Friday, April 13, 2012

National Safe Motherhood Day Observed

“Sustained development of the country can be achieved only if we take holistic care of our women and children. Maternal and child mortality and morbidity indicators reflect not only how well the health system is functioning, but also the degree of equity in public service delivery, utilisation of services, the social status of women and our concern for children”, observed the Minister of State for Health and Family Welfare, Sudip Bandyopadhyay, at Jaipur on 11th March, the event being National Safe Motherhood Day.

“Ensuring quality services for safe motherhood” was the theme for 2012 National Safe Motherhood Day. Launching the celebrations from Jaipur, the Minister of State for Health and Family Welfare, Sudip Bandyopadhyay said women are strong pillars of any vibrant society.

In India, over the last decade there has been a considerable decline in MMR, IMR and TFR. However, Regional disparities are considerable and an extra impetus needs to be given to the efforts to accelerate the pace of decline in these indicators in many states, cautioned Shri Bandyopadhyay.

Over the last few decades, the country has taken many initiatives and made progress. With the implementation of schemes like Janani Suraksha Yojana by Government of India we have been able to bring the women in the institutional fold.

Government of India has also taken several policy decisions to improve quality in service delivery, the Minister elaborated. Auxiliary Nurse Midwives (ANMs), Staff nurses (SNs) and Lady health visitors (LHVs) are being trained as skilled birth attendants, MBBS doctors are being trained in Essential life saving obstetric and anaesthetic skills, various types of equipments are being provided to the States, Infrastructure of the health facilities are being strengthened and new constructions are being sanctioned wherever the same is not available.

 “We have also launched Janani Shishu Suraksha Karyakaram (JSSK) entitling every pregnant women delivering at govt health facilities free drugs, free diagnostics, free diet , free delivery and Caesarean Section, free to and fro transportation. Similar facilities have been given to all sick neonates upto one month”, said the Minister while releasing the publicity material at the function held today during the Consultation Commemorating National Safe Motherhood Day.

 The Minister also gave away Health Workers Awards to best performing ANMs, ASHAs, etc. Shri Bandyopadhyay also flagged off the Hamari Beti Express alongwith, A. A. Khan, State Health Minister, Government of Rajasthan, on the occasion. The Minister hoped that deliberations during the day and way forward as deliberated would help us in not only understanding barriers in provision of quality care but also charting out a road map for future.

11th April, which is the birth anniversary of late Kasturba Gandhi, is being celebrated every year as National Safe Motherhood Day, from 2003 onwards. On this day celebration are organized throughout the country involving different stake holders to sensitize the people, media, health professionals and health institutions about safe motherhood.

SAARC Health Ministers' Conference at Male: Azad Calls for Regional Cooperation

Addressing the fourth Health Ministers’ Conference at Male, Maldives on 12th March, the Union Health and Family Welfare Minister, Ghulam Nabi Azad said that a strong and vibrant public health care system can cope with the enormous challenges emanating from demographic and epidemiological transition in the SAARC region.

Azad has said “We should collaborate amongst ourselves to find our own concrete solutions which are feasible, cost effective and suitable for our region”. The Minister added that full advantage of the strength and vibrancy of SAARC in addressing the common health problems of the region should be taken.

The President of Maldives, Dr Mohammed Waheed inaugurated the Health Ministers’ Conference. He noted that the meeting was being held at a very critical time, when there is a need to pool the resources, to recognise the changes and to agree on useful and effective solutions.

Noting that regional cooperation have long been a norm in combating common challenges, President Waheed expressed confidence that SAARC can continue to play a pivotal role in achieving better health goals for its peoples. He said the initiatives under the auspices of the meetings of SAARC Health Ministers, would greatly enhance the common understanding and capacity to deal with regional health challenges.

“Such collaborations not only make economic sense and results in efficiency, but also lead to greater understanding of the nature of the present challenges and foster clear-cut responses”, he said. The President further said he was confident that this forum would continue to address regional health issues such as the increasing burden of non-communicable diseases (NCDs), the challenges faced by many small countries in the area of Human Resources for Health, and “the very real threat of bio-terrorism, which require cohesive strategies and approaches across all countries of the region”.

In his speech, the President also highlighted the challenges to the health system of the Maldives. Describing those challenges, he said those challenges include “irresponsible and ill-informed intervention in the organization and management of the health system”; the dismantling of public health system; experimentation with the management of the system based on political activists; and, the complete neglect of prevention and primary health care.

Taking note of the large burden of communicable diseases and unacceptably high levels of maternal and child mortality, particularly in India and Pakistan, Azad had stated that adopting a comprehensive strategy for Diseases Surveillance for Prevention and Control of Communicable Diseases is the need of the hour.
Azad emphasised that it is of paramount importance to develop and put in place a comprehensive strategy for surveillance, early detection and response to such diseases and infections. Among the strategies discussed during the Health Ministers’ Conference include capacity building, effective response, laboratory support, information sharing, cross border collaboration, monitoring and research. 

 Azad stated that there are many examples of successful strategies and programs in the region in combating dreadful diseases. Directly Observed Treatment Short-course (DOTS) strategy originated from TB research in India and is now the global paradigm in TB prevention and control.

The response to HIV/AIDS in India over the last decade has yielded encouraging outcomes in terms of prevention and control of HIV whereby the number of annual new HIV infections has declined by more than 50% during the last decade from 2.7 lakh new infections in 2000 to 1.2 lakh in 2009, Azad elaborated.

Sri Lanka is an example of public health excellence in the region with health status indicators comparable with the best in the world. Bangladesh has set an example in dramatically reducing infant and maternal mortality in the face of most crippling circumstances, Azad pointed out. 


 Azad also invited attention of the gathering to the issue of non-communicable diseases  (NCDs) that have emerged as the major threat to the health of our populations. Tobacco related cancers, chronic cardio-vascular diseases, hypertension and diabetes are significantly contributing to morbidity and mortality in the region.

He said India’s experience in developing laboratory capabilities and a system of quality assurance could be of great assistance to the SAARC countries. “India would welcome requests from any country in training of manpower in the fields of epidemiology, disease surveillance, diagnostic tools and techniques and Information, Communication Technology applications” Azad offered.

Azad also suggested the Health Ministers of the region should meet more often to deliberate upon a selected theme or subject of common interest and agree on an action plan. “This should be followed up by interactions and workshops at the level of officials and technical experts 2-3 times a year on sharing of best practices, technological applications and innovations, and cross-border collaborations. In this regard, it is my privilege to state that India volunteers to host the next meeting of SAARC Health Ministers” Azad said.

Twenty Seven years ago SAARC was born with the objective of fostering joint action and cooperation in solving common problems, furthering regional interests and fulfilling the aspirations of the peoples of South Asia with the conviction that regional cooperation among the countries of South Asia is mutually beneficial, desirable and necessary for improving the quality of life of the peoples of the region.

H1N1 Influenza in India: No Cause for Panic

The situation with respect to instances of H1N1 in India is well under control and is being monitored. As reported in some section of the press, the virus has not mutated to a more virulent form or changed its character.

According to the Health ministry release, the Director, National Institute ofVirology, Pune has clarified that the presently circulating strain of H1N1 pandemic virus belongs to clade 6 and 7. (Clade is the medical terminology used to describe related organisms descended from a common ancestor). These clades are circulating in many countries and all are treatable with Oseltamivir, an antiviral drug, which slows the spread of the influenza causing virus.

The currently available vaccine can be used as an antigenic; antigen is a substance that when introduced into the body stimulates the production of an antibody. Antigens include toxins, bacteria, foreign blood cells, and the cells of transplanted organs. Currently, there is no mutation to suggest change of virus to 'dangerous form'.

The World Health Organization while declaring the Pandemic as over in August 2010, had conveyed that the influenza H1N1 pandemic virus would take on the behaviour of seasonal influenza virus, and continue to circulate for some years to come. Hence, in the post-pandemic period, localized outbreaks of varying magnitude with significant level of H1N1 transmission are expected.

Subsequent to this declaration, India had experienced major outbreaks during the period August to October, 2010 and again from May, 2011 to July 2011. In March-April, 2012, there is  an increased number of cases of Pandemic Influenza A H1N1 reported from the State of Andhra Pradesh, Maharashtra, Rajasthan, Karnataka and Tamil Nadu.

Small pockets of populations which remained unexposed to the pandemic stand the chance of being  susceptible and may be affected. In first week of March almost 30% of referred samples were positive for H1N1 in Pune which has come down to approx. 10% now.

A large number of these cases would be presenting with mild influenza like illness and as such requires no testing or anti viral drug treatment. However, it is important to get oneself examined at the nearest hospital in the initial part of illness to detect moderate illness and other associated risk factors/ diseases that require hospitalization, the ministry's release has pointed out.

The anti viral drug Oseltamivir is available free of cost through the State public health system. They are also available with retail chemists licensed to keep Schedule X drugs. A central stockpile of about 8 million doses of Oseltamivir is also maintained. As the virus is circulating within the country, there is no need to impose any travel restrictions or screening at inter-state point of entry, railway stations etc.

Committee of Secretaries Reviews State of Preparedness to Contain H1N1

The Cabinet Secretary, Ajit Kumar Seth, chaired on 12th March, a meeting of the Committee of Secretaries to review the state of preparedness to contain the incidence of H1N1 virus. Secretaries from Ministry of Health and Family Welfare, Biotechnology, Pharmaceuticals were among those who attended the meeting.

The Cabinet secretary was apprised that a central team was deputed to Pune on April 8, 2012 to investigate the outbreak of Influenza A H1N1 and their preliminary report shows that the cases and deaths reported from Pune and Pimpri-Chinchiwad are sporadic in nature.

 A central stockpile of Oseltamivir tablets (anti viral drug) is being maintained and Department of Pharmaceuticals is monitoring availability of raw ingredient for making the drug. There is adequate stock of drugs and vaccines for treatment of people affected by the illness and immunization of health care personnel and whosoever may require it. Vaccine manufactured by indigenous manufacturers is also available.

The medical response system has been put on a state of preparedness. Forty five laboratories are testing samples (26 in Government sector and 19 in Private Sector). The test is done free of cost in Government laboratories/Integrated Disease Surveillance Project supported private laboratories (KMC, Manipal and CMC, Vellore). A nationwide network of laboratories in the private sector are also available for rapid diagnosis.

It was also stated that at the time of the early warning of the cases in Pune itself, an advisory was sent to all the States and Union Territories about the possibility of sporadic outbreaks of H1N1 influenza. Owing to reports circulating in the media regarding mutation in the virus, expert opinion was sought from the Director, National Institute of Virology, Pune who has stated that there is no mutation to suggest change of virus to ‘dangerous form’.

The present strain of H1N1 pandemic virus are susceptible to Oseltamivir and the currently available vaccine can be used for protection against the virus. In the first week of March almost 30% of referred samples were positive for H1N1 in Pune which has now come down to approximately 10%.

During the period from March 1, 2012 to April 9, 2012, 689 cases of H1N1 have been reported from Maharashtra (392 cases), Karnataka (104), Andhra Pradesh (66), Rajasthan (84), Tamil Nadu (28), Delhi (6), Gujarat (5) and in Punjab, Haryana, Himachal Pradesh and Madhya Pradesh (one each). During the same period, 35 deaths have been reported, of which 15 were from Maharashtra, nine from Rajasthan, six from Andhra Pradesh, two from Gujarat and one each from Tamil Nadu, Himachal Pradesh and Madhya Pradesh.

Ministry of Health & Family Welfare has been asked to monitor the situation on a day to day basis and take all possible steps to ensure that the drug and vaccine are available in sufficient stock.

India fulfills reporting obligation to UNFCCC

The Union Cabinet on 12 th March approved India's Second National Communication to the Secretariat of the United Nations Framework Convention on Climate Change towards fulfilment of the reporting obligation under the Convention.

Studies on key sectors were conducted in the short to medium and long time frame using latest models and know-how so as to bring out extant and projected high regional and sectoral variability and vulnerability.

The estimations about  greenhouse gas emissions (GHG emissions) have helped in quantifying the extent of India's GHG emissions and its rate of growth, so as to help policy makers with appropriate information.

This report shall benefit state and national level policy makers in enhancing the understanding of the issues related to climate change and its impact and create general awareness of the stakeholders relating to Government of India's proactive commitment towards addressing the challenges due to climate change.

The range of studies included in this report has been conducted broadly at the national level, with some specific case studies highlighting the enormous diversity of India and their regional imperatives. India is a Party to the United Nations Framework Convention on Climate (UNFCCC).

The Convention, in accordance with its Article 4.1 and 12.1, enjoins all Parties, both developed and developing country Parties, to furnish information, in the form of a National Communication, a national report, regarding implementation of the Convention.

This project has been implemented with the financial support of US$ 3.5 million provided by GEF and matched by a support of US$ 3.0 million from the Government of India (in the nature of co-financing).

Thursday, April 12, 2012

Several Indian States Prohibit Release of GM Seeds

Minister of State for Environment and Forests, Jayanthi Natarajan on 27th March revealed in Rajya Sabha that the State Governments of Bihar, Madhya Pradesh, Kerala, Uttarakhand and Karnataka have informed that they have taken a decision to prohibit environmental release of all Genetically Modified (GM) seeds.

She said, currently field trials have been allowed only in Andhra Pradesh, Gujarat and Rajasthan. Recently Government of Rajasthan has conveyed its decision to withdraw the No Objection Certificate (NOC) which was issued to Centre for Genetic Manipulation of Crop Plants, University of Delhi for conduct of second season Biosafety Research Level (BRL-I) trial with GM Mustard in their state.

The Minister further stated that the Genetic Engineering Approval Committee (GEAC) has been approached by the Seed Industries, Ministry of Agriculture and Review Committee on Genetic Manipulation (RCGM) to reconsider its decision on the need of NOC from the State Government prior to the conduct of GM crop field trial.

The matter was discussed in the GEAC meeting held on 14.12.2011 wherein it was recognized that issue of non-issuance of NOC by the State Govt. is mainly due to lack of clarity on the role State Govt. officials and lack of awareness on highly technical issues associated with biotechnology and biosafety measures.

It was also reiterated that the role of the State Government is very critical for compliance monitoring and therefore it is important to have a dialogue with the State Government to provide necessary clarification. Accordingly, it was agreed that the GEAC may give a detailed presentations with a view to address the concerns of the State Government and provide more clarity on the role of the State Government.

Government Announces Incentives for Medical Professionals to Work in Rural Areas

The Government of India has taken various measures to provide monetary and non- monetary incentives to attract skilled medical and para medical professionals to work in rural areas. These include:

Monetary incentives under NRHM for both regular, adhoc and contractual staff posted in hard to reach and difficult areas.

The Central Government in consultation with the Medical Council of India, has made the following amendments to its PG Medical Education Regulations to encourage doctors to serve in rural areas :

  • 50 % reservation in PG Diploma courses for Medical Officers in the Governmentservice who served for at least three consecutive years in remote and difficult areas ; 

  •  Incentive at rate of 10 % of the marks obtained for each year in service in remote or difficult areas upto the maximum of 30 % of the marks obtained in the entrance test for admissions in PG Medical course.

Improved accommodation for healthcare personnel has been provided through NRHM at many rural facilities. Also health facilities have been upgraded and better equipped.

This information was given by Union Minister for Health & Family Welfare Shri Ghulam Nabi Azad in reply to a question on shortage of medical and paramedical staff in the rural areas in Rajya Sabha on 27th March.

Augmentation of human resource is one of the thrust areas under National Rural Health Mission [NRHM] : 2914 Specialists, 8722 Doctors, 10995 AYUSH Doctors, 33411 Staff Nurses, 69662 ANMs, 14529 Para Medics and 3894 AYUSH Para Medics have been engaged on contractual basis to increase the availability in the rural areas.

Various reasons attributed for shortage include non availability of requisite number of doctors and paramedics, shortage of medical colleges and training institutes and unwillingness on the part of doctors to work in rural areas.

Government increases spending on healthcare


The Planning Commission in their document- “Faster, Sustainable and More Inclusive Growth: An Approach to the 12th Five Year Plan”, aims at raising the total public health expenditure to 2.5% of GDP by the end of the Twelfth Plan.

According to World Health Statistics 2011 published by World Health Organization (WHO), the total expenditure on health as a percentage of Gross Domestic Product (GDP) in 2008, for India is 4.2% as compared to expenditure on health in respect of some select developing countries, e.g. China 4.3%, Bangladesh 3.3%, Indonesia 2.3%, Malaysia 4.3%, Pakistan 2.6% , Sri Lanka 4.1% and Thailand 4.1%.

The above information was given by the Union Minister for Health & Family Welfare Shri Ghulam Nabi Azad in the Rajya Sabha on 27th March.

CPCB Identifies Pollution Causing Industries

The Central Pollution Control Board (CPCB) has identified 17 categories of highly polluting industries (HPIs) which include thermal power plants, cement plants, distilleries, etc.

A total of 2720 industries have been identified as HPIs by CPCB in the country. Out of 2720 HPIs, 2076 units are reportedly complying with the environmental standards whereas, 261 units are closed and 383 units have not provided adequate facilities to comply with the environmental standards.

Giving further details on the matter in Rajya Sabha today Minister of State for Environment and Forests, Jayanthi Natarajan said the State Pollution Control Boards (SPCBs) ensure the compliance of environmental standards in an industry under the provisions of the Water (Prevention and Control of Pollution) Act, 1974 and the Air (Prevention and Control of Pollution) Act, 1981.

Under Environmental Surveillance Squad (ESS) scheme, CPCB undertakes inspections of 17 categories of HPIs to seek compliance of environmental standards.

She said in case of non-compliance, directions are issued by CPCB to concerned SPCB under Section 18(1)(b) of the Water Act, 1974 or the Air Act, 1981 to ensure compliance of standards. Actions in the form of show cause notices, closure orders and prosecutions are initiated by the SPCBs against the erring industries.

Sometimes, directions are issued directly under section 5 of the Environment (Protection) Act, 1986 by CPCB or by the Ministry of Environment and Forests.

India Improves on Forest Cover

As per the India State of Forest Report (ISFR) 2011, the Forest and Tree Cover of the country is 23.81% of the geographical area of the country. The forest cover of the country has registered a marginal decline of 0.05% as compared to the previous assessment published in ISFR 2009.

Minister of State (I/C) for Environment and Forests Smt. Jayanthi Natarajan further stated in Rajya Sabha today that in the India State of Forest Report, the forests are classified into three categories such as Very Dense Forest (VDF), Moderately Dense Forest (MDF)& Open Forests not as degraded forests.

The area covered by Very Dense Forests (VDF) is 83,471 km2 (2.54%), that with Moderately Dense Forests (MDF) is 320,736 km2 (9.76%) and Open Forests is 287,820 km2(8.75%). She said forests are defined legally in accordance to the provisions of Indian Forest Act, 1927 such as Reserve Forests, Protected Forests and Village Forests.

The Minister, however, clarified that the Hon’ble Supreme Court of India has extended the scope of forest and“forest” must be understood according to its dictionary meaning. This description cover all statutorily recognized forests, whether designated as reserved, protected or otherwise, including any area recorded as forest in the Government records irrespective of the ownership, for the purpose of Section 2 (i) of the Forest Conservation Act.

In India State of Forest Report, the different categories of forests are defined for assessment of forest cover on the basis of tree canopy density which are as follows:

(i) Very Dense Forest: All lands with tree canopy density of 70% and above;

(ii) Moderately Dense Forest: All lands with tree canopy density between 40% and  70%;

(iii) Open Forest: All lands with tree canopy density between 10% to 40%.

India Exceeds BOD Limit in River Stretches Across Country

The Central Pollution Control Board in association with State Pollution Control Boards and Pollution Control Committees have established a network of 1085 Water Quality Monitoring Stations along various river stretches.

Water quality data in respect of Bio-chemical Oxygen Demand (BOD) has exceeded the desired water quality criteria (< 3 mg/per litre) in 150 river stretches covering 121 rivers. The major cause of rising organic pollution, particularly BOD, in these rivers is due to discharge of untreated and partially treated domestic effluents by various municipalities across the country.

Giving further details in Rajya Sabha on 27th March in response to a question Minister of State for Environment and Forests, Jayanthi Natarajan stated that conservation of rivers is an ongoing and collective effort of the Central and State Governments.

This Ministry is supplementing the efforts of the State Governments in pollution abatement in identified river stretches through the centrally sponsored National River Conservation Plan, which presently covers 40 rivers in 190 towns spread over 20 states.

Pollution abatement schemes implemented under the Plan include interception, diversion and treatment of sewage; low cost sanitation works on river banks; electric/improved wood crematoria etc.


Government Moves on Green India Mission

The Ministry of Environment and Forests is implementing National Afforestation Programme (NAP) for afforestation and eco-restoration of degraded forests and adjoining areas in participatory mode under Joint Forest Management (JFM). Since the inception of NAP during 10th Plan, an area of about 1.8 million ha has been targeted till date by incurring an investment of about Rs.2762 crore.

Minister of State for Environment and Forests, Jayanthi Natarajan further stated that in order to improve eco-system services and to gear up afforestation and regeneration of degraded forest tracts, an area of about 10 million ha is envisaged to be tackled under Green India Mission (GIM) during 12th and 13th Five Year Plan period.
The 12th Plan outlay of NAP has also been proposed as Rs.10,000 crore against the outlay of Rs.2000 crore during 11th Plan. In addition, various State Governments are also implementing schemes for improvement of degraded forest utilizing State funds and externally aided projects.

Government Reopens Closed Vaccine Units

Production of vaccines has restarted in the existing manufacturing facility of Central Research Institute (CRI), Kasauli, Bacillus Calmette-Guérin (BCG) Vaccine Laboratory, Guindy and Pasteur Institute of India (PII), Coonoor.

134.55 lakhs doses of Diptheria, Pertussis, and Tetanus vaccine have been produced in CRI Kasauli till date since the revocation of suspension of license in February, 2010. The upgradation of vaccine manufacturing facilities at BCG VL, Guindy has been approved at an estimated cost of Rs. 64.72 crore. The upgradation of DPT group of vaccine manufacturing facilities at PII, Coonoor has been approved at an estimated cost of Rs. 149.16 crore.

Central Government in exercise of its powers under Sub rules (3) of Rule 85 of the Drugs and Cosmetics Rules, 1945, ordered revocation of suspension of the licenses of the these Institutes vide order dated 26/2/2010. These Institutes have also been asked to ensure that the production line is made fully compliant with GMP standards within three years.

The above information was given by Union Minister for Health & Family Welfare Shri Ghulam Nabi Azad in the Rajya Sabha on 27th March.


Government sets up agency to procure quality health products

The Ministry of Health & Family Welfare (MoHFW) has set up a Central Procurement Agency (CPA) under the Societies Registration Act, 1860, in the name of Central Medical Services Society (CMSS).

The CMSS has been registered on 22nd March, 2012. CPA is expected to start functioning in the ensuing financial year i.e. 2012-13.

The Society shall function as an independent, professional and autonomous agency for procurement of quality health sector goods and services required by the Department of Health & Family Welfare, Ministry of Health & Family Welfare, Government of India in a transparent and fair manner and make goods available at convenient locations for the benefit of users by addressing efficiently the supply chain issues.

The above information was given by Union Minister for Health & Family Welfare, Ghulam Nabi Azad in the Rajya Sabha on 27 March, 2012.