058. Open Letter To WHO On Pentavalent Vaccine Related Deaths In India

Open letter To WHO On Pentavalent Vaccine-Related Deaths In India

Pentavalent vaccine was introduced in two states of India last year by the World Health Organization (WHO). Several alleged deaths occurring due to the vaccine, prompted the All India Drug Action Network to write to WHO asking for a re-evaluation of the introduction of the vaccine.

By All-India Drug Action Network

To: 

Dr. Margaret Chan,
The Director General,
World Health Organization, 

Geneva

Dear Dr Margaret Chan,

All India Drug Action Network (AIDAN) is a network of not-for-profit civil society organizations that has been campaigning and working for rational use of medicines, largely in the Indian context. We have written to you in the past. We would like to bring your attention to the Pentavalent (DPT + Hib + Hepatitis B) vaccine related deaths in India.

According to the Brighton classification of ‘Adverse Events Following Immunization’ (AEFI), re-challenge and recurrence of symptoms in the individual is needed for classification of AEFI as ‘certainly related to vaccine’. Such re-challenge is impossible if in the first instance, AEFI results in death. In the absence of proof from a re-challenge experiment, deaths caused by vaccines can only be classified as ‘probably related to vaccine or possibly related’ to the immunization.

As you would know, there have been several Pentavalent vaccine related deaths in Sri Lanka, Bhutan and Pakistan. Using the WHO approved classification of AEFI many of these deaths are ‘probably related to the immunization’ because no alternate cause for the adverse events has been found. However an expert panel looking at the deaths in Sri Lanka deleted ‘probably related’ and ‘possibly related’ from the classification of Brighton for purposes of their evaluation report, and then certified that the vaccines were ‘unlikely to be due to the vaccines’. This report (Expert Panel Report 23 December 2008 Sri Lanka) is available on the World Wide Web.

One by one the WHO has de-listed a number of brands of pre-qualified Pentavalent vaccine, but the problem has refused to go away. Pentavalent vaccine was introduced in two states in India on 14th December and 17th December 2011, to evaluate the safety of the vaccine in India.

According to an affidavit filed in the Kerala High Court by the Government of Kerala India, there have been four deaths in less than two months since it was introduced in the public health system. For your information the full text of the submission by Kerala government can be accessed here.

The reactions in India suggest that the cause of the problem is unrelated to the brand or manufacturer or lot of the vaccine. It appears to be a form of ‘hypersensitivity reaction’ as described in the post mortem report on one of the children in Kerala.

The vaccine can be administered to many patients without problems and there is no available method at present to predict which infant will react adversely.

The US FDA has pointed out that vaccines are aimed mostly at healthy individuals for prevention of diseases to which an individual may never be exposed. Unlike conventional drug treatments meant for the management of existing disease, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause death of healthy children cannot be recommended.

Pentavalent vaccine is at present recommended by WHO and its introduction is supported by Global Alliance on Vaccines and Immunization (GAVI) funds. Given these circumstances the WHO needs to re-evaluate the recommendations. We propose to copy this letter to countries supporting the GAVI initiative so that they may be able to initiate action in a responsible manner.

Looking forward to your early action in the regard.


1. Dr Jacob Puliyel, Drug Action Forum– Karnataka (DAF-K), New Delhi

2. Dr Mira Shiva, Medico Friend Circle, New Delhi

3. Dr Gopal Dabade, DAF-K, Dharwad

4. Mr Srinivasan. S, LOCOST, Vadodara

5. Mr Naveen Thomas, Headstreams, Bangalore

6. Mr Prasanna Saligram, AID India, Bangalore

7. Dr Anurag Bhargava, JSS, Chattisagarh

March 12, 2012.


Republished here on public interest by courtesy of All-India Drug Action Network

Links:

Pentavalent Vaccines Promoted by WHO Despite Deaths of Healthy Children – Part I, Asia

http://www.dadychery.org/2012/05/01/pentavalent-vaccines-promoted-by-who-despite-deaths/

Tags:

Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

057. Kerala’s Everyday Drink Of Vaccine Cocktails

Kerala’s Everyday Drink Of Vaccine Cocktails

India serves up costly cocktail of vaccines

By Ranjit Devraj

Source: Inter Press Service News Agency,
New Delhi, India.
Saturday, November 9, 2013.

Ignoring widespread concern over the safety, efficacy and cost of pentavalent vaccines, India’s central health ministry has, this month, approved inclusion of the prophylactic cocktail in the universal immunization programme in seven of its provinces.

Pentavalent vaccine doses, a cocktail of five antigens in a single shot, confers immunity against five paediatric diseases – diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza type b (Hib), with the last one considered particularly problematic by some experts.

Pentavalents, produced by several manufacturers and promoted by the Global Alliance on Vaccines and Immunization (GAVI), has had a history of causing adverse reactions and deaths in India’s neighbouring countries like Bhutan, Sri Lanka and Pakistan.

In 2010, the National Technical Advisory Group on Immunization (NTAGI), a body of experts selected by the Indian government, recommended limited introduction of pentavalents in southern Kerala and Tamil Nadu and evaluation of results over a year before extension to other states.

Pentavalents were launched in Kerala and Tamil Nadu in December 2011, but the results were not encouraging. Kerala recorded four infant deaths following vaccination, with symptoms similar to what were seen in other South Asian countries.

Public health activists in Kerala, a state with 100 percent literacy and human development indices similar to those of advanced Western countries, quickly filed a public interest litigation (PIL) in the Kerala High Court asking for intervention in having the programme called off and a return to the existing health plan.

But despite infant deaths and two pending PILs (with yet another being heard in the Delhi High Court) against pentavalents, the health ministry announced on Apr. 16 that pentavalents would be introduced in five more states – Gujarat, Haryana, Karnataka, Goa, Jammu and Kashmir and Puducherry in October.

In making the decision, the government overlooked the NTAGI, which has not even been convened since August 2010 when the body suggested limited introduction to Kerala and Tamil Nadu as the two states have good adverse event following immunization systems.

“Going by what we have seen in the neighbouring countries and now in the state of Kerala, pentavalents can, without warning, cause children (to suffer) hypersensitivity reactions and death,”

Jacob Puliyel, an eminent paediatrician at St. Stephen’s hospital in New Delhi and member of the NTAGI, told IPS. Puliyel likened the situation to penicillin sensitivity and said it bordered on criminality to be administering pentavalents without first testing a child for hypersensitivity. “Every child that is being given a dose of pentavalent vaccine is a potential victim of the adverse reaction,” he said.

Puliyel was among the many eminent physicians and public health activists in India who wrote to World Health Organization (WHO) director-general Margaret Chan on Apr. 3 asking the health body to “re-evaluate” its recommendation of pentavalent vaccines on the grounds of safety.

Another signatory, Dr Meera Shiva, an expert on pharmaceutical drugs attached to the voluntary Medico Friends Circle, told IPS that WHO had to de-list a number of brands of ‘pre-qualified’ pentavalent vaccine, “but adverse reactions persist and we have surely not heard the last of them.”

The letter to Chan, written under the aegis of the All-India Drug Action Network, an umbrella of public health activist groups, suggested that the cause of the vaccination- related deaths was likely to be “hypersensitivity reaction as described in the post mortem report on one of the children (who died) in Kerala.”

“Unlike conventional drug treatments meant for the management of existing diseases, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause the death of healthy children cannot be recommended,” the letter to Chan said.

Policy analysts specializing in vaccines said they were dismayed at the move to approve pentavalents in as many as seven of India’s states, which account for 340 million of India’s 1.2 billion people.

“Pentavalents are a test case for India’s new policy on vaccines that is in keeping with liberalization and openly favours pharmaceutical majors at the cost of India’s public sector vaccine units,” said Madhavi Yennapu, a scientist who specializes in vaccines at the central government’s National Institute of Science, Technology and Development Studies.

Twenty of India’s 23 public sector vaccination units, once the mainstay of the country’s immunization programme, have been shut down one after another over the last four years on the grounds that the quality of their products was suspect.

Yennapu pointed to the draft National Vaccination Policy, released last year, for clues on why the government has not made any serious attempt to revive the vaccine- manufacturing units by enforcing quality standards, for instance.

The new policy demands that the “risk of manufacturing vaccines by private manufacturers must be cushioned by assistance from (the) government” and suggests that it be made mandatory for the government to support vaccine producers with advance market commitments (AMCs).

Madhavi explained that AMCs provide guaranteed markets for a vaccine even before trials are conducted, with the government committed to paying a supporting minimum price.

“Even if the vaccine turns out to be less efficacious than the existing one the government must honour the AMC by buying the new vaccine at the agreed price.

“This means that AMC funds must be deposited with the World Bank ahead of vaccine delivery by countries that GAVI is supposed to be helping with the introduction of new vaccines,”

Madhavi told IPS:

“Naturally, GAVI would be looking at large countries like India, Brazil and China to provide the AMCs.” For a country like India, what is important is to “see how many vaccines are needed to prevent how many deaths and at what cost, rather than throw out tried and tested vaccines in favour of a cocktail (pentavalent) which not only has doubtful advantages but has been shown to cause adverse reactions,” Madhavi said. According to Madhavi, there is no hard scientific evidence to show that India needs the Hib vaccine .“It is clearly piggybacking on other vaccines and the public made to pay for it.” The existing diphtheria, tetanus, pertussis (DPT) vaccine costs about 30 cents for all the doses needed to immunize a child, while immunization with pentavalents will cost more than 10 dollars. “We need to ask ourselves if introducing the new vaccine is really worth all the public money being spent on it,” Madhavi said.

Republished here on public interest by courtesy of Inter Press Services

Source: INTER PRESS SERVICE News Agency
Saturday, November 9, 2013

Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

056. Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Comptroller and Auditor General of India raps Kerala health department

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness

Press Trust Of India, Thiruvananthapuram
June 22, 2014

The Comptroller and Auditor General (CAG) has expressed concern over the failure of the public health system in Kerala to tackle the prevalence of sickle cell anaemia among the tribal population in Wayanad, home to nearly 31 per cent of Adivasi communities in the state.

According to a recent CAG report, out of the 85 per cent of tribal population screened by health authorities in the district, a total of 706 persons were found to be affected with the disease while 6,992 showed its traits.

Quoting a survey by the National Rural Health Mission (NRHM) from 2007-08 to 2012-13, it said as many as 312 of those suffering from the "life-long inherited disease" were in the age group of 18-40 and 262 in the school-going age of 5-17.

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness.

The NRHM had recommended grant of incentives to the school going students to continue their studies and for preferential treatment and temporary and contract jobs to those patients in the age group of 18-40, it said. However, the government and district administration did not initiate steps to implement this, the report said. The report also found fault with the state health department for not completing the disease screening to cover the entire tribal population in the region.

"No special efforts have been made by the Health Department to extend help to the identified patients to lead a normal life," it added.

Republished here on public interest by courtesy of Business Standard Dot Com

Link: http://www.business-standard.com/article/economy-policy/cag-raps-kerala-health-department-114062200709_1.html

Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, Sickle Cell Anaemia, CAG, NRHM, Adivasi, Wayanad, Tribal

055. Who Will Catch Fake DMOs Who Catch Fake Doctors?

Who Will Catch Fake DMOs Who Catch Fake Doctors?

By Special Correspondent
Kerala Health Research Online

A District Medical Officer of Kerala caught a fake doctor in the private sector. But who will catch fake DMOs in the Kerala State Health Services Department? Justice M P Menon Commission that enquired into the fake mark list and MBBS certificate cases in the 1980s concluded its report by saying that the Commission, with its limited resources, time and staff, could only catch and expose a few fake doctors and the majority of them might still be working in the Health Services Department as Assistant Surgeons and Civil Surgeons. No follow up action was ever ordered and undertaken by the Chief Ministers, Health Ministers, Health Secretaries or the Directors of Health Services of Kerala. Most of them were duly promoted and some may have eventually become DMOs and other key Programme Officers. And it is, was, not the end of faking certificates and bribing for appointments. Things became only easier since then with the advent of computers, laser printers and other advancements available to those who want to fake things. Where do they actually verify the certificates a person claiming to be a doctor produces? There are three major recruiters in government sector- the Kerala Health Services Department, the Kerala Medical Education Department and the new, free, liberal and open route, National Rural Health Mission. In the last, anything is possible with its non-accountability. In the first two, there is no initial verification before appointment; everything is taken as gentleman’s word. After appointment, when the supposed doctor goes to the concerned institution to join is the SSLC Certificate and MBBS Certificate physically verified for proof of age and entry qualification, by a lowly clerk. They rarely hand over these to the clerks but just ask them to prepare a covering letter to the Accountant General without seeing them. A clerk in Trivandrum District once reported this to his superintendent and the superintendent said: ‘this person, from Sooranad, did not show them to even me, then how would to you? Anyway, give him the covering letter.’ SSLC Book of another doctor from Karunagappalli revealed that she secured 5 marks for English I Paper and 8 marks for English II Paper in Eighth standard. How will she ever become a doctor? When these facts were reported to higher authorities, the then Deputy DMO, DMO and DHS were very, very, very eager to suppress news; after decades, they sent this clerk away without four higher grades, promotion as UD Clerk on attainment of 50 years age, gratuity or even a pension, even though he had a corruption-less service of 32 years and was recruited through PSC. (Documentations are available online). They are such long-remembering and spiteful. So, before arresting others for faking, every doctor in the Kerala Health Services Department in Kerala, including the Director, has to prove before the public that they are not fakes. Let them put relevant details with scan copies of certificates in their official website and let people verify. Let IMA and KGMOA officials do it first.

Link to news article:

കൊച്ചിയില്‍ 20 വര്‍ഷമായി ചികിത്സ നടത്തുന്ന വ്യാജ ഡോക്ടര്‍ അറസ്റ്റില്‍

http://www.indiavisiontv.com/2014/09/18/353814.html?fb_action_ids=531725000290925&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Fake Doctors, Illegal Medical Practice, Kerala Health Department, DMO, DHS, IMA, KGMOA, MBBS,

054. Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments.

Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments

'Kasaragode General Hospital spent 50,000 rupees for drawing 30 pictures of Micky Mouse, Tom & Jerry and Donald Duck in the walls of the children’s ward. The hospital superintendent Dr. Narayana Naik told Indian Vision Channel that this was made possible with the help of Hospital Development Committee, and as the next step, every wall in the hospital would be painted and filled with colourful pictures.' (News reported by India Vision Channel Live on 14th September 2014)

Special Correspondent
Kerala Health Research Online

According to health and revenue authorities, Hospital Development Committees in Kerala are outdated and long due for reconstitution. No one cared to regularize and develop them as societies fit enough to hold enormous sums in custody. Kasaragode District Hospital’s HDC is no exception. The District Collector of Kasaragode has full responsibility for the money-spending of this HDC which seems to have unlimited funds accumulated through years but no sense of destination. The politicians in this retired committee are spending money lavishly and foolishly. Indian hospital rooms have their long-approved colour patterns- green below and white above- to create pacifying, soothing effect. Nobody will paint them in red, pink and violet- angry colours. Normal stay for a child in hospital is three days. On the first and second days, the children won’t see practically anything for they would be in pains. On the third day, the day of their discharge, they do not need see anything; they just wish to go home. If they have to stay for more than three days in Kasaragode District Hospital, this hospital is bad in administration, cross-infectious, useless and risky. Because there is money, we cannot spend it; it is our reserves. When large amounts of money needed for a pediatric ward cannot be obtained from government, then, and then alone, can we spend HDC funds. Somebody must tell the Hospital Superintendent and the District Collector of this truth. Does this hospital have enough Pediatric Exam Tables and Scale Tables? Do they have Neonatal Infant Care Infant Warmers? How many working Transportable Infant Incubators do they have? How many Portable Vital Signs Monitors, Hand-Held Pediatric Vital Signs Monitors and Oximeters? How many Baby Finger Print Pulse Oximeters? Do they have Automated External Defibrillators, Fetal Monitors and Fiber-optic Phototherapy Systems? Have they ever demanded these from the Director of Health Services or Medical Services Corporation or have ever written to government requesting these. Have this committee ever discussed these basic necessities of children’s ward in meetings and recorded in minutes? There is a limit to ignorance, negligence and incompetence. Either leave decisions to doctors and other medically-qualified professionals or resign decently from this ornamental committee. Only in hospitals would this cheap political power play become possible. Will Kasaragode District Collector allow and tolerate a politically constituted Collectorate Development Committee imposed upon him, making him a puppet in taking decisions? If this committee, which knows nothing about children’s treatment other than how to make children, want to know about what are needed in pediatric wards, come down from the skies and ask the B.Sc. and M.Sc. Nursing-qualified staff who will tell them to purchase Electric Cots, Mobile Aneroid Stand With Cuffs (Rs.20000/-), Hand-Held Oximeters (Rs.60000/-), Portable Pulse Oximeters With Finger Sensors (Rs.80000/-), Gamma XL Patient Monitor (Rs.300000/-) or even a Da Vinci Robotic Surgical System which will cost only £500,000. Let this HDC prove their mettle.

Mobile Aneroid Stand With Cuffs is a Blood Pressure Machine with reusable blood pressure cuffs of varying sizes to suit any child. Hand-Held Oximeters are used to monitor oxygen levels in babies to prevent damage to vital organs due to lack of oxygen. Portable Pulse Oximeters With Finger Sensors are hand-held devises to monitor pulse and oxygen level while child patients are moved from place to place. Respiratory Humidifiers heat and moisturize the oxygen that is being delivered to children during mechanical ventilation, to prevent them from becoming cold, thick airway secretions from building up, breathing tubes from blocking up and the little lungs from collapsing, based on the principle that humidified and heated oxygen will make children recover faster. Vital Signs Monitors in pediatric and neo natal wards and emergency wards reads, registers and provides all necessary vital signs of the sick child. Gamma XL Patient Monitor can be purchased for Rs.300000/- which will watch all vital signs including Pulse Rate, Temperature, Blood Pressure and Cardiac and Pulmonary functions, replace all other equipments and prevent children from being moved to different monitoring levels, floors or rooms. The latest thing to present a children’s ward in a hospital with is the Da-Vinci Robotic Surgical System which ensures more accuracy in surgery, lesser pain, smaller scars and quicker discharge. The surgeon at the console sees 3D images of internal organs, makes tiny incisions, manipulates miniature instruments and performs surgery. These are becoming popular now- U.S. has 300 0f them and U.K. 1. Why don’t Kasaragode try? Anything is possible, and do not tighten purses where children are concerned. Also take care of a few other things. How many High Dependency Unit Beds, Electric Cots, Pediatric Nurses, Consultant Pediatricians and Anesthetists trained in Pediatric Care are there? Is there a Children’s Ambulatory Care Ward, so that children needn’t stay even a day for surgery? Are cots, waiting room chairs, and equipments including thermometers and birthing-baths beyond or with in Accepted Infection Control Parameters and Standards? Are all beds provided with oxygen space and access to oxygen outlets? What about prevention of cross-infection? Are medical and surgical patients separated? What about cleanliness in children’s baths, toilets and closets?

Link to News Article:

ചികിത്സക്കെത്തുന്ന കുരുന്നുകള്‍ക്ക് കൂട്ടായി കാര്‍ട്ടൂണ്‍ കഥാപാത്രങ്ങളും

http://www.indiavisiontv.com/2014/09/13/352453.html?fb_action_ids=530039403792818&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Kasaragode, Pediatric Equipments, Pediatric Wards, District Hospitals, Hospital Funds, HDC

049. Kerala Govt. Abandons Plans To Set Up Drug Manufacturing Units, To Please Bosses.

Kerala Govt. Abandons Plans To Set Up Drug Manufacturing Units, To Please Bosses.

By Special Correspondent

The Kerala Government had announced its desire, not decision, to enter the field of pharmaceutical manufacturing in the year 2012. Even after billions of rupees having flown into the coffers of multi national medicine manufacturing companies, the government has not cared to make common man’s dream come true. It is like the politicians in government, and their bureaucratic counterparts as well, do not like medicine manufacturing units to come up in the public sector, and the large corporates who contribute handsomely to their election funds and their children’s educational funds loose their huge sales in Kerala. Their loyalty is to large pharmaceutical companies, not to people or government. And they could not or did ever care to persuade these companies to stop extracting unrealistically high prices for life-saving drugs or refrain from withdrawing low-priced good drugs from the market. 

Even in 2013, the Government of Kerala was said to have been giving serious consideration to proposals for setting up drug manufacturing plants in the state, as was revealed in the health minister’s speech in the Emerging Kerala Global Connect Meet 2012, which in itself was an utter farce. Multi-faceted and many dimensional growth was assured in Kerala’s health sector by many participants but when they learned that it is not easy to cheat and lure the highly politicized people of Kerala as they do in states likes Bihar, these aspiring entrepreneurs suddenly vanished. Government’s declaration to set up state-owned drug manufacturing units today seems like a threat sent to large medicine manufacturers: ‘We are going to start; come up and pay’- which was it. If not, why did they defeat in every way the two dependable medicine manufacturing plants already functioning in Kerala, owned by the very government? 

The Pharmaceutical Corporation of Kerala Ltd for Indigenous Medicine, marketing medicines under the brand name of Oushadhi, was started even before India gained independence from the British. Started in 1941 as Sree Kerala Varma Ayurveda Pharmacy by the Maharaja of Cochin, it became a registered co-operative society in 1959 and then in 1975 was registered under the Indian Companies Act and renamed as The Pharmaceutical Corporation (Indian Medicines) Kerala Ltd, Thrissur. It has modern manufacturing units, regional distribution units, a full-fledged Research and Development Centre and a wide distribution network. It hands over crores of rupees to government each year as dividend. But, when the question of procuring medicines for government came, they were pushed back far, to stand behind large private companies. Politicians and bureaucrats in government are suffocating this company on the hope that it would vanish for ever and clear the field for favourite private companies.

The Kerala State Drugs & Pharmaceuticals Ltd., a Public Sector Undertaking fully owned by the Government of Kerala, ‘has been manufacturing and supplying essential and life saving allopathic medicines to cater to the need of the common patients resorting to Government Hospitals in the State of Kerala’ since 1974. It is self-revealing to analyze how much they are favoured while procuring medicines for the state-owned Kerala State Medical Service Corporation. When the government directly purchased medicine from manufacturers in the past, this public sector unit still had a hope. When government established this particular corporation for procurement of medicine for government, good public sector companies lost all hope. This corporation with its undemocratic bureaucratic haughtiness has been favouring only private companies and has been behaving so from the first. When government directly purchased medicine, there indeed had been corruption by purchasing committees and directors of health services had been charge-sheeted with corruption, but corruption had been comparatively lower and transparency higher when compared with this corporation. It is not illogical to doubt if this corporation was set up to monopolize corruption in drug purchasing in Kerala.

The original news, announcing Kerala government’s decision to enter drug manufacturing field is here, as reported by Pharma Biz.

Kerala Govt. Planning To Set Up Drug Mfg. Units In Public Sector.

By Pharma Biz

Joseph Alexander, New Delhi
Thursday, October 25, 2012

Kerala, which is heavily dependent on other States for medicines, is weighing the options to set up manufacturing plants in the public sector on the lines of the central public sector pharmaceutical manufacturing units to make drugs affordable and accessible.

Kerala which accounts for more than 10 per cent of the national consumption of medicines has only a few manufacturing units to cater to the demand. Out of the 10,000 licensed manufacturing units in the country, the State may have only a few dozens of units, making it almost fully dependent on the other States, a senior official of the State Health Department told Pharma Biz.

“The Government is considering a proposal for setting up drug manufacturing plants in the public sector to make drugs affordable. Detailed modalities were being worked out and feasibility studies were being done. The working and profitability of the central public sector manufacturing units were also being examined to work out a model for the State,” he said.

The State also is weighing options like going for public-private partnership model. The objective is to make available quality healthcare to all at affordable costs, he said, adding that the State has already taken a number of initiatives to bring down the prices of medicines.

“We have a better distribution system with State-run stores to make affordable the drugs. However, the main problem now is the supply side and many were advocating the entry of the government to produce the medicines,” he said.

Referring to the Clinical Establishment Act which was already implemented by many States following the passage of the Bill by the Union Government, he said the State has initiated steps to formulate laws and adopt the same in the State with a view to improving the quality of care to patients by regulating hospitals and laboratories.

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=71823&sid=1

Republished here by courtesy of Pharma Biz Dot Com

048. Health Director Post Permanently Reserved For Caste Candidates? Merit No Bar?

How Many Times Can Communal Reservation Be Sought For Government Promotions?

By Special Correspondent

How many times can a doctor seek communal reservation for departmental promotions in the Kerala Health Services Department which is supposed to be a department of specialists? No one in Kerala seems to know. Even those who know, fear about speaking aloud, for fear of angering extremely rich communal elements and alienating powerful politicians who enslave themselves to communal zealots for a few hundred thousand community votes. This issue of only communal candidates becoming Director of Health Services has been fuming in this department for more than a quarter century and qualified doctors in this department fear it would continue to be so the next century also. An Assistant Surgeon has to pass through the posts of Civil Surgeon, Deputy Director of Health Services and Additional Director of Health Services, to become a Director of Health Services. It is justifiable for a doctor to avail the benefit of communal reservation for once, for recruitment to the entry post of Assistant Surgeon or for one promotion. But availing the benefit of communal reservation for all levels is unbelievable among specialists in the world. If it happens regularly in each recruiting year, there will soon be a host of Additional Directors in the department within 15 years, all having enjoyed the benefit of reservation multiple times, ascending to the post of the super doctor, bypassing everyone not eligible to enjoy communal reservation. Every other qualified and brilliant doctor in the department, even after thirty years, will not have a chance. How they can become a Director is a Chinese mathematical puzzle which even the Abacus cannot solve. 

It was due to imbalance in the strength of several minority communities in the government due to long neglect by authorities and lack of resources for a good education, that the reservations bill was introduced in India which guaranteed recruitment of backward castes and communities into government posts, subject to a maximum of 50 percent of vacancies, the rest earmarked for merit. Later, orders from the highest law office in the country held that this reservation could be used only once in the entire service; if used for recruitment, it shall not be allowed for promotions; if was not sought for recruitment, it could be sought for promotion once. Recruitment to the post of the Director of Health Services is the finest example in Kerala of how a specialists’ department can allow merit to be overruled by communal factors, skillfully manipulate reservation to cent percent and bring down the efficacy and competency expected of the post. 

For the past three decades, Kerala Health Services has been helpless but to reserve this post for community and caste candidates. Seniority, service merit and academic qualifications are no consideration for recruitment to this post- the bare minimum is sufficient. The only question is, ‘do you have a reservation?’ The unusually brilliant in this department are tired. They are facing the dilemma of quitting joining private service or succumbing to communal powers and suffering the shame of working far below the incompetent. The main reason for brilliant doctors leaving this department and young ones not joining is this, and the unnecessary and illogical ban on home practice. Drive away the brilliant ones and make health service a haunt of inferior opportunists- that is what the government has only been able to achieve so far. 

One former Director of Health Services was recruited as Assistant Surgeon through special communal recruitment. While still under probation, was suspended for the death of a child and mother but still she managed to get promoted as Civil Surgeon Grade II through Special Recruitment.  While other doctors became Civil Surgeons Grade II in 13 years, she made it in 5 years. The same way she became Civil Surgeon Grade I. Then the posts of Deputy Director of Health Services and Additional Director of Health Services also were secured the same way and eventually the final one: five promotions using communal reservation! We will wonder who is there to acquiesce to demands for all these promotions and grant them too: it is those who already are there in government on the same communal and caste basis. Now, we know that the senior-most among the Additional Directors of Health Services only would be posted as the DHS. While a non-communal, doctor would take at least 30 years to become an Additional Director of Health Services, she could make it within 15 years. When she reached the final level, there was little competition there because these posts are limited in number and could be filled up only when a retirement vacancy arises. She naturally had to compete only against other reservation beneficiaries. And the seniority among them counted. So, now, we have a bunch of Additional Directors in the health services department- all recruited and promoted on the basis of community and caste, competing against each other for the post of the DHS. Our doctor anyway became the DHS, even though she had to retire without full charge of the DHS due to court’s intervention. 

During the past 25 years, the post of DHS has been reserved this way. And it is expected that it would be the same for the next 50 years also. Who will work at a place where caste and creed overrule brilliance and qualification? So our question arises, for Kerala government to answer: How many times can communal reservation be sought for promotions in the health department?

What the law states about availing reservation benefits multiple times:

The Supreme Court of India held that reservation of appointments or posts under Article 16(4) included promotions (in Akhil Bharatiya Soshit Karamchari Sangh (Railway) v. Union of India 1981, 1 SCC 246), which was later overruled and held that Reservations cannot be applied in promotions (in Indira Sawhney & Others v. Union of India. AIR 1993 SC 477).

77th Constitution amendment Art 16 (4 A) & 16 (4B) were introduced to make judgement as invalid but subsequent judgement in M. Nagraj & Others v. Union of India AIR 2007 SC 71 held the amendments constitutional. Those constitutional amendments do not alter structure of Art. 16(4). 

Roster-point promotees getting the benefit of accelerated promotion would not get consequential seniority and the seniority between the reserved category candidates and general candidates in promoted category shall be governed by their panel position. This was overruled and held that the date of continuous officiation has to be taken into account and if so, the roster- point promotees were entitled to the benefit of continuous officiation (Jagdish Lal and Others v. State of Haryana and Others (1997) 6 SCC 538) which was overruled again and held that held that roster promotions were meant only for the limited purpose of due representation of backward classes at various levels of service and therefore, such roster promotions did not confer consequential seniority to the roster point promotee (Ajitsingh Januja & Others v. State of Punjab AIR 1999 SC 3471; Jagdish Lal M G Badappanvar v. State of Karnataka 2001(2) SCC 666 : AIR 2001 SC 260) 

Relaxation of qualifying marks and standard of evaluation in matters of reservation in promotion was not permissible (S. Vinod Kumar v. Union of India 1996 6 SCC 580).

If the state wants to frame rules with regard to reservation in promotions and consequential seniority, it has to satisfy itself with quantifiable data that is there is backwardness, inadequacy of representation in public employment and overall administrative inefficiency, and unless such an exercise was undertaken by the state government, the rules in promotions and consequential seniority cannot be introduced. (Suraj Bhan Meena v. State of Rajasthan; M. Nagraj & Others v. Union of India AIR 2007 SC 71) Reservation in promotion is dependent on the inadequacy of representation of members of SC, ST and backward classes and subject to the condition of ascertaining whether such reservation was at all required, as no exercise was undertaken to acquire quantifiable data regarding in adequacy of representation. The Rajasthan High Court rightly quashed the notifications providing for consequential seniority and promotion to the members of SC and ST communities and held the same does not call for any interference. 

General observations and directives made by law courts are the following:

Backwardness and inadequacy of representation are the controlling/compelling reasons for the state to provide reservations, keeping in mind the overall efficiency of state administration. Government has to apply cadre strength as a unit in the operation of the roaster in order to ascertain whether a given class/group is adequately represented in the service. Roaster has to be post-specific with inbuilt concept of replacement and not vacancy based. If any authority thinks that for ensuring adequate representation of backward class or category it is necessary to provide for direct recruitment therein, it shall be open to do so. Backlog vacancies are to be treated as a distinct group and excluded from the ceiling limit of 50%. If a member from reserved category gets selected in general category, his selection will not be counted against the quota limit provided to his class and reserved category candidates are entitled to compete for the general category post. The reserved candidates are entitled to compete with the general candidates for promotion to the general post in their own right. On their selection, they are to be adjusted in the general post as per the roster and the reserved candidates should be adjusted in the points earmarked in the roster to the reserved candidates. Each post gets marked for the particular category of candidate to be appointed against it and any subsequent vacancy has to be filled by that category alone (replacement theory). (R K Sabharwal v. State of Punjab AIR 1995 SC 1371: (1995) 2 SCC 745). The operation of a roster, for filling the cadre-strength, by itself ensures that the reservation remains within the 50% limit.

047. Ayurvedic Products And Treatment Decline In Demand In Kerala

Demand For Ayurvedic Treatment And Products On Decline In Kerala: AMMOI Survey.

By Pharma Biz

Peethaambaran Kunnathoor, Chennai
Friday April 05, 2013 

A survey conducted by the Ayurvedic Medicine Manufacturers Organization of India (AMMOI) indicates that demand for ayurvedic medicines and confidence of the people in the traditional treatment system in Kerala is on the decline for the last several years.

The survey was primarily based on operations of the ayurvedic pharmacies working in all the districts in the state. According to the study, the number of Ayurvedic pharmacies has decreased in recent years and no new pharmacy has come up anywhere, said the physician-cum-manufacturer, Dr. D. Ramanathan of Sitharam Ayurveda Super Specialty hospital in Thrissur and the secretary of AMMOI.

About five years ago, the number of pharmacies in Kerala was 10,000 which is reduced to 9,000 now. The study reveals that the reason for the closure of stores and sales counters is due to lack of business and financial loss. Room rent, labour cost, shortage of trained and skilled people and poor demand for medicines are the supporting reasons for the closure of shops.

In the case of medication for diseases among youngsters, he said, the new generation is going after modern medicines only. Very few youngsters are following the traditional system; only the age-old people are depending on Ayurveda. A comprehensive study has to be done on what kinds of diseases can be cured by the application of ayurvedic system, he said.

Regarding the number of drug manufacturers, he said, currently only 800 licensed manufacturers are in Kerala. Previously the number was 1100 and that area is also declining. Whereas, the number of ayurvedic graduates is increasing year after year, which poses a threat of unemployment opportunities in the ayurvedic sector? The situation has to be addressed.

When asked about other states, he said despite the efforts of about 150 years, Ayurveda has got a foundation only in five states in India including Kerala. The system is followed mainly in Karnataka, Maharashtra, Gujarat and Himachal Pradesh apart from Kerala. Notwithstanding the efforts of Ayush Department and the respective governments, these states also could not succeed in achieving the confidence of all the people, especially of the younger generation, in this healing system.

Currently there are 17 Ayurveda Colleges in Kerala; 12 of them are private colleges, three are government colleges and two semi-government colleges (Kottackal and Vaidyaratnam). From these educational institutions 790 graduates are coming out every year. About 500 private nursing homes and 2500 clinics are run by ayurvedic graduates. All over Kerala, about 800 small scale manufacturing units are also working, Dr. Ramanathan told Pharmabiz.

To a question he said the sales of products from his company have also decreased in recent years.

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=74634&sid=1

Republished here by courtesy of Pharma Biz Dot Com

046. When Did Kerala Health Qualify For Central Grant For Total Automation?

When Did Kerala Health Qualify For Central Grant For Total Automation?

By Special Correspondent

The Department of Health, Kerala, in their Face Book page dated 24th January 2013, announced that they won a grant for total automation of the department. There was no mention of the amount involved or what specific uses the amount of this grant was ordered to be put into, as if it is their private pleasure and right to hide specific information from people and use this grant at their will. First we shall read here their own article from their Face Book. Do not mind the language and grammar, for it represents only the person going to benefit most from this ‘grant’. 

Then we shall look into the Face Book Set Up of this department to see how current, updated and sophisticated they are to receive such India Government grants for total automation. To tell the truth, they do not qualify for it. A screen shot of their page on April 05, 2014 denotes that they are 8 months back in digital updatedness and that they are not skilled and resourceful enough to control such elaborate e-health governance for an entire state, unless they outsource everything which is what they really wish to do. If they outsource it as is evidenced from this article, it is illegal and against the interests of the people. It seems this is going to become a sequel to the ill famous solar scam, involving perhaps the same kind of people. The government is quite unwilling to disclose the names of the people who ‘expressed their interest’ to participate in the various projects likely to come up in connection with the implementation of e-health in Kerala. Even then they ‘won’ a Union Government grant for total automation. How did this happen and which powers were behind it?

Their article which is reproduced here is just a blabbering of the uninformed and the uncaring in the health field of Kerala, knowing nothing about e-governance or electronic health informatics, interested only in the securing of funds from all possible sources and spending it at their will. They care nothing about people’s health or the privacy and confidentiality of people’s health data or government servants’ accountability. If what they say on doing things in the name of e-health is to be believed to be going to happen actually, they either intend to ignore the legalities of accessibility to health data, protection of health data, citizens’ rights to privacy and confidentiality of their sensitive health data and international guide lines for sharing patient data, or they think they can simply bypass these by sheer criminality. Certainly the health minister of Kerala, a politician who proclaims to know everything under the sun, the political parties of Kerala who assume the role of keeping suspicious views of everything, the various scientific, civil and human rights organizations who pretend to know about every law in the world and interfere in almost everything and the news media in Kerala who report every involvement above five lakhs rupees as scams, did not speak a word against this involvement which is sure to affect the life of every man, woman and child in Kerala. They all will have their piece of the pie, or their relatives or favourites will have it. Violating international chapters on safeguarding sensitive patient data, the people involved in e-health finance and administration in Kerala, are going to enlist private parties and outsource sensitive works to them, at the risk of data loss, theft and manipulation. If there are investigating agencies in Kerala, it is time they begin. 

Note that when it was assured that a considerable amount of money would be allotted by the Union Government, there were a rush of activities. Pages were opened in DHS and NRHM websites, news released to news papers and television channels and articles were posted in Face Book. When the money actually came to Trivandrum, it all stopped; there were no more updating or information release, ever. From then onwards, everything became secret and silent, till the alert and vigilant Treasuries Officers began to turn down e-health bills for enormous amounts.

Department of Health, Government of Kerala. Face Book Article On 24 January 2013. 

Health department Kerala was won a project grant from the Department of IT (DeITY) Government of India for total automation of the department. This will have three arms: automation of demographic data indexed on UID, State Data Centre (where all individual data would be stored) linked to all health institutions and accessed by field workers through a 3G enbled tablets and hospital automation. The field workers will digitise the family health register where each individual will be identified by UID. This data would be sent to the state data centre (SDC) through the Kerala State Wide Area Network (KSWAN). The field worker will be able to down load the demographic data she needs for her planned work for the data and be able to update the individual data at the SDC with new data generated (immunisation, Blood Pressure data) during her work for the day.

When the person visits any government health institution this data would be downloaded to the local server of the institution. This would be available at the OP, Consultation room, pharmacy, lab etc. It will contain alerts for the physician, pharmacist and other staff such as pre-existing condition, specific allergies etc. The communication between different parts of the hospital (e.g: Cinician and laboratory or Ward Nurse and Pharmacy) will be through the system. At the time of discharge an abstract will go back to update the data at the SDC.

Our aim to develop an Electronic Health Record for every citizen of the state. Once it is stablised the private sector may also be invited to participate. The project aims to make data available for planning, research and for individuals to manage their own health. Government of India sees this as a pilot project to apply IT to ensuring Universal Health Coverage in the country. 

The challenge is to develop good Functional Requirement Specifications. Our teams are on this task now.

Screen Shot of Department of Health, Kerala’s Face Book page. See how current they are:

045. Is The Era Of Antibiotics Over?

Is The Era Of Antibiotics Over?

By Health India.Com

October 28

The Center for Disease Control and Prevention in Atlanta has announced that the world has reached ‘the end of the antibiotics era period’. ‘Humans and livestock have been overmedicated to the point that bacteria have grown so resistant to antibiotics that we are now in the post-antibiotic era,’ said Arjun Srinivasan, associate director at CDC.

The WHO had earlier warned that simple infections would no longer have a cure and the blame was on the overuse and the misuse of antibiotics for the situation. ‘We’ve fuelled this fire of bacterial resistance. These drugs are miracle drugs… but we haven’t taken good care of them over the 50 years.’

Doctors, according to him, are running out of therapies to tackle infections that could be easily treated earlier.  ‘There are bacteria that we encounter … that are resistant to nearly all- or, in some cases, all- the antibiotics that we have available to us,’ he said.

What are antibiotics? 

An antibiotic is any chemical substance derived from bacteria that can slow down or destroy other micro-organisms and fight bacterial infections. They usually are semi-synthesized and modify existing bacterium to fight diseases and infections. An antibiotic’s efficacy depends on various factors like host defense mechanism, the infection’s location and properties of the antibiotic. Their indiscriminate use can lead to antibiotic-resistant bacteria. It is therefore imperative to only use antibiotics when necessary and only as per the doctors’ prescription.

Antibiotics in India 

In February, the Indian Health Ministry had resolved to add warning signs on medication, a move which was welcomed by doctors who felt that indiscriminate self-medication needed to stop. Docs were observing that ailments which could be treated with mild antibiotics now needed stronger ones. This growing trend is attributed to the fact that micro-organisms are quickly developing a resistance to a number of commonly used drugs.  

When an antibiotic is used without a prescription or is not taken for the number of days prescribed, the organism knows enough about the antibiotic to mutate in such a manner that the drug is rendered useless. These organisms then get passed on to other people, creating a stronger and much deadlier form of the disease. A glaring example of this is the mutation of mycobacterium tuberculosis, the organism that causes TB. When the disease was first diagnosed, all doctors needed to treat the patient with were a simple antibiotic like penicillin. Over the years the TB organism has mutated to such an extent that it has become difficult to treat, and extremely drug-resistant forms have also been discovered.  

Sadly, it looks like we’ve reached the end of the glorious period which started when Sir. Alexander Fleming discovered penicillin in 1928. Knowing humankind’s ingenuity, we sure hope we find something to replace antibiotics in the long run.

Link: http://health.india.com/news/is-the-era-of-antibiotics-over/

Republished here by courtesy of Health India Dot Com

043. Dengue Fever: Do Not Give Aspirin Or Ibuprofen To The Patient.

Dengue Fever: Do Not Give Aspirin Or Ibuprofen To The Patient.

By Health India.Com

Dr. Reshma Nayak
October 4, 2013

The cases of dengue are at an all-time high this year, especially in New Delhi. While people are scrambling to find out more about dengue symptoms and its treatment, they don’t know something very important. Since dengue presents as a fever with body ache in the beginning, most people mistake it as a case of viral fever. They end up self-medicating themselves with either Aspririn or Ibuprofen. Now, this can be very dangerous and cause severe bleeding. Why?

The infecting organism in dengue affects the platelets which are responsible for clotting (stopping bleeding), increasing the tendency of the person to bleed. Aspirin and Ibuprofen also have similar action. Both of them together could cause the person to bleed excessively, pushing the patient into what is called the ‘Dengue Shock Syndrome’. And once in this stage, medical treatment is needed in an emergency basis and hospitalization becomes necessary.

So what is dengue?

It is a tropical disease, usually transmitted by mosquitoes and the common symptoms include fever, headache, muscle and joint pains and skin rash. There is no vaccine for dengue and the only way to reduce infections is to improve hygiene levels so as to prevent mosquito-bites and prevent mosquitoes from breeding. It’s particularly difficult to create a vaccine because it’s caused by different viruses and there are no animal models available for testing. The disease kills over five thousand Indians every year and is a seasonal threat, particularly during the monsoon seasons.

So what are the symptoms of dengue?

Characterized by severe flu-like symptoms, dengue affects infants, children and adults alike and could be fatal. The clinical manifestations of dengue vary with the age of the patient. A person suffering from high fever in the range of 40°C/ 104°F, accompanied by any two of the following symptoms could be suffering from dengue:

Severe headache
Pain behind the eyes
Nausea, Vomiting
Swollen glands
Muscle and joint pains
Rash

Symptoms usually last for 2-7 days. Dengue could progress to severe dengue, a potentially fatal complication, causing leaking of plasma, fluid accumulation, respiratory distress, severe bleeding and organ impairment.

The warning signs to look out for occur 3-7 days after the first symptoms along with a decrease in temperature are severe abdominal pain, persistent vomiting, and rapid breathing, bleeding gums, blood in vomit, fatigue, and restlessness.

Link: http://health.india.com/diseases-conditions/dengue-fever-do-not-give-aspirin-or-ibuprofen-to-the-patient/

Reproduced here by courtesy of Health India. Com

042. Iranian Technology To Control Dengue Through Larvicide.

Iranian Technology To Control Dengue Through Larvicide.
 
By Health India. Com
 
October 29, 2013
 

Authorities in Haryana’s Gurgaon district will experiment with an eco-friendly larvicide prepared by an Iranian company to control the spread of dengue and malaria, a spokesman said in Chandigarh on Monday. 

A delegation of scientists from Iran Monday met senior officials of the Gurgaon administration and Municipal Corporation and gave a presentation on how the larvicide could control the spread of these diseases. The delegation offered to give a sample of its technology.

‘This exercise will be completely on ‘no commitment, no costs’ basis. If the results are found to be fruitful, as per the claims of the delegation, then the larvicide would be used in whole of district Gurgaon on experimental basis as a pilot project,’ the spokesman said.

He said that the delegation had claimed that the larvicide is eco-friendly and only kills larva of mosquitoes. ‘It is harmless to plants, animals and even human beings. The water with this larvicide is safe for human consumption as well,’ the spokesman said, quoting the delegation. 

The delegation claimed that since 2000, when this larvicide was used in Iran to control malaria, number of cases of the disease reduced from 20,000 to less than 1,000 annually. It has been used in countries like Oman, Sudan, Turkey, Thailand, Nigeria and Malaysia, he added.

Link: http://health.india.com/news/gurgaon-to-try-iranian-technology-to-control-dengue/
 
Reproduced here by courtesy of Health India. Com 

041. Prevent Dengue With These 10 Practical Tips.

Prevent Dengue With These 10 Practical Tips.

By Health India. Com

Pavitra Sampath
July 10, 2013

With the monsoon come various diseases, and one of the most severe one is dengue. Also known as ‘break bone fever’ it is a painful and debilitating disease spread by mosquitoes. Caused due to the bite of an infected female aedes aegypti mosquito, the disease can be fatal. 

Once bitten, it takes about four to ten days for the symptoms to show. The most common symptoms are high fever, severe headache, pain behind the eyes, nausea, vomiting, swollen glands, muscle and joint pain and in some cases a rash. The more severe forms of dengue are hemorrhagic fever and dengue shock syndrome. There is no clear treatment for the condition nor is there a vaccine against it, so the best way is to prevent the disease from occurring at all. Here are a few simple and practical tips to keep dengue at bay: 

Aedes aegypti mosquitoes are known to bite humans during the day and their most common breeding grounds are man made containers. Therefore, it is advisable to not have any stagnant water around. Remember to clean out empty flower pots and not to over water potted plants. If the container that contains water cannot be emptied, remember to cover it well when not in use. 

Turn over empty pails and buckets, so that they do not collect excess water.

Use mosquito repellants regularly. Apply it well on all exposed areas, during the day as well as at night.

Make sure your window and door screens do not have any holes. If so, block those areas properly to eliminate mosquitoes.

If someone at home is ill with dengue, try to not let the mosquitoes bite them or others in the house.

Always sleep under a mosquito net.

If you use a cooler remember to empty out and clean the water tray regularly, even when not in use.

Always cover your trash can when not in use.

A natural method to keep mosquitoes at bay is to plant Tulsi near your window. The plant has properties that do not allow mosquitoes to breed. 

Using camphor as a repellant also works wonders. Light camphor in a room and close all the doors and windows. Leave it this way for about fifteen to twenty minutes to have a mosquito-free environment. 

Dengue is a completely preventable condition, all you have to do is take a few steps to keep yourself and your family safe. 

Link: http://health.india.com/diseases-conditions/prevent-dengue-with-these-10-practical-tips/

Reproduced here by courtesy of Health India. Com

Comment:

Platelet count in dengue:

How many numbers of platelets are present in blood after being affected by dengue? If the count of platelets decrease, will it lead to dengue?

Normal platelet count in a healthy adult is 140,000-400,000 platelets/cubic mm of blood. When infected with dengue virus, our body’s capacity to produce new platelets is affected. Platelet count starts decreasing below normal. Dengue is a viral disease spread by mosquitoes from one human to another. So, the only way it can really be prevented is by avoiding mosquito bites. Low platelet count per se does not cause dengue.

037. Kerala Health Service being sold out wholesale to British.

Kerala govt to ink pact with London-based NICE to revitalize health sector in the state

By Pharma Biz

Peethaambaran Kunnathoor, Chennai
Wednesday, August 22, 2012

Amid reports that the health sector in Kerala is bedeviled by many problems that have led to reduction in quality of service delivery in certain health institutions, the state government has decided to ink a pact with the London based National Institute for Health and Clinical Excellence (NICE) to revitalize the entire health services in the state.

The tie-up will be for the next three years and with the intervention of NICE, best standard could be maintained in all spheres of health sector in the state, said Rajeev Sadanandan, principal secretary, health, government of Kerala. He was speaking at the valedictory session of the pharmacists’ conference at Thiruvananthapuram recently. The total system will become in a systematic and proper way and separate guidelines for treatment, medicine, services of doctors, nurses, pharmacists and other para medical professionals will come into force. In future, there will not be any variation in the treatment, he said.

NICE, an arm of the national health services of the UK government, provides independent, authoritative and evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health, reducing inequalities and variation.

“For the next three years, the department will be monitored by NICE, strict vigilance and standard can be maintained in each and every area of the health sector. They will carry out assessments of the most appropriate treatment regimes for different diseases. This will help the desired medical outcomes for patients. The use of new and existing medicines, treatments, clinical practice, guidance on treatment procedures, advice to patients and public sector workers on health promotion and ill-health avoidance will be provided by the experts of the organisation,” the health secretary said.

There are reports that the health sector in Kerala is bedeviled by many problems that have led to reduction in quality of service delivery in certain health institutions. Besides, unavailability of medicines in hospitals, high prices for essential drugs, inadequacy of sufficient staff and strikes by nurses have also affected the sector badly. The government is looking for a concrete solution to all these issues without chance for recurrence, it is learnt.

The health secretary said that in the next session of the state Legislative Assembly, the government will introduce the Clinical Establishment Bill which will standardize the fee being levied by private hospitals and clinical institutions for various services. Further, drug rationalization committee will also be formed in all district hospitals, which will prepare the list of medicines to be distributed under a scheme for providing generic drugs from November 1. In all the government hospitals in Kerala, generic medicines will be available on reasonable rates and a treatment protocol will also come into force from November, he added.

Regarding predicament of pharmacies in the hospital, the principal health secretary said he would look into the possibility of standardization of pharmacies and try to get accreditation from NABH for model pharmacies in the state. By receiving the set of guidelines prepared by the pharmacy council, he said the Council as well as the pharmacists association has to ensure the value addition to the health sector from their side.

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=70748&sid=1

Republished here by courtesy of Pharma Biz. Com


Comment:

There was an independent and reliable system of medicine-actually a system of a combination of ingenious and native treatment and nourishing system- existing in India before the British installed allopathy and revamped the field of Indian Medical Attendance. Today, almost all indigenous systems including the world famous ayurveda are ignored and neglected and only allopathy is being given importance and monopoly. In India, even now, poor people when they are sick, can still go to a government hospital and become healthy again, availing the benefits of the famous Free Indian Hospital System. It is when we have no money and therefore no nutrition that diseases afflict us. Therefore this free hospital system has been a great blessing to the Indian masses. It has been what sustained the people of India through their years of sickness. The money involved in retaining this system was people’s money, not the dowry money of Indian Health Authorities. It is the same money which funds the treatment of Government Ministers, MPs VIPs and Government Secretaries abroad; there is no shame in people regaining their health by availing free treatment. The very people in India who are directly partaking in bringing about this sale deed of a country's good will and charity are beneficiaries of this Free Indian Hospital System which they are going to abolish for ever. Which one of them does not receive free hospital care from government?

In the United Kingdom there is now no free hospital treatment. Either you pay money at the hospital or you pay money in advance for insurance. This is exactly what the British monitoring of Kerala Health Services Department is going to bring to Kerala. It is a full implementation of the British Health System, minus everything good in it. The first thing they are going to force without caring people’s resistance is abolishing every kind of free medical assistance. What is a collapsing British economy finding prospectful in extending managerial assistance to the health care sector of a thriving former colony, except exporting over-paid excess staff? -Editor-in-Chief.