, down to villages where most cases occurred, remarked Manish Kakkar, a public health specialist in infectious diseases at the Delhi-based Public Health Foundation of India. Only Tamil Nadu had a system in place to maintain a steady supply of vaccines right up to the local public health centres for treatment of people.

In much of India, measures to protect humans and control the threat posed by dogs had often been patchy and concentrated in urban areas, he pointed out.
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Booster dose for public health - Businessline
A steep shortage in primary healthcare centres (PHCs) across India is the prime reason why villagers are forced to trek almost 20 km to reach the nearest PHC. This may still be of little use, because most PHCs are perpetually plagued by a supply and staff shortage, making matters worse for sick patients who expend time, energy and resources to reach the PHC. For people from towns and semi-urban areas seeking modern medical care, the situation is no different, since they need to travel to the nearest city.

These facts should come as no surprise since the country has a cumulative shortfall of almost 17,000 PHCs and a concomitant shortage of 8,500 doctors across centres nationwide. Worse still, 41 per cent PHCs lack healthcare personnel. Nationwide, India suffers a shortfall of 2.6 million health workers, reveals a report by ‘Save the Children India’. Massive deficits in human resources mean India registers the highest annual number of newborn deaths with 900,000 casualties, coupled with the highest mortality levels for children less than five years old and the most maternal deaths worldwide.

Such staggering shortages in personnel can only be rectified if the number of doctors across India are doubled (from 700,000 to 1.5 million), nurses tripled (from 800,000 to 2.5 million) and paramedics quadrupled (from 2.5 million to 10 million). Clearly, this calls for long-term planning and won’t happen overnight. In the interim, it can hardly be comforting to inform disease-stricken patients that healthcare access issues would be resolved within a decade or so.

That is how long it may take to bring about healthy doctor-patient, nurse-doctor and nurse-patient ratios, which presently compare badly with global averages.

Despite 750,000 doctors registered with the Medical Council of India, the ground reality is that about 200,000 aren’t active anymore. This means India has only one doctor to treat 2,000 people, instead of one doctor for every 1,000. Still worse is the number of nurses. While there are 1.07 million registered nurses, as many as 600,000 aren’t active or working in India any longer. Given a nurse-to-doctor ratio of 1.5:1, India fares poorly against the global ratio of 3:1. Against the world average of 3.3 nurses per 1,000 persons, India has barely 0.8 nurses.
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