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Subject: Health

  • Growing Concern Over Nicotine Pouches in India

    Why in the News

    Health experts and anti-tobacco activists are demanding stricter regulation or a ban on nicotine pouches, which are increasingly being sold online in India. Tamil Nadu’s Directorate of Drugs Control has issued alerts and notices against their illegal sale.

    What are Nicotine Pouches?

    • Small microfiber pouches containing nicotine powder, flavourings and additives.
    • Placed between the gum and lip, where nicotine is absorbed through the mouth lining.
    • Do not contain tobacco, but still deliver nicotine directly to the bloodstream.

    According to the Centers for Disease Control and Prevention, nicotine pouches dissolve in the mouth and do not require spitting.

    Why Experts Are Concerned

    • Highly Addictive: Nicotine is a highly addictive chemical, especially harmful for youth and pregnant women.
    • Not Approved for Smoking Cessation: Neither the U.S. Food and Drug Administration nor Indian authorities approve nicotine pouches as a quitting aid.
    • Health Risks: Possible effects include:
      • Cardiovascular problems
      • Gum disease and oral health issues
      • Increased overall nicotine intake
    • Some pouches reportedly contain up to 50 mg nicotine, far higher than standard nicotine replacement products.
    [2020] Which of the following are the reasons/factors for exposure to benzene pollution? Automobile exhaust Tobacco smoke Wood burning Using varnished wooden furniture Using products made of polyurethane Select the correct answer using the code given below: (a) 1, 2 and 3 only (b) 2 and 4 only (c) 1, 3 and 4 only (d) 1, 2, 3, 4 and 5

  • HPV Vaccine Policy: India-made Cervavac Yet to Enter National Programme

    Why in the News

    India has launched a large-scale HPV vaccination campaign for adolescent girls using Gardasil, while the India-made vaccine Cervavac has not yet been included in the national immunisation programme due to ongoing research on its single-dose effectiveness.

    HPV Vaccine Campaign in India

    • India plans to vaccinate 1.15 crore girls aged 14 years.
    • The campaign currently uses Gardasil-4, developed by Merck.
    • Vaccination is supported by funding from Gavi.

    About the Indigenous Vaccine: Cervavac

    • Developed through collaboration between:
      • Department of Biotechnology
      • BIRAC
      • Bill and Melinda Gates Foundation
      • Serum Institute of India
    • Officially launched in 2022.
    • Estimated price if procured by government: ₹200–400 per dose (much cheaper than global vaccines).

    Why Cervavac is Not Yet in the Programme

    • Ongoing ICMR Study: The Indian Council of Medical Research is studying whether one dose of Cervavac produces enough long-lasting antibodies. Results expected by 2027.
    • WHO Recommendation Change: The World Health Organization now allows single-dose HPV vaccination in national programmes. Gardasil already has WHO prequalification for single-dose use, while Cervavac does not yet.
    • Free Vaccine Supply: India received GAVI support providing limited “free” HPV vaccine doses, encouraging the use of Gardasil initially.

    Two-Dose vs Single-Dose Debate

    • Earlier recommendation: 2 doses for girls aged 9–15 (6 months apart).
    • New WHO guidance (2022): Countries may use single-dose schedules to improve coverage and reduce costs.
    • Single-dose programmes are easier to implement because adolescent girls may not return for the second dose.

    Burden of Cervical Cancer in India

    • Second most common cancer among Indian women.
    • About 80,000 new cases annually.
    • Around 42,000 deaths each year.
    • India accounts for about 20% of global cervical cancer cases.

    About HPV (Human Papillomavirus)

    • A group of viruses spread mainly through sexual contact.
    • Certain strains such as HPV-16 and HPV-18 cause most cervical cancers.
    • Vaccination significantly reduces risk.
    [2022] In the context of vaccines manufactured to prevent COVID-19 pandemic, consider the following statements: The Serum Institute of India produced COVID-19 vaccine named Covishield using mRNA platform. Sputnik V vaccine is manufactured using vector-based platform. COVAXIN is an inactivated pathogen-based vaccine. Which of the statements given above are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2 and 3

  • India Ranks Second Globally in Childhood Obesity

    Why in the News

    The World Obesity Atlas 2026, released by the World Obesity Federation on World Obesity Day (March 4), reported that India ranks second globally in childhood obesity, after China.

    Key Findings

    Scale of Childhood Obesity in India (2025)

    • Children aged 5–9: ~15 million overweight or obese
    • Children aged 10–19: ~26 million overweight or obese

    High BMI figures among children:

    • China: 62 million
    • India: 41 million
    • United States: 27 million
    • India therefore ranks second globally in number of children with high BMI.

    Global Trend

    • 20.7% of children worldwide (ages 5–19) are overweight or obese.
    • This increased from 14.6% in 2010.
    • By 2040, about 507 million children globally may be overweight or obese.

    Major Risk Factors Identified in India

    • Low Physical Activity: 74% of adolescents (11–17 years) do not meet recommended physical activity levels.
    • Poor Nutrition: Increased consumption of sugary beverages among children.
    • Inadequate School Nutrition: Only 35.5% of school-age children receive school meals.
    • Sub-optimal Breastfeeding: 32.6% of infants (1–5 months) do not receive optimal breastfeeding.

    Health Risks Linked to High BMI

    By 2040, India may see rising cases of:

    • Hypertension
    • Hyperglycaemia
    • High triglycerides
    • Metabolic dysfunction-associated steatotic liver disease (MASLD)
      • These conditions increase the risk of diabetes and cardiovascular diseases later in life.

    Recommended Policy Actions

    • Introduce taxes on sugar-sweetened beverages.
    • Restrict junk food marketing targeting children.
    • Promote healthy school meals and physical activity.
    • Strengthen nutrition and breastfeeding programmes.

    Prelims Pointers

    • BMI (Body Mass Index) = weight (kg) ÷ height² (m²).
    • World Obesity Day is observed on March 4.
    • Childhood obesity increases risk of Type 2 diabetes and cardiovascular diseases.
    • MASLD refers to Metabolic Dysfunction-Associated Steatotic Liver Disease.
    [2016] Which of the following is/are the indicator/ indicators used by IFPRI to compute the Global Hunger Index Report? Undernourishment Child stunting Child mortality Select the correct answer using the code given below. (a) 1 only (b) 2 and 3 only (c) 1, 2 and 3 (d) 1 and 3 only

  • India to Launch Free HPV Vaccination for Adolescent Girls

    Why in the News

    India will roll out a nationwide free Human Papillomavirus vaccination programme for adolescent girls in 2026 to prevent cervical cancer, according to Health Ministry sources.

    Key Features of the Programme

    • Target group: 14 year old girls
    • Voluntary and free of cost
    • Administered at:
      • Ayushman Arogya Mandirs
      • Community Health Centres
      • District hospitals
      • Government medical colleges
    • Supervised by trained medical officers
    • Post vaccination observation systems in place
    • India joins over 160 countries that have introduced HPV vaccination.

    Disease Burden in India

    • Cervical cancer is the second most common cancer among women in India.
    • Around 80,000 new cases annually.
    • Over 42,000 deaths each year.
    • Persistent HPV infection, especially types 16 and 18, causes over 80 percent of cases.

    About HPV

    • Human Papillomavirus is a group of viruses transmitted through close contact.
    • Most infections resolve naturally.
    • Persistent high risk infection can cause cervical cancer over time.

    Why Target Age 14?

    • Vaccine is most effective before exposure to the virus.
    • Provides long lasting immunity.
    • Prevents infection before onset of sexual activity.
    • The World Health Organization and its Strategic Advisory Group of Experts on Immunization have recognised that a single dose schedule can provide comparable protection to two dose regimens in many cases.
    • Immunocompromised individuals may require two or three doses.
    [2022] In the context of vaccines manufactured to prevent COVID-19 pandemic, consider the following statements: The Serum Institute of India produced COVID-19 vaccine named Covishield using mRNA platform. Sputnik V vaccine is manufactured using vector based platform. COVAXIN is an inactivated pathogen based vaccine. Which of the statements given above are correct? 

    (a) 1 and 2 only 

    (b) 2 and 3 only 

    (c) 1 and 3 only 

    (d) 1, 2 and 3

  • How is India tackling mental health crisis?

    Why in the News?

    The Economic Survey flagged rising digital addiction and screen-related mental health disorders, particularly among children and adolescents. The Union Budget announced strengthening of mental health infrastructure, including establishment of a second campus of NIMHANS in North India and upgradation of premier institutions in Ranchi and Tezpur. Despite increased allocation from ₹683 crore (2020-21) to ₹1,898 crore (2024-25), mental health spending remains about 2% of total health outlay.

    What is the Scale of India’s Mental Health Burden?

    1. Suicide Burden: Accounts for nearly one-third of global suicides; depression and addiction contribute significantly to disease burden.
    2. Economic Impact: Mental health conditions impose an estimated economic loss of $1.03 trillion between 2012 and 2030.
    3. Treatment Gap: 70-92% of individuals with mental disorders lack proper treatment due to low awareness, stigma, and workforce shortages.
    4. Human Resource Deficit: 0.75 psychiatrists per 1,00,000 population against the recommended 3 per 1,00,000.
    5. Adolescent Vulnerability: Rising digital addiction and screen-related disorders flagged in the Economic Survey.

    What Institutional Measures Have Been Announced?

    1. National institute of mental health and Neuro Sciences (NIMHANS) Expansion: Establishes second campus of National Institute of Mental Health and Neurosciences in North India.
    2. Institutional Upgradation: Upgrades premier institutions in Ranchi and Tezpur to improve regional access.
    3. Centre of Excellence Expansion: Sanctions over 20 Centres of Excellence to train postgraduate students in mental health.
    4. Advanced Treatment Infrastructure: Establishes 47 PG departments in mental health.
    5. Primary Healthcare Integration: Integrates mental health services under Ayushman Arogya Mandirs and Health and Wellness Centres.
    6. Tele-MANAS Helpline: Provides 24×7 free mental health support via toll-free number 14416 and 1-800-891-4416; operational across 36 States/UTs and supported by 23 specialised mentoring institutes.

    How Has Budgetary Allocation Evolved?

    1. Allocation Increase: Raises allocation from ₹683 crore (2020-21) to ₹1,898 crore (2024-25).
    2. Relative Share: Maintains mental health share at approximately 1% of total health budget and about 2% of national health outlay.
    3. Historical Underfunding: Reflects long-standing low fiscal prioritisation despite rising burden.

    Where Do Structural Gaps Persist?

    1. Low Budgetary Share: Limits impact due to marginal share within overall health expenditure.
    2. Underutilisation of Funds: Prevents full utilisation of allocated funds at national level.
    3. Institution-Centric Focus: Directs significant funds towards tertiary institutions such as NIMHANS and Centres of Excellence.
    4. Limited Community-Based Models: Weakens early intervention and preventive mental health services.
    5. Capacity Constraints: Maintains shortage of trained professionals, with only 9% gap reduction in access to mental healthcare.

    What Approach is Required Going Forward?

    1. Affordable Access: Ensures continuity of care and long-term treatment.
    2. Preventive Focus: Reduces years lived with disability through early detection.
    3. Human Resource Strengthening: Expands trained workforce capacity.
    4. Community Integration: Integrates mental well-being into school curricula and workplace policies.
    5. Whole-of-Community Model: Mainstreams mental health beyond hospital-centric systems.

    Conclusion

    India’s mental health crisis reflects a structural mismatch between the scale of the burden and the scale of response. Rising suicides, a 70-92% treatment gap, severe psychiatrist shortages, and mental health spending hovering around 1-2% of the health budget indicate systemic under-prioritisation despite recent institutional expansion.

    Strengthening tertiary institutions alone cannot address a crisis rooted in access, stigma, affordability, and preventive failure. A shift towards community-based care, workforce expansion, full utilisation of allocated funds, and integration of mental well-being into schools and workplaces is essential to convert policy intent into measurable public health outcomes.

    PYQ Relevance

    [UPSC 2023] Explain why suicide among young women is increasing in Indian Society. 

    Linkage: UPSC frequently frames GS-I Society questions around emerging social vulnerabilities reflected in current data trends. The article highlights India accounting for nearly one-third of global suicides and flags rising mental health distress, making youth and gender-specific suicide patterns directly relevant to contemporary exam themes.

  • Obesity in India and Budget 2026 Expectations  

    Why in the News?

    India has emerged as the third most obese country in the world after the US and China, according to the World Obesity Federation. The Economic Survey 2026 flagged obesity as a rising public health challenge across age groups, raising expectations from Union Budget 2026 to make healthy living affordable.

    Key Findings on Obesity in India

    • Global ranking: India is the third most obese country globally
    • Social spread:
      • 76 percent Indians report at least one obese person in their close social circle
      • 42 percent report four or more obese individuals around them
    • Associated diseases:
      • 56 percent obese individuals also suffer from lifestyle diseases like diabetes, hypertension, high cholesterol, fatty liver

    Causes of Rising Obesity

    • Sedentary lifestyle and lack of physical activity
    • High consumption of fatty and ultra processed foods
    • Urbanisation and screen based work culture
    • Poor dietary diversity and nutrition awareness

    Official Data  

    • National Family Health Survey 5:Overweight or obese adults:
      • Women: 24 percent
      • Men: 23 percent
      • Children under 5 with excess weight: Increased from 2.1 percent (2015–16) to 3.4 percent (2019–21)

    Health Implications

    • Higher risk of non communicable diseases like: Diabetes, Heart disease and Hypertension
    • Increased long term healthcare burden
    • Reduced productivity and quality of life

    Budget 2026 Expectations

    Citizens expect Budget 2026 to:

    • Reduce taxes on healthy food options
    • Improve affordability of fitness and preventive healthcare services
    • Discourage consumption of ultra processed foods through fiscal measures
    • Promote lifestyle based prevention over drug dependent solutions
    [2017] Which of the following are the objectives of ‘National Nutrition Mission’? 1. To create awareness relating to malnutrition among pregnant women and lactating mothers

    2. To reduce the incidence of anaemia among young children, adolescent girls and women

    3. To promote the consumption of millets, coarse cereals and unpolished rice

    4. To promote the consumption of poultry eggs

    Select the correct answer using the code given below: 

    (a) 1 and 2 only (b) 1, 2 and 3 only (c) 1, 2 and 4 only (d) 3 and 4 only

  • Menstrual Health and MHM

    Why in the News?

    The Supreme Court of India ruled on January 30, 2026 that menstrual health and access to menstrual hygiene management (MHM) in schools are integral to the Right to Life and Dignity under Article 21 of the Constitution.

    What the Court Held

    • Right to menstrual health is part of Article 21, covering dignity, privacy, and bodily autonomy.
    • Lack of MHM facilities exposes girls to stigma, humiliation, and exclusion.
    • Menstrual poverty violates right to education by causing absenteeism and dropouts.

    Key Constitutional Dimensions

    • Dignity: Girls must manage menstruation without humiliation.
    • Privacy and Bodily Autonomy: Choice cannot be dictated by lack of facilities.
    • Equality in Education: Gender-specific barriers defeat free and compulsory education.

    Important Observations

    • MHM goes beyond sanitation to include decisional freedom.
    • Unsafe practices or forced absenteeism undermine a dignified existence.
    • Impairment of education has long-term social and economic consequences.

    Directions Issued by the Court

    • Functional gender-segregated toilets in all schools, government and private.
    • Free-of-cost oxo-biodegradable sanitary napkins, preferably via vending machines in toilets.
    • Creation of MHM corners with spare innerwear, uniforms, disposable bags, and essentials.
    • Sensitisation of male teachers and students to prevent harassment and invasive questioning.

    Accountability Mechanism

    • Government schools held accountable for non-compliance with Section 19 of the RTE Act.
    • Private schools face de-recognition and penalties for violating prescribed norms.
    [2024] Under which of the following Articles of the Constitution of India, has the Supreme Court of India placed the Right to Privacy? (a) Article 15 

    (b) Article 16 

    (c) Article 19 

    (d) Article 21

  • The antibiotic pipeline is running dangerously dry

    Why in the News?

    Antimicrobial resistance (AMR) has become a serious global public health threat as the development of new antibiotics has not kept pace with the rapid rise in drug resistance. Unlike earlier decades, when ineffective antibiotics were regularly replaced by new ones, no truly new antibiotic classes have emerged in recent years. India is among the worst affected, with very high antibiotic use and an estimated 2.74 lakh deaths linked to AMR in 2019.

    Why is antimicrobial resistance a growing public health crisis?

    1. Rising mortality burden: AMR-attributable deaths in India were estimated at 2.74 lakh in 2019, reflecting a large and growing health burden.
    2. Treatment failure: Common infections are increasingly difficult to treat, increasing complications, hospital stays, and mortality.
    3. Systemic impact: AMR undermines surgery, chemotherapy, organ transplants, and neonatal care by increasing infection risk.
    4. Global spread: Resistant pathogens spread rapidly through travel, trade, food chains, and the environment.

    Why is India disproportionately affected by AMR?

    1. High infectious disease load: India continues to face a high burden of communicable diseases requiring antibiotic use.
    2. Extensive antibiotic consumption: India is among the world’s largest consumers of antibiotics, both in human and animal health.
    3. Healthcare pressures: Overcrowded hospitals and limited diagnostic capacity encourage empirical and broad-spectrum antibiotic use.
    4. Survival advantage of pathogens: Drug-resistant bacteria survive treatment and transmit resistance genes to other bacteria.

    How does antibiotic misuse accelerate resistance?

    1. Inappropriate prescribing: Antibiotics are frequently used for viral infections such as colds, coughs, and diarrhoea.
    2. Empirical treatment: Lack of timely diagnostics leads to blind antibiotic use without pathogen identification.
    3. Prophylactic use: Antibiotics are prescribed preventively, even where clinical benefit is uncertain.
    4. Seasonal misuse: Antibiotics are used for seasonal viral illnesses due to patient demand and prescribing habits.

    What is happening to the global antibiotic pipeline?

    1. Limited innovation: Very few new antibiotic classes have been developed in the past three decades.
    2. R&D stagnation: Most recent approvals involve modifications of existing drugs rather than new mechanisms of action.
    3. Commercial disincentives: Antibiotics offer low returns compared to chronic disease drugs, discouraging private investment.
    4. Effectiveness erosion: Even newly introduced antibiotics lose effectiveness rapidly due to resistance.

    Why is antibiotic stewardship more effective than blanket bans?

    1. Behavioural regulation: Stewardship programs guide rational prescribing rather than eliminating access.
    2. Evidence from India: The Indian Council of Medical Research (ICMR) launched a national antibiotic stewardship programme in 2015.
    3. Measured impact: Prescription awareness improved, but full behavioural internalisation remains limited.
    4. Sustainability challenge: Stewardship requires continuous monitoring, training, and institutional commitment.

    How do livestock and agriculture worsen the AMR problem?

    1. Non-therapeutic use: Antibiotics are used in animals for growth promotion and disease prevention.
    2. Shared drug classes: Many antibiotics critical for humans are also used in animals.
    3. Environmental spread: Antibiotic residues enter soil and water through animal waste and food chains.
    4. Resistance transfer: Resistance genes move between human, animal, and environmental bacteria.

    Why is data collection on AMR inadequate?

    1. Limited surveillance: ICMR’s AMR surveillance network covers only 25 tertiary hospitals.
    2. Urban bias: Most data originates from large hospitals, missing community-level resistance patterns.
    3. Underestimation risk: Resistance prevalence is likely higher than reported due to incomplete coverage.
    4. Policy constraint: Inadequate data limits targeted interventions and resource allocation.

    Why can’t new antibiotics alone solve AMR?

    1. Rapid resistance development: Resistance emerges even against newly introduced drugs.
    2. Finite effectiveness window: Antibiotics lose usefulness within a few years of widespread use.
    3. Overreliance risk: Dependence on drug discovery ignores behavioural and systemic drivers.
    4. Adjunct necessity: Stewardship, infection prevention, and diagnostics remain central.

    Conclusion

    The antibiotic pipeline crisis reflects a structural mismatch between rising resistance and declining innovation. India’s experience demonstrates that stewardship, surveillance, and behavioural regulation are as critical as drug discovery. Without systemic correction, modern medicine risks returning to a pre-antibiotic era.

    PYQ Relevance

    [UPSC 2024] Can overuse and free availability of antibiotics without Doctor’s prescription, be contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

    Linkage: This question directly maps to GS Paper III (Science & Technology-Public Health), aligning with UPSC’s repeated focus on antimicrobial resistance as a governance and regulatory challenge. It links with PYQs on antibiotic overuse, emerging health challenges, and technology-policy gaps, reflecting UPSC’s trend of testing systemic failures rather than medical details.

  • Nimesulide Ban 

    Why in the News?

    The Government of India has banned manufacture, sale and distribution of oral formulations of Nimesulide above 100 mg with immediate effect under Section 26A of the Drugs and Cosmetics Act, 1940.

    About Nimesulide

    Nimesulide is a Non Steroidal Anti Inflammatory Drug (NSAID) used for acute pain relief and fever reduction.

    Key Features of the Drug

    • Pharmacological class: NSAID
       • Mechanism of action: Inhibits prostaglandin synthesis by blocking inflammatory chemical mediators
       • Therapeutic use: Short term treatment of pain and fever
       • Common side effects: Nausea, vomiting, diarrhoea, raised liver enzymes
       • Known risk: Hepatotoxicity, especially at higher doses or prolonged use

    Reason for the Ban

    • Oral doses above 100 mg pose serious risk to liver health
       • Increased incidence of drug induced liver injury
       • Safer alternative analgesics available
       • Action taken under Section 26A, which allows banning drugs harmful to public health
    [2019] Which of the following are the reasons for the occurrence of multi-drug resistance in microbial pathogens in India? 

    1. Genetic predisposition of some people 

    2. Taking incorrect doses of antibiotics to cure diseases 

    3. Using antibiotics in livestock farming 

    4. Multiple chronic diseases in some people 

    Select the correct answer using the code given below. 

    (a) 1 and 2 (b) 2 and 3 only (c) 1, 3 and 4 (d) 2, 3 and 4

  • FSSAI Egg Safety Drive 

    Why in the News?

    • FSSAI launched a nationwide egg safety drive. Triggered by allegations of nitrofurans residues in eggs

    Regulatory Authority

    • Food Safety and Standards Authority of India
     • Regulates manufacture, storage, distribution, sale, and import of food

    Trigger for Action

    • Viral social media video alleging nitrofurans in Eggoz eggs
     • Raised public health concerns

    Action by FSSAI

    • Directed Food Safety Officers to collect samples
     • Sampling of branded and unbranded eggs
     • Testing in 10 FSSAI laboratories across India

    About Nitrofurans

    • Synthetic antibiotics
     • Banned in food producing animals
     • Residues may occur due to illegal veterinary use
     • Linked to carcinogenic risk

    International Context

    • European Union has banned nitrofurans in food producing animals

    Company Response

    • Eggoz assured consumer safety
     • Committed to publishing lab reports publicly
     • Reaffirmed compliance with food safety norms

    Public Health Significance

    • Strengthens food safety surveillance
     • Protects consumer health
     • Addresses risks of antibiotic residues and AMR

    Prelims Pointers

    • FSSAI functions under Food Safety and Standards Act, 2006
     • Eggs are animal origin food products
     • Antibiotic residue monitoring is part of food safety regulation

    In India, the use of carbofuran, methyl parathion, phorate and triazophos is viewed with apprehension. These chemicals are used as (2019)

    (a) pesticides in agriculture 

    (b) preservatives in processed foods 

    (c) fruit-ripening agents 

    (d) moisturising agents in cosmetics