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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No clear treatment for kids with drug-resistant TB, say doctors

No clear treatment for kids with drug-resistant TB, say doctors | Healthcare in India |

A recent study by Andheri's Kokilaben Hospital has found that an overwhelming percentage of children referred to the hospital for tuberculosis had contracted its dreaded strain—multidrug resistant TB (MDRTB)—directly from the community and not from their immediate families. What makes the situation more alarming is the fact that there are negligible treatment options available for the paediatric population, say experts.

Kokilaben Hospital, which works as a referral centre for paediatric TB cases, has found a staggering 72% of the 21 referred children with the drug resistant form of the disease. A teenager also tested positive for the extensively drug-resistant tuberculosis (XDRTB), which is a rarity among kids and has only few documented cases in India. Shockingly, during the process of contact tracing, the study found none of the kids had an adult relative suffering from TB, leave alone its resistant form, suggesting they got the infection from outsiders.

Worse, all of them had MDRTB as the primary infection with no previous history of tuberculosis whatsoever.

Six of the patients had contracted TB in the lungs, five in the lungs as well nodes (glands), two in lymph nodes, and one in the central nervous system.

Commonly, in adults, non-adherence to TB drugs is what pushes them to its drug-resistant form but this was not found to be the case among these young patients.

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India records 5.2 million medical injuries a year

India records 5.2 million medical injuries a year | Healthcare in India |

India is recording a whopping 5.2 million injuries each year due to medical errors and adverse events.

Of these, the biggest sources are mishaps from medications, hospital-acquired infections and blood clots that develop in legs from being immobilized in the hospital.

Similarly, approximately 3 million years of healthy life are lost in India each year due to these injuries.

A landmark report by an Indian doctor from Harvard School of Public Health has concluded that more than 43 million people are injured worldwide each year due to unsafe medical care.

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India’s Medical Education In Extortionate Private Hands

India’s Medical Education In Extortionate Private Hands | Healthcare in India |

Almost half of India’s medical colleges are in just 4 states — Karnataka, Maharashtra, Andhra Pradesh and Tamil Nadu

Karnataka has the highest number of medical colleges and MBBS seats in the country

Every year, millions of young school passouts take multiple gruelling exams to secure a medical seat. In a nation of 1.2 billion people, only around 52,000 students are admitted annually to India’s undergraduate medical courses.  With few subsidised seats in government medical colleges, students are forced to shell out exorbitant fees to study in private ones.


Today, the number of the private medical colleges has surpassed the number of state/central government colleges.


Here’s why the situation is dire: For every  100,000 people, India has only 6.5 doctors; in contrast, China has 14.6.


The World Health Organization’s World Health Statistics 2013 report highlights the deficiencies in India’s health systems compared with BRICS nations and USA making a case for India to produce more doctors.

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Health Insurance in India still remains an untapped market

In a country where less than 15 per cent of population has some form of health insurance coverage, the potential for the health insurance segment remains high. It seems that there is an urgent need to ramp up the health insurance coverage in the country as out-of-pocket payments are still among the highest in the world. 

Furthermore, according to the statistics of the World Health Organization (WHO), in 2011, India has spent only 3.9 per cent of gross domestic product (GDP) on the health sector which is the lowest amongst the BRICS (Brazil, Russia, India, China, South Africa) member countries pack. 

Moreover, amongst the BRICS nations, in 2011, Russia’s out-of-pocket expenses stood highest at 87.9 per cent closely followed by India (86 per cent), China (78.8 per cent), Brazil (57.8 per cent), and South Africa (13.8 per cent). On the other hand, these expenses in developed economies of US and UK were comfortably poised at 20.9 per cent and 53.1 per cent respectively. 

Health insurance segment still remains an unexplored territory in India. Jacob at Apollo Munich Health Insurance asserted, “Health insurance has become one of the most prominent segments in the insurance space today and is expected to grow significantly in the next few years. As spending on healthcare in India is expected to double in a couple of years, we believe that health insurance will eventually become the biggest contributor in the non-life segment.” 

Furthermore, in the present scenario, the health insurance industry is dominated by four public sector entities (National, New India, Oriental, and United India) that together have 60 per cent market share. The rest of the share is with 17 private sector players, of which four are standalone health insurance players (Star Health, Apollo Munich, Max Bupa, and Religare Health). ICICI Lombard continued to be the largest private sector non-life insurance company, with market share of 9.74 per cent. 

Standalone health insurers have got a boost by the move taken by Insurance Regulatory and Development Authority (IRDA) in early 2013. Bandyopadhyay averred, “Few months back, IRDA has classified health insurance as a separate category and has permitted the insurers to tie-up with banks. All the four exclusive health insurance companies will be tying with the banks across the country and that will help them to move to the next level. The penetration of health insurance is now expected to increase with banks pushing for it through bancassurance tie-up.” 

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Health remains low priority for our politicians and that must change: Dr Jagdish Prasad

Health remains low priority for our politicians and that must change: Dr Jagdish Prasad | Healthcare in India |

Speaking with #BBV, Dr Jagdish Prasad, the Director General of Health Services laments political indifference towards health as an issue. Poor implementation at state level coupled with bureaucratic delays and a medical education system that promotes profiteering is ailing India's healthcare system.

If health is not a national priority for India, blame it on political indifference, says Jagdish Prasad, Director General of Health Services (DGHS). While political apathy has pushed health low on government agenda, bureaucratic tardiness coupled with federal complexities have created a maze where implementation of health schemes more than often goes for a toss. Not surprisingly, even big-ticket health schemes fail to meet stated objectives and goals.

“If there is political will, all problems related to the country’s healthcare system can be resolved. Health is a state subject. The Central government enacts laws, but implementation rests with a state government,” said Dr Prasad on Nishane Pe. 

While the centre can give direction and grants-in-aid, the onus is on the states to make health a priority and ensure proper implementation.

“State leaders must give high priority to public healthcare. Most states have not properly implemented the National Rural Health Mission (NHRM),” he added.

There is an urgent need to fix the entire medical education system, stressed Dr Prasad.

“High cost of medical education especially in the form of capitation fees charged by private medical colleges and institutes has spoiled the system. After paying capitation fee, a candidate will be more interested in recovering the money than serving the poor.”

The process of establishment of medical colleges too needs to be streamlined, said Dr Prasad.
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Forge and push public-private partnership in healthcare: Dr. Naresh Trehan

Forge and push public-private partnership in healthcare: Dr. Naresh Trehan | Healthcare in India |

India’s top cardiac surgeon Dr Naresh Trehan says that the country needs to look beyond grandiose populist schemes and instead devise realistic plans to increase the outreach of public health system. For starters, the government should increase the GDP share of healthcare system. And it should aggressively push forge public-private partnership model to reach the last mile.  

“Healthcare can be reached to the last man standing only if public, private and NGO sector work together,” suggested Dr. Trehan on Zee Media’s Bharat Bhagya Vidhata.

In an exclusive conversation with Zee Media’s Amish Devgan in ‘Mudda Aapka’, Dr. Trehan advocated a three-pronged approach to resuce India’s ailing healthcare system. Alignment of all healthcare providers in private, public and NGO sector, prioritize health insurance for all and Indianization of medical technology. 

Emphasis should be on building lasting blocks of healthcare infrastructure that reach out to the bottom of the pyramid instead of short-term populism. 

 “Only by announcing big schemes in health sector, things will not improve. It is our dharma to provide health care to the last man standing at district and village level in next five to seven years,” said Dr. Trehan.  

Dr. Trehan pitched for separating business from healthcare in the interest of the ‘aam aadmi’.  

He also admits that there are many unethical people in this industry and we need checks and balances. “Healthcare is a business with soul, but if we treat people as a commodity it is the violation of our Hippocratic Oath”, says Dr. Trehan.

He suggested adopting evidence-based medicine systems to bring down medical costs and unnecessary health checkups. While Trehan supports punitive action against doctors inflating treatment costs or for overcharging, basic awareness about diseases and treatment processes remains the ultimate check to prevent doctors from looting the patients. 

Dr. Trehan believes that we can only claim to give proper healthcare to our people only when we work out three things – how to control people who have chosen a wrong route, fill the gaps in the system and how to provide healthcare to everyone. 

He says India’s public health spending as a percentage of GDP is minuscule which ought to be increased. He avers, “On health front, the American government spends more than the annual health budget of India even when they have only 350 million people and we have 1.2 billion.” 

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Over 3L people in Andhra Pradesh suffering from Alzheimer's

Regular exercise, an active lifestyle and a healthy diet could reduce the risk of developing Alzheimer's, the most common cause of dementia that leads to memory loss, severe intellectual disability in addition to various behavioural disturbances in people, according to health experts.

Hyderabad has about 35,000 people with Alzheimer's while there are over 3 lakh people across the state affected by the disease. By and large, the onset of the disease is most likely to occur after the age of 60 years, making patients completely dependent on their families for care and support. The incidence of the disease is reaching epidemic proportions, experts said.

The 2013 World Alzheimer's Report, titled 'Journey of Care' released on the eve of the World Alzheimer's Day on Friday, reveals that over 35 million people worldwide live with the disease today. By 2050, the number of those affected is expected to more than triple to 115 million.

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Only Public-Private and people's partnership can hold sinking healthcare in India

Only Public-Private and people's partnership can hold sinking healthcare in India | Healthcare in India |

India’s Gross Development Product (GDP) spend on health care has improved post National Rural Health Mission (NRHM), said Dr. Syeda Hameed. The Planning Commission member was speaking with Zee Media anchor Romana Khan in Bharat Bhagya Vidhata’s ‘Ek Naari Aisi Bhi’. Dr Hameed said perception about health had changed thanks to the NHRM given its success. 

Despite serious infrastructure gaps, India has achieved significant milestones in public healthcare, claimed Hameed.
“It’s true that India’s healthcare has several infrastructural issues but we can’t ignore the milestones achieved in the health sector over the years.”

More institutions are being established across the country.

“We have more number of hospitals and medical colleges now,” added Dr. Hameed.

Concurring with Hameed on poor health infrastructure, Dr. Sunil Gupta, senior consultant and chief of head and neck medical oncology from Rajiv Gandhi Cancer Institute and Research Centre, Delhi stressed on tackling India’s ever-growing population. 
He said, “India’s infrastructural inadequacies in the health sector can be resolved only when our ever growing population can be controlled.”

Not surprisingly, there is always a shortage of skilled health personnel. According to World Health Statistics Report 2013, the physician density of India per 10,000 population stands at 6.5 (global average is 14.2); the nursing and midwifery density of India per 10,000 population stands at 10 (global average is 28.1); and the density of hospital beds per 10,000 population stands at 9 (global average is 30). India ranks 67th among developing countries in doctor-population ratios.

In addition, there is a need to establish state-of-the-art hospitals especially in urban centres across states. 

“It is very important to establish many better equipped hospitals like All India Institute of Medical Sciences (AIIMS) throughout the country so, that the major inflow of patients to the cities can be equally distributed to smaller towns and villages as well as suggested in the 11th and 12th five year plan,” Hameed stressed.

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India launches cloud-based Telehealth solution

India launches cloud-based Telehealth solution | Healthcare in India |

The Medical Informatics Group of the Centre for Development of Advanced Computing(CDAC) in Pune, India has launched the Mercury Nimbus Suite which allows health care organisations to roll out tele-medicine services using public and private cloud.

The Mercury Nimbus Suite is based on the concepts and technologies developed in a project earlier funded by Department of Electronics & Information Technology (DeitY), Ministry of Communications and Information Technology (MCIT), Government of India.

It has been designed to help doctor and health care specialists make healthcare more inclusive to people in far flung areas. With the new tool in place, patients no longer have to travel long distances for medical attention.

Apart from making health more inclusive, the tool also gives hospitals and healthcare providers the freedom from investing in procuring and maintaining expensiveIT infrastructure. According to CDAC, The flexible pricing models of cloud system coupled with ease of use and feature richness of Mercury™ Nimbus Suite provide an unbeatable tool in the hands of healthcare providers.

“This suite will revolutionize the healthcare delivery mechanism in the nation, while keeping cost of owning and using under control of the users,” the agency said in an official statement.

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Portable digital kit CareMother allows community health workers ensure the safety of pregnant mothers

Portable digital kit CareMother allows community health workers ensure the safety of pregnant mothers | Healthcare in India |

In an attempt to curb the mortality rate of mothers in rural parts of the country, five youths have developed a portable digital kit called CareMother, which will enable community health workers to visit the homes of pregnant women to conduct tests. 

The 3kg kit consists of digital sensors to test the woman’s blood pressure, blood sugar, urine sugar and protein levels, apart from the heart rate of the foetus and fundal height, among other things, all at a cost of Rs100. The results of these tests can then be uploaded on a web portal through a cell phone app. 

“With this kit, all pregnancies can be monitored on the web portal by a doctor sitting at a hospital. The doctor can send out SMS alerts in case the results show anomalies,” said Shantanu Pathak, one of the five who developed the kit. 

Rural parts of India usually lack medical facilities, leading to complex pregnancies going unnoticed. A UN report released last year revealed that there is one maternal death every 10 minutes in our country. The report put India close to sub-Saharan countries, with over 212 mothers dying per one lakh live births.

Another team member, Vaibhav Tidke, said, “It took us around six months to minimise all the medical components available in the market to put into the kit. For example, the weighing scales available in the market weighed not less than 3kg. We brought that down to 600g using lightweight polymer.”

Once fully charged, the kit can work for a month. The students spent Rs20,000 to develop this kit. The cost could be brought down if the kit is manufactured commercially. 

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Conclave to discuss reforms in medical education

Conclave to discuss reforms in medical education | Healthcare in India |

Issued related to reforms in medical education system of the country will be discussed at a two-day conclave of representatives from various students organisations in the field from September 8 here. 

Though India has progressed in other arenas, medical education has failed to keep pace with global standards as well as advancements in medicine and technology, which has affected Indian medical students when it comes to competing with international medical students, said Pratap A Naidu, executive president of Medical Students Association of India (MSAI). 

MSAI is organising the India International Medical Conclave on Dept8-9 which is likely to be also attended by representatives of medical student associations from NepalBangladeshMalaysia and the US. 

"This is perhaps for the very first time that medical students as main stakeholders are coming together with other stakeholders at a platform to discuss the crucial issue of reforms in medical education," Naidu said. 

According to Dr Narendra Saini, General Secretary, Indian Medical Association (IMA), "Some of the skills that need to be incorporated into medical education include communication skills, clinical skills, and information system and data management. 

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Medical education in India at crossroads

Medical education in India at crossroads | Healthcare in India |

The recent Supreme Court judgment, albeit a split verdict, has thrown more issues to ponder. The question of whether the Supreme Court rightly held that MCI has no mandate to intervene in admission process or otherwise is a matter of legal debate. Although the health ministry may file a review petition against the judgment, it is time for the government to go back to drawing table to clear the medical education mess.

Apart from legal aspects, the Supreme Court in its recent judgment also considered the practical aspects of holding single National Entrance Test for admission into medical courses. By endorsing arguments of the states and private institutions on the possible increase of urban-rural divide and disparity in educational standards of states, the Supreme Court seems to have ignored the ground realities and the greedy manipulations of private institutions.

If we look at the context of the case, the petitioners only sought relief on the ground that the students had to appear in multiple examinations and wanted to have only one single examination for admission in medical courses. By making invalid the single entrance examination, the top court brought the issue back to square one, giving undue advantage to private institutions. Besides the issue of admission process, the government has to seriously look at the aspect of fee structure and capitation fees charged by private institutions.

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India is the place to be, say home-bound doctors

India is the place to be, say home-bound doctors | Healthcare in India |

After technology sector, it's the health sector in Bangalore that is witnessing a reverse brain drain. Across fields-nephrology, general medicine, pathology, orthopaedics and oncology among others, doctors are returning to India in general and Bangalore in particular.

On an average big medical hospital chains in the city each get 8 to 10 applications every month from Indian doctors in the US, the UK, Canada, Australia and Singapore. "I interview one doctor a week. And in the last six months I have got 12 applications for jobs from doctors abroad. They are all in their 30s," says Dr H Sudarshan Ballal, medical director, Manipal Hospitals.

The scene is no different at Sparsh Hospital on Narayana Health City campus where chief orthopaedic and hospital head Dr Sharan Patil scrutinizes at least 10 applications every month from doctors in the UK, Australia and the US.

"There is no bigger canvas to paint yourself than in medicine. Two decades ago when doctors left India, the opportunities were few. Today opportunities outweigh frustrations. After the training, they want to return," says Dr Patil, who himself spent five years in the UK before returning to the city to become a doctor-entrepreneur.

Ten of the 40 orthopaedicians at Sparsh are those who have returned from abroad. "I began to feel I was making no difference in my job and decided to leave Australia. I find it more satisfying here. But it is good to study and train abroad for some time," says Dr A Thomas, spine surgeon, who practised for five years at St George Hospital, University of South Wales.

Hospital honchos are seeing the trend only in the past five years. In many hospital chains of Bangalore, the entrepreneurs are doctors themselves who left practice in the dream country where they were and came back home.

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Rising medical costs pinching Indian pockets

Rising medical costs pinching Indian pockets | Healthcare in India |

There is no respite in India’s woes when it comes to healthcare. While the common man faces acute shortage of hospital beds and doctors, the rising medical expenses haven’t helped their cause. According to a report by the National Sample Survey Office (NSSO), consumer expenditure on healthcare is ever increasing both in urban and rural India post 2004-05. 

While the consumer expenditure on healthcare in rural India increased from 6.6 per cent in 2004-05 to 6.9 per cent in 2011-2012, urban Indians’ expenditure on medical care increased from 5.2 per cent in 2004-05 to 5.5 per cent in 2011-2012. Medical expenses fall under the miscellaneous goods and services category in the NSSO report. 

The survey shows that miscellaneous goods and services constitute 26.1 per cent of consumer expenditure in rural India while it stands 39.7 per cent for urban India in 2011-12. Apart from medical care, the miscellaneous goods and services category also includes expenses on education, entertainment, toilet articles, other household consumables, consumer services excluding conveyance, conveyance, minor durable-type goods, rent, taxes and cesses. 

NSSO report also reveals that expenditure on healthcare is highest in rural India and fifth highest in urban India during 2011-2012 in miscellaneous goods and services category. 

Voicing concern over the impoverishing impact of health and medical expenses on the vulnerable sections of the society, President Pranab Mukherjee while addressing 40th convocation function of All India Institute of Medical Sciences (AIIMS) in New Delhi said, “It was unacceptable that almost 80 per cent of the expenditure on healthcare by people was met by personal, out of pocket, payment. I am shocked to note that as many as 4 crore people of our country plunge into poverty each year due to expenses on medical treatment.” 

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Two hospitals withdraw ads after medical councils crack the whip

Two hospitals withdraw ads after medical councils crack the whip | Healthcare in India |

The Medical Council of India (MCI) and Delhi Medical Council (DMC) have directed two private hospitals in the capital to withdraw advertisements issued in national dailies naming their specialists along with photographs. The hospitals were also directed to publish a corrigendum in the same ad space and size in the same dailies.

The councils cracked the whip reiterating the code of conduct rules of 2002 for doctors, which prohibit "soliciting patients directly or indirectly", by any physician or institution.

On August 23, Saket City Hospital published an advertisement in The Times of India with pictures of six doctors from its department of pulmonology and critical care under a heading "Breathe Easy...with our renowned team..." A text section below the photographs added that the "expert" team "has created an ensemble for achieving excellence", and "the experienced and renowned team of experts strive to deliver the best standards".

DMC secretary Dr Girish Tyagi said, "Self-publicity and promotion of doctors, with names or photographs, to invite patients is prohibited in the code of medical ethics in the the Indian Medical Council Regulations of 2002. We first received a complaint about the Nova centre advertisement, so we issued them a notice. They gave us an explanation, which we did not find satisfactory. So on August 23, we issued a letter asking them to withdraw this advertisement. They did so on September 11."

Dr Tyagi said when Saket hospital published a similar advertisement on the same day the DMC issued the letter to Nova centre, the MCI took suo motu cognisance of it and sent a notice to the Saket hospital, following which the hospital was asked to withdraw the advertisement.

On Tuesday, September 24, Saket City Hospital published its corrigendum in The Times of India stating that "Reference to the Delhi Medical Council letter..." "..the advertisement published on August 23, is hereby withdrawn."

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Don’t have health cover? Pay up to 60% more

Don’t have health cover? Pay up to 60% more | Healthcare in India |

Indian private healthcare system is moving closer to mirroring the situation in the US, where insurance firms are the prime factors in holding down healthcare costs.

In a dramatic reversal of the trend that existed just three years ago, big corporate hospitals today charge health insurance card holders much less than those paying in cash for the same procedures. Those paying out of their pockets are now billed anywhere between 25% and 60% more than those with cashless health insurance schemes

TOI did a comparative study of the amounts charged from the two categories of patients at Sir Ganga Ram, Max, Fortis and Apollo hospitals in Delhi, Medanta in Gurgaon and similar category hospitals in other metros. Sources say the trends are similar across most hospitals in India. 

It appears that the Indian private healthcare system is moving closer to mirroring the situation in the US, where insurance firms are the prime factors in holding down healthcare costs and those without insurance can face crippling charges. 

Treatment cost for patients without any insurance is 25% to 60% higher than for those with health insurance cards, a comparative study by TOI has found. This figure was arrived at after obtaining exclusive details of treatment costs paid to hospitals by four public sector insurers, commanding a 60% share in the health insurance segment, and tallied with the schedule of charges (price list) of these corporate hospitals for other customers. 

For instance, the package for a heart surgery at Sir Ganga Ram, Max, Fortis, Apollo hospitals in Delhi, Medanta in Gurgaon if you are holding an insurance policy — and other corporate hospitals across the country in the same category - is about Rs 2.25 lakh. This charge is for single-room occupancy and covers all expenses, including coverage for complications if any, and a stay for seven days and if required more. For the same treatment, if you are making out-of-pocket payment, it will cost you an average of Rs 3.63 lakh. 

For a caesarean delivery, these hospitals have been charging a fixed package of Rs 55,000 — whether it is Apollo, Fortis or Ganga Ram — for a cashless insurance card holder . A knee replacement can cost you up to Rs 2.44 lakh in any of these hospitals, but the same comes at a fixed package of Rs 1.60 lakh if you are backed by an insurance policy.

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Reliance Life Sciences taps cancer drug market in India

Reliance Life Sciences taps cancer drug market in India | Healthcare in India |

Reliance Life Sciences Pvt. Ltd has introduced six anti-cancer drug brands in India, including a generic version of Swiss drugmaker Novartis AG's anti-blood cancer drug Glivec, as it seeks to tap the fast-growing market for oncology drugs in the country.

Oncology, or the branch of medicine dealing with cancer, is expected to emerge as one of the largest therapeutic segments in the domestic market in five years, Reliance Life Sciences' president and chief executive K.V. Subramaniam said in an email. "Oncology is the leading therapeutic class in the global pharmaceutical market today," said Subramaniam, adding that the company is targeting both the domestic and export markets.

"For the domestic market, Reliance Life Sciences has set up a separate division for marketing oncology formulations. For international markets, it will pursue partnerships with pharmaceutical companies for commercialization of these products," he added.

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Fortis gifts Mumbaikar’s a Heart Anthem ‘Mumbai ki Dhadkan’

Fortis gifts Mumbaikar’s a Heart Anthem ‘Mumbai ki Dhadkan’ | Healthcare in India |

Fortis Healthcare Limited (Fortis), one of India’s largest private healthcare chains, today dedicated the anthem Mumbai Ki Dhadkan’, to the spirit of the Mumbaikar in tackling heart disease. The anthem has been specially created for Fortis by renowned singer-composer and guitarist Lesle Lewis on the occasion of World Heart day.

“Mumbai ki Dhadkan” –urges people to adopt a healthier lifestyle for a trouble free heart. The anthem will be promoted in Mumbai through several platforms and will be available for download on the microsite – It will also be accessible on Saavn, Youtube and Facebook. In addition, ‘Mumbai Ki Dhadkan’ CD’s will also be distributed free in colleges, gyms and clubs.
Fortis will organise a ‘World Heart Concert’ on September 29 on the occasion of the World Heart Day. Lesle Lewis will perform the Anthem– Mumbai ki Dhadkan, live, at the MMRDA grounds. Along with Lesle, 10-12 youth bands will also render their own compositions in support of the initiative. The youth bands are being chosen from college-wide promotions that Fortis is currently organizing.

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Delhi hosts first Indian Cancer Congress 2013

Over 300 leaders from across the country have worked together to create a very exciting scientific program.

The first Indian Cancer Congress (ICC) will be held from 21st to 24th November 2013 at the Kempinski Ambience Hotel in New Delhi. Experts from surgical, medical and radiation oncology will join forces with radiologists, pathologists, scientists, physicists, and ancillary service providers such as oncology nurses, technicians, and paramedics to comprehensively address various facets of cancer care. Additionally, patients, caregivers, advocacy groups, and NGO’s will also have an opportunity to share the platform with policy makers.

Hosted by the Association of Radio Oncologists of India (AROI), the Indian Association of Surgical Oncology (IASO), the Indian Society of Medical and Pediatric Oncology (ISMPO), the Indian Society of Oncology (ISO), and the Oncology Forum, the Congress enjoys the support of over 25 professional bodies, 100 cancer institutions, and 7 leading international associations involved in cancer care.

With a confirmed faculty of over 250 global thought leaders, ICC has already received 3,000 delegates registration for the conference and 5,000 delegates are expected to attend. This international conference will act as a catalyst for further research, treatment and dissemination of knowledge in the field of cancer.

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Need a healthcare watchdog: Former health minister Dinesh Trivedi

Dinesh Trivedi says that India has all the necessary resources to deal with country’s myriad health challenges but lacks effective planning.

Not surprisingly, even after six decades of independence, the healthcare situation of the nation remains pretty dismal. While the country continues to struggle with a poor health infrastructure including shortage of trained personnel, the government’s low priority vis-à-vis the sector and lack of concerted efforts haven’t helped the matters. 

The former union Rail Minister in an exclusive Zara Hat Ke chat with Zee Media anchor Mimansa Malik dwelt at length on India’s dismal health picture and made a fervent appeal to focus on gains. Apart from the requisite government intervention at various levels, Trivedi believes that a mindset change at the level of the people could drastically alter the scenario. What it requires is strong will and a commitment to the change. 

For starters, the abysmal doctor-to-population ratio of India must change, which at present stands at 1:2000, according to the World Health Statistics Report 2013. Against a global average of 14.2, the physician density of India per 10,000 population stands poorly at 6.5. India’s nursing and midwifery density of 10 per 10,000 of population is not even half the global average of 28.1.

The worst indicator of healthcare in India comes with the density of hospital beds per 10,000 population, which stands at nine against a global average of 30. 

India lacks skilled health personnel. Concurring with the above view, Trivedi, told #bbv on Zee Media, ‘There should be more medical colleges to meet the shortage of manpower in the country. However, parameters for setting up of medical colleges should be modified. Courses should be upgraded and one needs to relax the criteria at the entry level in medical colleges.’

Trivedi pitched for private sector involvement at the district level to provide healthcare services at an affordable price. He said that the inclination of the government should be to promote the nexus of private and public sector hospitals at the grass roots to tackle the gloomy health situation.

‘The main problem with the government hospitals is that there is no accountability,’ lamented Trivedi.

nrip's insight:

I've always been a big fan of Dinesh Trivedi. I wish if not him , we have a health minister with an outlook like him.

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U.S firm Bayada Acquires Stake In India Home Health Care

U.S firm Bayada Acquires Stake In India Home Health Care | Healthcare in India |

U.S firm Bayada has acquired 26% stake in Chennai’s India Home Health Care, ET states. This is the first investment of Bayada outside U.S which expects to earn $1 Bn in revenue next year. The investment will help IHHC to expand expertise in areas like cancer care and care for children with special needs.

IHHC, which focuses on elder care, post-surgery care and palliative care, has a 200-strong network of experienced nurses and trained home care workers in Chennai and Bangalore. It costs R700 to R1,200 a day for hiring trained nurses, depending on the need and type of care.

The healthcare firm aims to reach 2,000 patients a day in two years from 200 a day at present. It is targeting revenue of R30 Cr in fiscal 2016 and plans to have a presence in five cities, including Hyderabad and Pune.

Some of its partners include, Sparsh, Columbia Asia, HELPSoS, Fortis malar Hospitals.

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Indian Clinical Trial Reforms Take Shape as Report Condemns HPV Vaccine Trials

Indian Clinical Trial Reforms Take Shape as Report Condemns HPV Vaccine Trials | Healthcare in India |

As questions continue to be raised over the policies governing clinical trials in India, new regulations and amendments to the country's pharmaceutical laws are now coming to light.

Specifically, India’s CDSCO (Central Drugs Standards Control Organization) is looking to crack down on unauthorized trials and is now calling for sponsors to reveal payments made to CROs and trial investigators.

A recent announcement by CDSCO says that information in respect of the payments made by the sponsor to the investigator for the conduct [of the] clinical trial should be made available

Formal and legal agreements between sponsors, CROs (contract research organizations) and investigators should be decided prior to the start of the trial and define the relationship in terms of financial support, honorariums, fees and other payments, the order says.

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Lifestyle diseases to cost India $6 trillion, study estimates

Lifestyle diseases to cost India $6 trillion, study estimates | Healthcare in India |

 India's march towards being an economically stable nation is threatened not just by global financial issues. Poor health indicators pose an equally big threat.

The Harvard School of Public Health has, in a study on economic losses due to non-communicable diseases (NCDs), estimated that the economic burden of these ailments for India will be close to $6.2 trillion for the period 2012-30, a figure that is equivalent to nearly nine times the total health expenditure during the previous 19 years of $710 billion.

NCDs, chiefly cardiovascular diseases (including heart disease and stroke), diabetes, cancer and chronic respiratory diseases, are defined as diseases of long duration and generally slow progression. They are the major cause of adult mortality and illness worldwide.

The Harvard report, which is based on WHO projections of the mortality trajectory associated with NCDs, says ischemic heart disease is going to be the single most costly non-communicable disease in India (causing an output loss of about $1.21 trillion over 2012-30), followed by chronic obstructive pulmonary disease (COPD).

China, the report adds, is estimated to face output losses of $27.8 trillion for 2012-30 - which is more than 12 times the total health expenditure during the previous 19 years of $2.2 trillion. "The economic impact of NCDs is estimated higher in China than in India mainly because of China's higher income and older population," said David E Bloom, the lead researcher.

According to Dr K Srinath Reddy, president of the Public Health Foundation of India, NCDs can impact the economy in multiple ways. "Most of the non-communicable diseases, for example diabetes or heart disease, affect the person in the productive years. They cause reduced productivity and early retirement. Also, they put immense pressure on public health expenditure as in most cases the treatment costs are higher compared to communicable diseases," he said.

Reddy added that the increasing burden of NCDs could rob India of the 'demographic dividend' it is projected to reap on account of a predominantly young population. A recent report published by IRIS Knowledge Foundation in collaboration with UN-HABITAT states that by 2020, India is set to become the world's youngest country with 64% of its population in the working age group.

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Innovation in training programmes can transform the medical education in India in no time

Innovation in training programmes can transform the medical education in India in no time | Healthcare in India |
Young doctors across India have kicked off a “Save the Doctor’ campaign to demand for more post-graduate seats in medical colleges to make up for the acute shortage of specialists.

Has medical education changed much since you were a student? What are the changes you would like to see?
Unfortunately, the curriculum in India has not changed since I was a medical student 40 years ago.  Today, medical students across developed world follow problem-based education where in they get hands-on training from the day they join a medical college.  We are very far off from the innovation.  As a result, the quality of doctors who are graduating today in India has not improved significantly compared to 40 years ago.
What is the biggest shortcoming in India?
The greatest short coming in medical education system here is the acute shortage of post-graduate seats.  In the US, they have 19,000 undergraduate (UG) seats and 32,000 post-graduate (PG) seats.  Even in the UK, the ratio of UG to PG  seats is almost double.  In India, we have 47,688 UG seats 14,500 PG seats in clinical subjects.  This has resulted in nearly two lakh students spending two to five years in coaching classes to mug up multiple choice questions to get one of those rare PG seats.   If the trend continues, bright student, especially from working class and poor families, will not join medical college. 
Till the shortage of medical specialists is met, maternal mortality and infant mortality across the country cannot come down.  Also, hospitals won’t come up in Tier-2 and Tier-3 cities since these hospitals will not have anaesthetists, gynaecologists, radiologists and paediatricians.
What is the way forward?
The government should equalise UG and PG seats. This does not require any regulatory changes.  Medical Council of India (MCI) after assessing acute shortage of PG seats changed the norms for creating more PG seats.  All that we now require is to implement those policies across the country in all medical colleges.  Without spending even one rupee, government will straightaway get 40,000 PG seats.  If this is accomplished, within two to three years we will have enough medical specialists to run secondary medical care facilities in Tier-2 and Tier-3 cities, which is required to reduce maternal mortality and infant mortality.
How can we meet the unmet demand of doctors in the rural areas?
Unless the cities get saturated with medical specialists, doctors will not go to Tier-2 and Tier-3 cities, leave alone rural india.  Only when doctors do not have opportunity to practice in cities, they will decide to go to next level of Tier-2 or Tier-3 cities.  No regulation can push the doctors away to rural areas unless there is surplus skilled manpower.

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Why is India’s healthcare system in such a sorry state?

Why is India’s healthcare system in such a sorry state? | Healthcare in India |

R Srinivasan’s credible government document on healthcare in India titled ‘Health Care in India – Vision 2020’ draft published in 2004, sub-titled ‘Issues and Prospects’, has suggested four criteria that make a just healthcare system 

1. Universal access, access to an adequate level, and access without excessive burden.

2. Fair distribution of financial costs for access and fair distribution of burden in rationing care and capacity and a 
constant search for improvement to a more just system.

3. Training providers for competence empathy and accountability, pursuit of quality care and cost effective use of the results of relevant research.

4. Special attention to vulnerable groups such as children, women, the disabled and the aged.
Srinivasan's  draft is dated; but the criteria are relevant even today as India’s healthcare system remains in a very sordid state.

A recent study by IMS Institute of Health Informatics (19 July, 2013) has revealed that 72 percent of the rural Indian population has access to just one-third of the country’s available hospital beds while 28 percent of urban Indians have access to 66 percent of the total beds. The study also notes that those living in remote pockets have to travel more than five kilometres to access an in-patient facility, 63 percent of the time.

Evidently, the country’s historical spend on healthcare, apart from immunization programmes, has not been enough. WHO statistics show the total expenditure on health is 4.4 percent of the GDP, for a population of 1.27 billion. As a result of a low healthcare spend and lack of special attention towards this sector and absence of concrete regulatory policies, India’s healthcare system is in shambles.

Here is a picture of the current healthcare scenario:
Universal Access and Financial Costs: The IMS study noted that long waiting time and absence of diagnostic equipment at public facilities has caused an increasing number of patients to rely on private healthcare facilities.  Quality of treatment is also a reason why patients switch to private centres. However, this shift from public to private care is posing an affordability challenge to poor patients.
Training and distribution of Health workforce: Statistically speaking, Indian cities have four times the number of doctors and three times more nurses than in rural areas. Meanwhile, almost 80 percent of the medical colleges are located in South and West India. The direct impact is a dearth of trained professionals practicing in rural India.

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