PM Modi taking credit for Ayushman Bharat, says Mamata, Bengal exits scheme

Alleging that the Centre is using the picture of Prime Minister Narendra Modi in the official communication of the flagship Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna to take credit for a jointly-funded project, Bengal chief minister Mamata Banerjee on Thursday announced that her government has decided to stop paying the state’s share.

States are supposed to bear 40% of the project cost, while the Centre will foot 60% of the bill.

Described as the world’s largest public health insurance, the Ayushman Bharat – National Health Protection Mission, launched on September 23, provides coverage of up to Rs 5 lakh for 10 crore poor families for secondary and tertiary care hospitalization.

The National Health Authority (NHA), the central body responsible for implementation of the scheme, have been trying to reach out to the West Bengal government but there has been no response.

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Odisha performance pushed down India’s malaria count for 2017: WHO

Odisha’s sterling performance in cutting down the number of malaria cases reported in 2017 helped make India, the only country among the top five nations reporting the disease, to register a decline in cases, according to a report published by the World Health Organization (WHO).

“The country (India) registered a 24 per cent reduction in cases (from 2016 to 2017), largely due to substantial declines of the disease in the highly malarious state of Odisha, home to approximately 40 per cent of all malaria cases in the country,” WHO said in a Q&A published on its website.

According to WHO, by 2017, India accounted for four percent of the global burden of malaria morbidity and 52 percent of deaths outside of the WHO African Region, despite “impressive gains”.

The report commends the Odisha government for its rigorous training to detect and treat malaria and also to prevent outbreaks. The global body states that as per government data, the number of malaria cases in the state (July-December) 2017 fell by nearly 50 percent to 156,000, compared to the same time period in 2016. Overall, India in WHO’s 2017 assessment period, reported three million fewer cases — a fall of 24 percent —from the previous year.

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Zika warning: India asks US health agency to ‘withdraw or modify’ travel advisory

India has asked the United States’ public health agency, the Centers for Disease Control and Prevention, to “withdraw or modify” an advisory it issued on December 13 warning people against travelling to Rajasthan due to an outbreak of the Zika virus,

The government took exception to the use of “endemic” in the advisory as Zika outbreaks in India have been contained within small areas.

The CDC had said the virus was endemic to India and pointed out “there is an unusual increase in the number of Zika cases in Rajasthan and surrounding states”. It cautioned pregnant women against travelling to such areas. This is because Zika infection during pregnancy can cause serious birth defects. The health agency classified its alert under Level 2, which requires “enhanced protection”. Level 1 advises “usual precautions” and Level 3 advises against “non-essential travel”.

What is Zika Virus?

Zika virus is similar to dengue fever, yellow fever and West Nile virus. Carried by infected Aedes aegypti mosquitos, Zika is largely transmitted through bites, but can also occur through intrauterine infection.

It was first identified in 1947 in Zika Forest, Uganda from where it derives its name.

If a woman is bitten by an infected mosquito and becomes infected, Zika can cross into the placenta and affect the fetus. While anyone can contract Zika, pregnant women are the most at risk due to the potential for fetal microcephaly and other neurologic abnormalities.

Symptoms include fever, headache, red eyes, skin rash, fatigue, muscle pain etc.

Treatment and Prevention: There is no specific treatment or vaccine currently available to treat Zika. The best form of prevention is protection against mosquito bites and clearing stagnant water where mosquitoes breed.

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Cabinet approves setting up of the National Commission for Homoeopathy (NCH) Bill, 2018

The Union Cabinet chaired by Prime Minister Shri Narendra Modi has approved the draft National Commission for Homoeopathy, Bill, 2018, which seeks to replace the existing regulator Central Council for Homoeopathy (CCH) with a new body to ensure transparency.

The draft bill provides for the constitution of a National Commission with three autonomous boards entrusted with conducting overall education of Homoeopathy by Homoeopathy Education Board. The Board of assessment and rating to assess and grant permission to educational institutions of Homoeopathy and Board of ethics and registration of practitioners of Homoeopathy to maintain National Register and ethical issues relating to practice are under the National Commission for homoeopathy.

It also proposes a common entrance exam and an exit exam which all graduates will have to clear to get practicing licenses. Further, a teacher’s eligibility test has been proposed to assess the standard of teachers before appointment and promotions.

It further aims at bringing reforms in the medical education of Homoeopathy in lines with the National Medical Commission proposed for setting up for Allopathy system of medicine. The CCH had been earlier superseded by Board of Governors through an Ordinance and subsequent amendment of Act.

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CDSCO issues safety guidelines for Isotretinoin

The Central Drugs Standard Control Organisation (CDSCO) has issued safety guidelines for Isotretinoin, an oral drug, which is used in the treatment of severe acne.

Drug Controller General Dr S. Eswara Reddy has now directed Drug Controllers of all the States and Union Territories to monitor the sale, manufacture and distribution of Isotretinoin, which can cause birth defects in progeny if not taken without proper guidance. The directions have been given after taking recommendations from the Subject Experts Committee (SEC) with CDSCO.

Isotretinoin is an oral drug, which is used in the treatment of severe acne. Isotretinoin capsules of 10 mg/20 mg were approved by CDSCO in 2002 for the treatment of cystic and conglobate acne, and severe nodular acne unresponsive to antibiotic therapy.

It was later found that Isotretinoin can cause birth defects in progeny if not taken without proper guidance.

About CDSCO:

The Central Drugs Standard Control Organisation (CDSCO) under Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India is the National Regulatory Authority (NRA) of India.

Under the Drugs and Cosmetics Act, CDSCO is responsible for approval of New Drugs, Conduct of Clinical Trials, laying down the standards for Drugs, control over the quality of imported Drugs in the country and coordination of the activities of State Drug Control Organizations by providing expert advice with a view to bringing about the uniformity in the enforcement of the Drugs and Cosmetics Act.

CDSCO along with state regulators is jointly responsible for grant of licenses of certain specialized categories of critical Drugs such as blood and blood products, I. V. Fluids, Vaccine and Sera.

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National Medical Devices Promotion Council to be set up under DIPP

To give a fillip to the medical device sector, which is a sunrise sector, Union Minister of Commerce and Industry and Civil Aviation, Suresh Prabhu, announced setting up of a National Medical Devices Promotion Council under the Department of Industrial Policy and Promotion (DIPP) in the Ministry of Commerce & Industry.

The Medical Devices Industry (MDI) plays a critical role in the healthcare ecosystem and is indispensable to achieve the goal of health for all citizens of the country. The manufacturing and trade in MDI are growing steadily which includes a wide range of products. Although the industry has been growing in double digits but is predominantly import-driven with imports accounting for over 65% of the domestic market.

The announcement was made on the occasion of 4th WHO Global Forum on Medical Devices at Andhra Pradesh Medtech Zone in Vishakhapatnam.

National Medical Devices Promotion Council:

The Council will be headed by Secretary of the Department of Industrial Policy and Promotion (DIPP).

Apart from the concerned departments of Government, it will also have representatives from the health care industry and quality control institutions.

The Andhra Pradesh MedTech Zone of Visakhapatnam will provide technical support to the Council.

The Prime objectives of the National Medical Devices Promotion Council are:

Act as a facilitating, promotional & developmental body for the Indian Medical Devices Industry (MDI).

Render technical assistance to the agencies and departments concerned to simplify the approval processes for MDI promotion and development.

Enable entry of emerging interventions and support certifications for manufacturers to reach levels of global trade norms and lead India to an export-driven market in the sector.

Support dissemination and documentation of international norms and standards for medical devices by capturing the best practices in the global market.

Facilitate domestic manufacturers to rise to the international level of understanding of regulatory and non-regulatory needs of the industry.

Drive a robust and dynamic Preferential Market Access (PMA) policy by identifying the strengths of the Indian manufacturers and discouraging unfair trade practices in imports

Ensure pro-active monitoring of public procurement notices across India to ensure compliance with PMA guidelines of DIPP and DoP.

Undertake validation of Limited Liability Partnerships (LLPs) and other such entities within the MDI sector, which add value to the industry strength in manufacturing to gain a foothold for new entrants.

Make recommendations to government based on industry feedback and global practices on policy and process interventions to strengthen the medical technology sector.

The Medical Devices Industry (MDI) plays a critical role in the healthcare ecosystem and is crucial to achieving the goal of health for all citizens of the country.  The manufacturing and trade in MDI are growing steadily in double digits. However, it is largely import-driven with imports accounting for over 65 per cent of the domestic market.

The setting-up of the Council will spur domestic manufacturing in this sector as Indian companies and startups have started moving towards creating innovative products.

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Medical Devices Promotion Council to be set up, says Suresh Prabhu

To give a fillip to the medical device sector, which is a sunrise sector, Union Minister of Commerce and Industry and Civil Aviation Suresh Prabhu announced the setting up of a National Medical Devices Promotion Council under the Department of Industrial Policy and Promotion (DIPP).

Describing the industry as a futuristic industry, he said there was scope for many innovations. He praised the AP Government for setting up the park with modern labs and other facilities on a single campus. More such parks should come up in the country and his Ministry would extend support to AP Medtech and the efforts of the AP Government, he said

He also pledged logistical support to medical devices manufacturing companies. He thanked the WHO for holding the Global Forum for Medical Devices here.

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Government notifies four commonly used medical devices as drugs

The Union Government has notified four commonly used medical devices including nebulisers, blood pressure monitors, digital thermometers and glucometers as drugs under the Drugs and Cosmetics Act.

The decision will enable the government to ensure their quality and performance. The Drug Controller General of India (DCGI) will regulate the import, manufacture and sale of these devices from January 2020.

Key Highlights

The DTAB, the country’s highest drug advisory body, had approved the proposal to include the four medical devices under the purview of the Drug law.

All these devices will have to be registered under the quality parameters prescribed under Medical Devices Rules 2017 and other standards set by the Bureau of Indian Standard (BIS) certification.

Till recently, only 23 medical devices were monitored for quality by the nation’s drug regulator.

With the addition of these four new devices,  the number of medical devices that will now fall under the definition of drugs under the Drugs and Cosmetics Act add up to 27.

The other medical equipments are sold without any quality checks or clinical trials.

Background

The Union Ministry of Health had through a notification dated December 3, specified devices intended for use in humans for internal or external use in the diagnosis, treatment, mitigation or prevention of disease or disorder in human beings or animals, to be included in the definition of drug under the Drugs and Cosmetics Act, 1940, to be effective from January 1, 2020.

The ministry had proposed expanding the list of devices in eight new categories, under the definition of ‘drugs’ to bring them under the purview of the Drugs and Cosmetics Act, 1940.

The eight categories included implantable medical devices, MRI equipment, CT scan equipment, defibrillators, dialysis machines, PET equipment, X-ray machines and bone marrow cell separator.

The proposal to bring high-end medical devices like implants, X-ray machines , MRI and CT scan equipment, dialysis machines under the purview of the drug law is under consideration.

Once the proposal gets the required approval, the companies engaged in manufacture and import of these equipment will have to seek necessary permission or license from the Drug Controller General of India.

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Stunted, wasted: on Global Nutrition Report 2018

The health, longevity and well-being of Indians has improved since Independence, and the high levels of economic growth over the past two-and-half-decades have made more funds available to spend on the social sector. Yet, the reality is that a third of the world’s stunted children under five — an estimated 46.6 million who have low height for age — live in India.

A quarter of the children display wasting (that is, low weight for height) as well. As the Global Nutrition Report 2018 points out, this finding masks the wide variation in stunting levels in different parts of the country. District-level data show high and very high levels of stunting mainly in central and northern India (more than 30% and 40%, respectively), but less than 20% in almost the entire south. This shows the important role played by political commitment, administrative efficiency, literacy and women’s empowerment in ensuring children’s health. Food and freedom go together, and the availability of one strongly influences access to the other; social institutions can work to improve nutrition and children’s welfare in free societies, and the absence of hunger enables people to develop their capabilities. Governments should acknowledge the linkages and commit themselves to improved nutritional policies. The national framework to improve nutrition already exists. The Anganwadi Services scheme, which incorporates the Integrated Child Development Services, caters to children up to age six, and to pregnant and lactating women. If it has not worked well in several States, it must be subjected to a rigorous review and targeted interventions for supplementary nutrition made.

Among the factors affecting the quantity and quality of nutrition are maternal education, age at marriage, antenatal care, children’s diet and household size. Now that mapping of malnutrition at the district level is available, as in the Global Nutrition Report, it is incumbent on State governments to address these determining factors.

A second issue is that of the quality of nutrition in packaged foods available to children. Going by the report, only 21% of these foods in India were rated as being healthy, based on overall energy, salt, sugar and saturated fat on the negative side, and vegetable, fruit, protein, fibre and calcium as positive factors. The fact that the global average of processed foods scored only 31% and a peak of 37% in New Zealand indicates that whole foods and cooked meals emerge superior.

India should invest more of its economic prosperity in its welfare system, without binding itself in restrictive budgetary formulations. The Economic Survey 2017-18 put social services spending at 6.6% of GDP, an insignificant rise after a marginal decline from the 6% band during the previous year to 5.8%. The latest report on stunting and wasting should convince the Centre that it needs to understand the problem better and work with the States to give India’s children a healthy future.

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Every third child is malnourished, finds Global Nutrition Report 2018

We may be in the United Nations Decade of Nutrition but every country is affected by malnutrition, highlights the Global Nutrition Report 2018 released Thursday. About a third of the world’s children suffer some form of malnutrition.

According to the report, we have never been better equipped to fight malnutrition, yet the current burden is “unacceptably high”. Of 141 countries, 41 (28 per cent) are affected by all three forms of malnutrition—stunting among children, anaemia and obesity among women. A whopping 124 countries (88 per cent) suffers from at least two forms.

The Global Nutrition Report was conceived following the first Nutrition for Growth Initiative Summit (N4G) in 2013 as a mechanism for tracking the commitments made by 100 stakeholders spanning governments, aid donors, civil society, the UN and businesses.

Highlights of the report:

Global burden of malnutrition “remains unacceptably high and progress unacceptably slow”. Under-nutrition accounts for around 45% of deaths among children under five in low- and middle-income countries.

Overweight and obesity has led to around 4 million deaths and 120 million healthy years of life lost across the globe, with around 38.9% adults found to be overweight.

Among children under five years of age, 150.8 million are stunted, 50.5 million are wasted and 38.3 million are overweight; while 20 million babies are born underweight each year, it says.

The impact of malnutrition on global economy is close to US$3.5 trillion per year, with obesity alone costing US$500 billion per year.

A major section of the study looks at the quality, nutrient content and type of food consumed across the globe. The results suggest a disparity between developed and emerging markets, says the report.

The report says that regardless of wealth, school-age children, adolescents and adults are consuming too many refined grains, sugary foods and drinks, and not enough fruits, vegetables and whole grains.

India holds almost a third (31%) of the global burden for stunting, the prevalence of which differs from state to state. As per the UNICEF, stunting, or low height for age, is caused by long-term insufficient nutrient intake and frequent infections.

Stunting varies greatly from district to district (12.4% to 65.1%), with 239 of 604 districts accounting for stunting levels above 40%. The differences between districts were a result of multiple factors, including gender, education, economic status, health, hygiene, and other demographic factors.

India is the country with the largest number of children who are stunted at 46.6 million, followed by Nigeria (13.9 million) and Pakistan (10.7 million). The urban prevalence of stunting on average 19.2% compared with 26.8% in rural areas.

While wasting, or low weight for height, affects a greater proportion of rural children than urban. India again tops the list with the most number of wasted children at 25.5 million, followed by Nigeria (3.4 million) and Indonesia (3.3 million).

India is also among the countries with more than a million children who are overweight. As part of the report, a case study in Rajasthan found that key areas of infant and young child feeding and micronutrient supplementation were underfunded.

Way ahead- need of the hour- suggestions by the report:

·         Break down silos between malnutrition in all its forms.

·         Prioritise and invest in the data needed and capacity to use it.

·         Scale up financing for nutrition – diversify and innovate to build on past progress.

·         Galvanise action on healthy diets – engage across countries to address this universal problem.

·         Make and deliver better commitments to end malnutrition in all its forms – an ambitious, transformative approach will be required to meet global nutrition targets.

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