Indian Health Care Sector

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Prem
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Re: Indian Health Care Sector

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http://thinkprogress.org/health/2013/02 ... ?mobile=nc
As Tuberculosis Vaccines Flounder, Developing Nations Join To Fight Drug-Resistant Diseases
Five developing nations with high rates of infectious diseases — Brazil, Russia, India, China, and South Africa — have announced they will work collaboratively to fight back against drug-resistant tuberculosis (TB), an epidemic that contributes to hundreds of thousands of deaths around the globe each year.Drug-resistant TB has a fatality rate of about 50 percent. The new international effort to combat it comes on the heels of increasing reports that the epidemic is worsening, including Monday’s news that a highly-anticipated TB vaccine trial — a study of the first new tuberculosis vaccine in 90 years — failed to achieve its desired results. The World Health Organization warns that the rise of TB strains resistant to antibiotic treatment represents a serious global health threat, particularly in developing nations:
SSridhar
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New Child Health Initiative in Maharashtra - The Hindu
The initiative, titled Rashtriya Bal Swasthya Karyakram, under the aegis of the National Rural Health Mission (NHRM), aims to provide a comprehensive healthcare package for all children up to 18 years of age.

The programme will soon be extended to cover all districts of the country in a phased manner. This ambitious scheme, when implemented, is expected to benefit over 27 crore children.

While in the past children up to 6 years were examined in aanganwadis by a medical officer, those from 6 to 18 years were covered under the school health programme.

Medical teams are to screen children up to 6 years enrolled in anganwadi centres at least twice a year and screen children enrolled in government and government-aided schools.

A set of 30 common ailments/health conditions has been identified for screening and early intervention, including birth and heart defects, deficiency conditions, developmental delays and disabilities like hearing impairment, vision impairment, among others.

As part of the programme, District Early Intervention Centres are to be made operational in all districts to treat cases referred from block levels. Tertiary health services would also be made available for cases requiring surgery.
Prem
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Re: Indian Health Care Sector

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Absurdious Briturdious Again ?
An outbreak of swine flu in India has killed at least 94 people in just over five weeks, reports say.The health ministry said more than 450 cases had been reported, mostly in the northern state of Rajasthan.Officials say they are investigating the cause of the outbreak, with some experts saying low winter temperatures are to blame.The H1N1 virus, which causes swine flu, first appeared in Mexico in 2009 and rapidly spread around the world.It killed 981 Indians in 2009, 1,763 in 2010, 75 in 2011 and 405 last year.It is thought the virus has killed 200,000 people around the world. Indian officials said 246 cases had been recorded in Rajasthan, where 54 people had died. The capital, Delhi, has reported three deaths so far.But, with more than 60 cases reported in the city in 2013, Delhi authorities have ordered 22 hospitals - including five private clinics - to set up isolation wards to treat cases of swine flu.Health officials said there was "no need for panic", but advised people to take precautions "for prevention and management of the disease".
Vipul
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Re: Indian Health Care Sector

Post by Vipul »

Kerala doctor invents syringe that can't be reused.

In a major breakthrough, a doctor in Kerala has developed a cheap, effective and eco-friendly medical syringe that can never be reused.

"The Peanut Safe Syringe becomes absolutely redundant after its first use. Neither the syringe nor the needle can ever be reused. Scavengers will never be able to collect, repack and sell it in the market," said Baby Manoj, a radiologist from Kozhikode, who invented the syringe.

The syringe can be used for injection as well as blood aspiration in a single sitting. In other syringe models, separate devices are needed for each procedure.

For his product, Manoj last week received Best Invention Awards for 2011 from the National Research Development Corporation, an undertaking of the science and technology ministry, and World Intellectual Property Organisation at a function in New Delhi.A World Health Organisation report says more than 20 million people are infected with HIV and hepatitis every year and 1.3 million of them die.

The infection is spreading because around 600 crore used syringes come back in the market without being sterilised.Over a million blood infections occur annually in India leading to HIV and hepatitis, and around 300,000 of the infected people die.

Manoj has developed a disposable syringe whose needle and barrel can be disabled quickly after injection. He did this by creating a groove around the hub of the syringe to which the needle is connected.After use, a slight manual pressure on the groove breaks the needle and the barrel, which is its critical component.

The needle, which is a major disease-transferring component, is disabled as the broken piece of the barrel is tightly packed inside the needle's plastic connector.
"It is as simple as breaking a peanut shell and so I have called it Peanut Safe," he said.He said the name of the product was derived from a riddle.

"Break open a peanut shell, eat the nuts and nobody will use it again. This is true of Peanut Safe syringes too. Open the cover and you will get a syringe which nobody has ever used before. Use it and no one can use it ever again," Manoj said.Manoj has patented the product and plans to start marketing it soon.
vera_k
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Re: Indian Health Care Sector

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Revised BMI puts more in obesity bracket
For the first time, Union health ministry released India-specific norms for prevention and management of obesity and metabolic syndrome. All new pointers for obesity are a point or two lower than the international standard. According to the new standards, one is overweight if BMI (Body Mass Index) is 23 kg/m2 two points more than the international standard of 25 kg/m2
SSridhar
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A fight against anaemia in Kerala - The Hindu
A Weekly Iron and Folic Acid Supplementation (WIFS) programme formulated by the Union Ministry of Health and Family Welfare to tackle the acute problem of anaemia among adolescents will be launched in Kerala on Monday.

The programme is a major convergence exercise, involving the Health, Social Welfare and Education Departments and the National Rural Health Mission, to improve the nutritional status of adolescents, especially girls, in the State.

Kerala Chief Minister Oommen Chandy will launch the programme at a function at St. Joseph’s School here on Monday.

Anaemia among adolescent girls and pregnant women has been a major issue in the State despite the fact that the State has a fairly good ante-natal care system. Tackling the problem among adolescent girls is important as they are the future mothers

Under WIFS, all school-going children — both boys and girls — from Class VI to Class XII will be given weekly supplementation of iron and folic acid (IFA) tablets on a fixed day (Mondays). Adolescent girls who have dropped out of school will be given the nutritional supplements by Anganwadi workers in each locality.

The programme will benefit an estimated 31 lakh children and adolescents.

Anaemia develops when there are not enough red blood cells in the blood, which carry oxygen to all body cells. This oxygen is vital for the body cells to metabolise fats and sugars into energy for daily use. Iron-deficiency anaemia can make one feel constantly tired and lethargic because there is less oxygen supply in the body. The immune system is also affected and results in frequent infections.

Poor nutritional intake during adolescence, reliance on fried and fatty food, and high intake of sugar drinks had led to anaemia reaching alarming proportions among adolescents, health officials said. Girls especially, need to consume more nutritious and iron-rich food because they lose some iron when they go through their monthly cycles.

The District-Level Household Survey (DLHS) 2002-04, which assessed the nutritional status of children, adolescents, and pregnant women, puts the percentage of those with mild anaemia at 63.4 per cent and moderate anaemia 26.1 per cent, among 10 to 14 year-olds. Among 15 to 19 year-olds, 55.5 per cent had mild anaemia and 31.9 per cent had moderate anaemia. About 2.9 per cent had severe anaemia.
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No takers for geriatric project - The Hindu
Thiruvananthapuram: Union Finance Minister P. Chidambaram has allocated more funds in the Budget 2013-14 for the National Programme for the Health Care of Elderly (NPHCE), a project which is being implemented in five districts in Kerala, among 100 selected districts across the country.

Mr. Chidambaram has provided Rs.150 crore for the programme this year. However, the news about the additional funds allocation had a lukewarm response from the State Health Department because the project has no takers among the medical community here. Kerala is one of the States with largest population of the elderly in the country, yet NPHCE is one of the most poorly run national programmes in the State. The districts chosen for the implementation are Pathanamthitta, Idukki, Alappuzha, Thrissur, and Kozhikode.

Rs.288-crore project

The Rs.288-crore project was launched in 2011. Kerala till January this year had received Rs.8.79 crore under the scheme. But the utilisation has been a paltry 8 per cent, at Rs.36.78 lakh.

The NPHCE envisages long-term, comprehensive and dedicated healthcare services for the elderly by strengthening the primary health care system. Geriatric units in all district hospitals and rehabilitation units at community health centres have to be opened under the scheme. There will also be weekly health clinics for elderly and physiotherapy services at the community health centres under the project, which envisages the development of specialised and trained manpower for geriatric care. The NPHCE proposes a full-fledged geriatric department and research facility in a super speciality centre, which will be the Regional Geriatric Centre, and give technical aid to the geriatric units in district hospitals and sub centres.
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India lags behind in key health parameters - Aarti Dhar, The Hindu
Indians are living longer than before, but illness and disability of a very high order and relatively early death remain severe health care challenges. What should concern health care planners and providers is that India is lagging behind many of its South Asian neighbours, including China, in key health parameters.

Life expectancy at birth in India, that was 58.3 in 1990, has gone up to 65.2 in 2010. However, most of India’s neighbours are ahead on this measure; in 1990, life expectancy was 58.8 years in Nepal, 58.8 in Bhutan, 58.9 in Bangladesh, 62.3 in Pakistan, 69.3 in China, and 72.3 in Sri Lanka. These countries remained ahead of India in 2010. Life expectancy at birth in 2010 was 65.7 years for Pakistan, 69.0 for Bangladesh, 69.2 for Nepal, 69.4 for Bhutan, 75.5 for Sri Lanka, and 75.7 for China.

These are some of the findings from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study (GBD 2010), a collaborative project led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington that released country-specific findings. The findings detail the causes of death and disability for 187 countries around the world.

In terms of age-standardised death rate, per 1,00,000 population, India ranked 155 out of 187 countries in 1990. Bangladesh (at 143), Nepal (at 142), Bhutan (at 141), Pakistan (at 123), China (at 92), and Sri Lanka (at 45), were all ahead of it.

Between 1990 and 2010, there was significant improvement in India in terms of death rates. The number of deaths per 1,00,000 had come down in 20 years from 1,447.43 to 1,096.92. Its neighbours had a mixed record, but they remained ahead. India ranked 139 out 187 countries in terms of death rate in 2010. Pakistan ranked 127, Bangladesh 113, Nepal 108, Bhutan 107, Sri Lanka 68 and China 63.

“Our goal is to help governments and citizens make well-informed decisions about health policies and investments by arming them with information that is up-to-date, comprehensive, and accurate,” said IHME Director Dr. Christopher Murray. “With these new ways of making the data understandable, people everywhere for the first time can see the incredible progress being made in health and the daunting challenges that remain,” Dr. Murray added.

The top cause of death in India, as measured in 2010, was ischemic heart disease, followed by chronic obstructive pulmonary disease, stroke, diarrhoeal diseases, lower respiratory infections, tuberculosis, preterm birth complications, self-harm, road injury and diabetes.

Indian women are suffering from other distinct health threats. Suicide rates for women aged 15 to 49 are on the rise. In 1990, deaths of young Indian women, attributable to self-harm, was under 5 per cent, and by 2010 it had reached nearly 10 per cent.
Suraj
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A piece of good news.
India board rules against Bayer in cancer drug patent case
An Indian patent appeals board upheld on Monday a decision to allow a domestic company to sell a generic version of Bayer AG's cancer drug Nexavar, in a blow for global drugmakers' efforts to hold on to monopolies on high-price medicines.

The ruling paves the way for the issue of more so-called compulsory licenses as governments, particularly in emerging markets such as China and Thailand, battle to bring down healthcare costs and provide access to affordable drugs to treat diseases such as cancer, HIV-AIDS and hepatitis.

Bayer, Germany's largest drugmaker, said it would continue to fight to overturn the decision, which it said weakened the international patent system and endangered pharmaceutical research.

Under a global Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, countries can issue compulsory licenses on certain drugs that are deemed unaffordable to a large section of their populations.
SSridhar
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Integrated Vaccine Complex at Chennai to meet 100% needs of vaccines - Ramya kannan, The Hindu
The Integrated Vaccine Complex to come up in Chengalpet, about 55 km from the city, when operational, will be the first public sector unit to manufacture the pentavalent vaccine.

Apart from the pentavalent, the IVC will manufacture six vaccines, including some already being manufactured in public sector units: for Measles, Hepatitis B, Rabies, Hib, Japanese Encephalitis and BCG. It will be a facility that will be wholly cGMP compliant, and besides producing vaccines, it will function as a centre for research and development standardisation, testing and verification of the vaccines.

The complex will be a wholly-owned subsidiary of HLL Lifecare Ltd (HLL), a government of India enterprise, at Chengalpet, The project cost is Rs. 594 crore with a debt-equity ratio of 1:1. The Union government’s equity infusion in this will be Rs. 285 crore, of which Rs. 274.88 crore will be in cash, and Rs. 10.12 crore will be in kind, towards the transfer of land to the IVC. The company is expected to go for disinvestment and listing at a subsequent time, and the sale proceeds will flow into the Central government’s account. These details were revealed as a response to an RTI application to the Ministry of Health and Family Welfare received in February.

The key aspect, applicant K.V.Babu, a medical professional from Kerala says, is that though the IVC has not taken off yet, its potential is enormous. At the moment, the pentavalent is being sourced entirely from the private sector. The IVC is to be treated as project of national importance, and in it is vested the responsibility of ensuring vaccine security in the country. The Ministry could choose to procure 100 per cent of the country’s vaccine requirements from the IVC if the vaccines are not available in the private sector, says the office memorandum. Also, the government will keep the option to review the captive status after five years of commercial operations of the project.

The first phase of the project was to have been completed by 2012. The fresh memorandum dated May 2012 observed the government’s lack of tolerance for overshooting deadlines. No time and cost overrun will be allowed by the government, and HLL needs to submit quarterly reports on the progress of implementation of the project. {The IVC is still not operational. So, what does this 'lack of tolerance for overshooting' mean ?}
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Re: Indian Health Care Sector

Post by member_23858 »

Dear BRFites, I would like to bring to your notice the agony and frustrations experienced by doctors preparing for Post Graduate Entrance exams in India. It was announced in June 2012 that for admissions in Post Graduate (PG) courses a single National Eligibility and Entrance Test (NEET) would be mandatory. The exams were formulated on idea that a Single exam will be conducted on all India level by National Board Of Examinations on behalf of MCI in mont of Nov-Dec. This single score was then supposed to be used as a determinant of merit rank for entrance into prestigious MD/MS courses. This exam was mandatory for both Govt. and private institutes. However, CMC Vellore challanged this decision in Nov 2012 in Apex Court, and the case was taken for hearing on mid December. Shockingly, Apex court invited other private institutes to follow suit if they had any objections to the NEET, which they happily did. SC immediately place stay on publication of any result of any exam. Hearing for the case is going on. However, It has been going on since month of December and up till now no breakthrough is expected in near future. The students are frustrated as the results were expected in month of June and the courses were supposed to be commencing from April-May. Even More frustrating is lack of coverage in mainstream media on a decision which affects almost 95 thousand doctors.
SSridhar
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Paediatric Cancers on the Rise - Y. Mallikarjun, The Hindu
Image

The incidence of paediatric cancers are increasing with acute leukaemia (blood cancer) accounting for a majority of them followed by those relating to brain, nervous system, kidneys and others. However, the good news is that most of the paediatric cancers have 75 per cent cure rates.

The incidence of malignancy in children was increasing in developing countries as compared to developed ones, according to Dr. Sirisha Rani, consultant paediatric hemato-oncologist at Rainbow Hospital for Women and Children. She said around 45,000 children in India were being diagnosed with cancers every year and around one-third of them were of acute leukaemia.

She said a predominant number of cases were from lower economic strata and the disease was seen more in boys than in girls.

While there were no identifiable causes that explain paediatric malignancies, she said environmental and genetic factors probably play a role in triggering them. The imbalance between proto-oncogenes which get activated and anti-onco genes that remain suppressed could be secondary factors. Increase in awareness levels and better diagnostic facilities were among the reasons for detecting more cases now, she added.

Symptoms

In blood cancer, the immature cells proliferate and surpass the number of normal cells in the bone marrow. The Red Blood Cells (RBCs) and platelets go down, while the White Blood Cells (WBCs) could be normal or high. The symptoms are pallor, persistent fever, fatigue, bleeding, body pains, appetite and weight loss and enlargement of liver and spleen. Most of the time the patients were coming with a history of three to four weeks fever, she said.

While the cure rates in the UK and USA were 85-90 per cent, similar results could be achieved in India with good supportive care. In acute lymphoblastic leukaemia (ALL), one of the two common types of blood cancer, more than 85 per cent could get cured (remaining disease-free beyond five years) but it would be around 45 per cent for acute myeloid leukaemia (AML).

In acute leukaemia, children get better with chemotherapy and bone marrow transplant might be required in 10 per cent cases. Bone marrow transplant for children was currently being carried out in a few cities in the country, including Delhi, Chennai, Vellore and Bangalore. Chemotherapy treatment would cost Rs.2-3 lakhs while bone marrow transplant would be in the region of Rs.10-12 lakhs if the donor was a sibling and go up to Rs.20 lakh in the case of unrelated donor.
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Increasing access to eye care - The Hindu
Low accessibility to eye care is a huge problem in India. The reason: there are just about 15,000 ophthalmologists catering to the growing needs of the entire population. Worse, only about 30 per cent of them practice in the rural areas. Even the number of well trained optometrists is low.

It is to address this problem that the Chennai-based Healthcare Technology Innovation Centre (HTIC) has developed Eye-PAC computing technology that can be used even by people with minimal training. HTIC is an R&D centre of IIT Madras and is supported by the Department of Biotechnology (DBT).

The first product that has been launched in collaboration with the Bangalore-based Forus is the 3nethra. According to Dr. Shyam Vasudevarao, President and Chief Technology Officer of Forus, 110 3nethra devices have been sold in a year’s time both within and outside India.

3nethra can locate abnormalities indicative of diseases by studying the anterior and posterior parts of the eye. It can also study refractive errors. According to Dr. Vasudevarao, a few hours of training is all that is required for a person to operate the device. “It’s easy to use,” he said. HTIC is now looking at more complicated problems. “We are developing Eye-PAC computing technology for screening diabetic retinopathy and glaucoma,” said Dr. Niranjan Joshi, Researcher at HTIC. “The technology to screen diabetic retinopathy is at an advanced stage of development; glaucoma is at an intermediate stage.”

Eye-PAC computing technology is based on the principle of capturing the image of the eye, digitising it before transferring the information to a computing system. The technology teases out specific information from the images and provides a computer-assisted screening decision.

The technology can process the image obtained without dilating the eye, thus saving time both for the operator and patient.

Three-stage process

The technology goes through a three-stage process before arriving at a screening decision. In the first stage the image is processed —the image is first assessed for quality and then enhanced. Enhancement in the form of increasing the contrast and illumination is particularly essential to compensate for the less information collected while inspecting a non-dilated eye.

Once the image is processed, the details available on the image are computed. At this second stage, clinically significant conditions are assigned a value.

The value assigned depends on the severity of the condition. This becomes possible as the feature is compared with a large set of reference images with clinical annotations.


“All the three stages generate multitude of images depending on the end use. The parent image is also available,” said Dr. Mohanasankar S, who heads HTIC. This allows the end user to choose the one that he wishes to examine in detail.

Analytics, the final stage is where the decision-support capability of the technology comes into play. Here all the extracted values are integrated by Eye-PAC to provide a decision to either refer or not to refer the patient for a detailed examination.

The computer-assisted decision making is particularly useful during screening programmes.

“When used as a diagnostic solution, the computer-assisted decision saves the ophthalmologists’ time,” Dr. Joshi explained.

“Eye-PAC technology can be used to develop a range of applications such as disease screening systems, tools for clinical research and analytics,” explained Dr. Mohanasankar.
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Delayed Diagnosis, a Major Cause in TB Control - Aarti Dhar, The Hindu
India may have achieved a success rate of 88 per cent in treatment of tuberculosis — higher than the global treatment success rate of 85 per cent — but HIV-TB co-infection continues to be a cause of major concern, as the percentage of people infected with the twin infection increased substantially between 2010 and 2011. The percentage of TB patients tested for HIV increased nationally from 32 per cent to 45 per cent.

It is estimated that there are around 2.4 million HIV patients in India. Recent country- level data show that about 6 per cent of TB patients are HIV-positive. National surveillance has shown that the distribution of HIV among TB patients is highly heterogeneous, and is closely correlated with the distribution of HIV infection.

As per estimates of the World Health Organisation, released on the eve of the World TB Day, prevalence and incidence rates of all forms of TB were 249 and 181 per 100000 people respectively in 2011. However, the estimates have not yet been officially approved by the Ministry of Health and Family Welfare.

The report puts the multi drug-resistant tuberculosis (MDR-TB) prevalence at 2.1 per cent among new cases and 15 per cent among retreatment cases, which is based on sub-national surveys conducted in three States between 2006 and 2009.

Meanwhile, India is planning a national Drug Resistance Survey for 2013.

Despite the low MDR-TB prevalence, India ranks first among the 27 MDR-TB high burden countries. The Revised National TB Control Programme (RNTCP) has developed a plan to scale up the services considerably in order to treat at least 40,000 MDR-TB patients annually by 2017, supported by the Global Fund Round Single Stream Funding, Unitaid and domestic funds.

Ineffective and delayed diagnosis in both private and public sectors and failure to notify and register patients in the private sector diagnosed with TB, in addition to patients accessing private providers not linked with the RNTCP, have been identified as some of the major challenges faced by India in controlling the dreaded disease that claims 24 lives of every 100,000 people infected.

Achieving universal access, including marginalised and high risk groups, while maintaining and continuing to improve the quality of services across the country; introducing newer diagnostics and their positioning at various levels of health care, and ensuring adequate staffing at all levels — through improved human resource development — to reduce reliance on a limited pool of dedicated TB staff are some more issues that need to be tackled, the ‘Stop TB in South-East Asia — zero death to zero infection’ says.

Enforcing regulations for prescription and sale of anti-TB drugs; promoting rational use of first and second line drugs outside the programme to prevent MDR and extensively drug resistant TB (XDR TB), developing and implementing airborne infection control measures in health facilities and effectively promoting operational research to address local challenges are among the issues flagged in the report.

As on September 2012, all 28 States and seven Union Territories are providing MDR-TB diagnostic and treatment services. A cumulative total of 1,08,792 MDR-TB suspects were tested and 16,825 MDR-TB cases and 92 XDR-TB cases started on second-line standard treatment.

A limited number of TB mortality studies based on vital registration, and verification of the cause of death through verbal autopsies, have also been carried out in the region. A study in Chennai revealed that the TB mortality rate is 152 deaths per 100,000 population among men and 43 per 100,000 among women. A State-level study in Andhra Pradesh revealed that 5 per cent of deaths among men and 3 per cent among females were caused by TB.

Since its inception in 1997, the RNTCP has initiated almost 17 million patients on treatment.
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King's Prescription - Anusha Parthasarathy, The Hindu
The vast campus of the King’s Institute of Preventive Medicine, all of its 56 acres, engulfs you in a way that villages often do. Buildings thrive under the shelter of trees while some others, broken and battered are invaded by foliage. Large banyans provide abundant shade and a comfortable silence permeates its surroundings. A cluster of smaller departments with sloping roofs are connected by sheltered passageways. At the centre, the towering red heritage building of the Director’s office is reminiscent of Lt. Col. W.G. King, its first director, after whom the institute was named when it began in 1899.

The arched entranceways and roomy verandahs lead up through a grand stairway to the office of Dr. P. Gunasekaran, the current Director. “The concept of prevention being better than cure was very prevalent then and the Government wanted an institute that would play a vital role for the whole of the Madras Presidency,” says Gunasekaran.

And so, W. G. King, who was the Sanitary Commissioner of the Presidency at that time began a vaccine depot to treat small pox on November 7, 1899. “This was their biggest challenge that time and the building that the depot began in is still within the campus,” he adds, pointing to an old, circular, hut-like establishment next to the main building. “In 1903, a Bacteriology Department was established and performed various diagnostic tests on clinical examples that were received from all over the Presidency.”

A serum section and a water analysis wing were also added around that time, though the latter was handed over to the State Public Health Department in 1959. During World War II, more functions came under the responsibility of the King’s Institute. The Institute’s first Indian Director, K.P. Menon was in charge between 1941-1942, followed by C.G. Pandit. The Department of Biological Control was established in 1947. This helped analyse the quality of vaccines manufactured by the Institute and to help the State Drug Controller.

In 1969, the Department of Virology, which was later designated as the National Polio Lab (1993) was started. During the 1970s, the institute played an important role in the eradication of small pox and was awarded the UNESCO Mandram award in 1970. “This department has been accredited by WHO from 1995 and is moving towards eradicating polio,” he adds.

The institute also offers diploma, undergraduate, post graduate courses and Ph.D. programmes for medical and non-medical students. “Our School of Laboratory Technology has been imparting training to technicians from 1960,” says Gunasekaran, “We now have about 360 staff working in 15 departments within the institute.”

King’s was recently presented an award by FICCI for its diagnostic services — testing 30,000 samples of swine flu. “We have state-of-the-art equipment here to diagnose 23 types of viruses and we do this free of cost. But given that, we now want to strengthen our bacteria lab and allow it to act as a reference centre.”

The State Government has recently sanctioned Rs. 9.4 crores to the Institute for projects such as tissue bank, immunodiagnostic activities and revival of vaccine production. “We had shifted from production to diagnostic and service-oriented activities some years ago but now, we will begin production again.”

The campus now has five heritage buildings, including the Director’s office and the vaccine depot. “Most of the buildings here are old,” smiles Gunasekaran, “The King’s Institute began as a place to treat small pox but has grown into a research and testing facility. It has evolved and yet remains the same in many ways.”
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When paralysis strikes, Chennai GH offers some hope - The Hindu
The treatment is available everywhere but what struck me was this:
The drug costs about Rs. 50,000 and the entire treatment costs around Rs. 1lakh. “But it is free at the GH, making it the first State government-run hospital to do so. The treatment is covered under the Chief Minister’s comprehensive health insurance scheme,” he said.
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The Indian women pushed into hysterectomies
Thousands of Indian women are having their wombs removed in operations that campaigners say are unnecessary and only performed to make money for unscrupulous private doctors.

Sunita is uncertain of her exact age but thinks she's about 25 years old. I met her in a small village in Rajasthan, north-west India, surrounded by chewing cattle and birdsong. She was covered in jewellery, from a nose-stud and rings to bangles which jangled when she gestured with her hand.

Her face hardens when she tells me about her operation.

"I went to the clinic because I had heavy bleeding during menstruation," she says.

"The doctor did an ultrasound and said I might develop cancer. He rushed me into having a hysterectomy that same day."

Sunita says she was reluctant to have the operation straightaway and wanted to discuss it with her husband first. She says the doctor said the operation was urgent and sent her for surgery just hours later.


Sunita: "When I went to the clinic the doctor got me admitted on the same day and did the operation that evening"
More than two years have passed since that day but Sunita says she still feels too weak to work or look after her children.

When other local women crowded round, I asked how many of them had undergone hysterectomies. More than half raised their hands at once. Village leaders said about 90% of the village women have had the operation, including many in their 20s and 30s.

The doctors generally charge around $200 for the operation, which often means the families have to sell cattle and other assets to raise the money.

I tracked down the small private clinic where Sunita and some of the other women in the village said they had been advised to have hysterectomies, after suffering from symptoms such as heavy periods and period pain, bladder infections and backache.

The owner, a doctor, was in the middle of an ultrasound scan when I arrived. When I put the women's allegations to him, he shook his head and smiled. They weren't telling the truth, he said. Unlike others in the area, his clinic was genuine and ethical.

When I asked him how he could diagnose a pre-cancerous or cancerous growth on the basis of an ultrasound scan, he admitted that he sometimes didn't do biopsies before removing the uterus, only afterwards.

Once the removed uterus - and any biopsy tissue - has been destroyed, it becomes hard to prove that the operation wasn't justified.

But it is clear that something strange and deeply worrying is happening.

Reports from a handful of Indian states, including Rajasthan, Bihar, Chhattisgarh and Andhra Pradesh, suggest that an extraordinarily high number of women are having their uteruses removed, including many below the age of 40.

Hysterectomies elsewhere
It's hard to compare Indian hysterectomy rates with other countries, as only one generation of reproductive-age women has had access to the procedure

A study in Andhra Pradesh state concluded that women under 45 rarely needed the operation

Canada has one of the highest rates in the world - 346 per 100,000 women in 2006-7 - double that of the UK, the Netherlands,

Sweden and Norway
Data from the UK suggests a hysterectomy rate of 150 per 100,000 women
Source: Oxfam

The women often say the doctors frightened them into surgery by saying the uterus was cancerous. But in many cases, the diagnosis was made on the basis of a single ultrasound scan - which, according to independent doctors, cannot justify a decision to operate.

Dr Narendra Gupta, of the health charity, Prayas, a local partner of Oxfam, is one of many activists convinced that some private doctors are engaging in blatant malpractice.

"People say that in some places, there are whole districts without uteruses," he says.

"It seems that private doctors see this as an opportunity to make a fast buck. They're making money on ailments which could be treated in a simpler, less invasive way."

I met Dr Vineeta Gupta, a gynaecologist, in her consulting rooms in Rajasthan's state capital, Jaipur, her stethoscope dangling round her neck. She says she sees seven or eight women a week from villages in the region, who've been told they need hysterectomies but want a second opinion.

"In rural areas, doctors give a diagnosis of cancer very readily," she says.

"That's very wrong. When patients come to me, I tell them that an infection doesn't cause cancer. We'll cure the infection, I tell them, and you will be completely all right. Some are convinced but some are not convinced because they've been told: 'If you don't get your uterus removed you will get cancer and die.'"


A second doctor told Rajanthi a hysterectomy was not an immediate necessity
Until recently, no data was kept on the number of hysterectomies performed, but anecdotal evidence suggests the operations have become much more prevalent in recent years.

This follows the rapid expansion of small private clinics and hospitals, especially in remote rural areas that are poorly served by the government health system.

Health implications
"In the UK, a hysterectomy is very rarely performed to save life so other treatment options are usually explored first.

In order to confirm a diagnosis of cancer, doctors would first perform a biopsy and other lab tests. In some cases, they would treat with radiotherapy and/or chemotherapy before recourse to a hysterectomy.

The vast majority of hysterectomy cases in the UK involve women between the age of 40 and 50. It is rare for a woman in her 20s or 30s to have one.

Even when a hysterectomy leaves the ovaries intact, it may trigger menopause.

The operation can also lead to incontinence, irritable bowel syndrome, depression, back pain, loss of sexual pleasure, thrombosis and vaginal prolapse."

Ceri Averill, Oxfam's health policy advisor

Many campaigners accept that the clinics are necessary but they argue that the doctors must be properly monitored and regulated to ensure they provide a decent level of care - and do not swindle their patients or the state.

To ease the burden on the rural poor, the Indian government launched a national health insurance scheme, the RSBY, in 2008. Under the scheme, families living below the poverty line can receive treatment worth up to 30,000 rupees ($550) each year from designated private hospitals, which claim the costs directly from the state.

But in some states, critics say the scheme appears to be encouraging unnecessary hysterectomies, as unethical private clinics exploit the vulnerable poor, using them as a means to tap into government funds.

In Samastipur, a district in the northern state of Bihar, initial figures suggested that more than a third of operations carried out under the scheme were hysterectomies. The district magistrate, Kundan Kumar, became so concerned about these figures that he invited women who had had the operation to attend a government medical camp last August, where they received an independent evaluation from government doctors.

The report from the camp suggests that of 2,606 women who were examined, 316 - about 12% - had had their uteruses removed unnecessarily.


District magistrate Kundan Kumar had concerns about the number of operations being carried out
There were also cases of women whose doctors had claimed money for performing hysterectomy, but had in fact made only a superficial incision, leaving the uterus intact.

Mr Kumar accuses a number of private clinics of "excesses" carried out for "selfish gains" and is preparing to prosecute them.

"Instead of resorting to conservative techniques, they go straightaway for surgeries which meant more money for them," he says.

"I think there was basically a mad rush to earn as much money as possible to do unwarranted surgery."

The clinics involved in the district magistrate's investigation deny malpractice and say the hysterectomies were medically justified.

India's minister for rural development, Jairam Ramesh, says the root of the problem is the failings of the public health system.

"All the spending is in private clinics because the public system has collapsed," he told me.

"So it's rational behaviour for people to go to private clinics when the public health facilities are not there."

But in that case, I said, it was important that those private clinics had doctors who were both honest, and properly qualified.

"And that they do not fleece the consumers which they are doing right now," he said.

"That's what is leading people to spend extraordinary amounts of money for healthcare and probably getting treatments much in excess of what they need."

Legislation passed by the central government to regulate the private sector is now in the process of being implemented by India's individual states.

In the meantime, Indian women continue to have hysterectomies which many of them may not need.
Suraj
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After Bayer, Novartis also loses its patent protection battle in India's supreme court. Novartis is the combined entity formed by two former cos many Indians are familiar with: Ciba-Geigy and Sandoz.
Novartis loses India patent battle
India's Supreme Court on Monday rejected drug maker Novartis AG's attempt to patent a new version of a cancer drug in a landmark decision that health activists say ensures poor patients around the world will get continued access to cheap versions of lifesaving medicines.

Novartis had argued that it needed a patent to protect its investment in the cancer drug Glivec, while activists said the company was trying to use a loophole to make more money out of a drug that did not have a patent. The decision has global significance since India's $26 billion generic drug industry supplies much of the cheap medicine used in the developing world.

Pratibha Singh, a lawyer for the Indian generic drug manufacturer Cipla, which makes a version of Glivec for less than a tenth of the original drug's selling price, said the ruling sets a precedent that will prevent international pharmaceutical companies from obtaining fresh patents in India on updated versions of existing drugs.

The court ruled that a patent could only be given to a new drug, she told reporters outside the court.

"Patents will be given only for genuine inventions, and repetitive patents will not be given for minor tweaks to an existing drug," Singh said.

Novartis did not immediately return calls for comment. It has previously said that patent protection is crucial to fostering new drug research and innovation and has suggested that Indians could be denied access to its new medicines if it believes its patents won't be protected.

"Knowing we can rely on patents in India benefits government, industry and patients because research-based organizations will know if investing in the development of better medicines for India is a viable long-term option," the company said in statement it sent to The Associated Press late last year.

The Swiss pharmaceutical giant has fought a legal battle in India since 2006 to patent a new version of Glivec, which is mainly used to treat leukemia and is known as Gleevec outside India and Europe. The earlier version of Glivec did not have a patent, because it was introduced into India before the country adopted its first patent law in 2005.

India's patent office rejected the company's patent application, arguing the drug was not a new medicine but an amended version of its earlier product. The patent authority cited a provision in the 2005 patent law aimed at preventing companies from getting fresh patents for making only minor changes to existing medicines — a practice known as "evergreening."

Novartis appealed, arguing the drug was a more easily absorbed version of Glivec and that it qualified for a patent.
Anand Grover, a lawyer for the Cancer Patients Aid Association, which led the legal fight against Novartis, said the ruling Monday prevented the watering down of India's patent laws.

"This is a very good day for cancer patients. It's the news we have been waiting for for seven long years," he said.
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The decision by The Supreme Court of India have been Welcomed

What India’s Decision To Deny A Generic Cancer Drug Patent Says About Big Pharma In The U.S.
In 1993, Novartis patented a version of Gleevec that it later abandoned in development, but the Indian judges ruled that the early and later versions were not different enough for the later one to merit a separate patent. [...]Anand Grover, a lawyer who argued the case on behalf of Cancer Patients Aid Association in India, said the ruling had a sweeping effect since it confirmed that India has a very high bar for approving patents on medicines.“What is happening in the United States is that a lot of money is being wasted on new forms of old drugs,” Mr. Grover said. Because of Monday’s ruling, “that will not happen in India.”Indeed, the vast majority of drug patents given in the United States are for tiny changes that often provide patients few meaningful benefits but allow drug companies to continue charging high prices for years beyond the original patent life.
In a classic example, AstraZeneca extended for years its franchise around the huge-selling heartburn pill, Prilosec, by performing a bit of chemical wizardry and renaming the medicine Nexium. Amgen has won so many patents on its hugely expensive erythropoietin-stimulating drugs that the company has maintained exclusive sales rights for 24 years, double the usual period.This culture of Big Pharma companies reauthorizing U.S. drug patents by instituting negligible changes to the “inactive ingredients” in their products perpetuates high costs for both the American people and public insurance plans that must subsidize the price of expensive, brand name drugs. Pharmaceutical companies’ ability to extend their intellectual property protection (IPP) is a consequence of a series of laws that were passed beginning in the 1980s. While these laws were meant to encourage drug innovation, they have also had the adverse effect of extending patents on certain drugs’ active ingredients to as many as 20 years, as this data compiled in a National Institute for Health Care Management (NIHCM) Foundation report
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Re: Indian Health Care Sector

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DoT awakens to cancer causing cellphone towers
In September 2012, the government lowered radiation emission limits for mobile phone towers to 450 milliwatts/sq m from 4,500. But even this is way above international norms.
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First Ever International Meet on Health Tourism - New Indian Express
Chennai:

The first-ever international conference and exhibition on health tourism, showcasing the State as a premier healthcare destination, will be held in the city from April 19-20. The two-day meet - Tamil Nadu Health Tourism 2013 - organised by the Confederation of Indian Industry (CII), will highlight the emerging trends, opportunities and challenges in the health tourism sector in the country and the State.

“At present, Tamil Nadu is the third largest, after New Delhi and Mumbai, health tourism destination in the country,” said Dr Chandrakumar, convener of the meet and chairman of Kauvery Hospital .

“The primary objective in holding the conference is to strategize how to position the state as the No 1 player.”

Stating that the conference was being held with the active support and cooperation of the State government, Chandrakumar pointed out that the health tourism sector had made rapid strides, what with the finest qualified and experienced specialists, latest equipment and state-of-the-art infrastructure available in corporate hospitals across the country.

“Over 60,000 cardiac surgeries are done every year at par with international standards,” he said. “Last year, the revenue earned through foreign patients was around $2.5 billion.”

Most importantly, the major advantage of the medical tourism industry in India was its cost-effectiveness - one-tenth of the rates in the West - and competency, coupled with the attractions of tourism. And, Tamil Nadu was a pioneer in providing the best healthcare.

“Today, medical tourism in the country is synonymous with Chennai, Vellore, Madurai and Coimbatore,” Chandrakumar pointed out.

Visitors seeking treatment in the State would get more for only a fraction of what it would cost back home, leaving them with extra funds to spend on sight-seeing, he said.

All stakeholders - major hospitals, health insurance companies, policy makers, tourism promotion boards, hotels and resorts, health travel and tour operators - would put up pavilions at the venue - Chennai Trade Centre at Nandambakkam - showcasing their areas of expertise, services and products. “The State health ministry will also have its own pavilion,” he added.

More than 30 speakers, including ministers, diplomats, officials and medical professionals would be addressing the various sessions that would debate several issues, including best medical practices, enhancing competence and growth and challenges faced by the sector.

A major challenge of medical tourism related to insurance.

“At present, insurance is available only for specific segments,” said Dr S Prakash, co-convener and executive director, Star Health and Allied Insurance.

“If there is financial cover, then there will be more patients’ traffic and more traffic means more facilities in our hospitals,” he pointed out.
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http://greatandhra.com/viewnews.php?id= ... 10&scat=25
Yellow Home Health Care, the only corporate company based out of Hyderabad started its Home Health Care services providing professional Nursing Services & Bed Side Companion Care at the comfort of client’s home.

Home Health Care is an essential part of healthcare today, touching the lives of nearly every individual and especially to NRI’s who want to take care of their families back in India. It encompasses a broad range of professional healthcare and support services provided in the home. As hospital stays decrease, increasing numbers of patients need highly-skilled services when they return home.

Home Health care is necessary for a person who needs ongoing care that cannot easily or effectively be provided solely by family and friends. Home healthcare services usually include assisting those persons who are recovering from a surgery, disabled, chronically or terminally ill and are in need of medical, nursing, social, or therapeutic treatment.

Yellow Home Care offers a customized care plan by offering various services like General Skilled Nursing, Post Surgical Care, Geriatric Care and other Nursing Procedures.

Watch us on Youtube covered by TV5 http://www.youtube.com/watch?v=98chdVcCM88

One of the unique services is Suraksha, which allows NRI’s to monitor their Parents health and helps to prevent Medical emergency.

Announcing the launch of Suraksha, Mr. Sumanth Reddy, Co Founder of Yellow Home Care, said, “Our Parents pay less importance to their own health and tend to ignore some of the important measures to prevent health emergencies and at the same time we Sons/Daughters try to provide best health care. So, Suraksha is one such program where the loved ones can make a difference by signing up with Yellow home care. Yellow Home care team visits your loved ones twice a month and does a round of health checks like Blood Pressure, Sugar levels, supplies of Medication and any health related.”

The benefit from Suraksha Program is Unmatched Patient convenience. Clients can live in peace of mind. Get frequent health updates relating to your loved ones health. Make sure that they are taking their medicines regularly, have required medicines to take, Prevent Medical emergency etc.
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http://www.undispatch.com/indian-childr ... e-now-what
Natural AIDS Resistance. Now What?
NEW DELHI – Since the 1980s, much has changed: AIDS is no longer considered a “gay” disease, anti-retrovirals have extended the lifespan of those infected, and the general illogic that accompanied the initial terror of the epidemic has, if not disappeared, at least in many places morphed to include basic facts of the disease. What hasn’t changed is that until now, there hasn’t been a cure. But this spring, researchers at the Pediatric HIV Clinic in Mumbai published a paper in the Indian Journal of Medical Research reporting the first known cases of children in India naturally resistant to AIDS.For the last ten years, scientists world-wide have been studying “long-term nonprogressors” (LTNPs), people who are HIV-positive but who naturally resist developing symptoms for 6 to 10 years after contracting HIV. A smaller sample of people, known as “elite controllers,” have been known to stay healthy without any treatment for as long as 25 years after infection. While elite controllers are rare – there are only 25 known cases in the world – LTNPs are actually more prevalent than you might think, constituting somewhere between 5 and 15 percent of HIV-positive individuals, says Ira Shah, one of the doctors who wrote the Pediatric HIV paper.
The report studied children from western India, ranging in age from 9 to 13, who had been diagnosed with the virus, and who, without any treatment, maintained healthy CD4 counts, the white blood cells that fight infection. Their bodies naturally produce a type of broadly neutralizing antibodies (BNABs) that are able to keep up with the rapid mutation of HIV within the body. If scientists could artificially replicate these antibodies, an HIV vaccine might suddenly be in sight.This isn’t necessarily news in the scientific community: More than a dozen types of BNABs have been discovered through various research centers over the last several years. But identifying Indian children who have antibodies is particularly crucial because the most common strain of HIV in Asia is different than that in the West, and identifying local elite controllers here is therefore of particular import.Using research with LTNPS,the International AIDS Vaccine Initiative (IAVI) has since 2001 been testing vaccine combinations around the world. The vaccine, developed by U.S. bio-tech firm Therion Biolgics in India, takes genetic material from six HIV genes and uses a “viral vector,” or a version of a benign pox virus, that has been genetically manipulated to serve as a transport mechanism. Because only pieces of the virus are used, there’s no way that the vaccine could actually cause infection, but the introduction of the virus is hoped to stimulate the production of specific cells known as cytotoxic T lymphocytes – what the children in the Shah’s study had naturally. Recently a trial was run on HIV-positive people in Mumbai to test a bovine immunodeficiency virus vaccine without getting the patients’ consent, a story which only broke when one of the patients died. While it’s exciting that research in India is progressing, as projects launch into testing phases these issues will need to be addressed. IAVI India Country Director Rajat Goyal is aware of these concerns, explaining that IAVI’s work is not “just about having good labs and good research, but about good participation. We need media coverage, civil society, and political buy-in.” Last year, IAVI opened a $12 million dollar laboratory with federal support to continue their HIV vaccine research, and as they roll out projects, they have a unique opportunity to set standards for this sort of testing.Unlike the recent case of a child in Mississippi, splashed across U.S. headlines as the first “cured” case of AIDS, IAVI isn’t working with rare, one in a million cases.
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2,644 died during clinical trial of drugs in 7 years: Govt to SC
Responding to allegations by NGO, Swasthya Adhikar Manch, in its PIL that Indians were used as guinea pigs by foreign pharmaceutical majors for human trial of their new drugs, the Union health and family welfare ministry said of the 57,303 enrolled subjects, 39,022 completed the clinical trials.

"Serious adverse events of deaths during the clinical trials during the said period were 2,644, out of which 80 deaths were found to be attributable to the clinical trials," health secretary Keshav Desiraju said in an affidavit on behalf of the ministry of health and family welfare.
Out of 57K people, there is no data to tell how many were in vegetative state, how many with chronic-induced aliments and how many have acquired new diseases like vascular and other endocrine disorders due to these trails.

It seems Sonia-led UPA has found new guinea pigs in Indians. There is no end for these adharmic asuras' greed and their hatred contempt for Santhana Dharma. I do not know is it peak for these negative forces, so that Sri Hari will take another avatar to restore some balance. Really feeling helpless and hapless to fight off these monsters and their global network.
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Most new-born deaths in India, says report; Pakistan, Bangladesh fare better
Of every 100 new-borns that die in the world, 29 are in India. In real, heart-rending numbers that is three lakh babies who die on the day they are born, every year.

Infants fare better even in Pakistan and Bangladesh, says a new report.

Non-governmental organisation Save the Children compared first-day deaths in 186 countries for its "State of World's Mother Report". Luxembourg has the least new-born deaths, India the most, the reports says.

While infant deaths in India have come down by almost half compared to 1990, the rate has been slower than that in, say, Nepal.

The statistics only get worse. More than half the child deaths in India happen in the first month. And India has the biggest disparity between the rich and poor in child deaths.

The country's report card on mother and child health too is abysmal; India is behind Pakistan and Bangladesh on this list.
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Re: Indian Health Care Sector

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More on the issue of new-born deaths in India.
Three Lakh Newborns Last Hardly a Day - Arthi Dhar, The Hindu

Image
Over three lakh newborns in India die within 24 hours of their birth every year – the highest number in the world.

With a total of 3,09,000 babies hardly surviving a day, India tops the list for such deaths, according to a report titled ‘State of the World’s Mothers’ released here on Tuesday.

The country accounts for 29 per cent of all such deaths — ahead even of Nigeria, Pakistan and China, the study by Save the Children says.

The report also claims that 4,20,000 babies across South Asia die on their first day – almost one every minute. Chronic malnourishment which leads to mental or physical impairment or ‘stunting’ is particularly severe in the region.

According to the report, of the one million babies who die each year on the day they are born, almost 40 per cent are in India, Pakistan and Bangladesh.

Quoting Sample Registration Survey (SRS 2011) figures, the report says Madhya Pradesh has the highest burden of early newborn deaths (0-7 days) at 32, followed closely by Uttar Pradesh and Odisha (30). Other States with high burden are Rajasthan, Chhattisgarh, Bihar, Jharkhand and Jammu & Kashmir.

Kerala is the leader in reducing neonatal mortality by a wide margin, while Tamil Nadu, Delhi and Maharashtra too have improved the national rate.

Thomas Chandy, CEO of Save the Children in India, says: “For the first time in history, putting an end to this crisis is within our reach, but to achieve this will require unprecedented focus on saving babies in their first day of life. Save the Children recognises the immense efforts being made in India and the government’s commitment to end child mortality in a generation. Although many challenges remain, India has mobilised the most important ingredient to long term success: political will.{This has to be a mission like polio eradication or small-pox eradication before. Those states which are laggards must be targetted intensely.}

Overall, however, the report says that progress in South Asia, while “significant” has, along with sub-Saharan Africa, “lagged behind the rest of the world.”

Two thirds of all newborn deaths occur in 10 countries, four of which are in the region: Nigeria, DR Congo, Tanzania, Ethiopia, Pakistan, India, Afghanistan, Bangladesh, Indonesia and China.

Bangladesh has reduced newborn mortality by 49 per cent since 1990. Community health workers reaching mothers and babies at home, and training birth attendants and medical staff in resuscitation devices to help babies breathe are factors in this progress.

Nepal has reduced mortality by 47 per cent since 1990.

Maternal risk

In South Asia, there are striking differences among countries in the case of maternal risk to life. In Afghanistan, a mother has a one in 32 risk of maternal death, in India it is 1 in 170, and in Nepal one in 190.

The top five countries in the South Asian mothers’ ranking are: Maldives, Sri Lanka and Bhutan. The bottom five are (in descending order) Pakistan, India and Afghanistan.

Nigeria has 89,700 deaths in this category, followed by Pakistan (59,800), China (50,600), Congo (48,400), Ethiopia (28,800), Bangladesh (28,100), Indonesia (23,400), Afghanistan (18,000) and Tanzania (17,000).
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IITian quits Hollywood to design lab in suitcase.

Village folk may soon have access to accurate medical diagnosis at their doorstep with a miniaturised pathological laboratory packed into a suitcase capable of conducting tests which could lead to early identification of many diseases.

Amit Bhatnagar, an alumnus of IIT-Roorkee who quit a plush job in Hollywood's famed Universal Studios, has designed a portable biochemistry laboraotry, which comes packed in a suitcase and can perform 23 crucial medical tests including for kidney, liver, heart, anaemia, diabetes and arthritis.

The portable lab, which could prove a boon to people staying in remote areas that have little access to diagnostics which results in several diseases remaining undetected, was launched by Science and Technology Minister S Jaipal Reddy yesterday. "It is a complete compact lab in a suitcase with power backup. It has been designed to perform 23 vital blood tests for kidney, liver, heart, anaemia, diabetes and arthritis accurately, cost-effectively and timely," Bhatnagar said.

The lab, which costs a maximum of Rs 3.5 lakh, includes blood analyzer, centrifuge, Micro pipettes, incubator, Laptop with Patient Data Management Software and consumables."Key advantage of Mobile Lab is in its design, rugged analyser, portability, cost effectiveness," Bhatnagar said.

The portable lab is being used by Border Roads Organisation at its dispensaries in remote areas of Kargil, Leh, Nagaland, by the Central Reserve Police Force in the jungles of Chhattisgarh and various programmes of the National Rural Health Mission in Haryana and Kerala on a pilot basis.

"We did a trial for 800-900 people in our dispensaries in remote areas. It has a lot of potential for early detection of lifestyle diseases like diabetes, cardiac problems and in emergencies," Brigadier S B Mahajan, Deputy Director General, Border Roads Organisation said. Mahajan said the results of the tests performed by the portable lab were validated against those done in conventional laboratories and were found to be accurate. "We have put up a demand for procurement of more such units," he said. Bhatnagar received a soft loan of up to Rs four crore for developing the lab from Technology Development Board of the Government of India.

He raised an additional Rs four crore from various other resources. Bhatnagar did his B.Tech in Mechanical Engineering from IIT, Roorkee and went to the Pennsylvania State University in the US to complete his Masters in Biomedical Engineering.

He joined as a business consultant at the Universal Studios, where he analysed consumer trends for products of the Hollywood major. But homeland beckoned him and the stint in Hollywood was cut short after nine months. Back in Delhi, he and his technology partners at IIT Delhi decided to take on the problem faced by nearly 70 per cent of villages in the country which did not have access to accurate diagnosis. The 'lab in a suitcase' was a fruit of the efforts put in by Bhatnagar and his collaborators at IIT-Delhi.
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India unveils vacccine for deadly diarrhoea virus
Scientists unveiled Tuesday an affordable vaccine against a deadly diarrhoea-causing virus that kills some 100,000 children in India every year.

Rotavirus, which causes dehydration and severe diarrhoea, is globally responsible for some 453,000 deaths annually and is particularly threatening in Africa and Asia, where access to urgent healthcare is often out of reach.
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Re: Indian Health Care Sector

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Prem
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Cheap vinegar test cut cervical cancer deaths in India; could help many poor countries

http://www.washingtonpost.com/world/asi ... story.html
MUMBAI, India — A simple vinegar test slashed cervical cancer death rates by one-third in a remarkable study of 150,000 women in the slums of India, where the disease is the top cancer killer of women.Doctors reported the results Sunday at a cancer conference in Chicago. Pap smears and tests for HPV, a virus that causes most cervical cancers, have slashed cases and deaths in the United States. But poor countries can’t afford those screening tools.This study tried a test that costs very little and can be done by local people with just two weeks of training and no fancy lab equipment. They swab the cervix with diluted vinegar, which can make abnormal cells briefly change color.Experts called the outcome “amazing” and said this quick, cheap test could save tens of thousands of lives each year in developing countries by spotting early signs of cancer, allowing treatment before it’s too late.he story of research participant Usha Devi is not an unusual one. Despite having given birth to four children, she had never had a gynecological exam. She had been bleeding heavily for several years, hoping patience and prayers would fix things.“Everyone said it would go away, and every time I thought about going to the doctor there was either no money or something else would come up,” she said, sitting in a tiny room that serves as bedroom, kitchen, bathroom and living room for her entire family.One day she found a card from health workers trying to convince women to join the study. Devi is in her late 40s and like many poor Indians doesn’t know her date of birth. She learned she had advanced cervical cancer. The study paid for surgery to remove her uterus and cervix.
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India's Sun Pharma in talks to buy Sweden's Meda for $5-$6 billion: sources
http://news.yahoo.com/indias-sun-pharma ... 13477.html
MUMBAI (Reuters) - India's Sun Pharmaceutical Industries Ltd is in talks to buy Sweden's Meda AB for between $5 billion and $6 billion to boost its generics business in developed markets, two sources with direct knowledge of the process said.Meda makes specialty products, over-the-counter drugs and branded generics - the same areas of focus as Sun. The Swedish company had sales of about 13 billion crowns ($2 billion) in 2012 and has a stock market value of roughly $4 billion.
Mumbai-based Sun is India's most valuable drugmaker, with a market capitalization of some $20 billion, and has made several acquisitions in recent years.But a deal for Meda would be the largest yet for a company which had cash of 40.6 billion rupees ($722 million) at the end of March.
If it goes through, the transaction would be the latest in a string of multibillion-dollar deals involving generic and mid-sized drug companies.Such deals include the planned $5 billion purchase of Warner Chilcott Plc by Actavis Inc and Valeant Pharmaceuticals International Inc's $8.7 billion acquisition of Bausch & Lomb."Sun Pharma is in an extremely sweet spot with a low amount of debt and strong organic business growth," said Jagannadham Thunuguntla, equity head at SMC Global Securities in New Delhi."While this (deal) shows their aggression, they should play it a little carefully in terms of valuation," he said. "It can put the balance sheet under stress."
Buying Meda would give Sun access to Dymista, an allergy medicine that received U.S. approval last year and is viewed by analysts as having good potential. The inhaler product is manufactured and supplied to Meda by Cipla Ltd, an Indian rival of Sun.
Other Meda drugs have not performed so strongly in recent times, however, and its core earnings or EBITDA fell 16 percent last year. Analysts forecast core earnings to be flat in 2013, making its enterprise value of around 10 times EBITDA relatively expensive, according to one banker.
Sun is in talks with a clutch of banks to raise funds for a possible deal, the sources said, declining to be identified. They did not say how far along the discussions were, or how likely it was that a deal would be reached.But the recent pace of acquisitions in the sector may suggest Sun would not have much trouble securing funding."There have been a lot of deals and money is cheap if they (Sun) need to borrow," said Lars Hevreng, an analyst at SEB Equity Research in Stockholm.
Possible rival bidders could include Valeant, which considered acquiring Meda in 2011, according to a source familiar with the situation speaking at the time. But Valeant may have its hands full integrating eyecare group Bausch & Lomb.Clinching any deal is likely to hinge on the position of Sweden's Olsson family, which owns more than 22 percent of Meda as well as shipping, metal processing and property assets.A spokeswoman for Sun declined to comment. Meda was not immediately available for comment.Shares in Meda hit a 5-1/2-year high on the report, rising as much as 8 percent before pulling back to stand 3.4 percent higher by 1425 GMT. Sun shares closed down 2.8 percent in a broader market that was off 2.3 percent.Last year, Sun bought U.S.-based Dusa Pharmaceuticals Inc for about $230 million, as well as URL Pharma from Japan's Takeda Pharmaceutical Co for an undisclosed amount.It also sought to buy out minority shareholders in its U.S.-listed Israeli subsidiary Taro Pharmaceutical Industries for $571 million before withdrawing the proposal earlier this year.
Neshant
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Re: Indian Health Care Sector

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the Indian govt should have something like this.

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Finland's 'Starter Kit' for New Moms Is Brilliant

Finnish mothers are crediting a simple cardboard box with saving their babies' lives and providing them with a hopeful future.

More on Yahoo! Shine: 9 Baby Products Adults Can Use

The boxes, a 75-year-old tradition in Finland, are given to new mothers as they leave the hospital with their newborns, according to a story published Tuesday on the BBC. Dubbed a "maternity package" or a "baby starter kit," a typical box is lined with a mattress on which babies take their first nap during the ride home. Mothers are also given the option to accept the box or a cash grant set at 140 euros (approximately $180), but most mothers opt for the box. Here's what's included:

Bedding: An under sheet, mattress cover, duvet cover, blanket, and sleeping bag or quilt.
Clothing: A snowsuit, a hat, insulated mittens, booties, socks, mittens, leggings, knitted overalls and facemask, onesies, and a romper suit.
Bathroom products: A hooded bath towel, a hairbrush, a toothbrush, diaper cream and diapers, nail scissors, a baby thermometer, and washcloths.
Box: The box itself serves as a make-shift crib for newborns
Miscellaneous: A picture book, a teething toy, bra pads, burp cloths, and condoms.

More on Yahoo! Raising Awareness for Children With Immune Deficiency

The tradition began in 1938 when low income families were given the boxes to help get them started on their journey as new parents. In 1949, however, that all changed when new legislation was introduced. Families could still receive the box, but there was a catch: Mothers had to agree to visit a doctor or prenatal clinic before their fourth month of pregnancy. It was a win-win for everyone: Mothers scored the necessary gear to care for their babies and doctors saw that they received proper treatment.

A typical box (Photo by ©Kela/Annika Söderblom)A typical box (Photo by ©Kela/Annika Söderblom)This arrangement was essential in the 1930s because at the time, the infant mortality rate was high: 65 out of 1,000 babies died. "The boxes indirectly helped lower the infant mortality rate because women were forced to undergo prenatal care," Mika Gissler, a professor at the National Institute for Health and Welfare in Helsinki, Finland told Yahoo! Shine. "Also, by providing a bed for the babies, parents would be less inclined to co-sleep or have the infants share a bed with siblings, which can lead to SIDS [Sudden Infant Death Syndrome]."

For context, in 2011, the infant mortality rate in Finland was 3.43 per 1,000 births, compared with 6.05 per 1,000 births in the United States that same year. According to the BBC, while the boxes have remained a constant throughout Finland's history, the contents have evolved along with the times. For example, in the 1930s and 1940s when women were mostly making their own clothes, the boxes came with fabric. During World War II, when cotton was in demand for the armed forces, some of the material was replaced by paper bed sheets and swaddling clothes. The '50s, '60s, and '70s paved the way for stretchier fabrics. And the late 60s introduced a sleeping bag and disposable diapers, which were eventually traded in for cloth versions due to environmental concerns.

"Condoms were also added to the box as a reminder to mothers that they should have safe sex to prevent unintended pregnancies," said Gissler. "The colors changed, too. When the boxes were first introduced, the theme was white. In the '70s, we divided the boxes into pink and blue categories. Now, everything is gender-neutral—usually brown, yellow, or gray. We also switch up the colors every other year."

Gissler said the boxes are so popular that almost 100 percent of moms choose them over the cash voucher, even women who already have multiple children. The exception: "If a woman gives birth to twins or triplets, she's given both the money and the box," said Gissler.
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Malnutrition causes 45% of deaths of Under-five Children - The Hindu
Malnutrition is responsible for nearly 45 per cent of deaths in children under-five, according to new research report published as part of The Lancet Series on maternal and child nutrition. The research shows that malnutrition is responsible for around 3.1 million deaths in children under five annually.

Results estimate that stunting (reduced growth) affected at least 165 million children worldwide in 2011 while at least 52 million children were affected by wasting (low weight for height), and 100 million children were underweight. Over 90 per cent of these were in Asia or Africa, with Africa the only major world region where the number of children with stunting increased.

A study based on a survey of the height and weight of more than one lakh children across six States in India last year had found that as many as 42 per cent of under-fives were severely or moderately underweight and that 59 per cent of them suffered from moderate to severe stunting. The findings — contained in the Hunger and Malnutrition (HUNGaMA) report by the Naandi Foundation— were described by Prime Minister Manmohan Singh as a “national shame.” Undernutrition affects development of a child, with consequences ranging from poorer school performance to increased susceptibility to infectious disease.

While the adverse effects of premature birth on a child’s survival and development are well-established, the study reveals new findings which show that children born too small for their gestational age — over a quarter (27 per cent) of births in low-and middle-income countries — are also at substantially increased risk of dying. Restricted growth in the womb, due to maternal under-nutrition, is estimated to be responsible for more than a quarter of all newborn deaths. Children born too small are considerably more likely to be stunted a year later, and are also at greater risk of some types of illness as adults.

Maternal undernutrition

In addition to the enormous burden of illness and disease resulting from maternal and child undernutrition, changing diets and patterns of physical activity mean that obesity and overweight are now increasingly affecting many of the countries already suffering the adverse consequences of undernutrition, resulting in a ‘double burden’ of maternal and child disease and illness, the report says.

The authors, led by Professor Robert Black, of Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, performed a comprehensive new analysis of the different causes of maternal and childhood malnutrition to arrive at these conclusions.

Studies were done on breastfeeding practices and deficiencies of vitamins and minerals such as vitamin A, zinc, iron and calcium. They also analysed the consequences of malnutrition, including stunting, wasting and underweight (low weight for age), all of which result in increased risk of death and illness for both pregnant women and children.

Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential.

Maternal undernutrition contributes to foetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life.

Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups.

The Lancet reports that undernutrition reduces a nation’s economic advancement by at least eight per cent because of direct productivity losses, losses via poorer cognition and losses via reduced schooling.
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Polio case detected in Maharashtra district - The Hindu
A 10-month-old infant from Kanhapur village in Dharur tehsil of Beed district in Maharashtra has been diagnosed with polio infection.

District health department sources said the child has Vaccine Derived Polio Virus type 2, a very rare variety of the disease. The boy has been now sent to Latur for further treatment.

A.K. Singare, residential medical office of Swami Ramanand Teerth Hospital, Ambejogai, said the child might not have received timely vaccination doses.
Maharashtra has to quickly determine whether it is some wild polio or a vaccine induced polio. There has been some debate on the efficacy of the trivalent oral polio vaccine as compared to the bivalent one. This particular case is a serious matter and has to be investigated thoroughly and quickly too.
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More on the vaccine-induced polio case posted just above.

We are fighting a war against Polio without a General - The Hindu
Dr. T. Jacob John , member of the WHO committee on global polio eradication, in an email to R. Prasad , makes a strong case for quickly introducing injectable polio vaccines, along with oral vaccine, for better protection and prevention of VDPV cases.

What do you think caused the vaccine-derived polio virus (VDPV) type 2 in the baby?

Obviously the baby was undervaccinated and unprotected from polio. Also, obviously the child was infected by a vaccine-derived poliovirus from another person. Therefore, it was the combination of deficient number of doses plus the unlucky event of getting infected with a vaccine-derived virus. Not every child who gets infected with VDPV will become paralysed — so twice unlucky.

Does the emergence of VDPV reflect the lack of polio coverage in a particular area?

Yes. If coverage is good, VDPV cannot emerge or cause polio even if it is circulating silently. The two risk factors for emergence of VDPV are lower than adequate coverage and the continued use of OPV.

Is the VDPV equally capable of causing disease as the wild polio virus?

[There is] no accurate measure. VDPV may cause polio less frequently than the wild poliovirus; no one knows the ratio exactly. The point is, one case of VDPV means a large outbreak of infections already. Such outbreaks are very quickly put down with just two or three OPV campaigns. {This is setback for our anti-polio campaign. One hopes that Maharashtra has already started the campaign.}

Why do we see more of type 2 VDPV cases?

During the last 12 years — 2000 to 2011 (we have a count of only “circulating” VDPVs, not all VDPVs) globally there were 478 cases of type 2, 79 of type 1 and nine of type 3.

Of all circulating VDPV cases, 85-90 per cent was due to type 2; Type 1 was less often and type 3 was least often. These are biological phenomena as observed. Among the three viruses in OPV, type 2 is the most transmissible; hence the higher frequency seems to be due to this property of type 2 vaccine virus.

Why did the WHO recommend OPV in the first place?

[OPV was] believed to be highly efficacious (as live virus), safe (due to attenuation) and offer high degree of mucosal immunity and herd effect (slowing down of wild polio virus circulation). [The efficacy, herd effect and safety are] very relative, with wide geographic variations. [But it is] inexpensive and easy to give as oral drops.

Were cost and easy administration the only reasons for WHO recommending OPV?

There were experts who believed OPV was superior, without actual evidence of its superiority or inactivated polio vaccine’s (IPV) inferiority. [Unlike IPV that is injected], that belief was because OPV is given by mouth and vaccine viruses infect gut mucosa. We know from many other vaccines that mucosally infectious vaccines are not necessary to protect against diseases caused by mucosally infectious pathogens; there is no reason to suspect that IPV is any different. I do not believe OPV is superior to IPV.

What prompted India to adopt OPV and continue with it (despite its problems) even as developed countries switched to IPV years ago?

Decision making was mainly by administrators and not by public health experts or technocrats. And administrators may not be reading scientific literature. WHO recommended OPV in the Expanded Programme of Immunisation (EPI) and India complied without internal consultations or using Indian scientific information which spoke against OPV in favour of IPV. Our main problem was very low effectiveness of OPV, which was the reason why India had inordinate delay in eradicating wild polioviruses. We had to develop Type 1 and Type 3 “monovalent” OPV with higher efficacy to achieve success in 2011.

WHO was not convinced (until after failing to eliminate polio in India by 2005) that India (and other similar countries) had a problem with OPV — and our government had ignored Indian problems of very low effectiveness of OPV that was very well documented right from 1972.

Despite knowing that tropical conditions and denser population weakens the OPV immunity, why is India still continuing with OPV?

We were fighting a war against polio without a ‘war General’ — there was no official identified as the person in charge of, and accountable for, polio eradication. So, India followed WHO blindly, without independent assessment through Department of Health Research or through any agency.

Even six months after WHO’s recommendation to phase out type 2 from OPV and introduce IPV and use it along with OPV, what prevents the government from making a switch?

It will take time for a government to make a policy change and necessary program redirection. But things are moving now. However, there is another problem — high coverage with IPV requires a well performing EPI. Unfortunately, DPT coverage nationally for the third dose is stuck at 62 per cent. For IPV to be adequate we need at least 85 per cent coverage.

A WHO vaccinologist had gone on record stating that injectable vaccine is 10 times costlier than OPV. Your comments.

IPV is more expensive to produce, but the prices at which vaccines are sold are not the same as cost of production. OPV is purchased by the billions of doses and therefore it has to be much cheaper than IPV which was purchased only by rich countries and therefore companies did not have volume effect or competition to bring prices down. There were only two major IPV manufacturers. OPV has many more manufacturers.

Since the OPV programme costs about Rs.1,000 crores, will the cost of IPV not match that of OPV?

IPV has been promised at about $1 a dose by Serum Institute of India, if bulk ordered. In that case the price advantage is reversed!

How many injectable vaccine doses are needed and at what time periods to protect a child?

If first dose is given beyond the window of high maternal antibody, namely beyond eight weeks of age, and if second dose is given after an interval of eight weeks or more, just two doses will protect 100 per cent of children. Many countries follow a three-dose schedule. So perhaps a third dose could be planned — but no more are needed for very long-term protection.

For how long should OPV be given along with injectable vaccines before OPV is discontinued?

That needs careful assessment; no quick answer. But I can tell you that the main purpose of introducing IPV is for safely discontinuing OPV altogether.

But why should IPV be given along with OPV before the OPV programme is discontinued? Did every country that made a switch follow this protocol?

If OPV is withdrawn VDPV cases will increase. To pre-empt that we need to create an umbrella of immunity using IPV.

No, not all countries had to overlap both vaccines. Countries with very high (90 per cent or more) coverage simply switched over from OPV to IPV. Some countries use both vaccines in sequential schedule, as an interim tactic. Within this decade all countries will have to discontinue OPV.

Considering that fewer injectable vaccines are required, will the compliance not be superior to 15 OPV doses per year?

Not necessarily; OPV is being given in campaigns when we can get very high coverage. Where EPI is weak, campaigns can be very effective with high coverage like in India. So we have to ensure that EPI achieves high coverage in all States.
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Injectable Polio vaccine - R.Prasad, The Hindu
A 10-month-old baby in Beed district, Maharashtra who recently got infected by a vaccine-derived poliovirus (VDPV) type 2 is yet another reminder that despite India being declared polio free more than two years ago, children are getting infected with the polio virus. The only difference is that the virus in question is not the wild type but a vaccine-derived one.

As per the WHO definition, since only wild-type infections are taken into consideration for deciding the polio-free status of a country, the latest infection will not alter India’s polio status. But that technical difference offers little consolation to the victim and many other at-risk children.

“True polio eradiation is zero incidence of polio virus infection, by both wild and vaccine viruses. This new definition was universally accepted only last year,” said Dr. T. Jacob John, member of the WHO committee on global polio eradication.

The root cause of the problem is the use of live, weakened polio viruses in the oral polio vaccine (OPV) for inducing immunity against the wild-type virus. Although weakened, the viruses are still alive and can “quite often” undergo genetic changes (back-mutate) to cause neuro-virulence (polio). Hence the very vaccine that is supposed to protect children against polio causes the disease.

According to a 2000 paper in The Lancet , unlike in the case of the inactivated polio vaccine (IPV) given as injections, no trial was ever conducted on OPV before it was used in USSR and other east European countries.

Vaccine-associated paralytic polio (VAPP) is an adverse reaction to OPV and occurs when the live, attenuated viruses used in the vaccine, which are genetically prone to reversal, cause neurovirulence. The virus itself may not transmit to other children.

“There are only 15 per cent genetic differences between wild polio viruses and the weakened viruses used in oral polio vaccine,” said Dr. John. The weakened viruses in OPV are genetically highly unstable and have a tendency to drift back to the wild (back-mutate) and become neuro-virulent.

Aside from becoming neuro-virulent, the viruses can attain the capability of spreading causing polio in under-immunised, susceptible children, as in the current case.

“Therefore, vaccine-derived poliovirus is epidemiologically riskier [than VAPP] for the community,” he said. “These genetically reverted vaccine-derived viruses can silently spread and cause polio in children who are not sufficiently vaccinated.”

India had 21 VDPV polio cases in 2009, five in 2010 and seven in 2011 and one in 2012. But by more OPV campaigns, VDPV can be stopped; thus controlling VDPV is easier than in the case of the wild virus.

“Everybody knew about OPV’s neuro-virulence,” Dr. John said. “I picked up the transmissibility issue early, but nobody listened. In general, live, weakened viruses used in vaccines are supposed to be highly stable and non-transmissible. But OPV breaks both these rules.”

Worse, VDPV strains can silently circulate (cVDPV) for many months, even 1-2 years before showing up with polio cases,” notes a 2013 paper in the Indian Journal of Medical Research .

Hence the chances of the silently spreading cVDPV causing polio cases in children can be expected when OPV is discontinued.

The polio endgame is to introduce IPV and continue using oral vaccine and stop using OPV once India attains high levels of injectable vaccine coverage using IPV.
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TB Treatment in India - The Hindu
Even as the Union government rejected reports of shortage of tuberculosis drugs, saying fresh stocks will arrive by July-end, World Health Organisation (WHO) on Friday asked India to consider changing the regimen from intermittent to daily doses.

One of the challenges in anti-TB drugs procurement is that only a few manufacturers produce the particular regimen used by India’s programme, which is of intermittent schedule. “WHO currently recommends governments to consider changing the regimen from intermittent to daily,” WHO Representative to India Nata Menabde said in a statement issued here.

WHO understood there was no drugs stock-out for adult patients for both drug-sensitive and drug-resistant TB at present. However, there was a dip in the buffer stock of drugs. “We understand that the government has initiated steps to ensure replenishment. Also the stock of paediatric drugs, which is critically low, is being augmented through emergency procurement,” Dr. Menadbe said.

Health and Family Welfare Minister Ghulam Nabi Azad said, “At present there is no shortage. We always keep standby arrangements and we are providing medicines from that stock. Orders have been placed and within a month supplies will be made available to the States,” he said after inaugurating a private ward at the LRS Institute of Tuberculosis and Respiratory Diseases here.

He, however, acknowledged that despite socio-economic development and advances in medical science, tuberculosis still remained a major public health concern globally.

Drug resistance

Another challenge of great concern, Mr Azad said, was the growing resistance to drugs due to irregular and incomplete treatment with irrational regimens. “This is being dealt with through appropriate expansion of diagnostic and treatment services.”

However, WHO said that for patients who had started treatment, India’s programme provided one full course of drugs for each patient. This ensured that there was no interruption of treatment due to drug shortage. Hence, the fear that there could be interruption of treatment leading to development of drug resistance was unfounded. “It is reassuring to note that the Government of India has taken urgent action,” Dr. Menabde said.

India has one of the largest TB control programmes in the world with nearly 1.5 million patients placed under treatment every year. The treatment protocol ensures that the whole course of anti-TB drugs is given free of cost to patients with intense monitoring and other patient support systems.

Since inception, the Revised National TB Control Programme has evaluated over 55 million persons for TB and initiated treatment for over 15.8 million patients. There has never been any shortage of drugs in the programme due to a robust drug forecasting, procurement and distribution system

The programme ventured on a rapid scale-up for rolling out drug-resistant TB management services and by March 2013 this service was made available to the entire population of the country.
{Like anti-polio programme, the anti-TB programme is also something we have to be proud of}
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Rotary International, Gates Foundation to meet polio fund deficit - Aarti Dhar, The Hindu
This funding has nothing to do with India, but there is an interesting excerpt
India has gone over two successful years without a case of polio and the surveillance and monitoring report indicate another strong year for India to finally clinch the regional polio-free certification in 2014.

However, the danger of virus importation exists because of neighbouring polio endemic countries. The eradication effort in Pakistan has been sabotaged by radical groups who have killed some polio workers. The campaign, however, is struggling to get back on track there.

With the recent setbacks in the African countries and the conflict in Pakistan and Afghanistan, there are a lot of questions on whether the world can actually be polio free by 2018 as set by GPEI.
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