Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Understand the two types of the disease and what you can do to mitigate the effects

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

What is Palliative Care?

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Palliative Care

Mains level : Psychosocial impacts of the covid-19 pandemic

The newscard talks about palliative healthcare which may help when the world is reeling under this most unexpected and unprecedented pandemic, COVID-19.

Palliative Care is a promising approach to counter the psychosocial impacts of the COVID-19 outbreak. We can use this as an example to quantify the measures required to improve mental healthcare infrastructure in India.

Social sufferings caused by the pandemic

  • COVID-19, because of its unique nature and magnitude has brought in its wake, not only physical illness but more of emotional and social suffering.
  • These include- fear, anxiety, uncertainty, loss of loved ones and social distress such as losing jobs and income, inability to move freely to work and other places, frustrations, staying long hours at home and other hardships, all leading to psychological disturbances for many.

What is Palliative Care?

  • The literal meaning of the word ‘palliate’ is ‘to alleviate pain — physical and emotional’, meaning, relief of suffering. ‘Suffering’ literally means ‘the state of undergoing pain, distress, or hardship’.
  • It is an approach that improves the quality of life of patients and their families facing the problem associated with a life-threatening illness.
  • It involves prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
  • It is part and parcel of treatment for any patient for any disease at any stage, for any age. It is simply a ‘whole person’ approach to improving health in any patient.

A promising remedy

  • ‘Palliative Medicine’ is a medical speciality, which involves the treatment of pain, breathing difficulty and other distressing physical symptoms caused by chronic and life-limiting diseases.
  • It also addresses the psychological issues of both patient and family, with the sole aim of improving the quality of life. It is most beneficial when started early in the disease trajectory.
  • It is also a form of supportive care, giving that extra layer of support a patient needs, to alleviate suffering, alongside disease treatment even in acute illness.
  • In the present scenario, in addition to what physicians are toiling with to cure patients, and the government and health care policies and strategies, palliative care can play a supportive role.

Supportive role

  • Distressing physical symptoms like pain, breathing difficulty, restlessness (delirium) and others can be well relieved or palliated with medicines in consultation with the specialists.
  • Similarly, skilled counselling is an integral part of the palliative approach.
  • It helps address the psychological, social and spiritual issues, which both patient and family are experiencing in the present scenario.
  • There is a way of responding to their fears, anxieties and to questions. They rarely need antidepressants when we acknowledge their emotions as normal.

Conclusion

  • Active listening is by far the most important part of counselling.
  • This care can be availed of from psychologists, specialists in palliative medicine, as well as those from medical organisations who have the expertise and willingness to render their services.
  • Hence, Palliative care is the reinstatement of the humane aspects of medical care and is complementary to all medical specialities, a common thread running through the total care of all patients.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

The law cannot fall silent

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2-In fight against covid-19 epidemic we must follow the principles of international laws and treaty obligations.

Context

Amid the many developments in the wake of Covid-19 pandemic one of the facets that is also discussed is-How to read international law in the context of the pointers to the future?

Constitutional duty regarding international laws

  • Respect for the norms and standards of international law is among the paramount constitutional duties of the state under Article 51 of the Constitution.
  • The duty is regardless of the quibbles on whether the language here refers only to treaty/obligations or also to customary international law.
  • International norms remain relevant: Despite US President Donald Trump’s recent threat of actions against the WHO, international norms, standards, and doctrines remain relevant to making national policy and law.

Possibility of discussion over pandemic at UNSC

  • The difference between the United Nations as a site of normative discursivity and as a site of doing global power politics is sadly manifest even now in the accelerated pace of the pandemic.
  • Discussion extremely unlikely: President Trump’s insistence on calling it a “Chinese virus” renders it extremely unlikely that the pandemic will be discussed during the current monthly presidency of the UN Security Council by China.
  • Possibility of veto: The threat of veto by China and Russia will always loom large whenever the matter is placed for discussion.

Role of the UN in the codification of law

  • The UN is also a site of systems of norm enunciation.
  • Along with the International Law Commission, it is responsible for the progressive codification of law.
  • The UN system has developed lawmaking and framework treaties as well as provided auspices for systems of “soft” law that may eventually become the binding law.
  • There are three types of international laws which are described below.

1. The fundamental overriding principle of international laws

  • Jus cogens: Some of the norms of international law are robust and deeply relevant. For example, the peremptory jus cogens — a few fundamental, overriding principles of international law such as crimes against humanity, genocide, and human trafficking apply to all states.
  • And Article 53 of the Vienna Convention on the Law of Treaties goes so far as to declare that a “treaty is void if, at the time of its conclusion, it conflicts with a peremptory norm of general international law”.
  • And even when ingredients of genocide remain difficult to prove, the International Court of Justice (ICJ) has held, in 2007, that states have a duty to prevent and punish acts and omissions that eventually furnish elements for the commission of crime of genocide.
  • Erga omnes: There also exist erga omnes rules prescribing specifically-determined obligations which states owe to the international community as a whole.
  • This was enunciated by the ICJ in 1970 for four situations — the outlawing of acts of aggression; the outlawing of genocide; protection from slavery; and protection from racial discrimination.
  • A great significance of this judicial dictum is that it lays down obligations which transcend consensual relations among states.
  • In addition, there are three other sets of international law obligations.
  • These are primarily derived from the no-harm principles crystallised in the International Law Commission’s 2001 Draft Articles on the Prevention of Transboundary Harm (DAPTH) and the Paris Framework Agreement on Climate Change, 2015.
  • The DAPTH has carefully developed norms of due diligence, stressing all the way that these may be adapted to contextual exigencies.
  • But due diligence obligations certainly extend beyond local and national boundaries, especially because the environmental problems have a transboundary impact.
  • Each state is obliged to observe these standards in the fight against COVID-19 as a matter of international law.

2. International laws dealing with core human right measures

  • No law or policy to combat epidemics or pandemic can go against the rights of migrant workers, internally displaced peoples, and refugees and asylum seekers.
  • Respect for the inherent dignity of individuals in combating COVID-19 and for the rights of equal health for all, non-discrimination, and the norms of human dignity further reinforce accountability and the transparency of state and other social actors.
  • Panicky and sadist policing, including shoot-a- sight orders in collective exodus situations, and militaristic responses to food riots de-justify health lockouts and curfews.

3. International humanitarian law

  • The third set of obligations arises out of international humanitarian law. The Biological and Toxin Weapons Convention (BTWC) is pertinent here.
  • India did not subscribe to any conspiracy or racist theory about the origins of COVID-19 — in fact, India’s foreign minister rightly affirmed the BTWC obligations on March 26 (on the 40th anniversary of that Convention).
  • Surely, this global and non-discriminatory disarmament convention deserves applause because it outlaws a whole range of weapons of mass destruction.
  • India has, and rightly so, called for “high priority” to “full and effective implementation by all states parties”.

Conclusion

The starting point of a determined fight against COVID-19 has to be a full-throated repudiation of an ancient Latin maxim, inter arma enim silent leges (in times of war, the law falls silent). Combating this fearsome pandemic calls for re-dedication to nested international law obligations and frameworks.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

It’s time for the Red Berets

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- Formation of special UN force to deal with the COVID-19 pandemic.

Context

The World Health Organisation (WHO) is not equipped to fight a pandemic of this proportion. The world needs a special UN force to fight COVID-19.

Limits of WHO in the fight against COVID-19

  • The World Health Organisation (WHO) is not equipped to fight a pandemic of this proportion.
  • Its responsibility is to monitor threats to public health and inform and advise the member states. The fight against COVID-19 has to be on a war footing.
  • The need for the composite force: For this we need a composite force that has the capabilities of massive sanitisation, testing, hospitalisation and providing support systems.
  • Signs of conflict: Even the most powerful nations are not able to cope with the effort and there are signs of conflict on account of shortages of equipment and trained personnel.
  • The only UN body which has the training for assembling fighting forces for emergencies is the Department of Peace Operations.

Pandemic as a threat to international peace and security

  • Contentions over pandemic: The UN Security Council (UNSC) stands paralysed because of petty battles on the name of the pandemic, its origin and the need for transparency.
  • It should hold an emergency meeting and authorise the UN Secretary-General to put together a force under Chapter VII of the UN Charter.
  • Interpreting the mandate: The mandate of the Charter should be interpreted to emphasise that this is the greatest threat to international peace and security.
  • Possibility of conflict: Moreover, conflicts are possible on account of the fragility of the international system.
  • Member states should be requested to send not only troops but also police, health workers and equipment.
  • Deploying the peace force: In war situations, the Secretary-General is able to put together a force in about four months. This operation requires greater emergency.
  • There is some delicacy about deploying the army internally in different political systems, but UN forces have been acceptable in most countries.
  • Who should bear the cost? As for the cost, the responsibility for the deployment of forces for peacekeeping, peace-building and peace enforcement is that of the permanent members.
  • Instead of competing with each other for leadership of the post-COVID-19 world, let them help create a post-COVID-19 world.
  • Fear of devastation in the poor countries: So far COVID-19 has spread in relatively prosperous regions of the world, which have stable infrastructure and health systems.
  • We cannot trust that it will not spread to less equipped states, in which the devastation will be much more.
  • Only a UN force which can enforce social distancing and lockdowns can prevent a catastrophe.

Resolution under Chapter VII

  • In which situation it is used: Most Chapter VII resolutions determine the existence of a threat to the peace, a breach of the peace, or an act of aggression in accordance with Article 39, and make a decision explicitly under Chapter VII.
  • A UNSC Resolution is considered to be ‘a Chapter VII resolution’ if it makes an explicit determination that the situation under consideration constitutes a threat to the peace, a breach of the peace, or an act of aggression, and/or explicitly/ implicitly states that the UNSC is acting under Chapter VII in the adoption of some or all operative paragraphs.
  • Chapter VII resolutions are very rarely isolated measures.
  • Often the first response to a crisis is a resolution demanding the crisis be ended. This is later followed by an actual resolution detailing the measures required to secure compliance with the first resolution.
  • Sometimes dozens of resolutions are passed over time to modify and extend the mandate of the first Chapter VII resolution.
  • The UN stands discredited today as the UNSC has not been able to meet.
  • It may take place, now that China has vacated the Security Council chair and Dominican Republic has taken over.
  • Several resolutions are in circulation, but none under Chapter VII.

Way forward

  • The first step will be to pass a resolution to take action to end the crisis and authorise the Secretary-General to request member states to make personnel available.
  • Meanwhile, another resolution must spell out the modalities of the operation.
  • Red berets: The UN peacekeeping forces are called Blue Berets because of the colour of the caps that they wear. The health force can have caps of another colour, probably red. The launch of the Red Berets will be a historic action to be taken at a critical moment.

Conclusion

This is the right time for the UN to act for the collective action against the pandemic which in turn help in establishing the UN’s relevance.

 

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

The spectre of a post-COVID-19 world

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- What are the possibilities that could be brought in the world by the epidemic.

Context

As COVID-19 spreads exponentially across the world, profound uncertainty and extreme volatility are wreaking havoc of a kind seldom encountered previously. It might, hence, be wise to start thinking of what next, if at least to try and handle a situation created by the most serious pandemic in recent centuries.

China’s important role

  • No previous experience: The problem with the novel coronavirus is that with the exception of China, which battled another coronavirus epidemic in 2003 — SARS epidemic — there is little available for most nations on which to base their assessment of what next.
  • Further drop in China’s growth rate: What is known is that China’s growth rate has further plummeted, even as it was confronting an economic slowdown which had been in the works for some time.
  • Economic downturn internationally: The consequences for the global economy of China ceasing to be the world’s biggest exporter of manufactured goods are considerable.
  • And with no country in a position to replace it, this development will precipitate a further economic downturn internationally.

Uncertainties before epidemic

  • The COVID-19 pandemic could not have come at a more difficult time.
  • Uncertain economic environment: The world was already having to contend with an uncertain economic environment, with industries in turn facing newer challenges such as having to adjust to a shift from cost efficiencies to innovation and breakthrough improvements.
  • Added to this were: a global slowdown, increasing political and policy uncertainties, alterations in social behaviour, new environmental norms, etc.
  • India’s position: Newly emerging economies, such as India, were even more affected by all this, than some of the older established ones.

Impact on India and what lies ahead?

  • Estimate of cost by ADB: An early estimate by the Asian Development Bank, soon after the epidemic was declared, was that it would cost the Indian economy $29.9 billion.
  • A recent industry estimate pegs the cost of the lockdown at around $120 billion or 4% of India’s GDP.
  • May require six months to recover after epidemic: The Confederation of Indian Industry (CII) had at one point warned that the COVID-19 impact, and the existing stress in the financial sector, meant that India would require up to six months even after the entire course of the COVID-19 epidemic is over to restore normalcy and business continuity.
  • The COVID-19 Taskforce under the Finance Minister come up with measures to mitigate the economic hardship engendered by the pandemic, and finally a three-week-long lockdown.
  • Several precautionary measures based on guidelines in vogue elsewhere in the world for preventing pandemics of this kind, have also been introduced including ‘home isolation’, ‘home quarantine’, etc.
  • The prognosis as to what lies ahead is indeed bleak.
  • On the economic plane, according to most experts, a global recession seems inevitable.
  • The decline in demand: Uncertainty, panic and lockdown policies are expected to cause demand worldwide to decline in a precipitous way.
  • Start of downward cycle: Decline in demand will inevitably lead to a vicious downward cycle, where companies close down, resulting in more lay-offs and a further drop in consumption.
  • A precipitous decline in GDP would follow.
  • Massive funds would be needed: To compensate for this loss, massive inflows of government funds would be needed, but most governments, India included, might find it difficult to find adequate resources for this purpose.
  • Right time for fund: Equally important, if not more so, is that such massive inflows of funds (if they are to be effective) should be here and now, and not later, by which time the situation may well have spiralled out of control. Global coordination was a must in the extant situation.

Disruption in the global order- Implications for the position of the US

  • COVID-19 is, in turn, expected to bring about major changes in the global order.
  • Changes would get accelerated: Some of these changes have, no doubt, been in the making for some time, but would get accelerated.
  • As of now, though the U.S. is no longer the global power that it once was, it is hardly in retreat.
  • Retreat from Afghanistan, not the end: The US is, without doubt, increasingly disinclined to act as the world’s gendarme, as instanced by its retreat from Afghanistan after a dubious accord with the Afghan Taliban,
  • But this was not the end of the road as far as U.S. power was concerned.
  • The US would step back further: Post COVID-19, however, and given that the U.S. is among the countries badly affected by this pandemic, together with existing uncertainties affecting its financial markets, the U.S. can be expected to step back even further — from one of assertion to neutrality in global affairs.
  • Already, U.S. command of the global commons has weakened. Meantime, China and Russia have strengthened their relationship and improved their asymmetric capabilities.
  • US not the largest economy by PPP: The challenge from China is becoming more obvious by the day — measured by purchasing power parity, the S. is not the largest economy in the world as of now.
  • Russian challenge: Even more daunting from a U.S. standpoint, and also representing a sea-change from the recent past, Russia has become far more economically and politically stable and an important power broker in West Asia.
  • Impact on liberal international order: These shifts cannot but, and are likely to, have a direct impact on the liberal international order. It could, in turn, give a boost to authoritarian regimes and authoritarian trends.

Impact on social behaviour

  • Moving away from the political and economic consequences of COVID-19 are other concerns arising from an extended lockdown, social distancing and isolation.
  • The epidemic of despair: Psychologists are even talking of an ‘epidemic of despair’ arising from a fear of unknown causes, resulting in serious anxiety and mental problems.
  • Problems due to extended isolation: Extended isolation, according to psychologists, can trigger a different kind of pandemic even leading to possible suicidal tendencies, fits of anger, depression, alcoholism and eccentric behavioural patterns.

Inequality and impact

  • The impact is not the same for all: Another fallout from the current epidemic might well be the extent to which inequality in incomes impact segments of the population, facing a common malaise.
  • Countries lacking a comprehensive nation-wide health system would find this an even more difficult situation to handle.
  • Meantime, as the economy weakens, accompanied by job losses, those without high levels of skills would fall further behind.
  • This is evident to some extent already given recent reports of mass migration across the Indian landmass.
  • Out of work migrant labour, unable to find new jobs since they lack the necessary skills, are attempting to return to their normal habitat, bringing in their wake untold suffering and, perhaps even the spread of the virus.
  • This has all the makings of a huge human tragedy. Existing curbs on their movement would further exacerbate the problem, and could even lead to a major law and order situation.

Possibility of the rise of digital authoritarianism

  • One possible, and unexpected, aspect of the COVID-19 epidemic could be the thrust it could provide to ‘digital authoritarianism’.
  • China’s authoritarian methods seem to have helped it to contain the spread of the virus — at least for the time being.
  • Somewhat similar tactics are being employed by some other countries as well.
  • In turn, leaders across many nations may find China’s methods, and the embracing of technology to refashion authoritarianism for the modern age irresistible, and a standard to be adapted, even if they profess to be democratic.
  • The rise of digital autocracies could lead to digital repression, and in the age of AI-powered surveillance, create a capacity for predictive control, or what is often referred to as ‘social management’.

Conclusion

The pandemic even after it’s over could change the world in more than one ways and we must be cautious in our approach in accepting or rejecting these changes brought about by the epidemic.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Making the private sector care for public health

Note4Students

From UPSC perspective, the following things are important :

Mains level : Paper 2- Government should consider taking control of the private healthcare sector to deal with the Covid-19 outbreak.

Context

As India enters the second week of a national lockdown imposed in response to COVID-19, it is still unclear how well prepared the healthcare system is in dealing with the pandemic.

Need for roping in the private healthcare

  • No indication of an increase in expenditure on health: A preparedness plan has to address all levels of care in terms of infrastructure, equipment, testing facilities and human resources in both the public and private sectors.
  • However, so far, the Central and State governments have given little indication of bringing an increase in public expenditure on health.
  • So, an already overburdened public health system will be unable to meet the increase in moderate and severe cases of COVID-19 that would require hospitalisation.
  • Need for the comprehensive national policy: While some individual private sector companies have come forward with offers of creating capacity and making it available to COVID-19 patients, there is a need for a comprehensive national policy to ensure that private healthcare capacity is made available to the public.
  • Some states like Chhattisgarh, Rajasthan, Madhya Pradesh and Andhra Pradesh have already roped in the private sector to provide free treatment.

What the government should do?       

  • Provide universal health service: The governments at the Centre and in States have to take responsibility for providing universal health services free of charge and accessible to all.
  • Tap into private sector capacity: This will require governments to not just expand the capacity within the public sector, but also to tap into the available capacity in the private sector.
  • Faced with a serious health emergency, the silence of the government on the expected role of the private sector is intriguing.
  • Include COVID-19 testing in PM-JAY: The National Health Authority has recommended that the testing and treatment of COVID-19 be included in the PM-Jan Arogya Yojana (PM-JAY) but this proposal is still awaiting clearance.
  • Form the central command: The governance of the health service system is clearly fragmented and has created anxiety among the public.
  • There is a lack of a visible central command, which should be created under the supervision of the Union Health Minister, aided by a team of experts.
  • They should be tasked to make policies as and when required and communicate them to State governments, taking into account an evolving situation.
  • Ensure that there is no cost to the patient: There have been some tentative measures taken by States to allow individuals seeking testing for COVID-19 to access private laboratories at subsidised rates.
  • At present, the government has put a cap on the cost at ₹4,500 per test, which is a burden for even a middle-class patient.
  • The poor will clearly have no access to this and the government itself does not have adequate facilities to meet the increasing demand. It is here that the government needs to ensure that there is no cost to the patient.
  • Create adequate testing facilities: At this point, and certainly, before the lockdown is lifted, it is absolutely essential that adequate testing and quarantine facilities are created.
  • The Central government has already taken over some private hotels to accommodate persons quarantined for COVID-19.
  • One way of expanding such facilities would be for the government to ‘take over’ private corporate laboratories and hospitals for a limited period.
  • Standard treatment protocol: The political directive for such a move needs to come from the Central government while ensuring that the Ministry of Health provides standard treatment protocols for health personnel.

Learning lessons from Spanish and British experience

  • The Spanish government issued an order bringing hospitals in the large private corporate sector under public control for a limited period.
  • This tough decision was taken with the understanding that existing public healthcare facilities would not be able to cope with the sudden, if short-term, rise in COVID-19 cases.
  • British trade unions have demanded that the government make the 8,000 beds in 570 private hospitals in the country available.
  • They have argued that while beds in private hospitals are lying empty, there is a severe shortage of beds in public hospitals.
  • The unions have also been critical of the U.K. government decision to rent these beds at an exorbitant cost to the exchequer.

Way forward

  • Rope in the private healthcare sector: In India, private corporate hospitals have, in the past, received government subsidies in various forms and it is now time to seek repayment from them.
  • They are also well poised to provide specialised care and have the expertise and infrastructure to do so.
  • Bring in the universal public healthcare: Universal public healthcare is essential not only to curb outbreaks but also to ensure crisis preparedness and the realisation of the promise of the right to health.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

A pandemic in an unequal India

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- How lockdown affects the poor disproportionately and what the state must do mitigate the impact.

Context

The official strategies to deal with the virus place the responsibility on citizens, a majority without privilege, to fight the virus.

The poor disproportionately affected

  • If the COVID-19 pandemic lashes India with severity, it will not be just the middle class who will be affected.
  • India’s impoverished millions are likely to overwhelmingly bear the brunt of the suffering which will ensue.
  • Inequality and impact of a pandemic: The privileged Indian has been comfortable for too long with some of the most unconscionable inequalities in the planet.
  • But with the pandemic, each of these fractures can decimate the survival probabilities and fragile livelihoods of the poor.

Inadequate capacity of the health system  

  • Low investment in public health: India’s investments in public health are among the lowest in the world, and most cities lack any kind of public primary health services.
  • A Jan Swasthya Abhiyan estimate is that a district hospital serving a population of two million may have to serve 20,000 patients, but they are bereft of the beds, personnel and resources to do this. Few have a single ventilator.
  • The poor left with meagre services: India’s rich and middle-classes have opted out of public health completely, leaving the poor with unconscionably meagre services.
  • The irony is that a pandemic has been brought into India by people who can afford plane tickets, but while they will buy private health services, the virus will devastate the poor who they infect and who have little access to health care.

No planning and preparation by the state

  • Official strategies placing responsibility on citizens: Most of the official strategies place the responsibility on the citizen, rather than the state, to fight the pandemic.
  • No preparation by the states: The state did too little in the months it got before the pandemic reached India for expanding greatly its health infrastructure for testing and treatment.
  • This includes planning operations for food and work; security for the poor; for safe transportation of the poor to their homes; and for special protection for the aged, the disabled, children without care and the destitute.

What must be done?

  • 25 day’s minimum wage: For two months, every household in the informal economy, rural and urban, should be given the equivalent of 25 days’ minimum wages a month until the lockdown continues, and for two months beyond this.
  • Pensions must be doubled and home-delivered in cash.
  • There should be free water tankers supplying water in slum shanties throughout the working days.
  • Double the PDS entitlement: Governments must double PDS entitlements, which includes protein-rich pulses, and distribute these free at doorsteps.
  • Provide cooked and packed food: In addition, for homeless children and adults, and single migrants, it is urgent to supply cooked food to all who seek it, and to deliver packed food to the aged and the disabled in their homes using the services of community youth volunteers.
  • Ensure prisons are safe: To ensure jails are safer, all prison undertrial prisoners, except those charged with the gravest crimes, should be released.
  • Likewise, all those convicted for petty crimes. All residents of beggars’ homes, women’s rescue centres and detention centres should be freed forthwith.

Way forward

  • Commit 3% of GDP on health: India must immediately commit 3% of its GDP for public spending on health services, with the focus on free and universal primary and secondary health care.
  • Nationalise private healthcare: Since the need is immediate, authorities should follow the example of Spain and New Zealand and nationalise private health care.
  • An ordinance should be passed immediately that no patient should be turned away or charged in any private hospital for diagnosis or treatment of symptoms which could be of COVID-19.

Conclusion

While one part of the population enjoys work and nutritional security, health insurance and housing of globally acceptable standards, others survive at the edge of unprotected and uncertain work, abysmal housing without clean water and sanitation, and no assured public health care. Can we resolve to correct this in post-COVID India? Can we at least now make the country more kind, just and equal?

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Home and nation

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2-Role of administration in 21-day lock-down of country.

Context

A 21-day lockdown is extraordinary. Government, people must come together to ensure that supply chains and social trust must not break.

An unprecedented move

  • A 21-day nationwide lockdown: The way we conduct ourselves in these 21 days will be critical in our fight against the coronavirus.” With these words, Prime Minister announced a measure unprecedented in India’s 72-year-old history.
  • Never have the people of the country been asked to stay within the confines of their homes for this long a period, not even when the country has fought wars.
  • Yet extraordinary times demand extraordinary measures. As the PM underlined, “stringent social distancing and staying within the Lakshman Rekha of our homes is the only prevention against the coronavirus”, the only way to break its transmission cycle.

Challenges and consequences

  • There will be social and economic consequences and the PM did not equivocate on the challenges. He spoke of the vulnerable sections, and, as in last week’s speech, emphasised the imperative to be compassionate.
  • He lauded the frontline workers, doctors, nurses and other healthcare workers, expressed gratitude to safai karamcharis and praised the private sector and civil society.
  • A reworked social compact — more compassionate — will be necessary to confront the challenges posed by the lockdown.
  • It is now up to civil society, government agencies, the healthcare and corporate sectors to take their cues from the PM’s speech and ensure that the burden of fighting the pandemic does not fall too heavily on those at the margins, the migrant and daily wage labourers, the rickshaw pullers and others for whom these 21 days could prove to be the toughest.
  • Centre and state to work together: The Centre and state governments will need to work together, setting aside their political differences, to ensure that there is no shortage of essential commodities and the supply chains are not broken.

Measures to mitigate the impact

  • Earlier in the day, Finance Minister Nirmala Sitharaman had announced a slew of measures that could soften the blow of a 21-day lockdown.
  • The deadline for filing of income taxes for the financial year 2018-19 has been extended, as has the last date for filing GST returns.
  • Sitharaman also announced that the threshold for taking companies through the insolvency and bankruptcy proceedings has been increased from Rs 1 lakh to Rs 1 crore.
  • This will prevent creditors from taking small and medium-sized companies, who may be facing temporary cash flow management issues due to the lockdown, and hence are unable to meet their obligations, through the IBC process.
  • The Centre has also advised state governments to transfer funds to construction workers from the cess fund collected by the labour welfare boards.

Conclusion

As the PM said, “21 days is a long period”. It’s now up to the authorities and the people to own and implement his message — to ensure that not just supply chains, but also social trust, isn’t broken.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Taking a holistic approach to dengue

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Dengue vaccine

Mains level : Paper 2-Dealing with Dengue, stategies, suggestion, and holistic approach.

Context

The advent of a new tetravalent vaccine against the dengue virus has thrown new light into the evidence-based management of dengue.

Why the holistic approach is needed

  • Apart from promoting the use of the vaccine, gaining control over dengue will also require a holistic approach that has to include within its ambit vector control and proper case management.
  • Tetravalent vaccine: The vaccine is tetravalent i.e. it provides protection against all the four types of dengue viruses.
    • The vaccine confers about 80% protection to children vaccinated between 4 and 16 years of age without any major side effects.
  • Climatic factors: It is essentially a tropical disease that occurs in the countries around the Equator; hot weather and intermittent rainfall favour the sustenance of Aedes aegypti.
    • Aedes eggs can remain dormant for more than a year and will hatch once they come in contact with water.
  • Risk factors: Urbanisation, poor town planning, and improper sanitation are the major risk factors for the multiplication of such mosquitoes.
    • Aedes eggs can remain dormant for more than a year and will hatch once they come in contact with water.
    • Aedes mosquitoes cannot fly beyond a hundred meters. Hence, keeping the ambiance clean can help prevent their breeding.
    • Further, these mosquitoes bite during the daytime, so keeping the windows shut in the day hours is also useful.

What needs to be done?

  • Source reduction activities: Activities like preventing water stagnation and using chemical larvicides and adulticides.
    • These chemicals need to be applied in periodic cycles to kill the larvae that remain even after the first spray.
  • Dealing with the manpower shortage: The number of skilled workers available for such measures is low; many posts in government departments remain vacant despite there being a dire public health need.
    • Due to this deficiency of manpower, active surveillance is not being done in India, says the National Vector Borne Disease Control Program.
  • Ending the Under-reporting: Dengue cases are often under-reported due to political reasons and also to avoid spreading panic among the common people. Under-reporting needs to be dealt with.
  • Increasing coordination: There is a lack of coordination between the local bodies and health departments in the delivery of public health measures.
    • A comprehensive mechanism is required to address these issues.
  • Need for epidemiological measures: Any communicable disease needs the epidemiological approach. Singapore uses one successful model of mapping and analysing data on dengue, using Geographical Information System (GIS).
    • The use of GIS involves mapping the streets with dengue cases for vector densities.
  • Emphasis on the WHO guidelines: Fluid management in the body is the cornerstone in the management of severe diseases like dengue hemorrhagic fever and dengue shock syndrome.
    • According to the guidelines, coagulation abnormalities are not due to a reduction in the number of platelets alone.
    • This is why the WHO recommends fresh whole blood or packed cell transfusion in the event of bleeding.
  • Caution in using alternative medicine drugs: Modern medicine is not against any complementary medicine; when such a medicine is approved after rigorous testing.
    • However, in the absence of evidence, the efficacy of such medicines remains in the realm of belief instead of science.
    • So, medicines like Nilavembu kudineer and papaya leaf extract are only belief based.

Conclusion

The communicable nature of Dengue and its asymptomatic nature requires the holistic approach to successfully tackle the disease.

 

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Ahead on malaria: on reduction in cases in India

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From the UPSC perspective, the following things are important:

Prelims level: World Malaria Report, WHO

Mains level: Efforts needed to eliminate Malaria from South Asia


Context

Malaria incidence reduced in India

  1. The World Malaria Report 2018 of the World Health Organisation notes that India’s record offers great promise in the quest to cut the number of new cases and deaths globally by at least 40% by 2020 and to end the epidemic by 2030
  2. The declining trend of the scourge shows that sustained public health action can achieve good results

Factors for optimism: Odisha shows the way

  1. A lot of that optimism has to do with the progress made by Odisha, one of the most endemic States
  2. Investments made there in recruiting accredited social health workers and large-scale distribution of insecticide-treated bednets, together with strategies to encourage health-seeking behaviour, seem to have paid off
  3. The WHO report highlights a sharp drop in the number of cases in the State
  4. The reduction in cases by half in 2017 compared to the same study period in 2016 appears to reinforce research findings
  5. Malaria cases in Odisha have been coming down steadily since 2003, with a marked reduction since 2008, attributed to greater political and administrative commitment
  6. This positive trend should encourage authorities not just in Odisha, but in the northeastern States and elsewhere too to cut the transmission of the disease further

Further efforts required

  1. This positive trend should encourage authorities not just in Odisha, but in the northeastern States and elsewhere too to cut the transmission of the disease further
  2. Importantly, the reduction in the number of cases should not produce complacency and lead to a reduction in the deployment of health workers and funding cuts to programme components
  3. Where allocations have been reduced, they should be reversed
  4. One issue that requires monitoring in India is resistance to combination therapy using artemisinin
  5. Recent reports indicate that some patients in West Bengal became resistant to the treatment protocol used for the falciparum parasite, which causes debilitating cerebral malaria and leads to a high number of deaths
  6. Eliminating malaria requires an integrated approach, and this should involve Chhattisgarh, Jharkhand and West Bengal, which have a higher burden of the disease

Way forward

  1. India has suffered from a major burden of malaria for decades, with high levels of morbidity and death
  2. Odisha’s experience with using public health education as a tool and reaching out to remote populations with advice needs to be replicated
  3. Given that emerging resistance to treatment has been reported in Myanmar, among other countries in this belt, there is a need for a coordinated approach to rid southern Asia of malaria

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] A Matter of Dignity

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From the UPSC perspective, the following things are important:

Prelims level: Dementia, Global Action Plan on the Public Health Response to Dementia 2017-2025

Mains level: Along with demographic dividend, the number of ageing people is also rising in India and hence an increase in diseases related to older age. How can India tackle this problem in line with global actions.


Context

Increase in cases of dementia

  1. The rapid increase in ageing population across countries requires national strategies to deal with age-related diseases and thus dementia care is becoming a significant issue
  2. According to the WHO, it affects 50 million people worldwide; a number that is projected to increase to 82 million by 2030 and 152 million by 2050
  3. According to some estimates, one person gets affected by dementia every three seconds

About dementia

  1. Dementia is a form of cognitive impairment that affects memory and other cognitive abilities and significantly interferes with a person’s ability to perform daily activities
  2. Data from many parts of the world reveals age as a risk factor for dementia — though the debilitating condition is not an inevitable consequence of ageing

Social stigma related to dementia

  1. Studies have revealed how the stigma attached to the disease leads to the social isolation of patients, their families and careers
  2. Research has thrown light on the deterioration in the quality of their lives
  3. Studies that draw on interactions with people affected by dementia, their families and caregivers indicate that several of the needs of such people — social, economic or those related to health — remain unfulfilled
  4. For instance, leave concessions at work, adaptable housing environments, adequate diagnostic facilities, treatment options, care provisions and risk reduction measures for people with dementia are not in place
  5. Many require psychological support, biomedical facilities, appropriate medications, counselling services and end of life care. But these are not available

WHO action plan on dementia

  1. The complexity of needs cutting across health, economic and social sector requires attention and policy responses
  2. 2018 WHO dementia plan focuses on the urgent need for a multi-phased approach and a multi-sectoral policy response to address the needs of people with dementia, their carers and families
  3. Over a year ago, the World Health Assembly in Geneva adopted the Global Action Plan on the Public Health Response to Dementia 2017-2025
  4. India endorsed the plan, confirming its commitment to improving the lives of people with dementia, their carers and families

Policy action that needs to be taken in India

  1. The country’s commitment to Sustainable Development Goals — especially with respect to Goal 3 that deals with good health and well being — and the UN Convention on the Rights of Persons with Disabilities should push it into formulating a strategy to deal with this debilitating condition
  2. Such a plan should incorporate public awareness campaigns and research

Way forward

  1. As the percentage of aged people in the country increases, improving the lives of people with dementia and their families and careers must become a national priority
  2. These programmes could be aligned with existing policies and care models

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] The health transition

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: Non-Communicable Diseases

Mains level: Lifestyle changes leading to more NCDs and how its rise can be stalled


Context

UN award for India & rising NCDs

  1. In the last week of September, India’s health ministry received the prestigious UN Inter-Agency Task Force Award for “outstanding contribution to the achievement of NCD (Non-Communicable Diseases) related SDG targets”
  2. NCDs are the leading cause of mortality, globally and in India, and are dominated by cardiovascular diseases, cancers, diabetes and chronic respiratory diseases

Targets for reduction

  1. A Lancet paper by the monitoring group, NCD Countdown 2030 has contended that India will fall short of the NCD targets pertaining to SDGs
  2. The target set for all countries is to achieve the one-third reduction in NCD related mortality between the ages of 30 and 70 by 2030, relative to 2015
  3. The Lancet study reports that high-income countries and several upper middle-income countries are on course to achieve this target
  4. Lower middle income countries, like India, will need to accelerate the rate of decline to reach the target

Method of measuring NCD mortality

The Lancet paper examines global trends in NCD mortality, using three rates:

Mortality between 30-70 years, mortality under 70 years and mortality under 80 years.

  1. The first is the indicator linked to the SDGs.
  2. The second also measures NCD mortality below 30 years of age, which represents a considerable burden in regions like sub-Saharan Africa.
  3. The third regards most NCD deaths before 80 as preventable and premature

Scale needs to be changed

  1. The arbitrary selection of the 30-70 year age range limits consideration of, and action against, NCD deaths in the younger and older age groups outside that age band
  2. As the epidemics mature, the 70-80 age group will pose challenges in many parts of the world
  3. Therefore, the current response should not be a short-term staccato response but one which anticipates and mitigates preventable NCD mortality across the entire 0-80 age range even after 2030

UHC target

  1. Age limits should not become a barrier to the provision of NCD care under a Universal Health Coverage (UHC) programme — another major SDG target
  2. Countries keen on achieving the specified 30-70 age related mortality target may tend to focus their resources on preferential care for that group, especially in the provision of life saving clinical services, neglecting other age groups
  3. This militates against equity and undermines the principle of universality
  4. Reduction of under-80 mortality would be a better measure to judge the overall health impact of UHC

Tracking India’s progress

  1. Reduction in 0-70 mortality would be a reasonable indicator for tracking India’s progress on NCDs while progress in under-80 mortality would be a good indicator for assessing progress on UHC

Measures that need to be taken

  1. Actions to curb tobacco and alcohol consumption will help reduce future risk of NCD in the under-30 age group
  2. Actions related to reduction of blood pressure, control of diabetes and provision of competent primary care supplemented by cost-effective specialist clinical care for treatable NCDs will benefit all age groups, with the highest benefits in the 30-80 age group
  3. Energetic implementation of public health policies and NCD-inclusive health services under UHC are what the country needs

Way forward

  1. It is essential that the government, civil society, academia and media recognise the nuances of health transition which shape the sweep of NCD epidemics as they evolve
  2. This will help create a healthier society which will yield inter-generational benefits well beyond 2030

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Protecting persons with HIV/ AIDS

Note4students

Mains Paper 2: Governance | mechanisms, laws, institutions & Bodies constituted for the protection & betterment of these vulnerable sections

From UPSC perspective, the following things are important:

Prelims level: HIV Prevention Act 2017

Mains level: Discrmination meted out by society against persons suffering from HIV/AIDS and laws to prevent it


Context

HIV Prevention Act 2017

  1. The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act of 2017 safeguards the human rights of people living with HIV and AIDS
  2. The Ministry of Health and Family Welfare issued a notification to bring the Act into force from September 10

History of the law

  1. The Act was born out of an urgent need to prevent and control the virus and syndrome.
  2. It has highlighted the necessity for effective care, support and treatment for HIV and AIDS
  3. The Act spawns from the commitment to the global community under the Declaration of Commitment on Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (2001)
  4. The declaration calls for enhanced coordination and intensification of national, regional and international efforts to combat the virus and syndrome in a comprehensive manner

Provisions of the law

  1. The statute aims to provide equal rights to persons with HIV and bring them into the mainstream
  2. The Act gains importance as it makes it a legal obligation to protect the privacy of persons with HIV and AIDS
  3. The law addresses discrimination meted out to persons with HIV and AIDS. It fortifies the health and medical health-care system for them and introduces legal accountability along with formal mechanisms to inquire into complaints and redress grievances
  4. The Act lists various grounds on which discrimination against persons with HIV is prohibited
  5. The requirement for HIV testing as a pre-requisite for obtaining employment or accessing health care or education is also prohibited
  6. The Act provides that every HIV infected or affected person below the age of 18 years has the right to reside in a shared household
  7. Every person in the care and custody of the state shall have the right to HIV prevention, testing, treatment and counselling services

Protecting privacy

  1. The Act prohibits any individual from publishing information or advocating feelings of hatred against HIV positive persons and those living with them
  2. Section 37 makes such propagation of hatred punishable with a term of imprisonment which shall not be less than three months but which may extend to two years, with fine which may extend to ₹1 lakh

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Every breath you take

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: Global Burden of Disease Study

Mains level: National Health Policy and its relevance for Ayushman Bharat


Context

Global burden of diseases study

  1. The National Health Policy, drawn up last year acknowledged a public health challenge in the form of NCDs
  2. It underscored the need to focus on non-communicable diseases (NCDs) like heart ailments, diabetes and respiratory afflictions
  3. This led the Union Ministry of Health and Family Welfare to collaborate with the Indian Council of Medical Research, Public Health Foundation of India and the Institute for Health Metrics and Evaluation on a two-year long study that mapped NCDs across the country
  4. The results of the project are also a part of the Global Burden of Disease Study and throw light on the challenges at hand for the National Health Policy

Respiratory diseases on the rise

  1. India with 18 per cent of the world’s population bears more than 30 per cent of the global burden of respiratory diseases
  2. The study also draws attention to a little-understood disease, COPD (Chronic Obstructive Pulmonary Disease) which constitutes more than 75 per cent of the country’s burden of respiratory diseases
  3. Pollution has become the major reason for stressing the lungs of people in different parts of the country

Ayushman Bharat’s focus not on respiratory diseases

  1. The much-publicised insurance component of the programme has little relevance for people who suffer respiratory diseases
  2. Very few of them require extensive hospitalisation — the precondition for availing insurance under Ayushman Bharat
  3. There is a plan for opening more than 1,50,000 primary healthcare centres
  4. But several studies have also shown that respiratory diseases like COPD evade diagnosis because doctors do not follow the protocols for treatment and most often target the symptoms — cough, cold and fever

Way Forward

  1. The challenge for Ayushman Bharat would be to equip doctors at these healthcare centres with the diagnostic acumen to tackle respiratory diseases and to make sure that drugs are available at all public dispensaries

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

In a first, WHO recommends quadrivalent influenza vaccine

Image result for influenza

Note4students

Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

The following things are important from UPSC perspective:

Prelims Level: Influenza Strain Types,  H#N# Subtypes

Mains level: Read the attached story


News

Quadrivalent vaccine approved

  1. Sanofi Pasteur’s injectable influenza vaccine (FluQuadri) containing two A virus strains — H1N1 and H3N2 — and two B virus strains — Victoria and Yamagata — for active immunisation of adults of age 18 to 64 years was approved in May last year by the Drug Controller General of India (DCGI).
  2. The application for the paediatric indication is under review by the DCGI and final approval is expected by the end of this month.
  3. Sanofi’s quadrivalent influenza vaccine was licensed for use by the U.S. Food and Drug Administration (FDA) in 2013; it is licensed in 26 countries.

Why Quadrivalent vaccine?

  1. While a trivalent influenza vaccine contains both A subtype viruses, it has only one of the B subtype virus, the quadrivalent vaccine offers a greater breadth of protection as it includes both B subtype viruses.
  2. It is because of a greater breadth of protection that a few other companies too have shifted from a trivalent to a quadrivalent vaccine.
  3. Since the vast majority of influenza vaccines manufactured were trivalent till recently, the World Health Organisation (WHO) used to recommend two A subtypes and one B subtype, plus an optional fourth strain (the other B virus strain).

Benefits of Quadrivalent Vaccine

  1. The quadrivalent vaccine will contain four influenza virus strains (two A subtypes and two B subtypes — H1N1 and H3N2, and Victoria and Yamagata respectively).
  2. The viruses used in the vaccine are killed and this eliminates the possibility of the virus in the vaccine itself causing infection.
  3. In India, the vaccine will be available as a single dose pre-filled syringe
  4. Eventually, it will be available in a vial for public health use.

Incidences of different Strains

  1. In the case of H1N1, there are two strains — California and Michigan — that cause influenza. In India, the Michigan strain was earlier circulating and has been replaced by the California strain.
  2. For 2018, the WHO has recommended the Michigan strain for the southern hemisphere, including India.
  3. Each year, the vaccine changes to reflect the different strains in circulation.
  4. Year-round, scientists across the globe track, analyze and classify the viral strains causing illness.

 Indian context

  1. Despite the high number of infections and mortality each year, India does not have in place a national policy for influenza immunization.
  2. Pregnant mothers, children aged below five and young people with asthma, cardiovascular disease, diabetes and high blood pressure are at a greater risk of infection and death.
  3. The Ministry of Health issues only H1N1 vaccination guidelines for different vulnerable groups including healthcare workers.
  4. If we want to reduce the influenza burden in adults, then we must target children as they act as reservoirs.

Back2Basics

Influenza

Influenza is a virus that actually has hundreds of different strains. The virus mutates frequently, but the strains are classified into one of three main categories—A, B, or C.

Influenza A is the group that most commonly causes illness in humans.

  1. All influenza A viruses are further broken down into H and N subtypes. So, any influenza virus that is described as “H#N#” (such as H1N1) is an influenza A virus.
  2. There are 16 H subtypes and nine N subtypes, but only three combinations have actually caused highly contagious illness in humans.
  3. Other combinations have been found to infect other species (such as birds and pigs), but they have not caused widespread human infections.
  4. The three combinations that cause almost all outbreaks of the flu in humans are H1N1, H2N2 and H3N2.
  5. Even in these subtypes, the influenza virus can mutate and change each year. For this reason, influenza viruses are also named using:
  • The host of origin (swine, chicken, etc., or no host if it is of human origin)
  • The geographical location of origin (Hong Kong, Alberta, etc.)
  • Strain number
  • Year of discovery (or isolation)

Influenza B

  1. Influenza B is less common but still causes outbreaks of seasonal flu.
  2. One or two strains of influenza B are included in the seasonal flu vaccine every year to protect people from the strain(s) that researchers believe are most likely to cause illness during the upcoming flu season.
  3. The quadrivalent flu vaccine contains two strains of influenza B but the traditional trivalent flu vaccine only contains one.
  4. Influenza B is not broken down into subtypes like influenza A is, but it is broken down into individual strains.
  5. Typically, two strains of influenza A and one strain of influenza B are included in the seasonal flu vaccine. Quadrivalent flu vaccines contain two strains of influenza A and two strains of influenza B.
  6. Influenza B can cause outbreaks of seasonal flu but they occur less frequently than outbreaks of influenza A.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Preventing the next health crisis

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: State of nutrition report, stunting, wasting, non-communicable diseases,

Mains level: Rising levels of obesity in India and associated health dangers


Context

Annual state nutrition report

  1. In March, the government had announced that it would release an annual “state of nutrition” report
  2. It would be detailing India’s level of stunting, malnutrition and feature best practices for States to scale up nutrition interventions

Nutrition challenges

  1. 26 million children in India suffer from wasting (a low weight-for-height ratio)
  2. The country also has the second highest number of obese children in the world

Fighting obesity

  1. India must step up its efforts to fight overweight and obesity just as it has been doing with wasting and stunting
  2. Rising obesity is putting pressure on already fragile health systems in India by posing a high risk of chronic diseases such as cardiovascular diseases, diabetes and some cancers (clubbed together as non-communicable diseases, or NCDs)
  3. Research shows that Indians have higher levels of body fat and lower levels of lean muscle when compared to many other populations
  4. The potent combination of Indian children eating more junk food while becoming increasingly sedentary puts them at an even greater risk

Good opportunity to tackle obesity expansion

  1. This year is an ideal opportunity to tackle obesity
  2. Global health decision-makers are focussing on how to garner the political will to drive “best buys” such as sugar taxes and mass media campaigns on healthy diets
  3. A high-level commission and a UN General Assembly meeting on NCDs are giving new life to existing evidence-based yet largely unimplemented plans of action

Policy interventions that are required

  1. Policy responses should include
  • agricultural systems that promote crop diversity (to enable dietary diversity)
  • regulatory and fiscal measures (to decrease the availability, affordability and promotion of unhealthy foods, while making healthy foods more accessible)

2 India should ban the sale of junk food in and around schools

Obesity management, prevention and treatment should be provided as essential health services

India should link obesity and undernutrition and treat them as twinned challenges to be jointly addressed under the universal health coverage umbrella

Way forward

  1. Tackling obesity benefits the economy and the environment, as healthy and sustainable diets are good for productivity levels and the planet
  2. While tackling undernutrition through assurance of adequate nutrition (usually interpreted as dietary calories), we need to ensure that it is also about appropriate nutrition (the right balance of nutrients)
  3. Our policy response has to move from “food security” to “nutrition security”

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Accelerate efforts to end rabies: WHO to India, South East Asian countries

Note4students

Mains Paper 2: IR | Important International institutions, agencies & fora, their structure, mandate

From UPSC perspective, the following things are important:

Prelims level: World Health Organization, World Organisation for Animal Health (OIE), Food and Agriculture Organization (FAO), UNICEF, Zero by 30 plan, GAVI- the Vaccine Alliance

Mains level: Various non-communicable diseases and their elimination targets


Efforts needed to end Rabies

  1. The World Health Organization has asked India and other South East Asian countries to accelerate efforts to end rabies
  2. The WHO said that rabies causes 59,000 agonizing and painful deaths globally every year, translating to one person every nine minutes, mostly children and the poor

Causes and elimination

  1. Human rabies is caused mostly by dogs
  2. It can be eliminated by
  • increasing awareness about the disease
  • vaccinating dogs
  • making the already available life-saving rabies vaccines, medicines, tools, and technologies affordable and available to all

Fast-track elimination of dog-transmitted rabies by 2030

  1. The global rabies partners comprising the WHO, World Organisation for Animal Health (OIE), Food and Agriculture Organization (FAO) and UNICEF and rabies endemic countries from Asia-Pacific and Africa, shared and deliberated on measures to fast-track elimination of dog transmitted rabies by 2030
  2. The member countries shared initiatives being rolled out as part of the new ‘Zero by 30: The Strategic Plan’, to be launched by the WHO and its partners to end dog-transmitted rabies
  3. These studies were conducted with the WHO support to enable GAVI- the Vaccine Alliance take an informed decision to support rabies vaccines

About Zero by 30 plan

  1. The plan centers on ‘One Health’ approach and addresses the disease in a holistic and cross-sectoral manner
  2. It aims at preventing and responding to dog-transmitted rabies by improving awareness and education, reducing human rabies risk through expanded dog vaccinations, and improving access to healthcare, medicines, and vaccines for populations at risk
  3. The plan calls for generating and measuring impact by implementing proven effective guidelines for rabies control and encouraging the use of innovative surveillance technologies to monitor progress towards “Zero by 30”

Back2Basics

GAVI- the Vaccine Alliance

  1. Global Alliance for Vaccines and Immunization is a public-private global health partnership committed to increasing access to immunization in poor countries
  2. It is a global Vaccine Alliance with the goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries
  3. Gavi brings together developing countries and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialized and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and other private philanthropists
  4. Gavi was launched in 2000
  5. It is based in Geneva, Switzerland

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Expand national programmes to eliminate malaria by 2030: WHO

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: World Health Organization, World Malaria Day

Mains level: India’s target for Malaria elimination and issues related to it


Expanding the coverage of National Malaria Programmes

  1. The World Health Organization called on its member countries to expand the reach of their national malaria programmes among disadvantaged or neglected communities, including tribal, migrant or mobile populations, to achieve the disease elimination target by 2030
  2. On the eve of World Malaria Day (25th April) WHO urged member countries to ensure that national malaria programmes are provided sustainable funding along with strengthening surveillance

Targeting the Vulnerable

  1. WHO said that high-level commitment was crucial for elimination of malaria, and member countries should be focused on implementing a series of evidence-based interventions
  2. It means providing them access to long-lasting insecticidal nets (and ensuring they know how and why to use them)
  3. Other measures include- Carrying out the indoor residual spraying
  4. And providing pregnant women and children under-5 within these groups special attention, including increased access to antenatal services

Back2Basics

National framework for Malaria Elimination (NFME)

  1. NFME outlines the strategies for eradication of the disease by 2030
  2. It classifies districts or states/UTs depending upon their Annual Parasite Incidence (API) or malaria
    endemicity into categories 0,1,2,3
  3. API number gives the number of cases affected by malaria per 1000 population per annum
  4. The milestones and targets are set for 2016, 2020, 2022, 2024, 2027 and 2030 by when the entire country has sustained zero indigenous cases and deaths due to malaria for 3 years and initiated the processes for certification of malaria elimination status to the country
  5. The objectives of the NFME are to:
  • Eliminate malaria from all low (Category 1) and moderate (Category 2) endemic states/UTs (26) by 2022
  • Reduce the incidence of malaria to less than 1 case per 1000 population in all States/UTs and the districts and malaria elimination in 31 states/UTs by 2024
  • Interrupt indigenous transmission of malaria in all States/ UTs (Category 3) by 2027;
  • Prevent re-establishment of local transmission of malaria in areas where it has been eliminated and to maintain the malaria-free status of the country by 2030

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Heavy metals in fertilizers raise risk of diabetes, heart diseases in farmers

Note4students

Mains Paper 3: Environment | Conservation, environmental pollution and degradation, environmental impact assessment

From UPSC perspective, the following things are important:

Prelims level: Particulars of the disease mentioned in the newscard, heavy metals, etc.

Mains level: Effect on human health


News

Research done by the nanoscience and water research unit of the central government’s department of science and technology

  1. According to the research, synthetic fertilizers used in farming can trigger diabetes and cardiovascular diseases
  2. The scientists found a close link between toxic heavy metals used in fertilizers and the prevalence of diabetes and cardiovascular diseases among farmers

Particulars of the research

  1. The government funded research was carried out in a village in Tamil Nadu on around 900 people whose urine samples were tested
  2. Around 82.5% of the study population was involved in farming and high levels of toxic metals were detected in the synthetic fertilizers used in the study village
  3. The prevalence of pre-diabetes, diabetes and atherosclerosis was 43.4%, 16.2% and 10.3%, respectively
  4. Pre-diabetes is a condition in which blood sugar is high, but not high enough to be type 2 diabetes in which the body either doesn’t produce enough insulin, or it resists insulin
  5. Atherosclerosis is a cardiovascular disease in which there is narrowing of the arteries due to plaque buildup on the artery walls

Seriousness of the government

  1. The health ministry has been running screening programs in rural areas to get to the bottom of the rising incidence of non-communicable diseases in these areas

Prevalence of Non-Communicable disease

  1. The phase one results of the Indian Council of Medical Research (ICMR)-INDIAB (India diabetes) study have also shown that the prevalence of non communicable diseases is higher in both urban and rural areas of India compared to earlier studies
  2. A recent analysis of trends done by the All India Institute of Medical Sciences, New Delhi revealed an increase in diabetes prevalence among the rural population at a rate of 2.02 per 1,000 population per year

Back2basics

Heavy metals

  1. Heavy metals are generally defined as metals with relatively high densities, atomic weights, or atomic numbers. The criteria used, and whether metalloids are included, vary depending on the author and context
  2. In metallurgy, for example, a heavy metal may be defined on the basis of density, whereas in physics the distinguishing criterion might be atomic number, while a chemist would likely be more concerned with chemical behaviour
  3. More specific definitions have been published, but none of these have been widely accepted. The definitions surveyed in this article encompass up to 96 out of the 118 known chemical elements; only mercury, lead and bismuth meet all of them
  4. Despite this lack of agreement, the term (plural or singular) is widely used in science
  5. A density of more than 5 g/cm3 is sometimes quoted as a commonly used criterion and is used in the body of this article

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Health Ministry to roll out prog to combat hepatitis

Note4students

Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Particular of the Hepatitis disease

Mains level: Targets set under the initiative.


News

Important decision taken by the Health Ministry

  1. The Health Ministry has decided to roll out an initiative for prevention and control of viral hepatitis
  2. Why: to address aspects such as surveillance, awareness generation, safe blood and injection safety to combat the disease

Particulars of the initiative: The ‘Integrated initiative for prevention & control of viral hepatitis’ 

  1. Under the initiative, the ministry has decided to establish a state coordination unit under the state NHM for efficient rollout of the programme in 26 large and four small states
  2. There is also a plan to set up 50 state laboratories for assisting in diagnosis and training of the district hospitals for screening of hepatitis
  3. The ministry intends to scale up to 100 treatment and 665 testing centres over a period of next three years

Budgetary provisions

  1. The National Health Mission (NHM) has decided to roll out ‘Integrated initiative for prevention & control of viral hepatitis’ with a budget of Rs 517.39 crore for three years

Back2basics

Hepatitis

  1. Hepatitis is inflammation of the liver tissue
  2. Some people have no symptoms whereas others develop yellow discoloration of the skin and whites of the eyes, poor appetite, vomiting, tiredness, abdominal pain, or diarrhea
  3. Hepatitis may be temporary (acute) or long term (chronic) depending on whether it lasts for less than or more than six months
  4. Acute hepatitis can sometimes resolve on its own, progress to chronic hepatitis, or rarely result in acute liver failure
  5. Over time the chronic form may progress to scarring of the liver, liver failure, or liver cancer

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Free viral load testing for all PLHIV

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: Viral load test, HIV-AIDS, ART

Mains level: Growing incidences of HIV in country and measures to prevent it


Viral load testing for all HIV patients

  1. The Health Ministry has launched ‘Viral load testing for all People Living with HIV/AIDS (PLHIV)’
  2. India is home to the world’s third largest HIV population, with 25 lakh patients
  3. Out of these, only 12 lakh of the diagnosed HIV patients are on treatment

Services provided from ART centers

  1. These patients are availing the benefit of free treatment from ART (Antiretroviral Therapy) centers

Back2Basics

Viral load test

  1. Viral load tests measure the amount of HIV’s genetic material in a blood sample
  2. Viral load assays measure HIV genetic material called RNA from virus particles called virions in the blood plasma
  3. Results are reported as the number of copies of HIV RNA per milliliter of blood
  4. The three most commonly used assays for measuring viral load are: HIV-1 RNA polymerase chain reaction (PCR); Branched-chain DNA (bDNA); Nucleic acid sequence-based amplification (NASBA)
  5. Viral load kits are used to determine the severity of an infection before deciding on the treatment regimen that is appropriate for HIV patients

ART (Antiretroviral Therapy)

  1. ART are medications that treat HIV
  2. The drugs do not kill or cure the virus
  3. When taken in combination they can prevent the growth of the virus
  4. When the virus is slowed down, so is HIV disease

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

PM Modi to inaugurate first ever TB India summit next month

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: India TB summit, WHO End TB Strategy, SDGs, UN

Mains level: Rising incidence of TB in India


India TB summit

  1. The government of India is all set to organize a mega India TB summit from March 13-16
  2. It is a first of its kind event which is aimed at generating sufficient momentum for vision of a TB free India by 2025
  3. This is five years ahead of the global TB elimination target of 2030

National Strategic Plan for TB Elimination 2017-25

  1. During the summit, PM is also expected to formally launch the National Strategic Plan for TB Elimination 2017-25 (NSP)
  2. It has been designed in line with World Health Organization’s (WHO) End TB Strategy, and the Sustainable Development Goals (SDGs) of the United Nations (UN)
  3. The key features of NSP are to
  • Effectively address patients seeking care in private sector, including provision for free medicines
  • Augmentation of availability of rapid molecular tests
  • A nutritional support to TB patients in DBT mode – Rs 500 per month and
  • An India TB Control Foundation

Back2Basics

WHO End TB Strategy

  1. WHO’s post-2015 End TB Strategy, adopted by the World Health Assembly in 2014, aims to end the global TB epidemic as part of the newly adopted Sustainable Development Goals
  2. The resolution calls on governments to adapt and implement the strategy with high-level commitment and financing
  3. It focuses on serving populations highly vulnerable to infection and poor health care access, such as migrants
  4. The strategy and resolution both highlight the need to engage partners within the health sector and beyond, such as in the fields of social protection, labour, immigration and justice

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Eyes to the island: Car Nicobar’s victory over hyperendemic trachoma

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: Mass Drug Administration, Trachoma, WHO SAFE guidelines, GET 2020 alliance, Ten Degree Channel, Tribes of Andaman

Mains level: Measures required to control various public health concerns


Public health project to eliminate hyperendemic trachoma

  1. Mass Drug Administration is the medical response to a public health concern that entails treating the entire population of a specified area with a prescribed dosage of pharmaceuticals
  2. Such a project was started in Car Nicobar following the discovery of a hyperendemic and active infection of trachoma on the island

About Trachoma

  1. Trachoma is a contagious and preventable cause of blindness
  2. Trachoma occurs upon repeated infections from the bacterium Chlamydia trachomatis
  3. It thrives in congested living conditions among populations that have limited access to water and healthcare
  4. It is transmitted by flies and aided by poor personal hygiene and fomites
  5. Co-habitation with animals like pigs, hens, goats, dogs, cats etc. could be a contributory risk factor
  6. Trachoma is hyperendemic in many of the poorest and most rural areas of 41 countries of Africa, Central and South America, Asia, Australia and the Middle East

WHO SAFE guidelines

  1. World Health Organisation’s (WHO) SAFE (Surgery for trichiasis, Antibiotics for infections, Facial cleanliness, and Environmental improvement) guidelines were developed to address surgical safety
  2. These guidelines have undergone review and testing at pilot sites around the world

GET 2020 alliance

  1. WHO has been pushing the GET 2020 (Global Elimination of Trachoma by 2020) alliance since 1996
  2. India is a partner in the alliance
  3. India has moved to apply for ‘trachoma-free’ status
  4. India expects to meet the 2020 target

Nicobar archipelago

  1. Nicobar is India’s southernmost district
  2. The Nicobar archipelago is separated from the Andaman cluster by the Ten Degree Channel
  3. The Nicobarese are the largest, most urbanised, and most influential among the six better-known tribes of the Andaman and Nicobar Islands
  4. Other tribes are Jarawas, Shompen, Great Andamanese, Onge and Sentinelese

Back2Basics

National Programme for Control of Blindness (NPCB)

  1.  India was the first country to launch the National Programme for Control of Blindness (NPCB) in 1976
  2. The flagship Central government initiative emanated from the Trachoma Control Programme of 1963
  3. It had a goal to reduce the prevalence of blindness from 1.4% to 0.3%
  4. Main causes of blindness are as follows: Cataract (62.6%) Refractive Error (19.70%), Glaucoma (5.80%)
  5. The definition of Blindness under the National Programme for Control of Blindness (NPCB) is in line with WHO Definition: “Presenting distance visual acuity less than 3/60 (20/400) in the better eye and limitation of field of vision to be less than 10 degrees from centre of fixation”
  6. The nomenclature of the scheme has changed from ‘National Programme for Control of Blindness’ to ‘National Programme for Control of Blindness and Visual Impairment’

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

First India-designed vaccine passes WHO test

Note4students

Mains Paper 3: Science & Technology | Achievements of Indians in science & technology

From UPSC perspective, the following things are important:

Prelims level: WHO, Rotavac and Rabishield vaccine, India’s national immunization programme

Mains level: India’s achievements in pharmaceutical research


Rotavac vaccine pre-qualified by WHO

  1. For the first time, a vaccine conceived and developed from scratch in India has been “pre-qualified” by the World Health Organisation
  2. The Rotavac vaccine, developed by the Hyderabad-based Bharat Biotech Limited last year, was included in India’s national immunization programme
  3. To be “pre-qualified” means that the vaccine can be sold internationally to several countries in Africa and South America

Uniqueness of the vaccine

  1. Several vaccines from India have been pre-qualified, this is the first that was entirely developed locally
  2. The Rotavac vaccine protects against childhood diarrhea caused by the rotavirus
  3. It was built on strain of the virus isolated at the All India Institute of Medical Sciences here over 30 years ago

Another similar vaccine

  1. Pune-based Serum International also has developed a rotavirus vaccine called Rabishield
  2. It has also been included in India’s immunization programme

Back2Basics

India’s national immunization programme

  1. Universal Immunization Programme is a vaccination program launched by the Government of India in 1985
  2. It became a part of Child Survival and Safe Motherhood Programme in 1992 and is currently one of the key areas of National Rural Health Mission(NRHM) since 2005
  3. The program now consists of vaccination for 12 diseases- tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, measles, Hepatitis B, Diarrhoea, Japanese Encephalitis, rubella, Pneumonia( Haemophilus Influenza Type B)and Pneumococcal diseases (Pneumococcal Pneumonia and Meningitis)
  4. The other additions in UIP through the way are inactivated polio vaccine (IPV), rotavirus vaccine (RVV), Measles-Rubella vaccine (MR) and Pneumococcal Conjugate Vaccine
  5. Vaccines against rotavirus, rubella and polio (injectable) will help the country meet its Millennium Development Goals 4 targets that include reducing child mortality by two-thirds by 2015, besides meeting meet global polio eradication targets

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

India misses Kala Azar elimination deadline

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: Kala-Azar, PKDL

Mains level: Elimination of various communicable and non-communicable diseases in India


2017 deadline for elimination of black fever missed

  1. India has missed the 2017 deadline that Finance Minister had announced for elimination of Kala-Azar (black fever) in his Budget speech last year
  2. Endemic blocks have increased from 61 to 68 in 17 districts of Bihar and Jharkhand
  3. KA is a slow progressing indigenous disease caused by a single-celled parasite of the Leishmania family

Elimination criteria

  1. Elimination is defined as reducing the annual incidence of Kala-Azar (KA) to less than 1 case per 10,000 people at the sub-district level

Why increase in cases?

  1. KA vector needs to be eliminated to eliminate Kala Azar
  2. As the endemic blocks have majority of houses made from wood, it is very difficult to eliminate the vector as it dwells in the wooden structure and escapes various measures to kill it
  3. Further, a little-known skin condition called Post Kala Azar Dermal Leishmaniasis (PKDL) — a red flag for transmission of KA — has been growing steadily over the past few years

What can be done to control its spread?

  1. To stop the infection transmission, pucca houses need to be built
  2. Even after treatment of Kala-Azar patients, it is the PKDL cases which become a source for future KA cases

Back2Basics

Kala-Azar (Black fever)

Image source

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Supreme Court notice to Centre on PIL on laws

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Leprosy, fundamental rights

Mains level: Discrepancies in various laws that allow social discrimination


Notice to Centre against leprosy discrimination

  1. The Supreme Court issued notice to the Centre and states on a Public Interest Litigation (PIL) seeking repeal of 119 statutes that allegedly discriminate against leprosy-affected persons
  2. The PIL requested that the said Acts be declared unconstitutional

Violating fundamental rights

  1. PIL said that the provisions in the said statutes violated the fundamental rights guaranteed under Articles 14, 19 and 21 of the Constitution

Back2Basics

Leprosy

  1. Leprosy, also known as Hansen’s disease (HD), is a long-term infection by the bacterium Mycobacterium leprae or Mycobacterium lepromatosis
  2. Symptoms that develop include granulomas of the nerves, respiratory tract, skin, and eyes
  3. This may result in a lack of ability to feel pain, thus loss of parts of extremities due to repeated injuries or infection due to unnoticed wounds
  4. Weakness and poor eyesight may also be present
  5. Leprosy is spread between people. This is thought to occur through a cough or contact with fluid from the nose of an infected person
  6. Contrary to popular belief, it is not highly contagious
  7. Leprosy is curable with a treatment known as multidrug therapy

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

India unlikely to cut malaria by half in 2020: WHO

Note4students

Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: WHO, Malaria

Mains level: Eradication of malaria and other diseases


News

India unlikely to reduce its malaria case burden

  1. India accounted for 6% of global malaria cases and 7% of deaths caused by it in 2016, according to a report released by the World Health Organisation (WHO)
  2. This is in the same ballpark as last year
  3. The WHO figures also suggest that India is unlikely to reduce its case burden beyond 40% by 2020

Performance vis-a-vis other countries

  1. Maldives, Sri Lanka and Kyrgyzstan achieved malaria-free status in 2015 and 2016 respectively
  2. Bhutan, Nepal, Thailand, Bangladesh, Myanmar and Indonesia, says the WHO, are among the countries poised to reduce malaria incidence by over 40% by 2020
  3. About 80% of the deaths from malaria across the globe were accounted for by 15 countries, namely, India and 14 countries in Sub-Saharan Africa

Key impediments in elimination

  1. A key impediment to eliminating malaria is a weak surveillance system
  2. India and Nigeria, two major contributors to the global burden of malaria, were able to detect only 8% and 16% of cases, respectively, via the system

Why?

  1. 51% of Plasmodium vivax cases — the milder cousin of the p. falciparum — were traced in India
  2. This could be partially explained by resistance to chloroquine, the first line treatment to p. vivax infections
  3. For a long time, p falciparum dominated India’s case burden

Back2Basics

Malaria

  1. Malaria is a mosquito-borne infectious disease affecting humans and other animals caused by parasitic protozoans (a group of single-celled microorganisms) belonging to the Plasmodium type
  2. The disease is most commonly transmitted by an infected female Anopheles mosquito
  3. Five species of Plasmodium can infect and be spread by humans
  4. Most deaths are caused by P. falciparum because P. vivax, P. ovale, and P. malariae generally cause a milder form of malaria
  5. The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator
  6. The Malaria Policy Advisory Committee (MPAC) of the World Health Organization (WHO) was formed in 2012 to provide strategic advice and technical input to WHO on all aspects of malaria control and elimination

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Lifestyle risks higher in developed states, malnutrition in others

Image source

Note4Students

Mains Paper 2 | Issues relating to development and management of Social Sector relating to Health

The following things are important from UPSC perspective:

Prelims level: EAG, DALY, Global Burden of Disease 2016 study

Mains level: This article highlights various finding of the recently released “Health of the Nation’’ state level disease burden study


News

The first-ever “Health of the nation” state-level disease burden study has turned on its head the perception that some states, placed higher on the development ladder, are better than others in terms of health

The report- ‘India: Health of the Nation’s States India State-level Disease Burden Initiative’

  1. The analysis aims to equip the government with evidence to identify specific state-level health challenges and priorities for intervention.
  2. The health study focused on key drivers of ill health, disability and premature death in all states and union territories, and included people from over 2,000 ethnic groups.
  3. It covered 333 diseases and injuries, and 84 risk factor trends, for each state between 1990 and 2016, as part of the Global Burden of Disease 2016 study
  4. The report is a part of All India State-level Disease Burden Initiative, which was launched by the Ministry of Health with the ICMR, PHFI, and the Institute for Health Metrics and Evaluation, in 2015
  5. This report has major policy implications for national and local governments

Key highlights from the study

  1. The study shows that UP, MP, Bihar, Rajasthan, Jharkhand, Chhattisgarh, Odisha and Uttarakhand, in the government’s Empowered Action Group (EAG), continue to battle child and maternal malnutrition.
  2. However, it also shows that states such as Tamil Nadu, Kerala, Punjab, and Goa have become hubs of non-communicable diseases (NCDs), including cancer and lifestyle-linked issues like heart ailments and diabetes.
  3. It also includes states like Tamil Nadu, Kerala and Punjab in the highest bracket for NCDs, for which prevention is a primary counter-strategy
  4. The states with better health systems, as seen in infant mortality and immunization rates, are failing on the prevention front
  5. That is, while states like Bihar and UP are still battling diarrhea deaths in children, those that have won that war, now have newer battles to fight
  6. According to it the individual states in India are in different phases of epidemiological transition, and this has resulted in wide inequalities in the magnitude and progress against various diseases and their causes

What are the reasons for NCD burden?

  1. According to the study, the NCD burden is high in the southern states and Punjab
  2. One prominent factor is the lifestyle
  3. Also,National Rural Health Mission, 2005 for years have focused on reproductive and child health because infant and maternal mortality rates were among the MDGs (Millennium Development Goals)
  4. So they have not been focussing on prevention or spreading awareness about dietary requirements
  5. Therefore, the National Health Policy talks about shifting towards tackling NCDs

What does Report says about Life expectancy at Birth?

  1. The report also found that life expectancy at birth had improved from 59.7 years in 1990 to 70.3 years in 2016 for females.
  2. For males, it has increased from 58.3 years to 66.9 years.
  3. There are continuing inequalities between states, with a range of varying life expectancy for males in UP and Kerala for females and it varies widely in Assam and Kerela for women.

The contribution of injuries to the disease burden

  1. Increased in most states since 1990, with young adults forming the highest proportion.
  2. Road injuries and self-harm, including suicides, were the leading contributors to the injury burden.

DALY (Disability Adjusted Life Years)

  1. It is an internationally recognized metric to rate a disease or health condition
  2. It is calculated as the sum of years of life lost due to premature mortality and the years lost due to disability in people living with a health condition or suffering its consequences
  3. A higher DALY metric indicates a severe disease burden
  4. The report assessed DALY for various diseases and its trend across states in India

Back2Basics

Empowered Action Group (EAG)

  1. In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh are referred to as the Empowered Action Group (EAG) states
  2. They lag behind in the demographic transition and have the highest infant mortality rates in the country
  3. They receive special attention from the central government

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Insulin does not mean end-stage of diabetes: Take it earlier

  1. Fact: India is estimated to have about 69 million people with diabetes, the second largest in the world after China
  2. Context: Most of these people should take insulin at an early stage in their diagnosis period
  3. But social stigma and the fear that insulin marks the last stage of diabetes prevents them from doing so
  4. Diabetes is the theme of this year’s World Health Day
  1. Fact: India is estimated to have about 69 million people with diabetes, the second largest in the world after China
  2. Context: Most of these people should take insulin at an early stage in their diagnosis period
  3. But social stigma and the fear that insulin marks the last stage of diabetes prevents them from doing so
  4. Diabetes is the theme of this year’s World Health Day

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Anti-Diabetic Drug ‘Ayush-82’ to be commercialised

  1. News: National Research Development Corporation(NRDC) of Min of S&T signed a License Agreement with Kudos Laboratories India for commercialization of Ayush-82
  2. About Ayush-82: An ayurvedic formulation for prevention and management of Diabetes
  3. Developed by: Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi
  4. CCRAS is an apex organization for research in Ayurveda under the Ministry of AYUSH
  1. News: National Research Development Corporation(NRDC) of Min of S&T signed a License Agreement with Kudos Laboratories India for commercialization of Ayush-82
  2. About Ayush-82: An ayurvedic formulation for prevention and management of Diabetes
  3. Developed by: Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi
  4. CCRAS is an apex organization for research in Ayurveda under the Ministry of AYUSH

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Agreement for Commercialisation of Ayush-64 and Ayush-82

  1. Agreement: for commercialization of Ayush-64 and Ayush-82
  2. Developed by: Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, an Autonomous body of the Ministry of AYUSH
  3. Context: Ayush-64, an ayurvedic formulation for treatment of Malaria and Ayush-82, an ayurvedic Formulation for management of Diabetes
  4. About Ayush-64: effective for the treatment of Malaria which is one of the most prevalent; destructive widely spread disease
  5. About Ayush-82: Anti diabetic drug also developed by CCRAS is a combination of known and tested hypoglycemic drugs
  6. Significance: Use of these two drugs would help millions of people suffering from Malaria and Diabetes
  1. Developed by: Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, an Autonomous body of the Ministry of AYUSH
  2. Context: Ayush-64, an ayurvedic formulation for treatment of Malaria and Ayush-82, an ayurvedic Formulation for management of Diabetes
  3. About Ayush-64: effective for the treatment of Malaria which is one of the most prevalent; destructive widely spread disease
  4. About Ayush-82: Anti diabetic drug also developed by CCRAS is a combination of known and tested hypoglycemic drugs
  5. Significance: Use of these two drugs would help millions of people suffering from Malaria and Diabetes

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

Polished Rice? Hello Diabetes!

  1. Have you ever wondered why over 40% of the people in India are diabetic?
  2. The more polished white rice a person eats, regardless of their nationality, they are at great risk of contracting Type 2 diabetes.
  3. White polished rice (parboiled/ non-parboiled) raises blood sugar levels quickly.
  4. These are called high GI (Glycemic Index) foods. In comparison, brown rice has a lower GI.
  1. Have you ever wondered why over 40% of the people in India are diabetic?
  2. The more polished white rice a person eats, regardless of their nationality, they are at great risk of contracting Type 2 diabetes.
  3. White polished rice (parboiled/ non-parboiled) raises blood sugar levels quickly.
  4. These are called high GI (Glycemic Index) foods. In comparison, brown rice has a lower GI.

Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

New smartphone app to help people cut diabetes risk

  1. Aims to tackle type 2 diabetes by allowing users to track their exercise and eating habits.
  2. The app, called Noom, developed by a New York City tech startup.
  3. Noom’s app is an alternative to the CDC’s traditional in-person classes, in which attendees typically keep pen-and-paper journals for their diet and exercise.
  1. Aims to tackle type 2 diabetes by allowing users to track their exercise and eating habits.
  2. The app, called Noom, developed by a New York City tech startup.
  3. Noom’s app is an alternative to the CDC’s traditional in-person classes, in which attendees typically keep pen-and-paper journals for their diet and exercise.

Living with diabetes?

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