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Subject: Health

  • Iron Fortification: Health Risks of Excessive Iron Intake

    iron

    Central Idea

    • Iron is an essential mineral for bodily functions, but excessive intake can be harmful.
    • Fortification of food with iron is a suggested method for treating iron deficiency anemia.
    • Excess consumption of fortified foods or simultaneous consumption of multiple fortified foods can lead to excessive iron intake.

    What is Iron Fortification?

    • Iron fortification refers to the process of adding iron to food products to increase their iron content.
    • It is done using various forms of iron, such as iron salts or iron powders, which are added to the food during processing.
    • It is a public health strategy employed to address iron deficiency, particularly in populations where inadequate iron intake is prevalent.
    • The goal is to provide a significant portion of the recommended daily iron intake through fortified foods, contributing to the prevention and treatment of iron deficiency anaemia.

    Implications for Iron Overload

    • Comorbidities: Iron overload conditions, such as thalassemia, hemochromatosis, and chronic liver disease, have impaired iron excretion mechanisms.
    • Blooding events: Iron absorption is balanced by steady and minimal excretion, except during bleeding events.
    • Menstrual bleeding: Women can excrete iron through menstrual bleeding, while men are less capable of iron excretion.
    • Oxidative stress: Increased iron intake can lead to oxidative stress, cellular damage, and impaired mitochondrial function.
    • Heart ailments: High serum ferritin levels (a marker of iron storage) are associated with an increased risk of chronic diseases such as high fasting serum glucose, high total cholesterol, high triglycerides, and hypertension.
    • Liver damage: Very high amounts of iron can activate hepatic stellate cells and cause excessive deposition of extracellular matrix in the liver. Prolonged liver iron overload can lead to liver fibrosis and cirrhosis.

    Challenges and consequences

    • Minimal absorption: Only a small percentage of ingested iron from fortified foods is absorbed, with the rest passing through the intestine.
    • Digestive issues: Unabsorbed iron can cause inflammation in the gastrointestinal lining and disrupt the colonic microbiota, leading to abdominal discomfort and gastrointestinal issues.
    • Issues with nutrition absorption: Excessive iron in the gastrointestinal tract can impair the absorption of other essential minerals like zinc and copper and potentially result in other deficiencies.

    Way Forward

    • Implement individualized strategies for iron intake rather than mandatory fortification programs to avoid unsupervised high iron intake across diverse populations.
    • Ensure thorough monitoring and detection of adverse events related to iron intake.
    • Precision in public health approaches is necessary to prevent the risk of iron overload and potential long-term chronic illnesses associated with excess iron.
    • Evaluate the specific dietary iron needs of different population segments to avoid unnecessary excess iron consumption.

     

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  • Highlights of the Joint Malnutrition Estimates (JME)

    Central Idea

    • According to the Joint Malnutrition Estimates (JME) by UNICEF, WHO, and the World Bank, India has shown a reduction in stunting among children under five.

    Such reports (including NFHS) are credible sources of information to substantiate your answers in Mains answer writing ….

    What is Stunting and Wasting?

      Stunting Wasting
    Definition Impaired growth and development due to chronic malnutrition. Rapid weight loss and muscle wasting in a short period.
    Measurement Height-for-age comparison against standardized growth reference. Weight-for-height comparison against standardized growth reference.
    Causes Insufficient intake of essential nutrients, frequent infections, poor maternal health. Inadequate caloric intake, poor feeding practices, infectious diseases.
    Effects Irreversible consequences, reduced cognitive development, increased disease vulnerability. Increased morbidity and mortality, severe malnutrition.
    Time Frame Long-term condition Short-term condition
    Overall Nutritional Status Reflects chronic malnutrition Represents acute malnutrition
    Focus Impacts growth and development Impacts weight and muscle mass

     

    Decline in Child Stunting in India

    • The prevalence of stunting in India dropped from 41.6% in 2012 to 31.7% in 2022, with 1.6 crore fewer stunted children recorded.
    • India’s share of the global burden of stunting declined from 30% to 25% in the past decade.

    Concerns over Wasting

    • Wasting remains a concern in India, with an overall prevalence of 18.7% in 2022.
    • India contributes 49% to the global burden of wasting, reflecting the severity of this malnutrition indicator.
    • Two-thirds of wasting cases in India may be attributed to maternal malnutrition, leading to low birth weight for height.

    Rise in Obesity

    • The prevalence of obesity in India increased marginally from 2.2% in 2012 to 2.8% in 2022.
    • India’s obesity classification remains low compared to the global prevalence of 5.6%.
    • Obesity contributes to 8.8% of the global burden, with 31.8 lakh obese children in India.

    Way Forward

    • The JME report highlights the need for accelerated efforts to achieve global nutrition targets.
    • India’s progress aligns with the National Family Health Survey (NFHS) data, indicating a reduction in stunting.
    • More research is needed to understand the complexities of wasting, particularly its links to maternal malnutrition.
    • Continued focus on addressing malnutrition, access to health services, and maternal nutrition is crucial for further improvement.
    • Learning more about wasting and its determinants will be essential for tailored interventions in India and Asia.

     

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  • Debate over Fortified Rice

    fortified rice

    Central Idea

    • The Union Food Ministry refuted the allegations made by the Opposition regarding the distribution of Fortified Rice through fair price shops.

    What is Fortified Rice?

    • Fortified rice refers to the process of enhancing regular rice with essential nutrients to address nutritional deficiencies in populations that heavily rely on rice as a staple food.
    • These added nutrients aim to improve the nutritional value of rice and combat specific deficiencies prevalent in certain regions or population groups.
    • The fortification process involves coating the rice grains with a nutrient-rich powder or premix.
    • The specific nutrients added to fortified rice can vary, but commonly include:
    1. Iron: Iron is often added to fortified rice to address iron deficiency anaemia, a widespread nutritional problem globally.
    2. Vitamins: Essential vitamins such as vitamin A, vitamin B-complex (including thiamine, riboflavin, niacin, and folic acid), and vitamin D may be included in fortified rice to address specific vitamin deficiencies prevalent in target populations.
    3. Minerals: Other minerals like zinc, calcium, and iodine may be incorporated into fortified rice, depending on the specific nutritional needs and deficiencies of the target population.

    Need for fortification

    • Data from the National Family Health Survey 2019-21 shows that 57 per cent of women in the reproductive age group (15-49) are deficient in iron.
    • Moreover, studies have shown that about a fifth of the children (0-5 years) who do not have access to a nutritious and diversified diet suffer from vitamin-A deficiency.
    • Vitamin D deficiency has been termed a silent epidemic.

    Advantages offered

    • Health: Fortified staple foods will contain natural or near-natural levels of micro-nutrients, which may not necessarily be the case with supplements.
    • Taste: It provides nutrition without any change in the characteristics of food or the course of our meals.
    • Nutrition: If consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittently supplement.
    • Economy: The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 percent of the total food value.
    • Society: It upholds everyone’s right to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger.

    Issues with fortified food

    • Against nature: Fortification and enrichment upset nature’s packaging. Our body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring.
    • Bioavailability: Supplements added to foods are less bioavailable. Bioavailability refers to the proportion of a nutrient your body is able to absorb and use.
    • Immunity issues: They lack immune-boosting substances.
    • Over-nutrition: Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micro-nutrients, treatment failure, and increased mortality risk.

    Possible health hazard

    • Thalassemia, sickle cell anaemia and malaria are conditions where there is already excess iron in the body, whereas TB patients are unable to absorb iron.
    • Consumption of iron-fortified foods among patients of these diseases can reduce immunity and functionality of organs.

    Ministry’s justification of Fortified Rice

    • The Ministry cited various studies to support the assertion that consumption of fortified rice leads to a significant improvement in haemoglobin levels and a reduction in the prevalence of anaemia.
    • Rice fortification has been adopted by seven countries, including the U.S., since 1958, highlighting its effectiveness as a public health intervention.
    • Ongoing evaluation, conducted by NITI Aayog in collaboration with the Indian Council of Medical Research, is being carried out to assess the impact and effectiveness of fortified rice.
    • Evaluation studies focusing on pilot districts are currently underway to gather comprehensive data and insights.

    Way Forward

    • Collaborative efforts between the Ministry, NITI Aayog, and other relevant institutions should be prioritized to conduct a thorough and independent evaluation of the fortified rice program.
    • Transparent communication of evaluation results and findings is crucial to foster trust and address any potential shortcomings or areas of improvement.
    • Incorporating feedback and recommendations from stakeholders will be valuable in enhancing the implementation and impact of the fortified rice distribution program.
    • Continuous monitoring and assessment of the program’s effectiveness should be a priority, enabling necessary adjustments and improvements to be made in a timely manner.

     

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  • Arsenic Contamination in India

    arsenic

    Central Idea: A recent peer-reviewed study suggests that even low levels of arsenic consumption can affect cognitive function in children, adolescents, and young adults.

    Arsenic Contamination

    • Arsenic is a highly toxic element naturally present in the environment.
    • Contaminated water, particularly groundwater, is a major source of arsenic exposure.
    • Long-term arsenic exposure can lead to various health issues, including cancer, skin lesions, cardiovascular disease, and negative impacts on cognitive development.

    Menace in India

    • Arsenic contamination in groundwater is one of the most crippling issues in the drinking water scenario of India.
    • According to the latest report of the Central Ground Water Board (CGWB), 21 states across the country have pockets with arsenic levels higher than the BIS stipulated permissible limit of 0.01 milligram per litre (mg/l).
    • The states along the Ganga-Brahmaputra-Meghna (GBM) river basin — Uttar Pradesh, Bihar, Jharkhand, West Bengal and Assam — are the worst affected by this human-amplified geogenic occurrence.
    • In India, arsenic contamination was first officially confirmed in West Bengal in 1983.
    • Close to four decades after its detection, the scenario has worsened.
    • About 9.6 million people in West Bengal, 1.6 million in Assam, 1.2 million in Bihar, 0.5 million in Uttar Pradesh and 0.013 million in Jharkhand are at immediate risk from arsenic contamination in groundwater.

    Key findings of the recent study

    (1) Arsenic impact on behaviour

    • The study found that individuals exposed to arsenic had reduced grey matter and weaker connections within key regions of the brain associated with cognitive functions.
    • Chronic exposure to arsenic could have significant consequences at a population level, leading to increased school failures, diminished economic productivity, and higher risks of criminal and antisocial behavior.

    (2) Arsenic Exposure and Socioeconomic Factors

    • As previous studies have shown, arsenic exposure is particularly harmful to the poor.
    • The recent study reaffirms that economically and nutritionally disadvantaged individuals experience greater cognitive impairment from arsenic exposure.
    • The impact of arsenic on impairing cognition is more pronounced at a collective level rather than at an individual level.

    Government Initiatives to address Arsenic Contamination

    • Governments in Bihar and West Bengal have taken steps to address arsenic contamination since the 1990s.
    • Strategies include promoting piped water access, installing arsenic removal plants, and encouraging groundwater extraction from deeper aquifers with lower arsenic levels.
    • The goal is to minimize arsenic exposure and mitigate its health impacts in affected regions.

    Possible solutions

    Some of the management options include

    • Uses of surface water sources
    • Exploring and harnessing alternate arsenic-free aquifer
    • Removal of arsenic from groundwater using arsenic treatment plants/filters
    • Adopting rainwater harvesting/ watershed management practices.

     

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  • Trend of unnecessary Hysterectomies

    hyster

    Central Idea: The Health Ministry in India is concerned about the high incidence of unnecessary hysterectomies, particularly among poor, less-educated women in rural areas.

    Why in news?

    • The Supreme Court has directed States and Union Territories to implement health guidelines formulated by the Centre to monitor and prevent unnecessary hysterectomies.

    What is Hysterectomy?

    • Hysterectomy is a surgical procedure to remove the uterus, and sometimes surrounding organs and tissues.
    • It can be classified as a partial hysterectomy (removal of the uterus), total hysterectomy (removal of the uterus and cervix), or radical hysterectomy (removal of the uterus, cervix, part of the vagina, and surrounding tissues).
    • The procedure can be performed through the vagina or through an incision in the abdomen.

    Issues with such surgery

    • Overuse and unnecessary procedures: Hysterectomy can be performed without exploring alternative treatments.
    • Psychological and emotional impact: The procedure may lead to feelings of loss and changes in body image.
    • Surgical risks and complications: Hysterectomy carries risks such as infection and damage to surrounding organs.
    • Long-term health effects: Removal of the uterus may have impacts on hormones and bone health.
    • Patient autonomy and informed consent: Patients should be fully informed about the procedure and involved in decision-making.
    • Access and equity: Disparities in access to healthcare may contribute to overuse, particularly among marginalized communities.

    Concerns and Petition

    A public interest litigation (PIL) highlighted the occurrence of unnecessary hysterectomies in the states of Bihar, Chhattisgarh, and Rajasthan under government healthcare schemes.

    • Marginalized women were targeted: Women from marginalized communities, such as Scheduled Castes, Scheduled Tribes, and Other Backward Communities, were disproportionately affected.
    • Misuse and Insurance Fraud: Healthcare institutions were found to be misusing hysterectomies to claim high insurance fees from the government under various health insurance schemes.

    Key issue: Violation of Fundamental Rights

    • The recent judgement acknowledges that rising hysterectomy rates among young women in India deviate from trends observed in developed countries.
    • It recognizes the violation of fundamental rights, stating that unnecessary hysterectomies infringe upon the right to health and the right to life under Article 21 of the Constitution.

    Government action and guidelines

    • The Health Ministry has closely monitored the issue of hysterectomies and requested States to share data on hysterectomy cases before and after the implementation of guidelines.
    • Compulsory audits for all hysterectomies are advised, similar to those conducted for maternal mortality, in both public and private healthcare institutions.
    • In 2022, the Health Ministry issued guidelines to prevent unnecessary hysterectomies and urged States to comply with them.

     

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  • India nears milestone with first indigenous Dengue Vaccine

    dengue

    Central Idea: Serum Institute of India and Panacea Biotec have applied to the ICMR’s call for Expression of Interest for collaborative Phase-III clinical trials for an indigenous dengue vaccine.

    What is Dengue?

    Details
    Transmission Primarily transmitted through the bite of infected Aedes mosquitoes
    Virus and Serotypes Dengue virus belonging to the Flaviviridae family

    Four distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4
    Symptoms High fever, severe headache, joint and muscle pain, rash, pain behind the eyes, mild bleeding
    Severe Dengue Progression to severe dengue can cause plasma leakage, bleeding, organ impairment
    Geographic Distribution Endemic in more than 100 countries, particularly in tropical and subtropical regions
    Incidence and Global Impact 100-400 million dengue infections occur annually globally, affecting healthcare systems and economies
    Vector and Breeding Sites Aedes aegypti mosquito breeds in stagnant water containers found near human dwellings
    Treatment No specific antiviral treatment available; supportive care, rest, fluid intake, symptom management
    Prevention and Control Reduce mosquito breeding sites, proper water storage, cleaning of water containers, use of insecticides

     

    Dengue Virus Disease and Global Impact

    • Dengue virus disease causes significant morbidity and mortality worldwide, with 2 to 2.5 lakh (200,000 to 250,000) cases reported annually in India.
    • The global incidence of dengue has increased dramatically, with over half of the world’s population at risk.
    • The World Health Organization (WHO) has identified dengue as one of the top ten global health threats in 2019.
    • Currently, there is no specific treatment for dengue, highlighting the urgent need for effective vaccines.

    Desirable Characteristics of a Dengue Vaccine

    The ICMR highlights the desirable characteristics of a dengue vaccine, including a-

    • Favorable safety profile
    • Protection against all four serotypes of dengue
    • Reduced risk of severe disease and death
    • Induction of a sustained immune response and
    • Effectiveness regardless of previous sero-status and age

     

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  • Early Childhood Care and Education through Anganwadis

    Central Idea: The Centre is planning to promote ‘Early Childhood Care and Education’ through anganwadi centres as part of the ‘Poshan Bhi, Padhai Bhi’ slogan announced by the Women and Child Development Minister.

    What is Anganwadi scheme?

    • The scheme was started in 1975 and aims at the holistic development of children and empowerment of mother.
    • It is a Centrally-Sponsored scheme. The scheme primarily runs through the Anganwadi centre.
    • The scheme is under the Ministry of Women and Child Development.

    Moto: Poshan Bhi, Padhai Bhi

    • The focus will be on both nutrition and early learning for children under 6 years, with a particular emphasis on those under 3 years.
    • Early learning has been neglected in the Integrated Child Development Scheme (ICDS) and seen as secondary to nutrition.
    • Anganwadi centres will be repositioned as pre-schools to provide early learning access to socially and educationally backward communities.

    Why such move?

    • Two emerging trends are noted: young children shifting to private pre-schools and under-age children being admitted to Class 1 in some states.
    • The quality of services provided at Anganwadi centres is perceived as inferior, leading to the shift to private nursery schools.

    Task Force and Recommendations

    • Rebranding anganwadis: The task force recommends a “mission-mode approach” to rebranding anganwadis, including infrastructure upgrades, materials, play equipment, etc.
    • Focus on volunteer support: It suggests involving panchayat raj institutions, women’s self-help groups, local NGOs, and college volunteers to enhance the learning environment.
    • Boost to Anganwadi sisters: The task force proposes re-designating anganwadi workers as anganwadi teachers and helpers as childcare workers.
    • Nutrition boost: Infrastructure improvements, additional nutrition supplements (such as eggs and milk), extended timings, creches, and day care services are recommended.
    • MGNREGS liasion: The task force suggests leveraging funds from the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS).

    Major target: Improve Child Nutrition

    • The task force highlights that over 35% of young children in India are stunted, according to the latest NFHS data.
    • Although there has been a reduction, India still has the largest population of stunted children globally.
    • Child stunting affects developmental outcomes and the ability to learn at school.
    • NFHS-5 reveals that only 11.3% of children below 2 years receive an adequate diet.
    • The task force recommends introducing eggs as an effective intervention for nutrition.

     

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  • Govt. program for Non-Communicable Diseases renamed

    disease

    Central Idea: The article discusses the decision by the Indian Ministry of Health and Family Welfare to rename and expand its program for the control and prevention of non-communicable diseases (NCDs).

    What are Non-Communicable Diseases (NCDs)?

    • NCDs are also known as chronic diseases, which are not caused by infectious agents and are not transmissible from person to person.
    • NCDs are long-lasting and progress slowly, typically taking years to manifest symptoms.
    • Examples of NCDs include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
    • These diseases are often caused by modifiable risk factors such as unhealthy diet, lack of physical activity, tobacco and alcohol use, and environmental factors.
    • NCDs are a major cause of morbidity and mortality worldwide, accounting for around 70% of all deaths globally.

    Why in news?

    • The addition of many new diseases and health initiatives have prompted the Indian government to expand and rename its NCD program.

    Renaming of the NCD Program and Portal

    • The Ministry has renamed the NPCDCS as the “National Programme for Prevention & Control of Non-Communicable Diseases [NP-NCD].”
    • The application or software named Comprehensive Primary Healthcare Non-Communicable Disease (CPHC NCD IT) will now be renamed “National NCD Portal.”
    • The Ministry communicated this decision to the States on May 3, 2023, through a one-page letter and asked them to adhere to the changes.

    Implementation and future action

    • The NPCDCS is implemented under the National Health Mission across India.
    • The letter addressed to Principal Secretaries and Health Secretaries of all States and Union Territories advised the government to use the new names for the scheme and portal in all their future references and correspondences with the Indian government.
    • Under NPCDCS, 677 NCD district-level clinics, 187 District Cardiac Care Units, 266 District Day Care Centres and 5,392 NCD Community Health Centre-level clinics have been set up.

    Burden of NCDs in India

    • The study ‘India: Health of the Nation’s States – The India State-Level Disease Burden Initiative in 2017’ by the ICMR estimated that the proportion of deaths due to NCDs in India has increased from 37.9% in 1990 to 61.8% in 2016.
    • The four major NCDs are:
    1. Cardiovascular diseases (CVDs)
    2. Cancers
    3. Chronic respiratory diseases (CRDs) and
    4. Diabetes
    • The study shared four behavioural risk factors – unhealthy diet, lack of physical activity, and the use of tobacco and alcohol.

    Solutions to mitigate NCD burden

    • Promote healthy lifestyle: Encourage people to adopt healthy lifestyle habits such as regular physical activity, balanced and nutritious diet, avoiding tobacco and alcohol, and getting enough sleep.
    • Increase awareness and education: Increase awareness among the public about the risk factors of NCDs and educate them about ways to prevent these diseases.
    • Improve healthcare infrastructure: Increase access to healthcare facilities, especially in rural and remote areas, to ensure early detection, treatment, and management of NCDs.
    • Implement policies and regulations: Implement policies and regulations that promote healthy living, such as increasing taxes on tobacco and alcohol products, and regulating the marketing of unhealthy food products.
    • Foster public-private partnerships: Foster partnerships between the government, private sector, and civil society organizations to work collaboratively towards preventing and managing NCDs.
    • Increase research and innovation: Increase research and innovation in the prevention, early detection, and treatment of NCDs to develop new and effective interventions.

     

     

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  • Govt. to release Manual for Organ Donation & Transplantation

    organ

    Central Idea: The National Organ and Tissue Transplant Organisation (NOTTO) is working on a transplant manual as a step-by-step guide for the implementation of organ donation and transplantation programmes in hospitals and a standard course for training transplant coordinators.

    Organ transplant in India: Key statistics

    • According to data accessed from the Health Ministry, the number of organ transplants has increased by over three times from 4,990 in 2013 to 15,561 in 2022.
    • Of the 15,561 transplants, a majority — 12,791 (82%) — are from live donors and 2,765 (18%) are from cadavers (the dead).
    • Up to 11,423 of the 15,561 organ transplants are for the kidney, followed by liver (766), heart (250), lung (138), pancreas (24) and small bowel transplants (3).
    • Most of these transplants occur in private hospitals, the numbers in government hospitals are relatively lower.

    About National Organ Transplant Programme (NOTP)

    • In 2019, the GoI implemented the NOTP for promoting deceased organ donation.
    • Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994.

    Types of Organ Donations

    • The law allows both deceased and living donors to donate their organs.
    • It also identifies brain death as a form of death.
    • Living donors must be over 18 years of age and are limited to donating only to their immediate blood relatives or, in some special cases, out of affection and attachment towards the recipient.

    (1) Deceased donors:

    • They may donate six life-saving organs: kidneys, liver, heart, lungs, pancreas, and intestine.
    • Uterus transplant is also performed, but it is not regarded as a life-saving organ.
    • Organs and tissues from a person declared legally dead can be donated after consent from the family has been obtained.
    • Brainstem death is also recognized as a form of death in India, as in many other countries.
    • After a natural cardiac death, organs that can be donated are cornea, bone, skin, and blood vessels, whereas after brainstem death about 37 different organs and tissues can be donated, including the above six life-saving organs

    (2) Living donors:

    They are permitted to donate the following:

    • one of their kidneys
    • portion of pancreas
    • part of the liver

    Features of the NOTP

    • Under the NOTP a National Level Tissue Bank (Biomaterial Centre) for storing tissues has been established at National Organ and Tissue Transplant Organization (NOTTO), New Delhi.
    • Further, under the NOTP, a provision has also been made for providing financial support to the States for setting up of Bio-material centre.
    • As of now a Regional Bio-material centre has been established at Regional Organ and Tissue Transplant Organization (ROTTO), Chennai, Tamil Nadu.

    More moves for facilitation:  Green Corridors

    • Studies have suggested that the chances of transplantation being successful are enhanced by reducing the time delay between harvest and transplant of the organ.
    • Therefore, the transportation of the organ is a critical factor. For this purpose, “green corridors” have been created in many parts of India.
    • A “green corridor” refers to a route that is cleared out for an ambulance carrying the harvested organs to ensure its delivery at the destination in the shortest time possible.

    Recent amendments

    (1) No Age Bar

    • Now an individual of any age can register for organ transplant.
    • People beyond 65 years in need of an organ donation will also be eligible to get one.
    • The government has decided to do away with a clause in the National Organ and Tissue Transplant Organisation (NOTTO) guidelines as the clause violates the Right to Life.

    (2) Doing away with domicile compulsion

    • Earlier an organ recipient could register for a prospective transplant in domicile State.
    • States like Gujarat had made it mandatory for registered patients to furnish a domicile certificate to be eligible for a transplant.
    • In November last year, the Gujarat High Court quashed the discriminatory policy of the State government.

    About NOTTO

    National Organ and Tissue Transplant Organization (NOTTO) is a national level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare.

    1. National Human Organ and Tissue Removal and Storage Network
    2. National Biomaterial Centre (National Tissue Bank)

    [I] National Human Organ and Tissue Removal and Storage Network

    • This has been mandated as per the Transplantation of Human Organs (Amendment) Act 2011.
    • The network will be established initially for Delhi and gradually expanded to include other States and Regions of the country.
    • Thus, this division of the NOTTO is the nodal networking agency for Delhi and shall network for Procurement Allocation and Distribution of Organs and Tissues in Delhi.
    • It functions as apex centre for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.

    [II] National Biomaterial Centre (National Tissue Bank)

    • The Transplantation of Human Organs (Amendment) Act 2011 has included the component of tissue donation and registration of tissue Banks.
    • It becomes imperative under the changed circumstances to establish National level Tissue Bank to fulfill the demands of tissue transplantation including activities for procurement, storage and fulfil distribution of biomaterials.
    • The main thrust & objective of establishing the centre is to fill up the gap between ‘Demand’ and ‘Supply’ as well as ‘Quality Assurance’ in the availability of various tissues.

    The centre will take care of the following Tissue allografts:

    1. Bone and bone products
    2. Skin graft
    3. Cornea
    4. Heart valves and vessels

    Various issues involved

    • Lack of awareness: Lack of awareness leads to myths and misconceptions about organ donation, which further discourages people from donating organs.
    • Religious and cultural beliefs: Some religious and cultural beliefs view organ donation as a desecration of the body, which hinders organ donation.
    • Lack of infrastructure: India faces a shortage of medical infrastructure and facilities for organ donation.
    • Legal and regulatory challenges: India’s organ donation system is heavily regulated by the Transplantation of Human Organs and Tissues Act, 1994.
    • Socioeconomic factors: Poverty and lack of education can lead to reduced access to information and medical services, making it difficult for people to donate organs.
    • Organized crime: Organized criminal networks involved in organ trafficking and commercialization also create challenges for organ donation in India.
    • Stigma and Discrimination: Stigma against organ recipients, particularly those who receive transplants from other communities or castes, is also a challenge in promoting organ donation in India.

    Way forward

    • Developing a National Organ and Tissue Donation Registry: The registry could maintain a database of donors and recipients, along with their medical history and compatibility information.
    • Setting up Mobile Organ Donation Units: These units could be equipped with medical personnel and equipment to conduct donation procedures in remote areas.
    • Crowdfunding for Organ Transplant Surgeries: This could be used as a means to raise funds for organ transplant surgeries, especially for underprivileged individuals who cannot afford the cost of treatment.
    • Promoting Living Donor Transplants: Living donor transplants can help increase the number of organs available for transplantation.
    • Incentivizing for Organ Donation: Incentives could be introduced to encourage more people to donate organs. This could include tax breaks, priority access to medical treatment, and other benefits.
    • Leveraging Technology: Technology could be used to develop better donor and recipient matching algorithms, create virtual waiting lists, and streamline the donation and transplantation process.
    • International Collaboration: India could collaborate with other countries to share best practices, leverage technology, and develop new approaches to organ donation and transplantation.

     

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  • Psychedelics and its uses to treat Depression

    Central idea: The context of the article is about the use of psychedelic drugs for both recreational and medicinal purposes.

    What are Psychedelics?

    • Psychedelics are a class of drugs that alter an individual’s perception, mood, and thought processing while still allowing the individual to remain conscious and with unimpaired insight.
    • They are non-addictive and non-toxic, and cause less harm to the end user compared to illicit drugs.
    • The two most commonly used psychedelics are LSD (Lysergic acid diethylamide) and psilocybin. Researchers have also developed synthetic psychedelics.
    • In India, the Narcotic Drugs and Psychotropic Substances Act 1985 prohibits the use of psychedelic substances, except for ketamine which is used under strict medical supervision.

    History of psychedelics

    • Humans have used psilocybin and mescaline for ceremonial, healing, and spiritual rituals for millennia.
    • The modern-day use of psychedelics is commonly associated with the German chemist Arthur Heffter isolating mescaline from the peyote cactus in 1897.
    • In 1938, Swiss chemist Albert Hofmann first synthesized LSD while investigating compounds related to ergotamine.
    • LSD was widely used as a therapeutic catalyst in psychotherapy between 1947 and 1967, until it was criminalized in the US due to medical concerns and the Vietnam War.

    Experience of using psychedelic substances

    • Users of psychedelic substances report changes in perception, somatic experience, mood, thought-processing, and entheogenic experiences.
    • Perceptual distortions most commonly include the visual domain.
    • Somatic experiences may include the visceral, tactile, and interoceptive domains.
    • Mood changes may include elation, euphoria, anxiety, and paranoia.
    • Entheogenic experiences include transcendental and ineffable spiritual experiences.

    How do they work inside the body?

    • Classical psychedelics boost brain serotonin levels.
    • Psilocybin’s therapeutic effects require a ‘trip’ that is mediated by the activation of serotonin receptors.
    • Modern neuroimaging suggests that psychedelics increase the cross-talk between different brain networks, and this correlates with the subjective effects of psychedelics.

    Can psychedelic substances cause any harm?

    • Death due to direct toxicity of LSD, psilocybin, or mescaline has not been reported in the literature despite 50-plus years of recreational use.
    • Synthetic psychedelics have been associated with acute cardiac, central nervous system, and limb ischemia, as well as serotonin syndrome.

    What is Psychedelic-Assisted Psychotherapy?

    • Psychedelic-assisted psychotherapy has three types of sessions: preparatory, medication, and integration.
    • In the medication session, the patient is accompanied by a male-female co-therapist dyad and a psychedelic drug is administered in a comfortable and well-appointed room.
    • Over the next 6-8 hours, the therapists listen to the patient while maintaining a neutral therapeutic stance.
    • In the integration session, the therapists work with the patient to interpret the contents of their psychedelic experience into meaningful long-term change, based on their thoughts and ideas.

    Uses to treat Neuropsychiatric Disorders

    • Research has shown that psychedelic substances have potential therapeutic benefits in treating neuropsychiatric disorders such as treatment-resistant depression and post-traumatic stress disorder (PTSD).
    • In recent trials, a single dose of psilocybin or MDMA-assisted therapy has been shown to reduce depression scores and improve symptoms of PTSD in participants.

    Back2Basics: Narcotic Drugs and Psychotropic Substances Act, 1985

    Details
    Purpose Combat drug abuse and trafficking in India
    Scope Consolidates and amends the existing legal framework related to narcotics and psychotropic substances
    Regulations Strictly regulates and controls the production, manufacture, sale, transport, possession, and consumption of narcotic drugs and psychotropic substances
    Special Courts Establishment of special courts and appointment of special public prosecutors to handle cases related to drug trafficking and abuse
    Covered Substances Opium, heroin, cannabis, cocaine, synthetic drugs such as LSD and ecstasy
    Classification Substances classified into different schedules based on their potential for abuse and medical use
    Punishment Imposes different levels of punishment for offenses related to each schedule
    Enforcement Narcotics Control Bureau (NCB), Central Bureau of Narcotics (CBN), and state-level drug enforcement agencies
    Functions Prevention of drug abuse and trafficking, investigation and prosecution of drug offenses, rehabilitation and treatment of drug addicts

     

     

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