Indian Medicos

Centre proposes to merge rural and urban health missions

2012-01-28T15:35:00.000+05:30

The Centre proposes to merge the National Rural Health Mission (NRHM) and the yet-to-be-launched National Urban Health Mission (NUHM) in the 13th Five-Year-Plan period. The two ambitious Missions will be separate entities in the upcoming 12th Five-Year-Plan period, after the launch of the urban health mission, but subsequently merged.

In its proposals to the Planning Commission, the Ministry of Health and Family Welfare has said that the National Urban Health Mission would be taken up as a thrust area for the 12th Plan and launched as a separate mission for urban areas with focus on slums and urban poor. It will cover all cities and towns with a population of more than 50,000, broadly covering 779 cities and towns including seven mega cities including Mumbai, New Delhi, Kolkata, Chennai, Bengaluru, Hyderabad and Ahmedabad.

The budget allocation for the mission is envisaged to be Rs. 30,000 crore and the programme will be implemented by investing in health professionals, creating new and upgradation of existing infrastructure, and strengthening the existing health care service delivery system.

Principally, the NUHM will cover the entire urban areas irrespective of the dwelling status (including general population, listed and unlisted slums) but outreach services will be targeted for slum/slum like areas and other homeless people, street vendors, railway and bus station coolies, homeless people and street children, construction site workers who may be in slums or on sites. Inter-sectoral convergence will be planned between the Jawaharlal Nehru National Urban Renewal Mission, Rajiv Awas Yojana and the NUHM.

Realising that the health care needs of the urban poor and vulnerable populations, the urban health mission will ensure adequate resources for addressing the health problems in urban areas and address the need-based city specific urban health care system to meet the diverse health needs of the urban population with focus on the urban poor and other vulnerable sections. The institutional mechanism and management systems will be in place to meet the health-related challenges of a rapidly growing urban population and join hands with community for a more proactive involvement in planning, implementation and monitoring of health activities.

At the primary care level, one Urban Primary Health Centre will be established for every 50-60,000. At the community level, outreach services will be provided to the urban poor slums with the help of Urban Social Health Activist (USHA) (200-500 households) and Mahila Aarogya Samiti (50-100 households). No sub-centres are proposed but communisation will be made possible through Mahila Aarogya Samiti and Rogi Kalyan Samiti while secondary and tertiary level services will be provided through public or empanelled private providers.

The National Rural Health Mission was launched in 2005 and is proposed to be extended by five years.

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Talks on with pharma firms to check prices

2012-01-26T15:37:00.000+05:30

The State government is in talks with the pharmaceutical companies to control the rising prices of medicines, Minister for Health Adoor Prakash has said.

He was speaking at a curtain raising programme here on Thursday after releasing the brochure for the Global Ayurveda Festival scheduled to be held from February 9 to 14. He handed over the first copy to C. Retnakaran, Pro Vice-Chancellor of the Kerala University of Health Sciences.

Addressing ayurveda practitioners and students at the event, he asked them not to be led by unreasonable profit motives. At a time when new diseases were emerging, the traditional ayurveda sector could make a significant contribution towards promoting health and well-being, he said.

Pointing out that more students were taking up ayurveda in the recent times, the Minister hoped that the global festival would reaffirm the significance of this Indian branch of medicine to the world.

Presiding over the function, Deputy Speaker N. Sakthan called for a holistic approach by integrating streams of medicines like ayurveda, allopathy and homeopathy.

Jnanpith award winner O.N.V. Kurup, who was the chief guest, said the Ayurveda system took roots with a vision to save people and it was ‘primarily and fundamentally not for sale.'

The festival's organising committee working chairman G.G. Gangadharan said that the purpose of the festival was to propagate ayurveda in India and abroad. A host of programmes including an international seminar on ayurveda for Non-communicable Diseases (NCDs), health expo, students' conclave, and buyer-seller meet have been planned for the event.

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Free medicine scheme may set off doctor-patient clashes

2012-01-24T17:34:00.000+05:30

The district and sessions court on Tuesday remarked that the city police defiantly and deliberately avoided to comply with its order to arrest two senior government officials, including an IAS, and a businessman involved in the controversial Jal Mahal development project.

The court of additional chief judicial magistrate (number-4) Suresh Bhatt on Thursday directed the station house officer of Brahmpuri police station to explain why he should not be prosecuted for "defiantly" submitting a false report in the court. The police officer has been asked to be present in court on October 20.

Last month, the court directed the city police to arrest senior IAS Vinod Zutshi, RAS Hirdesh Kumar Sharma, one Rakesh Saini and businessman Navratan Kothari for allegedly conspiring to illegally lease 100 acres of government prime land near the historical Jal Mahal Lake for a throw away price. The Brahmpuri police, which received the arrest warrants on September 14, was granted time till October 24 to nab the accused.

Kotharias company Jal Mahal Resorts Pvt Ltd was the beneficiary in the deal, while Zutshi, Sharma and Saini were involved in it as office-bearers of the Rajasthan Tourism Development Corporation (RTDC),the government body owning the land,in 2005. Zutshi is presently serving as one of the deputy election commissioners with the Election Commission of India at New Delhi.

Bhagwat Gaur, a resident of the city, had filed a complaint in the court calling the deal illegal and accusing the foursome of a conspiracy.

Three of the accused, Zutshi, Sharma and Kothari,filed a revision petition to contest the arrest warrants issued against them. Their appeal is pending before another court. On the other hand, in its investigation progress report filed in the ACJM court-4 on September 30, the Brahmpuri police stated that it was unable to arrest the accused since they were out of Jaipur.

Complainant Gauras counsel Ajay Jain contested the police report and submitted news paper cuttings to prove that Kothari attended a public function in Jaipur on October 1 while RAS officer Sharma were regularly reporting to duty at his Jaipur office.

Taking a strong view against the police report, the ACJM court remarked that the police officer asdeliberately" ignored to arrest Kothari. "It appears that the SHO has committed offence under IPC sections 219 (filing false report in court) and 221 (not complying with court orders)," judge Bhatt noted in the order, seeking explanation from the police officer.

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Helion, Nexus invest in Eye-Q Super-Specialty Hospitals

2012-01-22T15:06:00.000+05:30

Gurgaon-based Eye-Q Super-Specialty Eye Hospitals today said it has received an undisclosed amount as investment from two equity funds, Helion Venture Partners and Nexus Venture Partners.

The company intends to utilise the investment by Helion Venture Partners and Nexus Venture Partners, both India-focused VC funds, to expand its footprint nationally, Eye-Q Super-specialty Eye Hospitals said in a statement.

The company, however, did not disclose the investment details citing confidentiality clause.
Commenting on the development Eye-Q Super-specialty Eye Hospitals CEO Rajat Goel said: "After the latest infusion of funds, Eye-Q will broad-base its operations for a national presence by spreading its wings to other regions across India."

Set up in 2007 by Ajay Sharma and Rajat Goel, Eye-Q over the past few years has expanded through a combination of greenfield hospitals and acquisitions, it said.

The company operates 16 centers in North and West India under a hub-and-spoke model.

In May 2010, the company had received investment by SONG Investment Advisors – a fund owned and managed by the Soros Economic Development Fund, Omidyar Network and Google, it added.

"With Eye-Q now poised for unprecedented growth, we'd like to see those benefits extend to people in various parts of India," Helion Venture Partners Sanjeev Agarwal said.

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Aurobindo, first major generic drugs-maker to tap into Patent Pool

2012-01-20T18:33:00.000+05:30

Generic-drugs maker Aurobindo Pharma Ltd has signed an agreement with the global Medicines Patent Pool for the manufacture of several antiretroviral medicines – making it one of the first major generic companies to tap into the patent pool.

The agreement will enable Aurobindo to manufacture products licensed to the Pool by Gilead Sciences in July: emtricitabine (FTC), cobicistat (COBI), elvitegravir (EVG), and the fixed-dose combination of these medicines known as the Quad (a combination of FTC, COBI, EVG, and tenofovir), said a MPP note from Geneva.

The development will speed-up access to critical HIV medicines in developing countries, in particular to new medicines still in development, a note from MPP said. Their uptake by generic manufacturers will help close the gap between the arrival of new medical technology in developed country markets and its often delayed arrival in developing countries, it added.

The Medicines Patent Pool, founded with the support of UNITAID in 2010, aims to bring down the prices of HIV medicines, and stimulate the development of needed new formulations, through access-oriented voluntary licences.

Aurobindo has chosen to take advantage of a key provision negotiated by the Pool so it can sell tenofovir to a larger number of countries and without paying royalties.

“We are pleased with the rapid uptake of our first licences by generic companies,” said Medicines Patent Pool Executive Director, Ms Ellen 't Hoen. Generic medicines producers have a key role to play in ensuring the availability of low cost medicines for the treatment of HIV, she added.

“Aurobindo looks forward to increasing its manufacture of HIV-related products, and expanding its work to cover promising new treatments, for the millions of people living with HIV across the globe,” said Mr P.V. Ramaprasad Reddy, Chairman of Aurobindo.

The Pool signed its first licence agreement with a pharmaceutical company, Gilead Sciences, in July 2011, securing several public-health related improvements on the status quo for voluntary licences.

However, the system has come in for some criticism from a group of about 70 health advocacy groups who have raised concerns on the lack of clarity around the process of determining whether a license negotiated by the MPP meets the primary purpose for which the MPP was created: to improve the health of people in low- and middle-income countries.

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Kerala Govt to open medical stores

2012-01-18T17:04:00.000+05:30

In an effort to control the prices of essential medicines in Kerala, the state government is planning to open nearly 2500 medical stores in the cooperative sector in all panchayats, state minister for health, Adoor Prakash has said.

Under this plan, the government aims to open two medical stores each in every panchayat, for which discussions with the cooperative department is on.

Adoor was interacting with the media after a meeting held to discuss the draft of the comprehensive health plan in the district, which has been prepared as part of a state mission, at the district collectorate here on Thursday.

The government is also taking steps to do away with the middlemen in the drug manufacturing sector so that manufacturers can directly supply medicines to the Medical Service Corporation, which would help control the price of medicines. Observing that scarcity of doctors in government hospitals, especially in rural areas is a perennial issue, the minister said steps are being taken to ensure the availability of doctors in all hospitals.

Even though the Kerala Public Service Commission (PSC) had sent advice memos to 300 doctors, only 60 appeared for counselling, of which only two were from Kannur district, said the minister, pointing to the reluctance of medical professionals to take up government service.

He said that even a medical graduate who appears for the walk in interview will be given appointment if they are willing to take up rural services.

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Pass HIV/AIDS bill in Winter session: NGOs to govt

2012-01-16T14:53:00.000+05:30

Expressing disappointment over the "apathy" shown towards HIV-infected people, activists on Wednesday demanded the government pass the HIV/AIDS Bill in the Winter Session of Parliament.

Activists from a group of NGOs and Lawyers` Collective, legal advocacy group that drafted the Bill, said the Bill is very important in the light of the large-scale discrimination faced by the HIV positive people in the country.

"It`s unacceptable that the government has not brought the Bill to the parliament till now," Pradeep Dutta of the Nai Umang Network of Positive People said.

The Bill was finalised in July 2006 by Health Ministry and was sent to Law Ministry in August, 2007. It has been pending since March 2010, when the Law Ministry cleared it.

"We met Health Minister Ghulam Nabi Azad yesterday and he said the Bill has been sent again to the Law ministry. We want to ask why such an important Bill, on which so many lives depend, is being shuttled between the two Ministries?" Dutta said.

Anand Grover of the Lawyers` Collective said, "the stakeholders were consulted through out the drafting of the bill, but suddenly the health ministry is being discreet and confidential over the Bill.

"We urge the government to take the community back in confidence and pass the Bill in its original form without tinkering with its important clauses such as easier access to treatment," he said.

Grover claimed that the Ministry was not in favour of including the provision for free health treatment to HIV patients in the Bill.

The present HIV programme of the government provides first line anti-retroviral treatment (ARVs) to people infected with HIV for free, but second line and third line treatment is not easily accessible.

The activists said there was a need to scale up the establishment of more second line and third line ARV treatment and demanded some crucial facilities to diagnose HIV which they allege are not available in government centres.

Speaking on discrimination faced by HIV affected women, Mundrika from Delhi Network of Positive People (DNP+) said, "There have been several occasions when doctors have refused to treat pregnant HIV positive women.

"Don`t they have the right to be mothers? Don`t they have the right to live a life with dignity? The Bill will reduce the stigma that we face," she said.

The Bill provides legal redressal against HIV-related discrimination in both public and private sector. It also provides for free and complete treatment to all HIV-positive people.

The other crucial aspects of the Bill are -- right to confidentiality, right to consent, special provisions for women like right to residence and counselling and rights of children to property and care.

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Despite opposition, health ministry plans to go ahead with Medical Devices Bill

2012-01-15T16:01:00.000+05:30

Notwithstanding the opposition from many states, the union health ministry wants to amend the Drugs and Cosmetics Act (D&C Act) to provide separate definition of medical devices and has sought an allocation of Rs. 205 crore from the Planning Commission to set up regulatory mechanism for the sector during the next Five Year Plan period.

Besides, the ministry also wants to bring all medical devices under regulation since only 14 medical devices are notified and under regulation at present, sources said. The ministry is examining the amendments to the D & C Act to bring a bill and introduce it in Parliament.

“The Government has already initiated steps to amend the D&C Act to have separate provisions for Medical Devices. The salient features of the proposed bill would be to provide a separate definition of Medical Devices, their risk based classification for regulatory control, Clinical Trials on Medical Devices, Conformity Assessment Procedures, Penal provisions, etc,” sources said.

The ministry has forwarded a proposal to the Planning Commission to strengthen the CDSCO in terms of manpower and infrastructure to take up additional responsibilities in the growing area of medical devices.

As per the proposal, it needed 300 personnel to man the sector. Besides, it will appoint 10 experts in the field of medical devices as the regulation required multi-disciplinary experts like bio-technologist, bio-materialists and electric engineer.

The proposal also suggests setting up of category-wise five national medical devices testing laboratories with each of them would require Rs. 40 crore each. Apart from this Rs. 200 crore, it also sought Rs. 5 crore for international travel for the personnel.

Sources said, though the health ministry had drafted a final version of the amendment to the D&C Act incorporating the concerns of the industry and the inputs from the Department of Science and Technology, the strong opposition by some states and some stakeholders put the bill on the hold.

The consensus still eluded the consultations and a final view could not be taken so far to introduce the bill in Parliament, though the move has been pending for almost four years now. The ministry had circulated the draft among the states, after revising it on the basis of the recommendations by the Parliamentary Standing Committee attached to the Health Ministry since health is under the Concurrent List.

The proposed Authority, under the Bill, will have a classification of devices, notify standards and guidelines from time to time, provide a mechanism for conformity assessment using direct or third party notified bodies and stipulate the procedure and guidelines for testing laboratories. The Bill, framed after many rounds of consultations with the industry under the guidance of the DCGI, has laid down the regulations from an India-specific angle.

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New clinical trial norms on anvil

2012-01-15T11:00:00.000+05:30

The Indian Council of Medical Research ( ICMR) has sought proposals from doctors and health activists to advise on the new draft guidelines for compensation to people undertaking drug trails. The subjects will be compensated if they are injured during the trails.

Proposals will be invited till December 31. As per the new guidelines, mothers undergoing clinical trials which harm their unborn child will be able to demand compensation from researchers. The guidelines apply to all clinical research, whether sponsored by the pharmaceutical or medical device industry, government or academia or individual investigators.

The guidelines say compensation could be in the form of payment for immediate medical/ surgical management of research-related injuries or for permanent disabilities. It says the Informed Consent Document (ICD) should state that the research participant has a right to claim compensation in case of research-related injuries and whom to contact for their rights as research participants. If guidelines are finalised then compensation has to be paid, irrespective of whether the injury was foreseeable/predictable and that the research participant had given his consent in writing about participating in the research study.

However, the new ethical draft guidelines for biomedical research on human participants have churned out mixed reactions in the medical fraternity and health activists. According to them, some issues have been left out in the guidelines to make them firm. Kalpana Mehta, a health activist who have been working on the issues of clinical trials since few years said, "If points related to continuing medical care to trial subjects, sharing the profits of the approved drug with trial subjects and points to equalise legal representation are added then guidelines will be better to deal with clinical trial issues." Dr Anand Rai, a whistle blower in clinical trials issues said, "The role of independent ethics committees is marred so some strong actions are needed on this front. Compensation must be paid to research participants receiving placebo or otherwise sponsor will misuse the guidelines."

On the other hand, doctors too feel there is a little scope of addition in the draft guidelines. Dr Sanjay Dixit, Head community medicine, MGM College says, "There should be systematic tracking of adverse events. In addition need of structured format for reporting and compensation must be included in the guidelines." Proposing continuing medical care to trials subject he further said all research institution should make it public about the ongoing trials at their notice boards.

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Tripura bags international award for Telemedicine

2012-01-14T18:52:00.000+05:30

Tripura has been honoured with an international award at Health World Expo-2011 in New Delhi for implementation of THTM (Tele-Homeopathy Treatment Method) recently, official sources said today. Tripura is the first recipient of an international award for tele-homoeopathy in North Eastern region, Health Minister Tapan Chakraborty said, adding that patients in rural areas have been diagnosed by doctors through video-conferencing. This project was initiated in Tripura in February last year and more than 21,000 patients were treated so far which received tremendous response in villages. This projected was launched by Ministry of Health and Family Welfare.

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No regulation to prevent hospitals from paying doctors

2012-01-12T14:37:00.000+05:30

While fee splitting between doctors is deemed unethical by the Medical Council of India (MCI), the statutory body is more concerned about the unethical practices adopted by corporate-run hospitals who pay referral fees to doctors.

“The larger problem these days is not doctors indulging in fee splitting. Big corporate hospitals and diagnostic centres are now giving out cheques to doctors who refer patients to them. They even ask for the PAN number of the doctor so that they can show it as a marketing expense,” said Dr Arun Bal, convenor of MCI’s ethics committee.
The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations barring doctors from accepting or giving referral fees does not apply to a corporate hospital. “This has led to this unofficial, underhand dealing gaining legitimacy,” said a senior doctor.

“This practice cannot be stopped by the MCI. There is no statutory authority governing hospitals. Only the government can take some action, and since health is a state subject, only the state governments can do something about this,” said Dr Bal.

“But the doctors cannot remain mute spectators to this practice. It is finally the community of doctors that is affected,” said Dr Kishore Taori, president of the Maharashtra Medical Council (MMC).

Dr Taori said that the MMC has not received any complaint regarding the fee-splitting practice. “We are not a policing agency. We act on complaints by agencies and try to find the truth,” said Dr Taori.

Many doctors say the system helps them get patients, especially early on in their careers. “Before they are established, at least for a year, doctors have to approach general practitioners for them to refer patients,” said a senior surgeon who practices in the western suburbs.

He added, “Everyone would like to follow ethics. But in a city with severe competition, it is difficult.”

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Bharti Airtel, Religare Technologies to offer medical advisory service

2012-01-10T20:36:00.000+05:30

Bharti Airtel will charge the medical advice phone calls at Rs15 a minute till 2 January 2012

Bharti Airtel Ltd has tied up with Religare Technologies Ltd to offer a medical advisory service for its mobile phone subscribers. Bharti Airtel will initially offer the service in six of the country's 22 telecom areas.

Bharti will charge the medical advice phone calls at Rs15 a minute till 2 January 2012 and at Rs30 a minute thereafter, apart from another Re0.50 fee, a note on its website showed. Subscribers can call the service to talk to accredited doctors and nurses.

Privately held telecom company Aircel Ltd also provides such services in partnership with Apollo Hospitals Enterprise Ltd.
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Health tourism is the new buzzword

2012-01-08T14:35:00.000+05:30

Sure, monuments, palaces, and malls attract tourists to Bangalore. Now, health and wellness tourism, too, is climbing up the rankings. Viswanath Reddy, department of tourism, said: “We have seen a 20% to 25% annual increase in medical and wellness tourism.”

It is increasing every year. The current state of tourism, especially in Bangalore, is leaning towards medical- and wellness- related ventures, he added.

City hospitals have experts and excellent healthcare services that easily match the best in the world and this makes it an important ‘health’ and ‘wellness’ destination for outsiders.

Dr Guru Dutt, owner of Anandmaya Wellness Centre, said: “Foreigners want Ayurveda treatment. India is the mother of Ayurveda. So it must have added to increased footfalls in Bangalore.”

“The new airport has played a major role in attracting foreign tourists. It must have increased the rate of tourism by at least 20%,” said Reddy.

Reddy also said Bangalore is a safe place. Among the heritage sites the most visited places are Vidhan Soudha, Vikas Soudha, Bengaluru Palace, Tipu Sultan Palace, Bull Temple and Iskcon temple. Foreigners love visiting these places. “However, a majority of tourists who recently visited the city were here for medical and wellness purposes,” added Reddy.

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Health Ministry to move SC on CET

2012-01-08T10:00:00.000+05:30

The Medical Council of India (MCI) and the CBSE may be gearing up to hold the Common Entrance Test (CET) for MBBS aspirants from May 2012, but the Health Ministry has some different plans. It is all set to approach the Supreme Court seeking permission to defer CET by an year, to the 2013-14 academic session.

Sources told that the Ministry will soon submit an affidavit to seek postponement of the CET, which is also known as National Eligibility-cum-Entrance Test (NEET), citing objections from States like Karnataka, Andhra Pradesh and Maharashtra — where majority of medical colleges exist.

“These States have been pointing out their difficulty in holding the examination next year stating that students will face problem. They feel that the MCI should go slow on administering CET to avoid inconvenience to the students,” senior officials from the Health Ministry confirmed.

They are not against the CET per se. But they want that the test be conducted from academic session 2013-2014 after framing a common curriculum for physics, biology and chemistry for standards XI and XII, the officials noted.

In case the Supreme Court considers the Ministry’s request, this will be the second time that the CET will be deferred.

The MCI, following the apex court order, has been preparing for the CET since 2011. But it was postponed to 2012 as the Council wanted to give enough time to the students to prepare for the exam.

But while the MCI has been keen to introduce the new system claiming that it would cut down multiplicity of examination, the Health Ministry has been dilly-dallying the matter citing various reasons, opposition from the States being the major one.

The Ministry’s disinterest in CET is no secret. It is yet to notify the revised syllabus and the examination system prepared by MCI for medical under graduates. Irked at the delay, the CBSE too had recently shot off a letter to the Ministry to notify the examination system so that it could smoothly ensure all logistics in place for the D-day.

Over eight lakh students take the MBBS examinations for over 330 medical colleges across the country.

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Medicines' prices should not escalate, Supreme Court tells Centre

2012-01-07T14:31:00.000+05:30

Amid fears that drug prices may shoot owing to the proposed drug pricing policy, the Supreme Court today asked the Union government to ensure that rates do not "escalate" causing a burden on the common man.

"Prices should not escalate. There are apprehensions that prices will escalate. In the name of the new policy the prices shall not escalate. Because we have much much more consumers in India than other parts of the world," the court observed.

A bench of justices G S Singhvi and S D Mukhopadhyaya posted the matter for further hearing to January 17, next year after Additional Solicitor General Parag Tripathi said the notification of the new policy would take place only after the Group of Ministers (GoM) takes a decision in about three months time.

The matter came up for hearing during a PIL filed in 2003 by the All India Drugs Action Network and others which had complained that currently only around 78 drugs are placed under the Drugs (Prices Control) Order, 1995 (DPCO) making rest of the medicines beyond the reach of the common man.

In an affidavit, the Department of Chemicals and Petrochemicals, however, informed the court that it had already initiated action for formulating a new policy, in which "348 medicines included in the National List of Essential Medicines (NLEM), 2011 and associated medicines will be brought under price control".

According to DCPC, a draft National Pharmaceutical Pricing Policy 2011 (NPPP-2011) has been circulated among all the stake holders and ministries concerned besides being put on its official website for their views.

However, senior counsel Colin Gonzalves appearing for the NGO told the bench that the proposed drug policy was fraught with apprehension of a steep hike and wanted the court to restrain the authorities from taking any step.

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Health ministry plans robust policy to recall faulty, ban

2012-01-05T18:24:00.000+05:30

The health ministry is planning to develop a foolproof mechanism to ensure recall of all faulty and banned drugs from the Rs 60,000-crore domestic pharmaceutical market.

The move will strengthen the existing recall provisions under the Drugs and Cosmetic Rules. The current law, however, fails to prescribe time-bound recall formats.

Although India has so far banned around 90 products, mostly fixed dose combinations that were found to be irrational, it had never attempted to enforce it with a strict mechanism. In each of the cases, the drugs were available in the market while the notification preventing further manufacturing or marketing came into effect.
Mostly, such drugs got phased out as companies stopped production and retail chemists exhausted their stocks over a period of time.

The ministry’s attempt has become significant as the Central Drugs Standard Control Organisation (CDSCO) confiscated several banned drugs from retail chemist shops in key metro cities a few months earlier. These seizures took place despite pharmaceutical companies claiming to have stopped the production of the medicines and instructed their field forces to take them off the shelves.

The companies had blamed retail chemists for stocking the medicines.

According to officials, an expert committee will be tasked to prepare the draft. The new system may draw much from the experience of developed nations, where drug recall systems are being followed for decades.

According to a senior health ministry official, “drug recall system” is one of the key agenda before the Drugs Consultative Committee (DCC), the expert group that includes drug controllers from every state.

A sub-committee of the DCC had recently recommended the introduction of a unique identification, similar to bar coding for all the pharma products, as a measure to track and check the presence of counterfeit products.

The authorities feel that a proper system to track the sale of medicines will prove helpful in effective recall of the products also.

Currently, there is no standard practice of setting deadlines for recall of faulty or banned medicines. Companies may be allowed to sell until the stock exhausts or they may be asked to withdraw the products immediately.

The practices followed by the European Union, the United States and others have specific deadlines set for different types of drug recalls. Thus, there can be a 24-hour deadline in case of a serious adverse effect or a firm initiated recall that may go on for several months as it does not concern the safety of the patient.

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Fake Doctors Scandal: Finland Runs Checks on 750 Doctors

2012-01-03T14:22:00.000+05:30

Finland authorities will review the credentials of up to 750 doctors trained outside the EU after a recent scandal over bogus medics, the health watchdog said Wednesday.

"We will check the credentials of every physician who qualified outside the EU and EEA (European Economic Area) and who has been licensed to practise in Finland over the past 20 years," Valvira medical advisor Liisa Toppila told AFP.

Valvira, the National Supervisory Authority for Welfare and Health, was responding to a furore that erupted last week when Finnish tabloids reported that a practising doctor, Esa Laiho, had fake credentials.

Tipped off by the media, Valvira discovered that the man did not graduate from a Saint Petersburg university as he claimed, nor did he even attend the institution.

Nonetheless, he had been granted a license to practise in Finland in 2003.

Valvira confirmed Monday that Laiho was struck off the Finnish medical register and now faces a criminal investigation.

The case has prompted ordinary Finns to come forward with suspicions of unqualified medical professionals, and a second man claiming to have graduated from a Russian institution was also found to have fake certificates.

The country's health minister has said she fears more cases will come to light.

The head of the Finnish Medical Association, Heikki Paelve, wants the authorities to verify the records of all doctors trained outside Finland, including from within the European Union.

"We understand that there have been similar cases in southern Europe, where some doctors have been found not to have all their papers in order," Paelve said in an interview with YLE interview.

In January 2010, Finnish police arrested and charged a young man who had duped patients and staff for almost a year at two health care centres in western Finland.

He later received an 18-month prison sentence.

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Panel to advise varsity on MBBS exam rules

2012-01-01T20:20:00.000+05:30

CHENNAI: The state health department will form a committee to advise the state medical university on the examination rules they can adopt for the next academic year , a senior health department official said.

The advisory committee to be chaired by health minister V S Vijay , who is also the pro-chancellor of the TN Dr MGR Medical University , will hold meetings and discussions with senior academicians and doctors and then frame rules for the next academic year .

Officials hope that the committee headed by the minister would be able to implement reforms carefully without surprising students and sparking unrest . "Students will know about the rules before they seek MBBS admissions . We intend to make all this clear in the prospectus ," said a health department official . The committee will consult with stakeholders including senior doctors , medical college heads and students before deciding on whether the university should merely follow the Medical Council of India (MCI) rules for exams or make it more stringent.

MCI secretary Dr Sangeetha Sharma said the council has only issued guidelines and the university has the powers to make them more stringent. "We have issued minimum guidelines . It up to the states to make them stricter ," she said over the phone from New Delhi.

On Wednesday , a day after the university announced that it will revise the results for the first year MBBS students as per MCI guidelines , students from the other batches petitioned the university and government . Meanwhile , students from other batches met university officials urging them to revise the rules for them , too.

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Rural docs to be trained in emergency procedures

2012-01-01T11:00:00.000+05:30

NAGPUR: State government finally seems to be taking the issue of lack of trained staff in public health sector seriously. Doctors posted in rural areas, sub-district hospitals and district hospitals will now be in specialties like paediatrics, emergency services like trauma, and gynaecology at the government medical colleges (GMCs) under specialists. The plan has support of directorate of medical education ( DMER).

Public health department had been working on the issue since about one and half years. A meeting in this regard was held on November 2 at Mumbai. Experts are suggesting a six-month residential training course for all MBBS doctors. Trained doctors from urban areas and post-graduate students are not ready to work in rural hospitals both due to low remuneration and bad working conditions. Hence the need for training the existing staff in subjects like paediatrics and gynaecology as women and children form a big number of patients in villages. Most of them, even simple cases of deliveries and fever, are referred to medical colleges in cities.

Dr Manohar Pawar, deputy director health services, Nagpur circle, told TOI that senior and retired teachers and specialists at three GMCs at Nagpur, Aurangabad and Pune would be training the doctors from their respective regions. "If needed we would frame a syllabus with support from Maharashtra University of Health Sciences. The doctors will benefit financially also as they would get a special incentive for taking the course," he said. At one time, ten doctors would be trained in each medical college in medicine and paediatrics.

At present, there are either no gynaecologists in rural set ups or they are not trained in conducting emergency deliveries and caesarean sections. Now all MBBS doctors would be trained in these to prevent maternal mortality and reduce the number of referral cases to urban centres. The MBBS doctors also cannot handle emergency cases like trauma. They will be trained in all kinds of emergency services to handle cases at their level before referring the patients to medical colleges.

They would also get training in administering anaesthesia (general and spinal) in emergency cases. The training would be such that they can take care of all gynaecology and paediatrics cases except those requiring certain special expertise.

Dr Praveen Shingare, acting director of medical education and research, however, said he was yet to get a formal nod from the state government for the proposal but the plan was in the offing and would start soon. Dr Mridula Phadke, former MUHS vice-chancellor and now a UNICEF consultant involved in the project, too confirmed the plan.

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Maharashtra University of Health Sciences to offer fellowships

2011-12-31T18:15:00.000+05:30

Maharashtra University of Health Sciences will be partnering with private hospitals to offer fellowships to medical students in subjects that were earlier not offered in India

Noting that most medical students in the state prefer to abandon India for foreign shores to pursue subspecialty courses in medicine and surgery, the Maharashtra University of Health Sciences (MUHS) has decided to partner with the state's private hospitals to start fellowship programmes.

The MUHS has already identified around 25 subspecialty subjects -- including Endocrinology, Laparoscopy, Vascular surgery, Nuclear medicine, Geriatrics and Paediatric neurology -- in which the fellowships will be offered.

"Most students prefer to go to foreign universities to specialise in a certain field, after their completing their postgraduation studies. They do this because these subspecialities are not offered at recognised centres in India. Realising that a number of private hospitals in cities -- especially Mumbai -- have doctors practicing these subspecialties, we have decided to start fellowship programmes, which will be recognised by the MUHS," said Dr Arun Jamkar, vice-chancellor of MUHS.

The university has now created a fellowship board, with representatives of private hospitals on its rolls -- to draw up the course details. Dr Gustad Daver, medical director, P D Hinduja hospital, said, "All the courses will extend for a minimum period of one year and a maximum period of two years. The students will also receive a sum as stipend for the entire course period, in which they will get hands-on training. The university will conduct entrance examinations for admission. We are now busy working out the curriculum details."

"By this public private partnership, the untapped expertise existing in private hospitals will be tapped for the benefit of young doctors," he added.

At present, private hospitals only offer courses that are recognised by the Diplomat National Board (DNB). "The DNB norms are stringent, as a result of which we cannot offer courses in all the possible subspecialties. With the MUHS fellowships, students will be benefited by the wider variety of subspecialties on offer," added Daver.

Dr Anup Ramani, robotic uro-oncologist at Lilavati hospital, said, "When I completed my postgraduation in Urology from Sion hospital, there was no institution offering a subspecialty course in robotic uro-oncology. I had to go abroad for training. But today, there are surgeons in most private hospitals who have been received training in foreign universities and and are practicing here. They can turn teachers for our students pursing the subspecialties. These fellowships will help students save on money as well."

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Accreditation boosts image of hospitals in India, say experts

2011-12-29T18:44:00.000+05:30

At a time when healthcare seems to be a sort of money-minting business, experts feel that hospitals in India should go for accreditation like National Accreditation Board for Hospitals and Healthcare (NABH). They opined this at the 'Health and Hospital Conclave -2011' of Confederation of Indian Industry (CII).

NABH is a constituent board of Quality Council of India that aims at setting benchmark for progress of industry. One of the experts, Parag Rindani, emphasised that going for accreditation for hospitals calls for accountability and consistent excellence and also encourages healthcare organisation for quality healthcare measures.

Rindani was speaking at the second day of the CII conclave during the discussion on 'Changing Face of Indian Healthcare: The Game Changers'.

Dr Vasundhara Atre, a specialist in anaesthesiology from Mumbai, said that the main challenges faced in the healthcare sector in India are reducing maternal and child deaths, malnutrition-related problems, and infectious diseases. "Only seven countries in the world spend less money than India on public health. About70% of India lives in more than 600,000 villages across rural India, and not more than an estimated 30% have access to modern medicine. India needs more than one lakh doctors per year, but we produce 30,000.

The presentation on 'Preparing for NABH / NABL - Doing it the Right Way' highlighted the fact that any hospital should go for the certification not because it just wants the same, but as it is required legally.

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IBM creates a doctor’s Watson

2011-12-27T17:40:00.000+05:30

Doctors should be cracking difficult diagnoses with the help of a Watson in their hand.

This one is not about Sherlock Holmes' dear doctor-pal, but IBM's upcoming supercomputer.

Named after Big Blue's founder, Thomas Watson, the machine has been built to process complex language nuances, and later speech, almost like we do.

In three seconds flat, it can tell the doctor the nearest, if not the exact, disease the patient has, said Dr Manish Gupta, Director IBM Research-India and Chief Technologist, IBM India South Asia.

Watson, Dr Gupta recently told Business Line, can search the equivalent of a million books or about 200 million pages of medical literature. It uses IBM's fastest tools and is not connected to the Internet.

If doctors tried to clear their doubts on the Web, it would take time and not yield a conclusive answer; much of medical literature is not on the Web, Dr Gupta reasoned. Watson would show similar cases; suggest treatment; or alert about side-effects of a prescribed medicine.

In the US, IBM has picked partners to commercialise Watson. Dr Gupta said the system should be available worldwide in a year or two.

One model was to offer it to hospitals on cloud. The doctor can tap Watson on a smart phone or a laptop. Other user industries could be customer care, stock exchanges and banks.

While IBM chose the healthcare industry as the first user, Watson would not jeopardise medical jobs.

Dr Gupta emphasised, “We are not at all talking about replacing the doctor.”

Nor would it increase the patient's spend as records would be available across the healthcare chain and reduce repeat-tests.

The first challenge was to increase the use of electronic health records.

Supercomputers have been used by the military, advanced scientific institutions, for weather modelling and drug discovery.

In February, IBM entered Watson into a popular and challenging US quiz show, Jeopardy – which it won over two human champions. And like humans, Dr Gupta said, it also erred on some answers.

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India doesn't have even 1 hospital bed per 1,000 persons

2011-12-25T16:00:00.000+05:30

Need admission in a hospital? Chances are that you might not get a bed, however unwell you are. Here is an example - the waiting time for a private ward under the neuro-surgery department at India's premiere All India Institute of Medical Sciences (AIIMS) is around four to six months.

However, if a patient needs to be admitted in the general bed for the same surgery, the waiting time is more than a year. And this, the Planning Commission says is because of India's acute shortage of hospital beds. The Commission's high level expert group (HLEG) on health says that when it comes to secondary and tertiary care, India lags behind most other countries in the number of hospital beds per 1,000 population, despite having a higher absolute number of hospital beds than other countries.

The World Health Statistics say that India ranks among the lowest in this regard globally, with 0.9 beds per 1,000 population - far below the global average of 2.9 beds. India's National Health Profile 2010 says India has a current public sector availability of one bed per 2012 persons available in 12,760 government hospitals - around 0.5 beds per 1,000 population.

Sri Lanka on the other hand has 3.1 beds per 1,000 population, China 3 beds, Thailand 2.2, Brazil 2.4, USA 3.1 and UK 3.9 beds per 1,000 population. Shakti Gupta, HOD of hospital administration at AIIMS said: "It was recommended in 1948 by Bhore Committee that there should be one bed per 1,000 population. However it's been 63 years since and we still haven't been able to reach that target. At present, India has around 0.7 beds per 1,000 population." Gupta added

The concept is that patients should be investigated on day care basis and if found fit for surgery should be admitted.

The average stay of a patient should be three to four days. Earlier, we would admit a patient, waste 7-10 days on diagnosing the problem and then take him for surgery."

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Panel wants 187 new medical colleges

2011-12-24T18:37:00.000+05:30

Aiming to bridge the medical education gap between the northern and southern states, a high-level expert group set up by the Planning Commission has suggested creation of 187 new medical colleges in the next 10 years.

Most of the medical colleges are currently located in the southern states of Karnataka, Andhra Pradesh, Tamil Nadu and Maharashtra with a very few colleges in large populous states like Uttar Pradesh, Bihar and Madhya Pradesh.

“We recommend setting up of 187 new medical colleges over the next 10 years in presently under-served districts with a population of more than 1.5 million,” the panel headed by K Srinath Reddy, president of the Public Health Foundation of India, said in its draft report, a copy of which is available with Deccan Herald.

The highly uneven distribution of medical colleges has resulted in skewed production and unequal availability of doctors across the country. For instance, there is only one medical college for a population of 11.5 million in Bihar, 9.5 million in Uttar Pradesh, 7.3 million in Madhya Pradesh and 6.8 million in Rajasthan.

On the contrary, in Kerala, Karnataka and Tamil Nadu, there is one medical college for a population of 1.5 million, 1.6 million and 1.9 million respectively. The panel has recommended establishing 49 medical colleges in UP, 27 in Bihar, 20 in West Bengal, 18 in MP and 17 in Rajasthan, besides 10 each in Jharkhand and Odisha. The experts also suggested mandating a substantial proportion of local student enrolment.

Recognising that establishment of so many medical colleges would pose a logistical problem for the state governments due to faculty shortage and paucity of resources, the panel recommended linking the new colleges to district hospitals to overcome the shortcomings.

At the same time, it advised the Plan panel to set up 58 new nursing colleges, 382 nursing schools and 232 schools for auxiliary nurse and midwives.

The proposals are aimed at improving the doctor-patient ratio besides doubling the number of nurses and midwives. Currently, one allopathic doctor serves 1,953 people, which can be brought down to 1,201 people by 2025, if the panel’s recommendations are followed.

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'Homeopathy fast becoming preferred mode of treatment in India'

2011-12-24T16:04:00.000+05:30

Homeopathy is not a placebo but is effective in treating many serious diseases, including certain kinds of cancer, and costs just one-fifth of allopathic medication, say experts in the field of homeopathy that is fast becoming a preferred mode of treatment for many in India.

Homeopathic medicines, sourced from plants, "can cure cancer in the initial stages and can cure certain kinds of cancer completely, like breast cancer," said Sushil Vats, senior homeopathic consultant and one of the main organisers at an international homeopathy event in the capital.

In fact, at the 66th World Homeopathic Congress of Limhi (Liga Medicorum Homeopathica Internationalis) here, a case study of a double side breast cancer patient who was treated successfully with homeopathy was presented. According to Vats, the patient was a "Stage five" case.

"Homeopathy can effectively support ongoing allopathic treatment in all types of cancers, improve the quality of life of the patient and also the life span," Vats told IANS on the sidelines of the Dec 1-4 conference.

He said that homeopathy can effectively treat diabetes, thyroid, hypertension, AIDS, asthama, but the results vary from case to case. Sometimes a patient may take longer to show results, he said. "In cases treated for many years with allopathy, it becomes difficult to treat with homeopathy as the patients develop homeopathy drug dependency," he said.

Homeopathy is in fact the number two preferred mode of treatment, after allopathy, in India, as per the government of India survey, and it costs just a fraction, he said. Besides, homeopathy has no side effects or adverse effects, he added.

According to R.K. Manchanda, deputy director (homeopathy) in the Directorate of Indian System of Medicine and Homeopathy, government of NCT and Delhi, the Delhi government "is regularly opening homeopathic dispensaries". At present there are 92 homeopathic dispensaries in the capital, mostly in poor areas, which together see around 1.8 million patients a year.

"Mostly, the patients come to these dispensaries with difficult problems like arthritis, skin allergies and chronic gastric problem and with renal stone complaints," Manchanda told IANS.

Manchanda recounted a survey he and a colleague had done in 2005, which showed that homeopathy costs "just one fifth of allopathic treatment to provide day-to-day care".

The conference, attended by 2,500 delegates from 35 countries, was aimed to project India as a "hub of homeopathy in the world", he said.

If homeopathy is so effective in treating so many difficult diseases, then why was it described as a placebo in a study by Lancet?

According to Vats, the study by Lancet was "biased". He said in the UK, the National Health Service runs many homeopathy clinics and they get a "huge budget". During the recession, the allopathic companies were hit and they floated the theory of homeopathy being a placebo in order to get the government withdraw the budget, he said.

Eswar Das, consultant advisor to the government on homeopathy, said the Lancet study was "not based on homeopathy concepts and philosophy". Explaining, he said, homeopathy does not give one standard dose of a medicine to all patients suffering from a disease. Homeopathy studies the patient in terms of the symptoms, body type, nature, likes, dislikes, etc., and then prescribes the dose of medicine accordingly.

"In India, homeopathy has proper recognition. There is a believability and it is an effective form of treatment," said Manchanda.

Stressing on purity of homeopathic medicine, the government has made manufacturers, who initially numbered around 200, comply with Good Manufacturing Practices (GMP) for quality assurance. With this coming into force, there are now only around 30 firms that manufacture homeopathic medicines in India, said Vats. The market in India is worth around Rs.1,000 crore. The homeopathic medicine market has grown manifold in last 4-5 years, he informed.

Eswar Das said though homeopathy was "born in Germany it has flourished in India". The system of healing was founded by German doctor Samuel Christian Hahnemann (1755).

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