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Subject: Health

  • The impact of the CUET is likely to be harsher on disadvantaged sections

    Context

    The introduction of the Common University Entrance Test (CUET) can be seen as a step in the direction of aligning India with international standards.

    About CUET

    • The UGC’s rationale for introducing the test is to address the disparity in the allocation of marks by different examination boards, and provide a “level playing field” to students from different sections of society and diverse regions.
    • The CUET has been envisaged as a corrective.
    •  Of the 48 central universities, 45 seem to have the requirements to institute the test.
    • The CUET is going to decide the fate of approximately 1.3 crore students for roughly 5.4 lakh undergraduate seats in 45 central universities.

    Issues with the CUET

    • Students to contend with two examinations: The marks obtained in the board examination will remain vital for admission to state and private universities as well as job applications.
    • The students will now have to contend with two examinations.
    • Impetus to coaching classes: Many educationists argue that the new examination is likely to give an impetus to coaching classes.
    •  Coaching and private tuition will flourish without much concern for quality in the preparation of the study material.
    • Not all State Boards prescribe NCERT textbooks: The CUET syllabus will be based on NCERT (under the Ministry of Education) textbooks even though not all state boards prescribe these books.
    • The coaching industry stands to take advantage of this situation and students will have a hard time navigating two sets of textbooks.
    • The impact is likely to be harsher on disadvantaged sections of the society for whom access to higher education is seen as the only route to upward mobility.

    Way forward

    • The Gross Enrolment Ratio (GER) is constantly increasing for higher secondary education (51.4 per cent according to UDISE, 2019-20) and higher education (27.1 per cent to AISHE, 2019-20).
    • The figures indicate that higher education has acquired a mass base in the country.
    • This has important implications for a knowledge-based economy and society.
    • Maintaining the momentum of GER would require more teachers, schools and higher education institutions of quality and slow down the rush for a few but highly sought after universities and colleges.

    Conclusion

    The new examination would put additional pressure on both students and teachers at a time when they are trying to overcome the exactions of the pandemic. It appears to diverge from the objective of the National Education Policy-2020 — equitable access to good quality higher education for all students.

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  • [pib] Fortification of Rice

    The Cabinet Committee on Economic Affairs has approved supply of fortified rice in all States and Union Territories (UTs) by 2024 in a phased manner.

    What is the news?

    1. National Food Security Act (NFSA)
    2. Integrated Child Development Services (ICDS)
    3. Pradhan Mantri Poshan Shakti Nirman-PM POSHAN [erstwhile Mid-Day Meal Scheme (MDM)] and
    4. Other Welfare Schemes (OWS)

    Phases of implementation

    The following three phases are envisaged for full implementation of the initiative:

    1. Phase-I: Covering ICDS and PM POSHAN in India all over by March, 2022 which is under implementation.
    2. Phase-II: Phase I above plus TPDS and OWS in all Aspirational and High Burden Districts on stunting (total 291 districts) by March 2023.
    3. Phase-III: Phase II above plus covering the remaining districts of the country by March 2024.

    What is Fortification?

    • The Food Safety and Standards Authority of India (FSSAI) has explicitly defined fortification.
    • It involves deliberate increasing of the content of essential micronutrients in a food so as to improve the nutritional quality of food and to provide public health benefit with minimal risk to health.

    Types of food fortification

    Food fortification can also be categorized according to the stage of addition:

    1. Commercial and industrial fortification (wheat flour, cornmeal, cooking oils)
    2. Biofortification (breeding crops to increase their nutritional value, which can include both conventional selective breeding, and genetic engineering)
    3. Home fortification (example: vitamin D drops)

    How is fortification done for rice?

    • Various technologies are available to add micronutrients to regular rice, such as coating, dusting, and ‘extrusion’.
    • The last mentioned involves the production of fortified rice kernels (FRKs) from a mixture using an ‘extruder’ machine.
    • It is considered to be the best technology for India.
    • The fortified rice kernels are blended with regular rice to produce fortified rice.

    How does the extrusion technology to produce FRK work?

    • Dry rice flour is mixed with a premix of micronutrients, and water is added to this mixture.
    • The mixture is passed through a twin-screw extruder with heating zones, which produces kernels similar in shape and size to rice.
    • These kernels are dried, cooled, and packaged for use. FRK has a shelf life of at least 12 months.
    • As per guidelines issued by the Ministry of Consumer Affairs, Food and Public Distribution, the shape and size of the fortified rice kernel should “resemble the normal milled rice as closely as possible”.
    • According to the guidelines, the length and breadth of the grain should be 5 mm and 2.2 mm respectively.

    But why does rice have to be fortified in the first place?

    • India has very high levels of malnutrition among women and children.
    • According to the Food Ministry, every second woman in the country is anaemic and every third child is stunted.
    • Fortification of food is considered to be one of the most suitable methods to combat malnutrition.
    • Rice is one of India’s staple foods, consumed by about two-thirds of the population. Per capita rice consumption in India is 6.8 kg per month.
    • Therefore, fortifying rice with micronutrients is an option to supplement the diet of the poor.

    What are the standards for fortification?

    • Under the Ministry’s guidelines, 10 g of FRK must be blended with 1 kg of regular rice.
    • According to FSSAI norms, 1 kg of fortified rice will contain the following: iron (28 mg-42.5 mg), folic acid (75-125 microgram), and vitamin B-12 (0.75-1.25 microgram).
    • Rice may also be fortified with zinc (10 mg-15 mg), vitamin A (500-750 microgram RE), vitamin B-1 (1 mg-1.5 mg), vitamin B-2 (1.25 mg-1.75 mg), vitamin B-3 (12.5 mg-20 mg) and vitamin B-6 (1.5 mg-2.5 mg) per kg.

    Does fortified rice have to be cooked differently?

    • The cooking of fortified rice does not require any special procedure.
    • The rice needs to be cleaned and washed in the normal way before cooking.
    • After cooking, fortified rice retains the same physical properties and micronutrient levels as it had before cooking.

    What is India’s capacity for fortification?

    • At the time of the PM’s announcement last year, nearly 2,700 rice mills had installed blending units for the production of fortified rice.
    • India’s blending capacity now stands at 13.67 lakh tonnes in 14 key states, according to figures provided by the Ministry.
    • FRK production had increased rapidly from 7,250 tonnes to 60,000 tonnes within 2 years.

    How can a beneficiary distinguish between fortified rice and regular rice?

    • Fortified rice will be packed in jute bags with the logo (‘+F’) and the line “Fortified with Iron, Folic Acid, and Vitamin B12”.

    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.

    Back2Basics: Public Distribution System (PDS)

    • The PDS is an Indian food Security System established under the Ministry of Consumer Affairs, Food, and Public Distribution.
    • PDS evolved as a system of management of scarcity through the distribution of food grains at affordable prices.
    • PDS is operated under the joint responsibility of the Central and State Governments.
    • The Central Government, through the Food Corporation of India (FCI), has assumed the responsibility for procurement, storage, transportation, and bulk allocation of food grains to the State Governments.
    • The operational responsibilities including allocation within the State, identification of eligible families, issue of Ration Cards and supervision of the functioning of FPSs etc., rest with the State Governments.
    • Under the PDS, presently the commodities namely wheat, rice, sugar, and kerosene are being allocated to the States/UTs for distribution.
    •  Some states/UTs also distribute additional items of mass consumption through PDS outlets such as pulses, edible oils, iodized salt, spices, etc.

    Mid-Day Meal Scheme

    • The Midday Meal Scheme is a school meal program in India designed to better the nutritional standing of school-age children nationwide.
    • It is a wholesome freshly-cooked lunch served to children in government and government-aided schools in India.
    • It supplies free lunches on working days for children in primary and upper primary classes in government, government-aided, local body, and alternate innovative education centers, Madarsa and Maqtabs.
    • The program has undergone many changes since its launch in 1995.
    • The Midday Meal Scheme is covered by the National Food Security Act, 2013.

    The scheme aims to:

    1. avoid classroom hunger
    2. increase school enrolment
    3. increase school attendance
    4. improve socialization among castes
    5. address malnutrition
    6. empower women through employment

     

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  • Fighting TB with lessons learnt during Covid pandemic

    Context

    On World TB day, we need to ask how best we can leverage the lessons learnt from Covid-19 to help gain a new momentum in TB control.

    Comparing the impact of Covid-19 and TB

    • In the first year of the Covid-19 pandemic, 1.8 million people were reported to have succumbed to the virus.
    • In the decade between 2010-20, 1.5-2 million individuals died every year because of tuberculosis.
    • The difference in responses to the two pandemics can only be explained by the differences in the profiles of those who get infected.
    • TB disproportionately affects people in low-income nations, the poor and the vulnerable.
    • The increased burden on healthcare to manage Covid has led to a serious setback in TB control.

    Using lessons from Covid-19 for TB control

    • To leverage the lessons learnt from Covid-19 to control TB, we need to focus on the epidemiological triad: Agent, host and the environment.
    • Test, treat and track has been a strategy successfully employed for Covid.
    • Scaling up testing: We need to aggressively scale up testing with innovative strategies such as active surveillance, bidirectional screening for respiratory tract infections using the most sensitive molecular diagnostics, and contact tracing.
    • Vaccine: The biggest victory against Covid has been the speed with which vaccines were developed, scaled up and deployed.
    • We need to replicate the same for tuberculosis, lobbying for funding from governments and industry to develop a successful vaccine for TB.
    • Social security programs for the prevention of risk: Malnutrition, poverty and immuno-compromising conditions such as diabetes are some of the factors strongly associated with TB.
    • Social security programmes that work towards prevention of modifiable risk factors would possibly pay richer dividends than an exclusive focus on “medicalising” the disease.
    • Environmental factors: Environmental factors which have been neglected include ventilation of indoor spaces, educating individuals to avoid crowds when possible, and to encourage voluntary masking, especially in ill-ventilated and closed spaces.
    • Investment and actions: Covid has been a stellar example of how investments and actions can be swift, and public education can transform behaviour.
    • Similar aspirations for TB can help turn this crisis into an opportunity to re-imagine our overburdened and underfunded systems.
    • Involvement of private sector: We need to actively engage the private sector, build bridges and partnerships as we did in the case of Covid.

    Way forward

    • The country needs to invest in state-of-the-art technologies, build capacity, expand its health workforce and strengthen its primary care facilities.
    • It also needs to consider telemedicine and remote support as important aspects of health services.
    • We need to build an open and collaborative forum where all stakeholders, especially affected communities and independent experts, take a lead role.

    Conclusion

    We have ignored TB for too long. It’s time we acknowledge the magnitude of the disease, and work harder at offering individuals equitable healthcare access and resources that the disease warrants.

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  • Mid day Meal Scheme

    A parliamentarian has recently asked the government to re-start the mid-day meals in reopening schools and to ensure that the meals provided are cooked and nutritious.

    What is the Mid-Day Meal Scheme?

    • The Midday Meal Scheme is a school meal program designed to better the nutritional standing of school-age children nationwide.
    • It was launched in the year 1995.
    • It supplies free lunches on working days for children in primary and upper primary classes in:
    1. Government, government aided, local body schools
    2. Education Guarantee Scheme, and alternate innovative education centres,
    3. Madarsa and Maqtabs supported under Sarva Shiksha Abhiyan, and
    4. National Child Labour Project schools run by the ministry of labour
    • The Scheme has a legal backing under the National Food Security Act, 2013.

    Objective: To enhance the enrolment, retention and attendance and simultaneously improve nutritional levels among school going children studying in Classes I to VIII

    History of the scheme

    • In 1925, a Mid Day Meal Programme was introduced for disadvantaged children in Madras Municipal Corporation.
    • By the mid-1980s three States viz. Gujarat, Kerala and Tamil Nadu and the UT of Pondicherry had universalized a same scheme with their own resources for children studying at the primary stage.
    • In 2001, the Supreme Court asked all state governments to begin this programme in their schools within 6 months.

    Features: Calorie approach

    • Primary (1-5) and upper primary (6-8) schoolchildren are currently entitled to 100 grams and 150 grams of food grains per working day each.
    • It also include adequate quantities of micronutrients like iron, folic acid, Vitamin-A, etc.
    • The calorific value of a mid-day meal at various stages has been fixed at a minimum:
    Calories Intake Primary Upper Primary
    Energy 450 calories 700 calories
    Protein 12 grams 20 grams

     

    Why in news?

    • The flagship report of The State of Food Security and Nutrition in the World 2020 estimated that as of April 2020 369 million children globally were losing out on school meals, a bulk of whom were in India.
    • As many as 116 million children — actually, 116 million hungry children — is the number of children impacted due to indefinite school closure during the pandemic.

    Why discuss it now?

    • The recent Global Hunger Index (GHI) report for 2020 ranks India at 94 out of 107 countries and in the category ‘serious’, behind our neighbours Pakistan, Bangladesh and Nepal.
    • The index is a combination of indicators of undernutrition in the population and wasting (low weight for height), stunting (low height for age), and mortality in children below five years of age.

    What measures were resorted to counter this?

    • In March and April 2020 the GoI had announced that the usual hot-cooked mid-day meal or an equivalent food security allowance/dry ration would be provided to all eligible school-going children even during vacation.
    • Nearly three months into this decision, States were still struggling to implement this.

    What lies ahead?

    • Across the country and the world, innovative learning methods are being adopted to ensure children’s education outcomes.
    • The GHI report calls for effective delivery of social protection programmes.
    • With continuing uncertainty regarding the reopening of schools, innovation is similarly required to ensure that not just food, but nutrition is delivered regularly to millions of children.
    • For many of them, that one hot-cooked meal was probably the best meal of the day.

     

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  • 13% reduction in air pollution deaths due to UJJAWALA Scheme

    Greater penetration and usage of LPG as a cooking fuel is estimated to have prevented at least 1.5 lakh pollution-related premature deaths in the year 2019 alone, according to the first independent impact assessment of the government’s flagship Ujjwala program.

    About the PM Ujjwala Yojana

    • Pradhan Mantri Ujjwala Yojana (PMUY) was launched in 2016, with the aim to provide Liquefied petroleum gas (LPG) connections to five crore women members of below poverty line (BPL) households in the first phase.
    • he scheme was expanded in April 2018 to include women beneficiaries from seven more categories (SC/ST, PMAY, AAY, Most backward classes, tea garden, forest dwellers, Islands).
    • In the second phase the target was expanded to eight crore LPG connections.

    Why was this scheme launched?

    • Indoor air pollution is also responsible for a significant number of acute respiratory illnesses in young children.
    • Providing LPG connections to BPL households will ensure universal coverage of cooking gas in the country.
    • This measure has empowered women and protected their health. It reduced drudgery and the time spent on cooking.
    • It will also provide employment for rural youth in the supply chain of cooking gas.

    Ujjwala 2.0

    • Under Ujjwala 2.0 migrant workers would no longer have to struggle to get address proof documents to get the gas connections.
    • Now migrant workers would only be required to submit a self-declaration of their residential address to get the gas connection.
    • Along with a deposit-free LPG connection, Ujjwala 2.0 will provide the first refill and a hotplate free of cost to the beneficiaries.

    Significance of Ujjwala 2.0

    • LPG infrastructure has expanded manifold in the country due to the Ujjwala scheme.
    • In the last six years, more than 11,000 new LPG distribution centres have opened across the country.
    • The LPG coverage in India is now very close to becoming 100 per cent.

     

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  • TB’s steep socio-economic cost to women

    Context

    As India steadily steers its way through the pandemic to safer shores, we must foreground a disease which has been impacting our country for years, and disproportionately affecting women –  tuberculosis.

    Toll of TB

    • In India, the TB case fatality ratio increased from 17 per cent in 2019 to 20 per cent in 2020.
    • According to a joint report (2010-13) of the Registrar General of India and the Centre for Global Health Research, TB was the fifth-leading cause of death among women in the country, accounting for nearly 5 per cent of fatalities in women aged 30–69.

    How TB affects women more than men

    • Much steeper socio-economic price: While both men and women suffer the consequences of this debilitating disease, women patients pay a much steeper socio-economic price.
    • Beyond clinical metrics: From social ostracisation and lack of family support to the negative impact on marital prospects, women absorb the repercussions of TB beyond the clinical metrics.
    • Stigma also acts as a strong deterrent when it comes to health-seeking behaviour.
    • Fewer women, therefore, get included in the available cascade of care for TB.

    Measures by government

    • In 2019, the Health Ministry-Central TB Division developed a national framework for a gender-responsive approach to TB in India.
    • The document takes cognisance of the challenges faced by women in accessing treatment and offers actionable solutions.
    • Gender-responsive policy interventions: In December 2021, a parliamentary conference on ‘Women Winning Against TB’ was organised by the Ministry of Women and Child Development where gender-responsive policy interventions were discussed.
    • The Vice-President of India urged states to take proactive steps such as ensuring nutritional support to women and children and the doorstep delivery of TB services, especially for women from socio-economically weaker backgrounds.

    Suggestions

    1] Highlight the issue at the relevant forum

    • One, as elected representatives, we need to come together more to highlight the issue at all relevant forums and spaces.
    • These meetings see increased participation of women leaders from all walks of life in the community going forward.

    2] Strengthen counselling network

    • We need to strengthen counselling networks for women patients and their families.
    • Irrespective of where the patient seeks care – public or private sector – build the capacity of healthcare workers to educate the patient’s family about the importance of providing her a supportive environment during the course of her treatment.

    3] Nutritional needs

    • We need to ensure that the nutritional needs of women are being met.
    • Undernutrition is a serious risk factor for TB and research indicates such risks are higher for women.
    • It is commendable that the government, through Nikshay Poshan Yojana, has effectively provided a monthly benefit of Rs 500 to enable a nutritious diet for TB patients in the last few years.
    • For the 2020 cohort, the total amount paid under NPY via DBT has been over  Rs 200 crore.
    • Additionally, we can look to further strengthen inter-departmental coordination, wherein the Public Distribution System can explore appropriate linkages with relevant departments of the MoHFW and even include a protein-rich diet for TB patients.

    4] Amplify accurate TB messaging

    • At a community level, we must amplify accurate TB messaging and showcase how gender plays a role in determining the course of action on the ground.

    Conclusion

    These are universal problems that must transcend gender binaries. Only when equitable solutions are offered to vulnerable sections of society will we be able to realise the dream of TB-Mukt Bharat.

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  • Maternal Mortality in India

    Kerala has yet again emerged on top when it comes to maternal and child health, with the State recording the lowest Maternal Mortality Ratio (MMR) of 30 (per one lakh live births) in the country.

    What is Maternal Mortality?

    • Maternal mortality refers to deaths due to complications from pregnancy or childbirth.
    • The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period.
    • It depicts the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth.

    Trends in India

    • India’s maternal mortality ratio (MMR) has improved to 103 in 2017-19, from 113 in 2016-18.
    • Seven Indian states have very high maternal mortality. These are Rajasthan, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Bihar, Odisha and Assam.
    • The MMR is ‘high’ in Punjab, Uttarakhand and West Bengal. This means 100-130 maternal deaths per 100,000 live births.
    • It is ‘low’ in Haryana and Karnataka.
    • The states of Uttar Pradesh, Rajasthan and Bihar have seen the most drop in MMR.
    • West Bengal, Haryana, Uttarakhand and Chhattisgarh have recorded an increase in MMR over the last survey.

    Various determinants of maternal health in India

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  • Tobacco and related issues in India

    Context

    Tobacco is a silent killer in our midst that kills an estimated 1.35 million Indians every year.

    The harm caused by tobacco

    • It is the use of tobacco as a result of which more than 3,500 Indians die every single day, as estimated by scientific studies.
    • It also comes at a heavy cost: an annual economic burden of â‚č1,77,340 crore to the country or more than 1% of India’s Gross Domestic Product (GDP).

    How price and taxation of tobacco matters

    •  Research from many countries around the world including India shows that a price increase induces people to quit or reduce tobacco use as well as discourages non-users from getting into the habit of tobacco use.
    • There is overwhelming consensus within the research community that taxation is one of the most cost-effective measures to reduce demand for tobacco products.
    • There has been no significant tax increase on any tobacco product for four years in a row.
    • This is quite unlike the pre-GST years where the Union government and many State governments used to effect regular tax increases on tobacco products.
    • As peer-reviewed studies show, the lack of tax increase over these years has made all tobacco products increasingly more affordable.
    •  The absence of a tax increase on tobacco has the potential to reverse the reduction in tobacco use prevalence that India saw during the last decade and now push more people into harm’s way.
    •  It would also mean foregone tax revenues for the Government.

    Way forward

    • The Union Budget exercise is not the only opportunity to initiate a tax increase on tobacco products.
    • The Goods and Services Tax (GST) Council could well raise either the GST rate or the compensation cess levied on tobacco products especially when the Government is looking to rationalise GST rates and increase them for certain items.
    • For example, there is absolutely no public health rationale why a very harmful product such as the bidi does not have a cess levied on it under the GST while all other tobacco products attract a cess.
    • GST Council meetings must strive to keep public health ahead of the interests of the tobacco industry and significantly increase either the GST rates or the GST compensation cess rates applied on all tobacco products.

    Conclusion

    The aim should be to arrest the increasing affordability of tobacco products in India and also rationalise tobacco taxation under the GST.

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  • What is ‘Front-of-Pack Labelling’ (FoPL)?

    The Food Safety and Standards Authority of India (FSSAI) will soon start labelling the front of packaged food products with Health Star Rating (HSR).

    What is FoPL?

    • In India, packaged food has had back-of-package (BOP) nutrient information in detail but no FoPL.
    • Counter to this, FoPL can nudge people towards healthy consumption of packaged food.
    • It can also influence purchasing habits.
    • The study endorsed the HSR format, which speaks about the proportions of salt, sugar, and fat in food that is most suited for consumers.
    • Countries such as the UK, Mexico, Chile, Peru, Hungary, and Australia have implemented FoPL systems.

    What warranted such rating in India?

    • Visual bluff: A lot of Indian consumers do not read the information available at the back of the packaged food item.
    • Burden of NCDs: Also, India has a huge burden of non-communicable diseases that contributes to around 5.87 million (60%) of all deaths in a year.
    • Healthy dietary choices: HSR will encourage people to make healthy choices and could bring a transformational change in the society.
    • Supreme court order: A PIL seeking direction to the government to frame guidelines on HSR and impact assessment for food items and beverages was filed in the Supreme Court in June 2021.

    Which category of food item will have HSR?

    • All packaged food items or processed food will have the HSR label.
    • These will include chips, biscuits, namkeen, sweets and chocolates, meat nuggets, and cookies.
    • However, milk and its products such as chenna and ghee are EXEMPTED as per the FSSAI draft notified in 2019.

    Will there be pushback from food industry?

    • Negative warning: Some experts opposed the use of the HSR model in India, suggesting that consumers might tend to take this as an affirmation of the health benefits rather than as a negative warning of ill effects.
    • Lack of awareness: This is significant because there is lack of awareness on star ratings related to consumer products in India.
    • Impact on Sale: Certain organisations fear it might affect the sale of certain food products.

    When will the rating come into force?

    • FSSAI’s scientific panel recommends voluntary implementation of HSR format from 2023 and a transition period of four years for making it mandatory.
    • FSSAI noted that the proposed thresholds are in alignment with the models implemented in other countries and ‘WHO population nutrient intake goals recommendations’.
    • FSSAI will analyse the nutritional information in 100 mg of packaged food.
    • The food safety compliance system licensing application portal will have a module for generating certificates wherein a licensee can enter details of a product.

     

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    Back2Basics: Food Safety and Standards Authority of India (FSSAI)

    • The FSSAI is an autonomous body established under the Ministry of Health & Family Welfare, Government of India.
    • It has been established under the Food Safety and Standards Act, 2006 which is a consolidating statute related to food safety and regulation in India.
    • It is responsible for protecting and promoting public health through the regulation and supervision of food safety.
    • It is headed by a non-executive Chairperson, appointed by the Central Government, either holding or has held the position of not below the rank of Secretary to the Government of India.

  • Anti-microbial resistance needs urgent attention

    Context

    Ever since the pandemic struck, concerns have been raised about the improper use of antimicrobials amongst Covid-19 patients.

    Concern over anti-microbial resistance

    • The “Global burden of bacterial antimicrobial resistance in 204 countries and territories in 2019 (GRAM)” report, released last month, 4.95 million people died from drug-resistant bacterial infections in 2019, with 3,89,000 deaths in South Asia alone.
    • AMR directly caused at least 1.27 million of those deaths.
    • Lower respiratory infections accounted for more than 1.5 million deaths associated with resistance in 2019, making it the most burdensome infectious syndrome.
    • Amongst pathogens, E coli was responsible for the most deaths in 2019, followed by K pneumoniae, S aureus, A baumannii, S pneumoniae, and M tuberculosis.

    Concern for India

    • As per the yearly trends reported by the Indian Council of Medical Research since 2015, India reports a high level of resistance in all these pathogens, especially E coli and K pneumoniae.
    • Only a fraction of the Indian data, available through the WHO-GLASS portal, has been included in the GRAM report.
    • India has been reporting high levels of resistance to fluoroquinolones, cephalosporins and carbapenems across the Gram-negative pathogens that cause almost 70 per cent of infections in communities and hospitals.
    • Therefore, the Indian data on the AMR burden may not look very different from the estimates published in the report.
    • Now that we know that AMR’s burden surpasses that of TB and HIV, a sense of urgency in containing such resistance is called for.
    • With no new drugs in the pipeline for drug-resistant infections, time is running out for patients.

    Addressing AMR through a multipronged and multisectoral approach

    • Use existing antimicrobials judiciously: The urgency to develop new drugs should not discourage us from instituting measures to use the existing antimicrobials judiciously.
    • Improved infection control in communities and hospitals, availability and utilisation of quality diagnostics and laboratories and educating people about antimicrobials have proved effective in reducing antimicrobial pressure — a precursor to resistance.
    • The National Action Plan for AMR, approved in 2017, completes its official duration this year. The progress under the plan has been far from satisfactory.
    • There is enough evidence that interventions like infection control, improved diagnosis and antimicrobial stewardship are effective in the containment of AMR.

    Conclusion

    The GRAM report has underlined that postponing action could prove costly.

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