đŸ’„Join UPSC 2027,2028 Mentorship (July Batch) + XFactor Notes & Microthemes PDF
Talk to Mentor

Civilsdaily

Login

Subject: Health

  • Ayushman Bharat Digital Mission

    The PM has launched the Ayushman Bharat Digital Mission to provide a digital Health ID to people which will contain their health records.

    Ayushman Bharat Digital Mission

    • The pilot project of the National Digital Health Mission was announced by PM Modi during his Independence Day speech from the Red Fort on August 15, 2020.
    • The mission will enable access and exchange of longitudinal health records of citizens with their consent.
    • This will ensure ease of doing business for doctors and hospitals and healthcare service providers.

    The key components of the project include

    • Health ID for every citizen that will also work as their health account, to which personal health records can be linked and viewed with the help of a mobile application,
    • Healthcare Professionals Registry (HPR)
    • Healthcare Facilities Registries (HFR) that will act as a repository of all healthcare providers across both modern and traditional systems of medicine

    What makes this special?

    • The mission will create integration within the digital health ecosystem, similar to the role played by the Unified Payments Interface (UPI) in revolutionising payments.
    • Citizens will only be a click-away from accessing healthcare facilities.

     

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Disease surveillance system

    Context

    A well-functioning system can reduce the impact of diseases and outbreaks.

    Importance of disease surveillance system

    • Successful tackling of cholera in 1854 in London by use of the health statistics and death registration data from the General Registrar Office (GRO) started the beginning of a new era in epidemiology.
    • Importance of data: The application of principles of epidemiology is possible through systematic collection and timely analysis, and dissemination of data on the diseases.
    • This is to initiate action to either prevent or stop further spread, a process termed as disease surveillance.
    • Subsequently, the high-income countries invested in disease surveillance systems but low- and middle-income countries used limited resources for medical care.
    • Then, in the second half of the Twentieth century, as part of the global efforts for smallpox eradication and then to tackle many emerging and re-emerging diseases, many countries recognised the importance and started to invest in and strengthen the diseases surveillance system.
    • These efforts received a further boost with the emergence of Avian flu in 1997 and the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002-04.

    Surveillance in India

    • The Government of India launched the National Surveillance Programme for Communicable Diseases in 1997.
    • However, this initiative remained rudimentary.
    • In wake of the SARS outbreak, in 2004, India launched the Integrated Disease Surveillance Project (IDSP).
    • The focus under the IDSP was to increase government funding for disease surveillance, strengthen laboratory capacity, train the health workforce and have at least one trained epidemiologist in every district of India.

    Issues with surveillance: Interstate variation

    • Variation among states: The disease surveillance system and health data recording and reporting systems are key tools in epidemiology.
    • In the fourth round of serosurvey, Kerala and Maharashtra States could identify one in every six and 12 infections, respectively; while in States such as Madhya Pradesh, Uttar Pradesh and Bihar, only one in every 100 COVID-19 infections could be detected.
    • This points towards a weak disease surveillance system.
    • In a well-functioning disease surveillance system, an increase in cases of any illness would be identified very quickly.
    • While Kerala is picking the maximum COVID-19 cases; it could pick the first case of the Nipah virus in early September 2021. 
    • On the contrary, cases of dengue, malaria, leptospirosis and scrub typhus received attention only when more than three dozen deaths were reported and health facilities in multiple districts of Uttar Pradesh, began to be overwhelmed.

    Way forward

    • A review of the IDSP in 2015, conducted jointly by the Ministry of Health and Family Welfare, the Government of India and World Health Organization India had made a few concrete recommendations to strengthen disease surveillance systems.
    • These included increasing financial resource allocation, ensuring an adequate number of trained human resources, strengthening laboratories, and zoonosis, influenza and vaccine-preventable diseases surveillance.
    • Increase allocation: The government resources allocated to preventive and promotive health services and disease surveillance need to be increased by the Union and State governments.
    • Trained workforce: The workforce in the primary healthcare system in both rural and urban areas needs to be retrained in disease surveillance and public health actions.
    • The vacancies of surveillance staff at all levels need to be urgently filled in.
    • Capacity increase: The laboratory capacity for COVID-19 needs to be planned and repurposed to increase the ability to conduct testing for other public health challenges and infections.
    • The interconnectedness of human and animal health: The emerging outbreaks of zoonotic diseases, be it the Nipah virus in Kerala or avian flu in other States as well as scrub typhus in Uttar Pradesh, are a reminder of the interconnectedness of human and animal health.
    • The ‘One Health’ approach has to be promoted beyond policy discourses and made functional on the ground.
    • Strengthening registration system: There has to be a dedicated focus on strengthening the civil registration and vital statistics (CRVS) systems and medical certification of cause of death (MCCD).
    • Coordination: It is also time to ensure coordinated actions between the State government and municipal corporation to develop joint action plans and assume responsibility for public health and disease surveillance.
    • The allocation made by the 15th Finance Commission to corporations for health should be used to activate this process.

    Consider the question “Examine the measure for disease surveillance in India? How it can help reduce the impact of the diseases?”

    Conclusion

    We cannot prevent every single outbreak but with a well-functioning disease surveillance system and with the application of principles of epidemiology, we can reduce their impact.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Front-of-pack labelling of Food Stuffs

    Seven years, four committees and two draft regulations later, India still does not have a clear labelling system to warn consumers about harmful levels of fat, salt and sugar in processed foods.

    Context

    • According to the Food Safety and Standards (Packaging and Labelling) Regulations, 2011, every pre-packed processed food product sold in the country must be labelled with nutritional information.
    • To ensure that consumers are able to easily see and interpret the nutritional information on food packets, an expert committee was established by the Food Safety and Standards Authority of India (FSSAI).
    • The committee, set up following an order of the Delhi High Court which was hearing a public interest petition seeking a ban on the sale of junk food in and around schools.

    Why label nutritional information?

    • This helps the consumer know everything about the food they buy and make an informed decision about what and how much to eat.
    • Such information is particularly crucial because the packaged food contain ultra-processed foods that are high in fat, salt or sugar and low in fibre and other essential micronutrients.
    • On the one hand, these foods cause malnutrition.
    • On the other hand they are linked strongly with obesity and diet-related non-communicable diseases, such as Type-2 diabetes, hypertension, heart ailments and certain cancers, like that of the colon.
    • All these increase the risk of premature death.

    Issues with labelling in India

    • Most products provide information in English understanding which can be daunting for a vast number of people in India.

    What is FoP labelling?

    • The front-of-pack (FoP) labelling system has long been listed as one of the global best practices to nudge consumers into healthy food choices.
    • It works just the way cigarette packets are labelled with images to discourage consumption.
    • Countries such as Chile, Brazil and Israel have laws to push the packaged food industry to adopt FoP labelling.
    • They have used FoP labelling as a measure to fight obesity and NCDs.

    FoP labelling in India

    • The system is yet to be implemented in India even seven years after it was first proposed by FSSAI.
    • The fact is, makers of packaged foods are also a powerful lot, with strong business acumen.
    • While companies in other countries have acceded to the FoP labelling laws, they are unwilling to do so in India — a country experiencing a dietary shift.

    Why must we have FoP labels?

    • Countries are working to find ways to nudge consumers into healthy food choices and to contain the growing crisis of obesity and diet-related non-communicable diseases (NCDs).
    • It is a crisis that increasingly impacts children and also exacerbates novel coronavirus disease (COVID-19) symptoms. Front-of-pack (FoP) labelling is definitely an effective tool in this effort.

    India definitely needs ‘warning labels’ on front-of-pack, but this must be a symbol-based label with no text and numbers. This is because:

    (1) Junk foods have high levels of unhealthy nutrients

    • There is strong evidence that sugar, salt and fat in junk foods are addictive, like nicotine in tobacco.
    • FoP ‘warning’ labels have helped reduce cigarette consumption. It is time we adopted the same for junk foods.

    (2) Warning labels are easy to notice and understand

    • They do not confuse consumers with mixed messages.
    • Their distinct shape, colour and size make them noticeable in the otherwise cluttered and colourful packaging.
    • With one label for one nutrient, it becomes easier to know if a product is high in more than one nutrient.

    (3) Warning labels are the global best practice now

    • At least seven countries have adopted warning labels in the past five years. These include Chile, Peru, Mexico, Israel and Uruguay.
    • Low- and middle-income mothers have shown profound changes in attitudes towards food purchases as they now understand the nutritional content of packaged foods.
    • Even children can read the labels and take an informed decision. This has also forced food companies to reduce the amount of sugar and sodium in foods and beverages.

    (4) They are best suited for India

    • Warning labels are best suited for India as they do not include numbers unlike many other FoP labels.
    • In fact, warning labels that are symbol-based, like that of Israel, can transcend the barriers of literacy and language in India.

    (5) FSSAI has experience of successfully implementing symbol-based FoP labels

    • Its “green filled circle in green outlined square” logo to depict vegetarian food has been hugely successful in informing consumers.
    • In recent years, FSSAI also has made similar laws to depict fortification (+F logo) and organic food (a green-coloured tick for Jaivik Bharat logo).

    Way forward

    • FoP labels must include information on nutrients that make food injurious to health.
    • This should be distinct from the details on the back-of-pack. FoP labels should aim to inform the consumer, while the back-of-pack label serves the purpose of scientific compliance and enforcement.
    • FoP labels should have information on ‘total sugar’ and not ‘added sugar’. There is no analytical laboratory method to differentiate ‘added sugar’ from total sugar and quantify it.

     

  • Outpatient Opioid Assisted Treatment Centres

    The state government in Punjab is banking on Outpatient Opioid Assisted Treatment Centres (OOAT) to curb the drug menace in the state.

    What are the OOAT Centres?

    • The move to set up OOAT centres in Punjab began in October 2017.
    • The centres administer de-addiction medicine, a combination of buprenorphine and naloxone, to the opioid-dependent people registering there.
    • Administered in the form of a pill, the treatment is primarily for addicts of opioid drugs, including heroin, poppy husk and opium.
    • There are such private and state-run centres in Punjab.

    Why is the Punjab government planning?

    • Punjab is planning to open OOAT linked extension centres and clinics in rural areas to broaden the outreach of this treatment.
    • The idea is that patients get medicine nearer their place of residence.
    • It will also reduce pressure on existing OOAT centres which cater to patients from far-off places.

    Administering medicine at OOAT Centres

    The patients are broadly put into three categories or phases.

    • In the induction phase, the newly-registered patients are administered medicine at the OOAT centres for a week or two to manage withdrawal symptoms in the presence of the doctor and counselor.
    • In the second, stabilization, phase, which extends between two to four months.
    • The patient is put on watch for taking any opioid-based “super-imposed” illicit drug and accordingly maximum tolerated dose is administered to nullify the kick of the “super-imposed” drug.
    • In the third, maintenance, phase, the patient is given take-home medicine and it continues for a year and a half before an assessment is done to see whether the medicine can be tapered off.

    Why is Punjab banking so much on OOAT therapy?

    There are two major approaches to wean away opioid-dependent persons.

    • One is the abstinence approach and another alternate medication approach.
    • There are more chances of relapse in an abstinence-based approach as compared to alternate medication for de-addiction.
    • In the abstinence approach, it would have taken years to rehabilitate patients by admitting them to facilities and there would have been increased chances of relapse.
    • On the other hand, the alternate medication approach has been acknowledged as better in various scientific studies worldwide.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • The nutrition-hygiene link

    Context

    A recent UNICEF report stated that nearly 12 lakh children could die in low-income countries in the next six months due to a decrease in routine health services and an increase in wasting. Nearly three lakh such children would be from India.

    Problem of nutrition in India and factors responsible for it

    • The National Family Health Survey (NFHS 5) indicates that since the onset of the pandemic, acute undernourishment in children below the age of five has worsened.
    • According to the latest data, 37.9 per cent of children under five are stunted, and 20.8 per cent are wasted — a form of malnutrition in which children are too thin for their height.
    • Comparison with other countries: This is much higher than in other developing countries where, on average, 25 per cent of children suffer from stunting and 8.9 per cent are wasted.
    • Factors: Inadequate dietary intake is the most direct cause of undernutrition.
    • Several other factors also affect nutritional outcomes, such as contaminated drinking water, poor sanitation, and unhygienic living conditions.
    • According to the World Health Organisation, 50 per cent of all mal- and under-nutrition can be traced to diarrhoea and intestinal worm infections.
    • Nutrition and water, sanitation, and hygiene (WASH) are intricately linked, and changes in one tend, directly or indirectly, to affect the other.
    • Poor hygiene and sanitation in developing countries lead to a sub-clinical condition called “environmental enteropathy” in children.
    • Environmental enteropathy is a disorder of the intestine which prevents the proper absorption of nutrients, rendering them effectively useless.
    • Childhood diarrhoea is a major public health problem in low- and middle-income countries, leading to high mortality in children under five.
    • According to NFHS 4, approximately 9 percent of children under five years of age in India experience diarrhoeal disease.

    Way forward

    • Investment in WASH: The link between WASH and nutrition suggests that greater attention to, and investments in, WASH are a sure-shot way of bolstering the country’s nutritional status.
    • Addressing nutrition sanitation problems together: Both WASH and nutrition must be addressed together through a lens of holistic, sustainable community engagement to enable long-term impact.
    • One of the first instances of the link between WASH and nutrition appeared in the Convention on the Rights of the Child in 1989, which urges states to ensure “adequate nutritious foods and clean drinking water” to combat disease and malnutrition.
    • Safe drinking water, proper sanitation, and hygiene can significantly reduce diarrhoeal and nutritional deaths.
    • Multistructural approach: What we require is a coordinated, multisectoral approach among the health, water, sanitation, and hygiene bodies, not to mention strong community engagement.
    • WHO has estimated that access to proper water, hygiene, and sanitation can prevent the deaths of at least 8,60,000 children a year caused by undernutrition.

    Conclusion

    At the end of the day, all sides are working towards a common goal: A safe and healthy population and the hope that the 75th year of Independence becomes a watershed moment in India’s journey.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Why India needs an NHS-like healthcare model

    Context

    Even after the pandemic, the Indian government continues to budget less than 1 per cent of GDP for healthcare, one of the lowest in the world.

    About NHS

    • Every year, Britain’s legendary health network National Health Service (NHS) cures 15 million patients with chronic ailments, at a fraction of the cost spent by the US.
    • The NHS funded by direct taxes is also the fifth largest employer in the world, after McDonalds and Walmart.
    • One of every 20 British workers is employed as a doctor, nurse, catering and technical personnel.

    Public healthcare in India

    • Even after the pandemic, the Indian government continues to budget less than 1 per cent of GDP for healthcare, one of the lowest in the world.
    • In contrast, China invests around 3 per cent, Britain 7 per cent and the United States 17 per cent of GDP.
    • So, 62 per cent of health expenses in India are paid for by patients themselves
    • This is one of the main reasons for families falling into poverty especially during the pandemic.
    • In India, hospitals are beleaguered with absentee staff.
    • As per a Niti Aayog database, in the worst state of Bihar in 2017-18, positions for 60 per cent of midwives, 50 per cent of staff nurses, 34 per cent of medical officers and 60 per cent of specialist doctors were vacant.
    • Those on the job, despite being handsomely paid, are chronically overworked.

    Conclusion

    In the 21st century, not much has improved in India’s public hospitals. Still, in India doctors are often equated with gods. What India needs in NHS like healthcare model.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • PM announces Rice Fortification Plan

    PM in his I-day speech has announced the fortification of rice distributed under various government schemes, including the Public Distribution System (PDS) and mid-day meals in schools, by 2024.

    What is Fortification?

    • FSSAI defines fortification as “deliberately increasing 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”.

    What is Fortified Rice?

    • Rice can be fortified by adding a micronutrient powder to the rice that adheres to the grains or spraying the surface of ordinary rice grains with a vitamin and mineral mix to form a protective coating.
    • Rice can also be extruded and shaped into partially precooked grain-like structures resembling rice grains, which can then be blended with natural polished rice.
    • Rice kernels can be fortified with several micronutrients, such as iron, folic acid, and other B-complex vitamins, vitamin A and zinc.
    • These fortified kernels are then mixed with normal rice in a 1:100 ratio, and distributed for consumption.

    Note: Biofortification is the process by which the nutritional quality of food crops is improved through agronomic practices, conventional plant breeding, or modern biotechnology. It differs from conventional fortification in that Biofortification aims to increase nutrient levels in crops during plant growth rather than through manual means during the processing of the crops.

    What is the plan announced by the PM?

    • Malnutrition and lack of essential nutrients in poor women and poor children pose major obstacles in their development.
    • In view of this, it has been decided that the government will fortify the rice given to the poor under its various schemes.
    • Be it the rice available at ration shops or the rice provided to children in their mid-day meals, the rice available through every scheme will be fortified by the year 2024.

    Why such a move?

    • The announcement is significant as the country has high levels of malnutrition among women and children.
    • According to the Food Ministry, every second woman in the country is anemic and every third child is stunted.
    • India ranks 94 out of 107 countries and is in the ‘serious hunger’ category on the Global Hunger Index (GHI).
    • Fortification of rice is a cost-effective and complementary strategy to increase vitamin and mineral content in diets.
    • According to the Food Ministry, seven countries have mandated rice fortification – the USA, Panama, Costa Rica, Nicaragua, Papua New Guinea, Philippines, and the Solomon Islands.

    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.

    Adhering to FSSAI standard

    The Food Safety and Standards Authority of India (FSSAI) sets standards for food items in the country.

    • According to FSSAI norms, 1 kg fortified rice will contain iron (28 mg-42.5 mg), folic acid (75-125 microgram), and Vitamin B-12 (0.75-1.25 microgram).
    • In addition, rice may also be fortified with micronutrients, singly or in combination, with zinc(10 mg-15 mg), Vitamin A (500-750 microgram RE), Vitamin B1 (1 mg-1.5 mg), Vitamin B2 (1.25 mg-1.75 mg), Vitamin B3 (12.5 mg-20 mg) and Vitamin B6 (1.5 mg-2.5 mg) per kg.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

    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 programme 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

  • Issues related to people with disabilities

    Context

    Twenty years ago on August 6 in Erwadi in Tamil Nadu’s Ramanathapuram, a fire broke out in a thatched shelter, engulfing 43 chained people who had psychosocial disabilities.

    Legal provision for the persons with disabilities

    • India ratified the Convention on the Rights of Persons with Disabilities (CRPD) in 2007.
    • The Rights of Persons with Disabilities Act  was enacted in 2016.
    • The Mental Healthcare Act (MHCA) was enacted in 2017.

    Failure of the states

    • Sates have failed to uphold the human rights of people with disabilities in general and those with psychosocial and intellectual disabilities in particular.
    • Only eight states/UTs — Karnataka, Andhra Pradesh, Uttar Pradesh, Jammu & Kashmir, Maharashtra, Odisha, Kerala, and West Bengal — have framed rules for implementation of MHCA.
    • Unless we implement the law in letter and spirit, the Global Mental Health Movement will remain a mere buzzword and the CRPD-reliant MHCA will remain a law only on paper.

    Violations of rights in private asylums

    • Private asylums survive because of their close proximity to faith-based healing centres.
    • Because mental health conditions carry a high stigma, caregivers flock to these faith-based facilities in the hopes of finding a cure.
    • Private players take advantage of their vulnerabilities, forcing such persons with psychosocial issues to be grouped together and chained in these shelters.
    • Chaining in any way or form is outlawed under Section 95 of the MHCA.

    Way forward

    • Human right approach: We must work to ensure that the human rights approach to disability is integrated into mental health systems, education, law, and bureaucracy.
    • We move away from pathologisation, segregation, and a charity-based approach.

    Conclusion

    Implementation of rights of the persons with disability needs implementation in letter and spirit and human rights based approach.

  • [pib] SATYAM Programme

    The Ministry of Science & Technology (MoST) is implementing the Science and Technology of Yoga and Meditation (SATYAM) Programme to explore the effect of yoga and meditation as add on therapy to fight COVID-19.

    SATYAM Programme

    • The MoST is implementing SATYAM Programme since the year 2015-16 to promote scientific research in the field of yoga and meditation in order to understand its role in human wellbeing.
    • Its main objective is encouraging scientists, clinicians and experienced practitioners of yoga and meditation, with a proven track record, to submit concept notes.

    Themes covered:

    • Investigations on the effect of Yoga and Meditation on physical and mental health and well being.
    • Investigations on the effect of Yoga and Meditation on the body, brain, and mind in terms of basic processes and mechanisms.

    Focus on COVID

    It shall focus on three dimensions of COVID related illness:

    • Mental Stress
    • Respiratory
    • Immune system

  • Organ Transplantation in India

    The Government of India is implementing National Organ Transplant Programme (NOTP) to promote organ donation and transplantation across all States/Union Territories (UTs).

    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.

    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