Healthcare in India
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Healthcare in India
Selection of Articles, Opinions, Discussions and News on Healthcare in India from all over the web covering Healthcare Policy, Healthcare Reform, News, Events, #HealthIT , Edipdemics, Chronic Diseases, #mHealth, #hcsmin ,
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Rougher Passage to India’s Drug Market

Rougher Passage to India’s Drug Market | Healthcare in India |

FDA Commissioner Margaret A. Hamburg, M.D., contrasted the craftsmanship and beauty of India’s Taj Mahal with recent lapses in quality by “a handful” of the country’s drug manufacturers during a recent visit there. If the comparison was meant to flatter the domestic pharma executives and regulators with whom she met, they didn’t appear to think so.

Dr. Hamburg and officials from India’s Ministry of Health and Family Welfare pledged cooperation in data sharing and even “medical and cosmetic product and inspections conducted by the other Participant.” That’s no small promise since India is the world’s second largest exporter of prescription and over-the-counter drugs. Yet their formal Statement of Intent conditioned such cooperation “as time and resources allow” and didn’t set specific terms.

In a conference call with reporters today, Dr. Hamburg said implementing the statement was a five-year commitment “already under way” as both countries “have already embarked upon some cross-training activities and started to identify some critical areas for future activities together, so I think progress will be made.”

Indian drugmaker Ranbaxy has come under repeated FDA scrutiny. It agreed last year to pay a $500 million fine for safety and record-keeping violations. More recently, it urged Dr. Hamburg to lift the FDA’s consent decree. Extended as of January, this decree effectively bans four of Ranbaxy’s Indian plants from exporting active pharmaceutical ingredients to the United States. Although Ranbaxy contended that it needed the export activity to fund FDA-sought quality improvements, Dr. Hamburg declined the company’s request.

Domestic Generics

According to the All India Chemists and Druggists Association data reported by Indian newspaper The Economic Times, Mumbai-based Glenmark Pharmaceuticals impacted the Rs 3,000 crore ($483.7 million) Indian diabetes drug market long dominated by multinationals last year. Glenmark racked up Rs 16 crore ($2.58 million) in eight months for its Zitamed and Zita generic versions of sitagliptin

These generics sold 30% cheaper than the Januvia and Janumet branded drugs of market leader Merck & Co., which generated more than $5.8 billion in combined global 2013 sales for Merck and are the subject of a patent dispute between the companies.

Through court decisions and regulatory actions, Indian officials have pressed foreign-based multinationals for lower-cost drugs. These multinationals, however, have argued that Indian actions hinder their ability to do business selling innovative if costlier drugs.

Patent Questions

India’s Patent Office sent shivers through the biopharma industry in 2012 when it revoked the exclusive patent rights held by Bayer for cancer drug Nexavar, and awarded the nation’s first-ever compulsory license to a domestic maker of a much cheaper generic. Industry cringed again last year when India’s Supreme Court rejected patent protection for Novartis’ blockbuster cancer drug Glivec, as the drug faces a 2015 expiration of its first U.S. patent.

The patent decisions, Bagla explained, reflect Indian compliance with the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organization, of which India is a founding member.

“Western companies need to factor this situation among the risks of doing business in India,” Bagla emphasized. “Some of our clients are limiting their involvement in India due to this. Others are a taking a measured approach to what products and technologies they bring. Very few are walking away from India completely.”

Legal and Regulatory Moves

Last year, the Indian Supreme Court ordered a nationwide halt to clinical trials for 157 new chemical entities, citing the need for stricter ethical standards after seven girls died in a Phase IV trial of an HPV vaccine carried out on children unaware they were under study. The court also shifted responsibility for trials from the Central Drugs Standard Control Organization headed by Dr. Singh, ordering India’s Health Secretary personally responsible for new-drug clinical trials.

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Dabur Launches India's First Ayurvedic Medical Journal

As part of its plans to propagate the benefits of traditional Indian form of medicine, leading Ayurvedic healthcare company Dabur India Ltd today launched 'Ayurveda Samvad', India's first Ayurvedic Medical Journal. 

The quarterly journal was unveiled by Shailaja Chandra, General Secretary, AYUSH, Government of India. 

The quarterly publication will cover detailed information on various clinical trials being conducted on Ayurvedic medicines.

Announcing the launch, Dabur India Ltd Ayurveda R&D Head Dr J L N Sastry said the journal would cover the holistic approach on Ayurveda. It would popularise Ayurveda and reach out to the doctor fraternity to propagate messages on the Ayurvedic way of life to manage health and diseases. 

The journal will feature articles covering original scientific studies in the field of Ayurvedic medicines with direct clinical significance, addressing health care issues and public health policy. 

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India has to indicate its position on certain aspects of IPR

India has to indicate its position on certain aspects of IPR | Healthcare in India |

US lobby groups such as the US Trade Representative and the International Trade Commission are demanding trade sanctions against India if it does not take a tough stand on intellectual property rights, or IPR, after receiving several complaints from US pharmaceutical companies and government representatives against India's trade policies, particularly concerning the Indian Patents Act (2005).

Local drug makers say the Indian government should not be bullied into taking decisions based on demands by such lobby groups. Kiran Mazumdar-Shaw, chairman and managing director, Biocon Ltd, in an interview said the US should not take action based on a trade body's request, while also explaining that India will have to find a middle path of working with big pharma.

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The UPA regime: A Decade of massive healthcare reform

The UPA regime: A Decade of massive healthcare reform | Healthcare in India |

Winston Churchill once said, "Healthy citizens are the greatest asset any country could ever have." The UPA's effort to invest in citizen's health deserves better coverage and notice than it has attracted so far.

As we inch towards the end of United Progressive Alliance's (UPA's) second term, it is important to look back and reflect on what was accomplished and what is still to be achieved. If health indicators are any yardstick, then the UPA's thrust on social healthcare has led to improved health of citizens and set the stage for future reforms.

In 2004, when UPA came to power, expenditure on public health was around Rs 7,500 crore. This has now almost quadrupled to Rs 27,000 crore. In the beginning of UPA's regime, the National Rural Health Mission (NRHM), known to be "the most ambitious rural health initiative ever", was initiated.

The NRHM was formed to provide effective healthcare delivery to our rural population, especially women and children. The latest data shows that in the last 10 years, infant mortality rate (IMR) has come down from 58 per 1,000 to 44. This is further set to decline sharply.

During the National Democratic Alliance's regime, the IMR declined at a snail's pace of 1.3% annually, whereas now this deceleration is happening at 6.4% per annum.

With government focusing on early and periodic health screening of children through its Rashtriya Bal Swasthya Karyakram, children's health indicators could improve further.

With the Janani Suraksha schemes, institutional deliveries through skilled birth attendants have increased rapidly. Approximately 12 million deliveries per year are taking place at no expense to the beneficiaries. This is followed by cash incentives and other benefits.

As a result of such initiatives, the maternal mortality ratio of India has been reduced by 50% from 390 in 2000 to 200 in 2010.

Providing government-run health insurance to below poverty line (BPL) workers and their families through Rashtriya Swasthya Bima Yojana (RSBY) is yet another milestone achieved by the UPA government.

The objective of RSBY is to protect BPL households from major health expenses that could wipe out their life's savings.

This scheme allows inpatient treatment up to Rs 30,000 per year, and since its inception in 2008, around 35 million families have enrolled in the programme. This scheme has been praised by global leaders for its unique, innovative and inclusive business model.

Making India free from the blot of polio is another achievement of the UPA. This was only possible due to massive immunisation and awareness efforts of the government. Nevertheless, the government should be in surveillance mode as we are surrounded by nations that are still afflicted by polio.

Due to improved life expectancy, the average Indian would live five years longer than he would have had a decade ago. An increase in life expectancy will be a driver of economic growth, as it happened in Japan, which saw an increase in life expectancy by 13 years after World War II, followed by rapid economic growth.

This is a battle half-won. We have people falling into the trap of poverty and indebtedness due to escalating healthcare cost. The government should speed up its intention to provide free medicine to all through public hospitals and health facilities.

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'New law to regulate clinics should focus on rights of patients'

'New law to regulate clinics should focus on rights of patients' | Healthcare in India |
As a 19-member high-powered committee drafts the clinical establishment law for the state before the forthcoming budget session, citizen groups have demanded that it should be focused on patients instead of on doctors.
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Docs use WhatsApp to save heart patients

Docs use WhatsApp to save heart patients | Healthcare in India |

Doctors at KEM Hospital have turned to the most ubiquitous personal technology - the smartphone - to speed up diagnosis of patients with suspected heart complications. 

They have started using the popular smartphone messenger 'WhatsApp' to send pictures of patients' electrocardiograms (ECG) to each other for a quick review, saving time spent on reaching the emergency ward and checking the actual report. 

The approach enables them to begin the treatment of a person who has suffered a heart attack within the crucial golden hour, the period when emergency care is most likely to be successful. Delay in proper diagnosis and treatment during this period results in amajority of cardiac fatalities. 

In fact, over 60 per cent of patients who have suffered a heart attack reach the hospital way beyond the golden hour, the average being about five hours. So every moment they spend waiting for the doctor to arrive and study their ECG increases the risks. 

"The moment a patient walks in here complaining of chest pain or any other related problem, a specialist takes out an ECG and sends the image to the doctors on hand," said Dr Prafulla Kerkar, head of KEM's cardiology department. "We, in fact, have a WhatsApp group where the experts in our department are signed in." 

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Morphine available to just 1% cancer sufferers

Morphine available to just 1% cancer sufferers | Healthcare in India |

 When the winter session of Parliament begins on December 5, millions of cancer patients hope lawmakers will clear a long-awaited amendment that will allow them easier access to morphine.

Morphine, one of the best known pain-control medicines, is available to barely 1% of all patients suffering from pain arising out of their cancer or HIV/AIDS infection, say experts. "India has 2.4 million cancer patients who need pain relief and another 2.5 million living with HIV. These patients sometimes suffer unbearable pain that is best relieved by morphine," said Thiruvananthapuram-based Dr M R Rajagopal, who is often referred to as the father of palliative care in India.

Last two sessions of the houses failed to take up the amendment to the Narcotic Drugs and Psychotropic Substances Act, 1985. Dubbing its poor access as a human rights violation, Dr Rajagopal said, "We hope the amendment will be passed this time.''

Morphine is classified as a narcotic under the NDPS Act, resulting in tight restrictions to prevent misuse. The law states that anybody found with 250 grams of morphine without adequate licences could face up to 10 years of rigorous imprisonment.

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Online Profile Management for Oncologists

An understanding of Online Profile Management for Oncologists, with an Indian perspective. 

Covers Digitally Aware Patients and Social Networks, The Need for Online Profile Management, an understanding of Local Reputation vs Global Reputation, Tips for How to do it while avoiding the traps and describing techniques for Maximizing Online Exposure for Oncologists 

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Tackling corruption in Indian medicine

Some doctors and non-governmental organisations are taking up the fight against corruption in Indian medicine, which many observers claim is widespread in the country. Dinsa Sachan reports.

When a cheque landed on the desk of 63-year-old doctor Himmatrao Saluba Bawaskar, from a diagnostic centre under the guise of “professional fee”, Bawaskar not only returned it, but he also filed a complaint against the centre with the Medical Council of India (MCI), the national watchdog for medical education and doctors. His case is currently being heard by the state medical council of Maharashtra.

Kickbacks have been part of the Indian medical practice since the beginning, says Puneet Bedi, a leading gynaecologist based in New Delhi who has appeared on Indian television to speak about medical ethics in the country. He notes that many hospitals and clinics routinely issue cheques to doctors under sanitised names such as “professional fee” to encourage them to recommend their services to their patients.

K K Aggarwal, a Delhi-based physician on the ethics committee of MCI, says there's no method at present to document the percentage of doctors taking kickbacks, but he admits that the practice exists.

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Medical Negligence: Supreme Court Awards Record Compensation To US Doctor

Medical Negligence: Supreme Court Awards Record Compensation To US Doctor | Healthcare in India |

India's Supreme Court awarded a record compensation payment of almost a million dollars for medical negligence to Kunal Saha, an HIV/AIDS doctor.

While in India during the summer of 1998, Anuradha Saha, a 36-year-old child psychologist, contracted toxic epidermal necrolysis but was incorrectly diagnosed and given an overdose of steroids that caused her death. Today, a full 15 years later, India's Supreme Court made steps to rectify this wrong by awarding a record compensation payment of Rs. 5.96 crore (almost a million dollars) for medical negligence to her husband.

Ohio resident Kunal Saha, an HIV/AIDS specialist of Indian origin, said the ruling set vital precedents and would help save lives. After being awarded a far smaller payout by a consumer dispute commission in 2011, Saha appealed to the Supreme Court seeking greater compensation, leading to today’s judgment. He noted the large compensation sum would deter both doctors and hospitals from acting with negligence in the future.

"It's closure of a personal battle for justice for my wife," Saha told AFP by phone. "The purpose was served,” Saha told Agence France-Presse. “The medical community in India will sit up and the courts will have to think."

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Infant mortality down by 30% in past decade

Infant mortality down by 30% in past decade | Healthcare in India |

Setting a blistering pace, Tamil Nadu has halved its infant mortality rate (IMR) in the past decade while a bunch of other states — Maharashtra, Punjab, Karnataka — have shown significant decreases of around 40%. The overall IMR for the country has gone down by a third. This emerges from the latest vital statistics data for 2012 collected under the Sample Registration Scheme by the Census office.

The infant mortality rate is a count of deaths of infants under one year of age per 1000 live births in one year. It is considered a key indicator of health services, nutritional levels, poverty and educational level of the people. Reduction of IMR is one of the millenium development goals set by the UN with a deadline of 2015.

The wide gap between rural and urban areas in infant death rates continues in India but is declining . Rural IMR in 2012 was 46 infant deaths per 1000 live births while the urban rate was 28. In fact, the rural IMR declined by 30% compared to the urban decline of 28% since 2003.

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Kristen Trammell's curator insight, March 23, 2015 11:49 PM

I. Tamil Nadu has halved its infant mortality rate in the past decade while many other states have decreased their mortality rate by 40%. Infant mortality rate is viewed as a key marker of wellbeing administrations, healthful levels, neediness and instructive level of the individuals. 


II. In developing countries, infant mortality is caused from a lack of medical attention. Developing countries do not have the technology needed for childbirth, ultrasounds and x-rays in order to perform diagnostics on pregnant women. However, with today’s extensive and better run primary health services, some women can get the attention they need. 

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Deadly duo: Urban India battles diabetes and high blood pressure

Deadly duo: Urban India battles diabetes and high blood pressure | Healthcare in India |

Twenty per cent of India's population in the metros and above the age of 30 years suffer from the deadly duo of diabetes and high blood pressure according to a large-scale government study released recently.

Over 4 crore people from across the country screened under the Government's National Programme for Prevention and Control of Cancer, Diabetes, cardio-vascular Diseases and stroke (NPCDCS) has revealed that 6.34 per cent of the population is suspected to be suffering from diabetes and over 6 per cent are hypertensive.

Dr Upendra Kaul, Executive Director and Dean Cardiology, Escorts Heart Institute and Fortis Hospital says, "Unless we take strict measures, the deadly duo of high BP and diabetes will continue to take a high toll of our population. It leads to heart attacks, brain strokes, chronic kidney and early blindness and is preventable by taking preventive measures early in life."

The survey results in urban areas of the country, including Delhi, Bangalore, Ahmedabad, Chennai and Kamrup (Assam) has pointed out trends that almost 11 per cent people are suspected to be suffering from diabetes and 13 per cent are hypertensive.

Madhya Pradesh recorded the lowest diabetes(2.61 per cent). From the overall (16.91 lakh) of those tested, 44,133 people were found to be diabetic and 49,391 were hypertensive.

Sikkim recorded the highest prevalence of diabetes (13.67 per cent) as well as hypertension (18.16 percentage).

Gujarat had the second highest prevalence of diabetes (9.57 per cent) followed by Karnataka (9.41 percent) and Punjab (9.36 per cent).

States that recorded comparatively lower per centage of diabetes are Assam (4.91 per cent), Haryana (4.80 per cent), Kerala (4.79 per cent), Rajasthan (4.43 per cent) and Uttar Pradesh (4.32 per cent).

The remaining states which fell in the middle order rung for diabetes among those surveyed are as follows.

Andhra Pradesh (7.42 per cent),

Tamil Nadu (6.50 per cent)

West Bengal (6.34 per cent),

Jharkhand (5.44 per cent),

Jammu and Kashmir (5.61 per cent),

Maharashtra (5.64),

Himachal Pradesh (5.78 per cent),

Bihar (5.83 per cent),

Oissa (5.89 per cent),

Chhatisgarh (5.92),

Uttarakhand (5.44 per cent)and

Delhi (5.02 per cent).

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75% fear public spaces are disease hubs: Survey

In India the top three illness concerns are seasonal cold (47.3%), skin infections (37.1%) and seasonal flu (31.9%), reveals a Global Hygiene Council 2013 study. The survey was carried out on over 18,000 adults across 18 countries, including India.

When it comes to contracting an infectious disease, Indians are most cautious. About 95% are concerned about themselves or their family contracting one. As many as 77% Indians ensure they and their families wash their hands with soap after going to the toilet and before eating.

On the risky places for contracting disease, 75% of the respondents in India perceive public places as the riskiest, while 49% adults around the world (including India) picked mass gatherings. Also, 20% said they avoided attending mass gatherings to pre-empt infections.

About 68% of adults from across the globe believe public transport is one of the riskiest places for picking up infectious diseases while 11% view the home as potential disease carriers.

The biggest (30%) infectious disease concern across the world is seasonal flu, but it varies widely across the world.

Clean factor

75% respondents in India view public places as disease carriers

49% of adults around the world view mass gatherings as risky

77% Indians wash their hands with soap after going to toilet and before eating

Illness concerns

India - seasonal cold, skin infection and seasonal flu

UK - stomach upset, diarrhea and vomiting and staph infection

Nigeria - seasonal colds, waterborne illnesses and skin infections


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Amendments to Drug Act Simplify Access to Pain Medicines

Amendments to Drug Act Simplify Access to Pain Medicines | Healthcare in India |

Millions of Indians suffering chronic pain will get better access to pain medicines following changes in India’s drug law, Human Rights Watch said today. On February 21, 2014, the Rajya Sabha, the upper house of parliament, approved amendments to the Narcotic Drugs and Psychotropic Substances Act (the Drug Act) that  the lower house had approved a day earlier.

The amendments eliminate archaic rules that obligated hospitals and pharmacies to obtain four or five licenses, each from a different government agency, every time they wanted to purchase strong pain medicines. As Human Rights Watch documented in a 2009 report, “Unbearable Pain: India's Obligation to Ensure Palliative Care,” this resulted in the virtual disappearance of morphine, an essential medicine for strong pain, from Indian hospitals, including from most specialized cancer centers.

“The revised Drug Act is very good news for people with pain in India,” said Diederik Lohman, senior health researcher at Human Rights Watch. “These changes will help spare millions of people the indignity of suffering needlessly from severe pain.”

Patients who experience severe pain without access to adequate treatment face enormous suffering. Like victims of torture, these patients have often told Human Rights Watch that the pain was intolerable and that they would do anything to make it stop. Many said that they saw death as the only way out and some said they had become suicidal.

The amendments to the Drug Act give the central government authority to regulate so-called “narcotic drugs,” require a single license to procure morphine and other strong opioid medications, and charge one government agency, the state drug controller, with enforcement. The government introduced the amendments to the Drug Act in 2012.

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Hospital warned against deal with stem cell banks

The couple, unaware that Hiranandani did not allow any other service provider to collect stem cells, had made an arrangement with LifeCell International. They had paid an advance of Rs 60,000 for the banking, that lasts up to 21 years. A complaint was lodged in June 2012, after which a probe was ordered by the Competition Commission of India (CCI). 

Hiranandani's refusal came when the couple went to seek permission to allow the LifeCell representative to collect the stem cell on the day the baby was born. Stem cells must be collected shortly after a baby is born. Hiranandani cited its tie-up with Cryobank for denying entry to another company representative on its premises. The couple tried to reason with the hospital and then decided to shift to SevenHills Hospital, Marol, for the delivery. 

The body, while penalizing the company 4% of its annual turnover of the last three years, said the hospital should behave ethically towards patients. It said the hospital's arrangement was based more on a commission model rather than competition and that was "against the spirit of health services". CCI found that Cryobank was paying the hospital Rs 20,000 for every patient who opted for stem cell banking. This practice is common in the industry. 

The industry hailed CCI's decision. "Patients deserve to be given a fair choice. The industry is new and such pacts can hamper its growth," said Meghnath Roy Chowdhry, secretary, Association ofStem Cell Banks of India (ASBI). Gynecologists said most city hospitals affiliate more than one player though the practice may be different for nursing homes. "Each company may have something better to offer. As doctors we only explain the benefits and disadvantages of storing stem cells, but beyond that the choice is with the patients," said Dr Suchitra Pandit, president, Federation of Obstetric and Gynecological Societies of India. 

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Indian drug that breaks down blood clots approved for human clinical trials in India

Indian drug that breaks down blood clots approved for human clinical trials in India | Healthcare in India |

Clot-specific Streptokinase (CSSK), a drug that breaks down blood clots, developed by an arm of the Council for Scientific and Industrial Research (CSIR), has been cleared by the office of the Drug Controller General of India (DCGI) for phase two human clinical trials.

The CSSK is the first so-called biotherapeutic drug developed in India -- meaning it entailed the use of antibodies, proteins and enzymes, unlike conventional chemical drugs. If and when the drug reaches the market, it could offer an affordable alternative to expensive thrombolytic drugs used to treat patients of myocardial infarction or heart attacks, and other severe heart conditions like deep vein thrombosis.

Work on the Indian drug began seven years ago under a partnership between the CSIR's Institute of Microbial Technology (IMTECH), Chandigarh, and Nostrum Pharmaceuticals LLC of the US.

"Streptokinase has been modified by IMTECH through protein engineering and then made clot-specific, so that the basic risk of hemorrhage or bleeding, which is the problem with clot-busters in general, is much reduced," said Girish Sahni, director of IMTECH and inventor of the molecule.

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Indian pharma firms can't be judged by U.S. standards

Indian pharma firms can't be judged by U.S. standards | Healthcare in India |

Hours after the US drug regulator banned imports from a fourth factory of Ranbaxy Laboratories Ltd, the drug controller general of India G.N. Singh chose to back the Indian company, saying the current situation may not require withdrawal of its medicines from the local market.

On Friday, the US Food and Drug Administration (FDA) barred Ranbaxy, a subsidiary of Japan's Daiichi Sankyo, from producing or distributing drug ingredients manufactured at its Toansa facility in Punjab for the US market.

The FDA has already banned imports from Ranbaxy's plants in Mohali in Punjab, Dewas in Madhya Pradesh and Paonta Sahib in Himachal Pradesh. At the Toansa facility, the regulator found the company's staff found that workers retested drug products to produce acceptable findings after the items originally failed analytical testing. While the US has banned imports from these facilities, the Indian pharma market continues to use raw materials from these plants. Singh in an interview said, "Indian pharmaceutical companies cannot be judged by American standards." Edited excerpts:

Were the other three plants of the company found to be in violation of India's Drugs and Cosmetics Act?

We had approached them last year after US FDA flagged certain issues. Some of those were found to be true and my office had told Ranbaxy to take corrective measures. Similar procedures will be followed in this case as well. But I do not think this is a situation which will warrant withdrawal of drugs from the domestic market. Our biggest objective is to maintain good quality of medicines and we are doing that. There are no drugs in the Indian market that are not up to the standards stated under the Drugs and Cosmetics Act. We will shortly be in touch with Ranbaxy's management to find out what went wrong at the Toansa plant.

Will such decisions adversely affect India's image as a manufacturer of safe, affordable drugs?

As of today, India supplies low-cost drugs to over 200 countries. Our pharmaceutical sector is a huge success. We cannot be doing well if our drugs were of substandard quality. Many multinational pharmaceutical companies stand to gain if India loses its image as a supplier of quality drugs. However, we will take appropriate action. We are in the process of streamlining the drug regulation in India and fundamental changes will be taking place soon. I am not worried about issues of quality

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Oh doctor, you're in trouble

Oh doctor, you're in trouble | Healthcare in India |

It is not in the interest of patients or doctors to remain on a collision course forever. While growing awareness among patients about their rights is a welcome trend, medical councils have to step up to the plate.

Aam aadmi (and aurat) at the high table in Delhi has buoyed the hopes of citizens’ groups across the country. As 2014 kicks in, be prepared to hear a lot more from one group whose interests have been long-neglected — the harried aam patient.

Over the past year, a series of developments suggests that patient activism is on the surge, and could be shaping the practice of medicine in this country.

People for Better Treatment (PBT), a citizens’ group which started on December 30, 2001, in Kolkata, is fanning out across the country. Last month new PBT branches sprung up in Delhi, Chennai and Hyderabad. Next on the list is Ahmedabad and possibly Lucknow. PBT’s goal is to raise public awareness about medical negligence. It is the brainchild of US-based

Dr Kunal Saha, whose wife Anuradha died due to negligence of doctors in a Kolkata hospital. Dr Saha fought a long, protracted battle for justice for nearly 15 years, boning up on toxic epidermal necrolysis in the process, and mobilising an international panel of experts to bolster his arguments.

Last October, the Supreme Court gave its judgment. The apex court’s ruling found three doctors of the private hospital, Advanced Medical Research Institute (AMRI), negligent in the civil case but dismissed the criminal complaint. The judgment grabbed headlines because of the unprecedented compensation amount in a medical negligence case in India — `5.96 crore plus interest for each of the 15 years — awarded to Dr Saha.

The landmark judgment of the apex court has unleashed a fierce debate on fair compensation for patients who suffer due to medical negligence. The medical fraternity led by the Indian Medical Association (IMA) and the Association of Healthcare Providers India (AHPI) is seeking a limit on the maximum amount that hospitals should be asked to shell out in such cases. Their argument: without a cap, hospitals will go bankrupt.

Patients’ groups such as PBT led by Dr Saha say that is not true.
Dr Saha says AMRI has not yet coughed up the compensation money. Instead, the hospital authorities have asked for an extension of the deadline to pay the sum. The Kolkata hospital has also partially resumed operations.

Dr Saha has responded by petitioning the Supreme Court against what he terms “deliberate violation” of its order. The case is listed for hearing early January.

The debate over a compensation cap is taking place in the backdrop of a Parliamentary Standing Committee on health’s report on the Indian Medical Council (Amendment) Bill 2013, introduced in the Rajya Sabha last March. The committee recommended that teams probing cases of medical negligence include external experts instead of just Medical Council of India (MCI) members.

“All of the members of the Medical Council of India are medical professionals and whenever any complaint of medical negligence or violation of code of ethics is brought before the council, such cases are decided by the medical professional themselves,” the committee noted.

The MPs recommended that all cases of medical negligence should be inquired into by a committee of experts drawn from various fields and experience, including social activists, patients’ representative and so on.

Although MCI is the regulatory body governing medical practice, there is growing concern that the few cases brought before it are not impartially decided as council members are very lenient towards their colleagues and hardly anyone is willing to testify that another doctor has been negligent. The fact that the MCI has been embroiled in various corruption scandals in the past adds to the concern.

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The rise of internet use and telehealth in India

The rise of internet use and telehealth in India | Healthcare in India |

“Making geography history,” “making distance meaningless,” “a hospital in your pocket,” “cost effective, need based healthcare for everyone, anytime, anywhere,” are all hyperbole—fertile imagination working overtime and hype. But is it possible that in my lifetime I may actually see this happen? Improbable, yes. Impossible, no.

According to the Internet and Mobile Association of India, by June 2014 243 million people in India will have internet access, with 75 million of those living in rural India. India will be second only to China in terms internet use. 130 million people in India now access the internet via smart phones. 50% of urban internet users access the internet daily. So is healthcare via a phone possible in an “emerging economy?” Can this be the equivalent of buying a pizza or booking a ticket online?

Encounters between doctors and patients have always been face to face. I had serious concerns about whether India was ready to receive healthcare via a phone. From October 2012 to April 2013, 1866 individuals from five states were interviewed, 31% from rural areas. 22% from rural areas had smart phones (46% in urban). Surprisingly 48% in rural India and 72% in urban areas had heard of mobile health (mHealth). I would love to do a similar study in the UK or the US.

Perhaps it will clearly show that we are no longer following the West, not even piggy backing, but just leap frogging. In 2011, when I carried out a smaller study at a world renowned temple of technology in Chennai, the awareness of mHealth was dismally low.

The most reassuring finding now was that 55% of respondents (urban and rural) showed a very strong intent to use mobile phones for healthcare, if available. Mobile network operators in India should wake up to this. Their role in this will be much more than offering mobile TV—Tendulkar not withstanding.

Kenzie and Courtney's curator insight, October 29, 2014 4:21 PM


This article shows how India is developing by using a more modern type of communicating. By having over 243 million people introduced to the internet by this year. They're becoming more social within themselves and with the world around them because they're now opened up to the world of technology.

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Privatising public healthcare in India, one report at a time

Privatising public healthcare in India, one report at a time | Healthcare in India |

Public health experts and activists are attacking a proposal by India's leading government think tank that recommends handing many of the country's healthcare responsibilities to the private sector.

The document, written by India's Planning Commission, proposes eliminating the government as the primary healthcare provider. Instead, it would focus on specific areas such as immunisation and HIV testing. Getting rid of many of its other responsibilities would amount to a shortcut to its goal of universal healthcare. Patients would get private healthcare at a cost that the government would negotiate with the private sector, and service providers could be reimbursed for each medical prescription.

The proposal, which is similar to the managed care system in the United States, caused such a ruckus that some of the major parties who contributed to the plan have distanced themselves from it. Members of the High Level Expert Group set up by Prime Minister Manmohan Singh, say that the commission has distorted their recommendations.

"Planning Commissions' document calls for a 'managed healthcare' approach where the role of the government is reduced from a provider to that of a manager," said Rakhal Gaitonde, a public health researcher and state coordinator for the government's National Rural Health Mission in Tamil Nadu.

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Why is India's healthcare in critical condition?

Why is India's healthcare in critical condition? | Healthcare in India |

 India's health parameters are amongst the worst in the world right now and a child born in India today has less chances of survival than in Nepal or Bangladesh. On The NDTV Dialogues, Dr Srinath Reddy, Kiran Mazumdar Shaw, Dr Binayak Sen and Dr Ashok Seth join NDTV's Sonia Singh to look at why India's healthcare is in a critical condition.

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Doctors must be dealt with strictly for medical negligence: Supreme Court

Doctors must be dealt with strictly for medical negligence: Supreme Court | Healthcare in India |

Doctors and medical establishments must be dealt with strictly for their negligence in giving treatment to patients, the Supreme Court on Thursday held and asked the government to enact laws for effective functioning of the private hospitals and nursing homes. 

"The doctors, hospitals, the nursing homes and other connected establishments are to be dealt with strictly if they are found to be negligent with the patients who come to them pawning all their money with the hope to live a better life with dignity," a bench of justices CK Prasad and V Gopala Gowda said. 

The bench directed Kolkata-based AMRI Hospital and three doctors to pay over Rs 11 crore which includes interest to a US-based Indian-origin doctor who lost his 29-year-old wife during their visit to India 14 years ago. 

The bench said that its decision would act as deterrent to people associated with practice of medicine and do not take their responsibility seriously. 

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SC orders video recording of clinical trials of new drugs

SC orders video recording of clinical trials of new drugs | Healthcare in India |

The Supreme Court on Monday ordered the government to video record clinical trials of five new drugs, making it tougher for multinationals to shirk responsibility when testing of their patented medicine reacts adversely on patients.

A bunch of petitions in the apex court had complained about lax implementation of the clinical trial regime and alleged that multinational manufacturers had exploited the loopholes to make India the testing ground of their new drugs.

Countering senior advocate Colin Gonsalves and Sanjay Parekh who argued for halting clinical trial of 162 new drugs permitted by the Drug Controller General till their usefulness for India was established, additional solicitor general Sidharth Luthra said the government had established a three-tier scrutiny system comprising New Drugs Advisory Committee, technical committee and apex committee to examine applications for clinical trials in India.


Estibaliz Undiano Hernandez's curator insight, November 10, 2013 2:11 PM

Este artículo comenta la aceptación por parte del Corte Supremo de la grabación de los ensayos clínicos de nuevos fármacos. Me parece adecuado que se haya tomado una medida así, ya que se está garantizando el principio de seguridad a los participantes. Es decir, en el caso de que exista alguna irregularidad o se detecte algún tipo de riesgo para la salud de los mismos, se puede identificar rápidamente y detener el ensayo. Es una idea que habría que tener muy en cuenta en nuestro país.'s curator insight, November 23, 2014 6:17 AM

La grabación del consentimiento informado de los pacientes es un buen método para asegurar que no haya fraude respecto a los sujetos del ensayo. Sin embargo, debe tenerse cuidado de no infringir el derecho a la intimidad. Las medidas que ayuden al cumplimiento de los derechos básicos evitarán los abusos por parte de las empresas farmacéuticas en su búsqueda de beneficios económicos.

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The era of personalised medicine

The era of personalised medicine | Healthcare in India |

People react differently to drugs based on how they metabolize, and the aim of pharmacogenetics is to assist in choosing the right medication for an individual

I.C. Verma, a senior consultant at the Center of Medical Genetics at New Delhi’s Ganga Ram Hospital, was approached by the parents of a child who suffered from epilepsy and whose whole body was covered with painful blisters.
After carrying out tests, doctors at the hospital determined that the blisters were the result of the child’s adverse reaction to the medicine he had been taking for epilepsy.
The child had a mutation in a gene called HLAB 1502 that caused the allergic reaction. “In India, this mutation is found in only 2% of the population,” said Verma. “We had to change his dosage to suit the mutation to avoid this adverse reaction.”
The Center for Genetics at Ganga Ram Hospital is currently studying the mutation in Indian genes that can cause adverse reactions to anticoagulant medicines such as Warfarin. “We have seen patients who take such medicines for heart diseases, but can have adverse reactions like haemorrhage, due to certain gene mutations,” Verma said.
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Badly run trials behind Indian drug testing freeze

Badly run trials behind Indian drug testing freeze | Healthcare in India |

The Supreme Court in India has halted clinical testing of new drugs following a parliamentary probe into a vaccine trial

"Foreign companies are treating India as a heaven for clinical trials, but it is proving hell for India." So said an Indian Supreme Court judge on 30 September as he pressed the pause button on the country's clinical trials, ruling that all drug trials must be halted for two weeks. That period is now up, but there is no sign of the ban being lifted.

In recent years, India has emerged as the destination of choice for foreign companies looking to conduct clinical trials, attracted by low costs and access to a large pool of research participants.

But while the companies reap the rewards, the Indian people enrolled in the trials may be paying the price. In March, the Indian health minister Ghulam Nabi Azad testified in the Rajya Sabha, the upper house of parliament, that The government has found that between 2005 and 2012, over 2868 deaths were recorded during government-approved clinical trials of new drugs, 89 of which have been directly linked to the trials.

To put this in context, Ken Getz, founder of the Centre for Information and Study of Clinical Research Participation in Boston says the global risk of dying in a clinical trial is 1 in 10,000. In India, the risk in 2011 was an order of magnitude higher.

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