25 Mar,2024

Why is the government not serious about super-profiteering by the pharmaceutical companies

Date: 25.03.2024

 

Why is the government not serious about

super-profiteering by the pharmaceutical companies

 

Dr Arun Mitra

 

Pharmaceutical companies have been a bone of contention around the globe. Exorbitant profiteering in this industry should not be a priority. But around the world these companies are making huge profits at the expense of people’s health. There is enough data to support super profits by the pharmaceutical companies. During the COVID Pandemic when the people were dying in large numbers, the vaccine making companies made huge profits. Not only that, they forced many developing countries that do not have resources or technical knowhow to make vaccines, to accept the conditions laid down by these companies. These included the clause of no civil liability of the company in case of any adverse reaction to the vaccine. They also made the governments to mortgage their properties as a guarantee. 

India has been no better. Aparna Gopalan in an article in The Intercept published on 19th June 2021 has pointed out that ‘for each dose sold to private hospitals, Serum made profits of up to 2,000 %  and Bharat Biotech up to 4,000 %, what might be considered as “super profits”.  In India, 38 new billionaires were minted in the first year of the pandemic, while the combined wealth of the country’s 140 billionaires went up by 90.4 %’.(1)

 

After much outcry on the drug prices by the health activists the Government of India formed a Committee on the High Trade Margins in the Sale of Drugs on 16th September 2015. The committee submitted its report on 9the December 2015. The committee pointed that on some medicines the profit margin was up to 5000%. As a remedy it recommended capping of the trade margins and came out with the proposal of graded trade margins with reference to the Price to Trade (PTT). According to their proposal no capping of the trade margins was recommended on the product with a value of Rs.2/- per unit i.e per tablet, capsule, vial, injection, tube etc. But at higher unit price i.e  on the product from Rs.2 – Rs. 20 per unit a capping of 50% and from per unit price Rs. 20 – Rs. 50 a capping of 40% and above Rs.50 per unit it recommended a capping of 35% on the trade margins. Even though the committee submitted the report in December 2015, the government has been just sleeping it over till date.

The World health assembly had recommended in 1988 that the Pharmaceutical marketing practices should be controlled, checked, streamlined and made ethical. As a follow up of that the Department of Pharmaceuticals, Government of India formed a code for the pharmaceutical companies named as Uniform Code for Pharmaceutical Marketing Practices (UCPMP) on 19th March, 2012. This made recommendations for the Pharmaceutical companies so that they adopt ethical practices like promoting only the evidence based drugs and desist from over claims and avoid irrational combinations which can be harmful. However the UCPMP mentioned that the code will be voluntary for a period of 6 months after which it will be reviewed and made mandatory if it is found to be not being followed properly by the pharmaceutical companies. The world wide experience however has shown that voluntary codes are hardly practiced. They have to be made legally binding.

Now the government has come up with a new UCPMP on 12th March 2024. Even this new code is not mandatory. It has again asked the companies to voluntarily implement the rules of the code. Companies have been asked to form ethical committees. Their associations too have been asked to form ethical committees. But these committees clearly have a conflict of interest. So it is only a window dressing. Interestingly the punishment to the companies is simply losing membership of the association.

Sensing the need for cost effective drugs, Prime Minister Jawahar Lal Nehru went ahead to establish drugs manufacturing in the Public sector. While inaugurating the Indian Drugs and Pharmaceutical Ltd.(IDPL) in 1961 he cautioned  “the drug industry must be in the public sector….. I think an industry of the nature of the drug industry should not be in the private sector anyhow. There are far too much exploitation of the public in this industry”. The IDPL played a major role in the strategic National Health Programmes. Recognising its role, the World Health Organisation commended that “IDPL had achieved in 10 years what others have in 50. IDPL products have been examined for quality very carefully by the developed countries and many of them want to buy from here”.

All this is being reversed now. In 2016, the government took a decision to close two Public Sector Units (PSUs) of the five, namely the IDPL and RDPL. The government had also decided to strategically disinvest HAL, BCPL and Karnataka Antibiotics & Pharmaceutical Ltd (KAPL).

It is well known that the people in our country have to spend on the healthcare from their own pocket. Nearly 70% of this is on the purchase of drugs. It is therefore imperative that the prices of medicines should be within the reach of common man. But government’s indifference is a cause of concern. There is a strong suspicion of government having nexus with big pharma magnates. No wonder some pharmaceutical companies and some healthcare facilities purchased electoral bonds to the amount of 800 crore rupees. This strengthens scepticism over the nexus between the government and the big Pharma magnates. 

It is time to review the policy and strengthen the public sector units in pharmaceutical to save corrupt practices and super profiteering at the expense of people’s health. Free market approach to drugs and vaccines will only help the big pharma magnates and add to profiteering while ignoring the people’s health needs.

References:

  1. https://theintercept.com/2021/06/19/india-covid-vaccine-profiteering/

 

Published Link:

https://ipanewspack.com/big-pharma-companies-are-making-superprofits-in-india-at-the-cost-of-peoples-health/

 

https://tryxyz.com/article27625-BIG-PHARMA-COMPANIES-ARE-MAKING-SUPERPROFITS-IN-INDIA-AT-THE-COST-OF-PEOPLE-S-HEALTH

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/big+pharma+companies+are+making+superprofits+in+india+at+the+cost+of+people+s+health-newsid-n594835934?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

06 Mar,2024

World needs statesmen, not delusional leadership

Date: 06.03.2024

 

World needs statesmen, not delusional leadership

 

Dr Arun Mitra

 

There was lot of complacency after the end of cold war as several people felt that now we shall enter an era of lasting peace and a world free of nuclear weapons. But this did not happen. The United States and its allies, many of them erstwhile colonial masters, have constantly been putting efforts for a unipolar world. With their designs they have pushed several parts of the world in different continents into armed conflicts.

 

However this is being challenged by several countries who are taking stand on various issues including disarmament, abolition of nuclear weapons and other weapons of mass destruction. This is apparent from passage of the Treaty on the Prohibition of Nuclear Weapons (TPNW) in the UN General Assembly (UNGA) on 7th July 2017 despite tremendous pressure by the nuclear weapons possessing countries. Several countries after the initiative by the south Africa have contested Israeli genocide in Gaza despite US backing Israel. The developing countries have also raised their voice for changes in multilateral trade agreements, strategy for economic growth based on justice and equality, peaceful coexistence with the neighbours without third party interventions etc. But there is a constant pressure from the big powers to checkmate all these efforts. As a result we are finding tension in parts of Asia, Africa and also Europe. This is threatening global peace and endangering the use of nuclear weapons. Blatant intervention by the NATO backed by the USA for its expansionist designs led to the war between Russia and Ukraine. This has led to internal and external displacement of over 10 million people and death of large number of civilians and combatants. As a result of Israeli aggression on women and children in Gaza with explicit support of the US and allies, situation in the Middle East is like that of holocaust perpetrated by Nazis.

 

These situations require statesmen at the helm of affairs who have vision and influence and desire to salvage these. Unfortunately that is lacking. The west, particularly the United States of America, is obsessed with power and to sell arms around the world to make profit at the cost of human lives.

 

Gone are the days of Marshal Tito, Gamal Abdel Nasser and Jawaharlal Nehru, who had the vision to form a non-aligned movement (NAM) that would work outside any military block. During that period the world produced several luminaries who resisted barbaric colonialism and apartheid. It would be most appropriate to mention the name of Nelson Mandela. Rajiv Gandhi put forth an action plan for nuclear disarmament. It was during that period that democracy in different countries flourished.

 

Things are different now. Unfortunately several of the present day leaders have delusionary ideas. Zelensky for example is happy with claps to greet him in European parliaments without realising their designs. No wonder US & NATO are directly interfering in the affairs in Ukraine and not letting the war to end.  The death of Navalny in prison has raised questions over the credibility of Putin. The Chinese leader Xi Jinping wants to rule till the end of his life. We can see North Korea's Kim Jong Un happy with clapping by the parliamentarians. Bolsenaro of Brazil and Trump in the US too fall in that category. Erdogan is out to supress democratic ethos of Turkish society. Several countries which have theocratic regimes are in similar situations.

 

Such leaders are narcissistic, authoritarian, ruthless, undemocratic, obscurantist and megalomaniac. With their delusionary behaviour they are unstable, unreliable, do not hesitate in telling lies repeatedly and can be a threat to the society. To stick to power they are ready to spread hatred, bigotry, obscurantism and glory of the past without evidence. This are delusional megalomaniac behaviour can be very dangerous. We have seen this in Hitler, Mussolini, Pol Pot and now in Netanyahu.

 

It is dismaying that in our country we have moved from the days of Nehru to the present day leadership at the helms of affairs who very well fit in that category. Our Prime Minister is always obsessed with building his image and continuously portraying himself with the help of corporate controlled media.

 

That he always tries to demonise Nehru, only shows his own worth. He cleverly uses Gandhi’s name even though his bandwagon is always abusive of Gandhi and eulogises his murderers. But he never utters a single word on this.

 

That he has not faced the media even once in the last ten years raises scepticism about his capability. Therefore he believes only in one way discourse. Several of his henchmen have already labelled him as God sent ‘Avtaar’. He is not ashamed to say himself that he has been sent by god. No wonder the BJP chief Nadda called him god of gods. Such people always feel insecure and are afraid of even their own nears and dears.  

 

In such conditions, the only hope is people’s power with vision to save the world from marching towards neo-colonial era. Civil society around the world has a great responsibility to come forward to change the mind-set of the polity. True, the truth shall prevail, but we cannot afford the harm being done. 

 

Published Link:

https://ipanewspack.com/big-world-leaders-are-failing-to-protect-peace-and-security-in-the-globe/

 

https://tryxyz.com/article27510-BIG-WORLD-LEADERS-ARE-FAILING-TO-PROTECT-PEACE-AND-SECURITY-IN-THE-GLOBE

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/big+world+leaders+are+failing+to+protect+peace+and+security+in+the+globe-newsid-n589478254?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

27 Feb,2024

Peace in Gaza now !

 

Date: 27.02.24

 

Peace in Gaza now !

 

India should take a strong position

 

Amidst the barbaric aggression by the Israel on Gaza and its latest offensive on Rafah, the self-immolation of an active-duty member of the U.S. Air Force 25-year-old Aaron Bushnell outside the Israeli embassy in Washington, D.C., on 25th February, as a protest to the on-going Israeli aggression on Gaza, which he described as a “genocide has sent shock waves around the world. This is also a reflection of anger that is growing against the war mongering policies of his own country’s government. The death of 30000 Palestinians, 70% of which are women and children has moved saner people around the world. There is also sharp division in approach of the global south and many developed countries of the north.

 

Brazilian President Luiz Inacio Lula da Silva, while speaking to reporters in Addis Ababa, where he was attending an African Union summit, has accused Israel of committing "genocide" against Palestinian civilians in the Gaza Strip and compared its actions to Adolf Hitler's campaign to exterminate Jews. "It's not a war of soldiers against soldiers. It's a war between a highly prepared Army and women and children," he remarked. This is a repeat of what Hitler did to the Jews during the 2nd world war, he said. He had previously condemned Hamas's October 7 attack on Israel as a "terrorist" act.   So he is not being partisan in his utterance. His views are confirmed by the latest rhetoric by the Israeli officials who are Justifying the killings of children in Gaza.  

 

Similar statement has been issued by Republican Representative Andy Ogles of Tennessee in the US, who responded to an activist’s question about the deaths of Palestinian children in Gaza by asserting that “we should kill ‘them all”. Double standards of the US administration are obvious. Whereas they talk of humanitarian ceasefire and advise Israel to be cautious in bombing, they are supplying billions of US$ worth arms to them. The US has vetoed Algerian resolution in the Security Council for ceasefire in Gaza. All these are a pointer to serious situation likely to develop in the Middle East and is bound to have global ramifications.

 

After four months of unprecedented aggression on Gaza the Israel has not been able to find the Hamas or the hostages. Starting from North of Gaza to the center, to the tunnels, the hospitals, schools, every building they have destroyed and evacuated, now they are saying that the Hamas is hiding in Rafah. Palestinians are being pushed to the sea as they have nowhere to go.  These happenings are reminiscent of the barbaric era of colonialism and apartheid.

 

It is now crystal clear that the sole aim of Israel is to eliminate the Palestinians and establish a Zionist regime in that region with the explicit support of the US administration. Western countries' recent decisions to halt aid to the UN agency for Palestinian refugees, UNRWA, after Israel accused some of its employees of involvement in the October 7 attack is totally unjustified as there is no evidence of Israel’s accusations. This has led to spread of disease and hunger among the Palestinians with serious impact on children.  

 

It is most unfortunate and condemnable what happened during the Holocaust. But what the Zionist regime is doing is a repeat of the Holocaust. Any one who questions the Israel’s actions is dubbed as being anti-semitic by Netanyahu. Commenting on the Israel’s repeated talk of anti-Semitism,  Russia's foreign minister Sergey Lavrov has said that there was a mass genocide of 6 million the Jews, but there were others too (NUMBER ?) who were killed by the Nazis in the concentration camps. These included Soviet prisoners of war, Non-Jewish (ethnic) Poles, Romani men, women, and children and other people derogatorily labeled as "Gypsies", Serb civilians murdered by Ustaša authorities of the Independent State of Croatia, People with disabilities living in institutions and care facilities, German political opponents and dissenters , Germans imprisoned in concentration camps as "professional criminals" and "asocials", Jehovah's Witnesses killed in concentration camps or executed for refusing to serve in the German military, Gay men, bisexual men, and other men accused of homosexuality Hundreds, possibly thousands Black people in Germany. Total number of these include 6 million. This however does not give anyone right to kill any German of today. It is high time that global community rises to the occasion and stops the genocide otherwise the war is likely to escalate to countries of the middle East. Other countries of the world could enter in it in the same manner as various nations joined the 2nd world war slowly during 1939 to 1945. 

 

It is in this backdrop that the ICJ ruling on Jan 26 ordered Israel to take action to prevent acts of genocide as it wages war against Hamas militants in the Gaza Strip. The top United Nations court for handling disputes between states was ruling in a case brought by South Africa. The court ordered Israel to refrain from any acts that could fall under the Genocide Convention and to ensure its troops commit no genocidal acts in Gaza. A majority of at least 15 out of 17 judges voted in favour of imposing the so-called provisional measures, including the court's president, Joan Donoghue of the United States. Israel however has not made public the action taken in this regard till date.

 

The UN Secretary General expressed anguish over Israel’s decision to attack Rafah and condemned collective punishment of Palestinians. But despite his several efforts the UN has failed to contain Israel. The multilateral institutions are not properly equipped to deal with the current challenges, as has been demonstrated by the Security Council’s inability to act on the on-going conflicts. Will the G20 group whose chair is now with Brazil will be able to take a position ?. 

 

There have been many peace keeping forces around the world b the UNO but now when situation is most complex and with grave humanitarian crisis that is missing. India as a big country and a big market could have played tangible role but it did not participate in the presentations at the ICJ. Indian government was the leader of NAM at one time but that is completely missing. Instead India changed its position on the relationship with Israel to the extent that India has developed strong defence relations with Israel and has supplied Israel with drones made by the Adani group to carry out operations. Modi government has cleared the recruitment of several thousand Indian workers to work in Israeli companies after the Palestinians were expelled by them. India’s actions are in contrast to the stand taken by several countries of global south. India should come forward to re-emerge as leader of the peace loving developing countries.

 

Published Link:

https://ipanewspack.com/immediate-ceasefire-in-gaza-is-imperative-to-stop-wanton-killings-by-israel/

https://tryxyz.com/article27459-IMMEDIATE-CEASEFIRE-IN-GAZA-IS-IMPERATIVE-TO-STOP-WANTON-KILLINGS-BY-ISRAEL

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/immediate+ceasefire+in+gaza+is+imperative+to+stop+wanton+killings+by+israel-newsid-n587434650?listname=newspaperLanding&topic=ipaspecial&index=4&topicIndex=1&mode=pwa&action=click

 

21 Feb,2024

Ensure nutritional security

 

Date: 21.02. 2024

 

Ensure nutritional security

 

Dr Arun Mitra

 

Nutritional security is essential for all-round development of an individual and the society. Only a physically and mentally healthy person can contribute for growth of the nation. Therefore it is imperative that various factors which contribute to nutrition security must be fulfilled. These include good living conditions, healthy working environment, sufficient remuneration to ensure purchasing capacity, diversified crop pattern, trading system based on justice and equality.  The government is duty bound to ensure nutritional security of the citizens.

 

According to 'State of Working India’ report, 82% of male and 92% of female workers earn less than Rs.10,000 a month (1). The Trade Unions have been demanding Rs.26000/- per month to be fixed as minimum wage to fulfil the bare minimum needs of an individual. They have also been demanding laws to ensure healthy living conditions and good working environment. There is need to ensure jobs and means of livelihood through various schemes.

 

Situation is however not conducive. Unemployment in India is expected to increase in the coming years. The Organization for Economic Cooperation and Development (OECD) had predicted in 2018 that India’s unemployment rate will double from 4% to 8% by 2024, even if the country’s economy continues to grow at a healthy rate.  According to a private agency named Centre for Monitoring Indian Economy (CMIE) which publishes the daily and monthly unemployment rate of India, our unemployment rate in 2024 is 7.70%. In Urban India, it is 8.60% whereas in Rural India it is 7.30%. (2). It may also be noted that women workforce in India is only 37% (3) as compared to 50% globally (4).

 

These reports corroborate with the findings which declared India at 111 rank out of 125 countries in Global Hunger Index as with such low wages and high unemployment rate it is not possible to have a nutritious diet. This is a cause of much worry.

 

That there arose the need to supply 5 Kg of Grains and one Kilo Gram of Daal to 80 crore people, which is nearly 60% of population, is a reflection of abject poverty. The supply of Grains and Daal may fill their stomach but does not meet their requirements of micronutrients essential for over all physical and mental development.

 

A balanced nutritious diet means sufficient number of proteins, fats, carbohydrates and micro nutrients in the form of vitamins and minerals. According to the Planetary Health Diet as suggested by the EAT-Lancet Commission on Food, Planet and Health the daily food should include  Nuts: 50 g, Legumes (pulses, lentils, beans): 75 gm, Fish: 28 gm, Eggs: 13 gm / day ( 1 egg per week), Meat: 14 gm / Chicken: 29 gm, Carbohydrate: whole grain bread and rice, 232 gm, Carbohydrate: 50 gm of starchy vegetables like potato and yam, Dairy: 250 gm, Vegetables: 300 gm  of non-starchy vegetables and 200 gm  of fruit, Other: 31 g of sugar and Cooking oil : 50 g.  Indian Council of Medical Research too has issued similar guidelines for Indians.  

 

At the present market price the cost of this food per person comes to be around Rs.200/- per day. This means that a family of five members should spend Rs.1000/- per day or Rs.30000/- per month on food only. There is need to bring about changes in the policy framework so that income of the people must increase to sufficient level.

 

In addition it is important to increase the production of crops which help in providing nutritious food at affordable cost. Crop diversification can help in this. For this farmers must be assured minimum support price of their produce. The Vice Chancellor of the Punjab Agricultural University Dr S S Gosal has supported the farmers demand as it will help in diversification of crops. ‘Convincing farmers to adopt diversification without giving them basic income is not possible. We want assured MSP on all crops which are grown in Punjab if diversification has to succeed’, he said in an interview to the Indian Express on 16th February 2024.

 

It is being projected that at a higher price it will be difficult to procure the farmers’ produce as it will add to burden on the government. This is fallacious, says Prof Arun Kumar, a leading economist of our country. ‘Whatever the government procures would get sold in the market, so it would only need working capital which would be a fraction of the Rs.10 lakh crore bandied about’ (5).

 

In our country there is need for permanent solution for public stockholding (PSH) programmes for food security, in which the MSP is a critical component. The developed countries have been constantly pressing the developing countries to cut down subsidies on agriculture. Pressure by the developed countries has to be resisted to frame laws to support our farmers and fulfil nutritional security of our people. Upcoming 13th Ministerial conference of the WTO at Abu Dhabi is an occasion for India to lead the developing countries in pressing our demands. In case of stiff machinations by the developed world we should move ahead to organise the developing countries under the Non Aligned Movement (NAM) which has 120 members, 17 Observer Countries and 10 Observer organizations, for a multilateral trade agreement.

 

 

References:

 

  1. https://www.businesstoday.in/latest/trends/story/82-per-cent-of-male-and-92-per-cent-of-female-workers-earn-less-than-rs-10000-a-month-state-of-working-india-report-110136-2018-09-25#:~:text=82%20per%20cent%20of%20male,unemployment%20across%20sectors%20and%20industries
  2. https://www.theglobalstatistics.com/unemployment-rate-in-india/?expand_article=1
  3. https://www.livemint.com/economy/india-will-manage-8-pc-gdp-growth-by-2030-if-more-women-join-workforce-says-report-11698328560823.html
  4. https://genderdata.worldbank.org/data-stories/flfp-data-story/#:~:text=The%20global%20labor%20force%20participation,do%20work%2C%20they%20earn%20less.
  5. https://thewire.in/agriculture/the-solution-to-farmers-problems-lies-in-the-macro

 

Published link:

https://ipanewspack.com/nutritional-security-for-every-indian-is-essential-for-development-of-society/

https://tryxyz.com/article27400-NUTRITIONAL-SECURITY-FOR-EVERY-INDIAN-IS-ESSENTIAL-FOR-DEVELOPMENT-OF-SOCIETY

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/nutritional+security+for+every+indian+is+essential+for+development+of+society-newsid-n585380324?listname=newspaperLanding&topic=ipaspecial&index=9&topicIndex=1&mode=pwa&action=click

05 Feb,2024

The science will triumph

Date: 05.02.2024

 

 

The science will triumph

 

Dr Arun Mitra

 

No one believed when Copernicus proposed that the Sun was the centre of the solar system and the Earth and other planets revolved around it or when Galileo proposed the principle of the pendulum and the law of falling bodies. They were demonised and persecuted because they said something which was against the popular philosophical religious discourse at that time. Science, which in broad terms means inquisitiveness, rationality, urge to discover and invent, to find the truth and not to believe in what has been told even for centuries without evidence. Discussion and debate are the means to reach a conclusion and not imposition or aggression. Therefore many a times there has been contradiction, even conflict between those who believe in the philosophy of divinity & eternal and those who look for the reasons about the happenings in nature.

 

Belief systems have been prevalent in every society. The rationalist thought has to struggle to counter them with evidence. Belief to seek blessings of the divine, will stay for long time to come because the nature is so vast and endless that we will never be able to explore it fully. In the ancient times the events in nature were attributed to the celestial happenings and powers beyond our control. Belief in the unknown became a dictum, so must we fear from it. This fear was perpetuated through centuries of propaganda. Those who came up with different ideas were demonized as evil. Questioning would meet aggression, verbal or physical. We have the example of Rishi Charvak in our ancient times who was burnt alive when he tried to question the prevailing Brahminical discourse. Similarly Socrates was made to drink poison for his rational thoughts. But such people never relented from speaking the truth.

 

As the number of those who questioned has been less, the majority got swayed away by the constant propaganda of belief and fear of the unknown. Slowly this propaganda got organised and took the form of what became to be called as religion. Though the basic concept of religion was belief in the divine and fear of the unknown, the principles and practices varied in different parts of the world. To sustain in public life the religion tried to preach the values system. Whereas science believed in change, the philosophy of divinity was made dogmatic.

 

The ruling classes have used this to retain and cling to power. King was declared to be God sent. He cannot be questioned or opposed. This was done through clique between the clergy and the ruling circles.

 

As the society advanced, particularly after the period of renaissance, when new technological developments took place, the voice of rationality and reasoning increased. This has been reflected in some modern philosophies.

 

The inimical forces however have not taken this lying down. They have used different strategies and there is persistent effort to keep their thoughts alive by eulogising our ancient past, of which every citizen is naturally proud of. Several stories about our ancient past have been manufactured and propagated to appear as truth.

 

Effort is being made to replace science by the Pseudo-science. The Prime Minister and his bandwagon have taken up this task. They have also promoted some religious preachers to serve them. Even the healthcare has not been left out. We have the statements about using Cow urine and cow dung as treatment for COVID even though they are the waste products with no medicinal value. Worse was that people were made to clap, bang thalies and light Diyas to get rid of COVID in 21 days.

 

In the recent past such effort has increased manifold. The Prime Minister immediately after the elections in 2014, while addressing a meeting of the doctors in Mumbai, had said that science in ancient India was so much advanced that we could transplant elephants head on human body. Also the Ideas like Udan Khatolas (equivalent to modern space crafts), stem cell research and powerful ‘Astras’ (equivalent to nuclear weapons) are being propagated even though all this sans evidence. People’s mind set is prepared through constant propaganda to believe in such irrational ideas.

 

These forces always use such manufactured thoughts and people’s beliefs to garner crowds around them. First such trial was done in 1995, when mass hysteria was created around statues of Lord Ganesha drinking milk. This gave such forces an idea that the people can be mesmerized by such obscurantist ideas and may be used to any extent.

 

During the COVID that experiment was used by asking the people twice to bang Thalies and to clap and shout “Go Corona Go”. They believed in Prime Minister’s statement that we will defeat Corona in 21 days the way we won Mahabharta in 18 days.

The recent example is the frenzy created over the Pran Prathishta in the idol of Ram Lalla.

 

These forces can turn the situation uncertain and volatile by creating hyper-nationalism, jingoism and aggression. No space is left for debate and rationality.

 

This will go on for some time. But the truth always prevails and scientific knowledge ultimately supersedes such mythical obsolete concepts. Not long after Galileo and Copernicus were persecuted, their theories were accepted worldwide.

 

Even today the obscurantist ideas are being challenged continuously. Several people have challenged the concept of putting life into the stone through the ritual of Pran Pratishtha.

 

Published link:

https://ipanewspack.com/narendra-modi-govt-has-been-spreading-myths-in-the-last-ten-years/

 

https://tryxyz.com/article27266-NARENDRA-MODI-GOVT-HAS-BEEN-SPREADING-MYTHS-IN-THE-LAST-TEN-YEARS

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/narendra+modi+govt+has+been+spreading+myths+in+the+last+ten+years-newsid-n580734912?listname=newspaperLanding&topic=ipaspecial&index=9&topicIndex=1&mode=pwa&action=click

 

07 Oct,2023

Students’ suicides is not just a medical problem

Date: 07.10.2023

 

Students’ suicides is not just a medical problem

 

Dr Arun Mitra

 

News of suicides by the students from Kota, a dream destination for the aspirants to get coaching for entry into higher education courses like the Engineering and Medicine, are highly disturbing. These students are the next generation who are to shape the future of our country. End of their life at this tender age is heart breaking for the parents who have nurtured their children with love and affection. They are shattered by this irreparable loss. Parents and other family members are likely to develop significant psychological and physical comorbidities under such circumstances. These incidents are also a warning for the society to introspect deep into the whole issue and find out causes and remedial measures.   

 

According to the National Crime Report Bureau data the number of students committing suicides has grown by 70% over the past decade as per a report published in the Money control (1). The number of students who committed suicides in India rose from 5.7% to 8% of total suicidal deaths in 10 years; that is 7696 in 2011 to 13089 in 2021. This is nearly 70% increase in the decade (2).

 

In the present day cut throat competition, there is a mad race for getting better score and higher merit. MCQ type of examinations, have become the routine to check one’s knowledge. Purpose of education is to prepare good citizens with ethical values and social concerns. In the growing consumerist culture this has changed and success of a person is measured by entry into prestigious institutions and a career which ensures huge profits. This concept has diminished the trend to join the humanities. As a result large number of present day generation is devoid of information about history, civics, political science and economics. There is too much of inflow of information on the social media which the young people consider as gospel truth. This affects the analytical capabilities. Too much involvement in the online/virtual working has reduced their interaction with the fellow beings. This has adverse impact on personality development and reduces decision making though collective discussion. Mushrooming coaching enters and their glittering advertisements leave powerful impact even though such centers charge exorbitant amount.  

 

There was a time when the students would discuss several issues in groups and make a collective wisdom. Now there is hardly any student movement compared to 40 years back when student organisations would react to increase in tuition fees, bus & train fares and travel passes for students. They would also agitate for improvement of infrastructure in their school or college. There was a trend to organise debates on the education policy, job opportunities, social harmony, gender equality etc. These things are little to be seen. 

 

Lack of physical activity has worsened the situation. Most of the students in the middle and upper middle classes are pampered at home and are unable to bear the stress of cut throat competition once they move out. Undue pressure and expectations from parents puts them under tremendous stress and a feeling of shame in case of non-fulfillment of their desires. When they find that they are unable to satisfy and have lost all hopes, they resort to such drastic steps to end their life.

 

Whereas there is need for continuous counseling of the teachers, students, families, parents, there is a real need to look at the system of education. “Just giving counseling to a student will not matter much, because society defines a ‘successful’ student as someone who clears IITs or such competitive exams by defeating lakhs of other students. We need a society where a kid’s worth is tied to talent or extra-curricular activities or hobbies they enjoy, not marks,” points out Itisha Nagar, an assistant professor of psychology at Delhi University while talking to The Wire. Societal factors must be addressed in tandem with providing counseling to students according to her (3).

 

Albert Einstein had said way back in 1949 that “This crippling of individuals is considered the worst evil of capitalism. Our whole educational system suffers from this evil. An exaggerated competitive attitude is inculcated into the student, who is trained to worship acquisitive success as a preparation for his future career.” (4) “If you want your children to be intelligent, read them fairy tales. If you want them to be more intelligent, read them more fairy tales.” “A human being is a part of the whole called by us universe, a part limited in time and space. He experiences himself, his thoughts and feeling as something separated from the rest, a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty.” “Try not to become a man of success. Rather become a man of value.” (5) (6)

 

 

 

We have forgotten the fairy tales era when our grandmother used to tell us stories while going to the bed or gather a few children to narrate events of her past experience. That was preparing a person with a wider vision. 

 

Technological revolution would go on. But we have to make corrective methods to develop a youth of moral values and full of compassion and empathy. This is possible through rationalising education for all with equity as envisaged by the Kothari Commission in 1968. The commission had recommended common school and neighbourhood school system. This would have meant mixing of students from different classes and socio economic groups.

 

However the whole concept has been thrown into dustbin with the neo-liberal economic policies. Education has gone under the control of elite. This has become a global phenomenon points out Michael Apple, Professor of Curriculum and instruction and educational policy, University of Wisconsin USA. Under the Neo liberal economic policy, education is only for those who have resources while a large section is marginalized and alienated.

 

It is important that students’ aptitude is taken into account while deciding the future education plans instead of pressure of market forces. In this work facilitators and psychological counsellors can do useful job. The students should be continuously counseled on health and encouraged to involve in recreational and extracurricular activities. This will help their physical and mental growth.

 

 

References:

 

https://www.moneycontrol.com/news/india/the-silent-crisis-student-suicides-rise-70-in-a-decade-in-india-11341191.html

 

https://thewire.in/society/share-of-students-among-indian-suicide-victims-has-grown-over-last-10-years

 

https://thewire.in/caste/two-dalit-students-suicides-in-two-months-highlight-institutionalised-discrimination-at-iits

 

http://www.exponentialimprovement.com/cms/uploads/Einstein%20on%20Why%20Socialism.pdf

 

https://www.goodreads.com/author/quotes/9810.Albert_Einstein

 

https://www.institute4learning.com/2020/01/15/14-great-quotes-from-einstein-on-education-with-sources/

 

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27 Sep,2023

The G20 Heath Declaration

Date: 27.09.2023  

          

The G20 Heath Declaration  

Drastic Policy Changes Needed at Global and National Level  

        

Dr Arun Mitra        

        

The declaration on health at the G20 summit has highlighted several objectives. These include Food security; Pandemic preparedness; equitable access to vaccines, therapeutics, diagnostics, and other medical countermeasures. Concern was shown for growing Antimicrobial Resistance (AMR), Mental health problems and the impact of climate change on health. The declaration also gives importance to the potential role of evidence-based Traditional and Complementary Medicine. The summit took up serious debate over the increasing use of narcotics around the world.  In this background the declaration emphasized that to achieve better health of the citizens, the global health architecture is to be strengthened.     

     

Since nutrition is the basic requirement for health, it is important to gauge the status of nutrition around the world and in our country.  As many as 828 million people were undernourished in 2021 globally. Poverty, inequality, inadequate governance, poor infrastructure, and low agricultural productivity contribute to chronic hunger and vulnerability. South of the Sahara in Africa and South Asia are the regions with the highest hunger levels and are most vulnerable to future shocks and crises (1).        

    

According to Bhavani R V in The Hindu dated 1st January 2023, the UN Food and Agriculture Organisation's (FAO) report on ‘Food Security and nutrition in the world’  puts the number of people undernourished in India in 2019-21at 224.3 million i.e., 16% of 1.4 billion population (2).  India is 107 among 121 countries in the Global Hunger Index (GHI). The countries which fall below this are  Sierra Leone, Uganda, Djibouti, Congo Rep., Sudan, Afghanistan, Zimbabwe, Timor-leste, Haiti, Liberia, Zambia, Madagascar, Chad,  Yemen Rep. and Central African Republic.   

  

The countries of the global south need food security for their citizens, but under the neoliberal economic policies and the diktats of the World Trade Organisation (WTO), many countries had to dismantle programs for food security (3). This has adversely affected nutritional status of the people. Situation is so pathetic that in India 800 million people were provided with 5 Kg of grain and one Kilo of cereals. This may fill their stomach but lacks the micro nutrients essential for physical and mental growth.          

        

Equity in the supply of medicines, vaccines and other countermeasures has been a big challenge. The big vaccine producing companies exploited the situation during COVID Pandemic. They even forced the small counties to mortgage properties of their embassies as a guarantee for the supply of vaccines.    

   

These vaccine making companies made huge profits at the cost of human needs. Pfizer made nearly $37bn (£27bn) in sales from its Covid-19 vaccine in 2021– making it one of the most lucrative products in history. The US drug maker’s overall revenues in 2021 doubled to $81.3bn says Julia Kollewe in the article published in The Guardian on 8th February 2022 (4).   

         

The Indian government’s free-market approach to vaccine distribution too has ensured profit to the companies over lives of the people. Aparna Gopalan in an article in The Intercept published on 19th June 2021 has pointed out that for each dose sold to private hospitals, Serum made profits of up to 2,000 %   and Bharat Biotech up to 4,000 percent, what might be considered as “super profits”.  In India, 38 new billionaires were minted in the first year of the pandemic, while the combined wealth of the country’s 140 billionaires went up by 90.4 % (5).     

  

In the G20 there is ample opportunity for India to highlight the health problems facing the developing world in general and India in particular. This is also time to set the direction for global equity in health care.      

     

As per the WHO there were 6,943,390 deaths globally till 14th June 2023. Unofficial figures could be even higher! During the Pandemic, the problem of unavailability of drugs, equipment and vaccines has been very acute. Smaller countries that lacked resources and knowhow to make vaccines or drugs suffered the most.      

           

Developing countries which have so far been faced with pressure of communicable diseases, are now feeling the burden of the non-communicable diseases as well. India is hub to both communicable and non-communicable diseases. According to Global TB Report 2022 released by the World Health Organisation (WHO) there were 505000 deaths due to Tuberculosis in India in 2021 which comes to 1383 deaths per day(6).           

  

The Non Communicable Diseases (NCD) too are at alarming level in India. Indian Council of Medical Research–India, Diabetes (ICMR-INDIAB) study, found prevalence of Diabetes among 11.4 per cent population. The new study published in The Lancet puts the prevalence of hypertension at 35.5 per cent; general obesity at 39.5 per cent and dyslipidemia (lipid imbalance which can cause heart diseases) at 81.2 per cent. One in every three Indians has hypertension and two in five are obese (7).            

  

Based on the above it is important to envisage the steps required to bring down the disease burden. Disease prevention and control programmes have to be designed accordingly.    

         

It is important to develop policies for inclusive growth which ensure jobs with proper remuneration and means of livelihood to all. Purchasing capacity of the people has to be improved to meet the nutritional requirements. To utter dismay the government has fixed floor level wage at  Rs.178/- per day or Rs.5340/- per month in the wage code bill approved by the union cabinet. Trade unions have however demanded Rs.26000/- as the minimum wage to ensure healthy living.     

     

To promote equity it is important to make necessary changes in the WTO.  The intellectual Property Rights and the Patent laws at present benefit the big companies. Whole issue whether the drugs should be patented has to be reviewed. The founder of ORS, Dr Dilip Mahalanabis never patented his product saying that this is for public good and not for making profits. Will the companies and the governments follow suit? Many public health experts agree that a temporary waiver of the World Trade Organization’s Trade-Related Aspects of Intellectual Property Rights, or TRIPS, provision is a necessary first step toward increasing vaccine production and access and creating a more competitive pharmaceutical industry worldwide.  Drug pricing policy has to be streamlined effectively to check exorbitant profits.  

 

With Africa inducted into the G20 there is a good chance to develop communication between India, Africa nations, Argentina and Brazil to forcefully take up the matter of bringing changes in the TRIPS. The developing countries should exchange the technical knowhow to check mate the pressures from the developed world. The clause of compulsory licensing in the WTO should be used more frequently.  

   

Finance allocation to health in our country has to be increased substantially. It has been hovering around 1.2% of the GDP as against the minimum required of 6%.  Allocation to R&D in health has to be increased.           

 

      

There is need to revive the manufacture of drugs, vaccines and medical equipment in the public sector so as to produce them at lower cost with quality control.      

     

Health education of the people on scientific grounds is important so that they do not fall prey to the unscientific, non-evidence based treatment modalities like the use of Gau Mutra (Cow Urine)  or Cow Dung.           

          

To ensure equitable health services it is important to take bold initiatives. State should own the responsibility of healthcare to its citizens. Insurance based healthcare benefits only the insurance companies. Senior citizens are worst effected in such cases as they are unable to pay hefty premiums.   

  

      

India can play a big role if our approach is not limited to mere electoral gimmickry. Time only will tell whether the Indian government stands up to its commitment. The civil society however should continue to put pressure.       

  

References:    

  

  1. https://www.globalhungerindex.org/trends.html#:~:text=In%20many%20countries%20across%20regions,million%20people%20undernourished%20in%202021.  
  2. Road to a malnutrition-free India | Latest News | The Hindu  
  3. https://en.wikipedia.org/wiki/Criticism_of_the_World_Trade_Organization  
  4. https://www.theguardian.com/business/2022/feb/08/pfizer-covid-vaccine-pill-profits-sales  
  5. https://theintercept.com/2021/06/19/india-covid-vaccine-profiteering/  
  6. https://www.businesstoday.in/latest/trends/story/despite-increased-budget-estimated-tb-deaths-rise-in-india-whos-global-tb-report-2022-351182-2022-10-29  
  7. https://www.business-standard.com/health/over-11-4-indians-diabetic-35-5-suffer-from-hypertension-lancet-journal-123060900263_1.html  

 

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https://www.ehitavada.com/index.php?edition=Mpage&date=2023-09-28&page=8

 

12 Sep,2023

No talk on nuclear weapons abolition in the G 20 summit is disappointing

Date: 12.09.2023    

     

No talk on nuclear weapons abolition in the G 20 summit is disappointing   

    

The G20 summit publicized with much fanfare ended without any commitment for disarmament and abolition of nuclear weapons. There were several expectations from this summit since it was held in the background of on-going war between Russia and Ukraine; and it was held in India which has been a strong protagonist of a nuclear weapon free world. Therefore, it was felt that some concrete decisions will be taken on the issues of disarmament and peace.  

 

Concern has been expressed in the declaration over the humanitarian consequences of war. The declaration says in point 7 on page 2 ‘we note with deep concern the immense human suffering and the adverse impact of wars and conflicts around the world’. On the same page in point No. 8 the declaration mentions ‘The use or threat of use of nuclear weapons is inadmissible’. So it was imperative to expect that some concrete steps would be taken to end the Russia Ukraine war and for abolition of nuclear weapons which pose an existential threat to the mankind today.    

 

The G20 summit is the meeting of heads of the states or their representatives. They have the authority to take concrete decisions to end Russia Ukraine war. But the declaration released reads on page 2 point 8  ‘concerning the war in Ukraine....we reiterated our national positions and resolutions adopted at the UN Security Council and the UN General Assembly (A/RES/ES-11/1 and A/RES/ES-11/6)’ These resolutions condemn the Russian invasion but nowhere mention the explicit involvement of US and NATO who are supplying huge consignments of arms to Ukraine to let the war continue and create a situation that no meaningful dialogue is held to end the war.   

 

In the G20 there were 6 nuclear weapons possessing countries out of total of nine. The USA and Russia together possess about 90% of the world's nuclear weapons. This was the opportunity where thrust of the discussion could have been on steps to be taken to abolish nuclear weapons and avoid existential threat.    

‘Nuclear Famine’, a study by the International Physicians for the Prevention of Nuclear War (IPPNW) in collaboration with Physicists, Biologists,’ Climatologists and other scientists has shown with evidence that even a limited nuclear exchange between India and Pakistan using 100 nuclear weapons would put two billion people at risk of survival. A nuclear exchange between Russia and USA-NATO would kill over 5 billion people and mean end of the modern civilization built through thousands of years of human labour.    

 

The Treaty on the Prohibition of Nuclear Weapons (TPNW) passed by an overwhelming majority of the members of the U N General Assembly on July 7 2017 and which has already entered into force is an opportunity not to be lost. The countries present could have decided to join the TPNW and taken concrete steps to abolish nuclear weapons.   

 

The summit also failed to elaborate steps to check proliferation of small arms.  Many areas of the world are involved in large scale armed conflicts particularly in the African continent. Point 74, on page 28 in the declaration expresses concern about illicit trafficking and diversion of small arms and light weapons and calls for international cooperation among states to combat these phenomena, including export, import controls, and tracing. However, there is no mention of state sponsored terrorism, nor a word on controlling legal arms supplies which are ultimately used in violence around the world. Many countries gathered at this G20 meet have gun producing industries located on their land. These governments can very well take steps to check the proliferation and trading of small arms. 

   

The final declaration on this score is very disappointing. India could have easily taken a lead on this as India had been the founder member of the on Aligned Movement (NAM). The seventh summit of the NAM held in Delhi in 1983 had 117 heads of the states and 20 observers. It was much bigger an event then the present one. The NAM summit held serious discussions on disarmament, peace, human rights, on the issue of Palestine and economic development of the underdeveloped world through mutual cooperation. But such issues were not given due importance in the debate in the G20.    

 

The G20 failed to take cognizance of the growing lust for profit by the Military Industrial Complex. A day before the event, US President Joe Biden on arrival said that this is a good opportunity for defence deals with India. Shri Munish Tiwari Member Parliament has raised scepticism on the India-US joint statement after the bilateral meeting between Prime Minister Narendra Modi and US president Joe Biden on 8th September 2023. The statement says “The leaders applauded the conclusion of a second Master Ship Repair Agreement, with the most recent agreement signed by the U.S. Navy and Mazgaon Dock Shipbuilders, Ltd., in August 2023. Both sides recommitted to advancing India’s emergence as a hub for the maintenance and repair of forward-deployed U.S. Navy assets and other aircraft and vessels….” With this India would emerge as 'a hub for the maintenance and repair of forward-deployed U.S. Navy assets and other aircraft and vessels.' So far India has not provided its space for any such activity.    

 

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07 Sep,2023

People are struggling with health issues in the relief camps of Manipur

Date: 07.09.2023

 

People are struggling with health issues in the relief camps of Manipur

 

Dr Arun Mitra

 

People of Manipur have a glorious history of resistance against the British imperialism. They struggled hand in hand with the Indian National Army (INA) led by Subhash Chandra Bose to free the country from the yolk of colonialism. But the state of Manipur is in crisis these days. Insensitivity of the government towards the state was apparent for a long time, but silence of the Prime Minister even after the video showing women being paraded without clothes went viral on 19th July 2023 proves the point. This insensitivity led to deterioration of the situation; as a result the violence continues unabated. 

 

Health is a major victim under such circumstances. People lose their life, get injured and develop mental stress. It is in this connection that a five member team of Indian Doctors for Peace and Development (IDPD) including two women doctors visited relief camps in the valley and hills of Manipur on 1st and 2nd September 2023 in both Meitei and Kuki areas to assess the health conditions in the relief camps.. The team members had come from Punjab, Bihar, Tamilnadu and Telangana.  The team visited the relief camps in Khumanlankpak sports hostel in Imphal district and IIT relief camps under Sapormeina Primary Health Centre (PHC) in Kangpokpi District in hill areas. There are 334 relief camps in Manipur at present. The team of doctors met inmates and nodal officers of the relief camps, officials of health department, workers of Civil Society organisations and officers of district administration.  

 

It was observed that the referral systems for seriously ill patients in the relief camps in hilly areas are far from satisfactory. The displaced people in the hills of Manipur informed us that they had to travel to Nagaland covering a distance of up to 150 KMs to Kohima or Dimapur to get medical assistance in case of even moderately ill patients. Some of them even travel to Assam for their medical needs. Earlier, before the ethnic violence, they were referred to medical colleges in Imphal for better treatment. Now the movement of citizens from hills to valley and vice versa is impossible due to on-going ethnic conflict in Manipur.  

 

Kangpokpi district hospital presently has neither an operation theatre nor blood storage facility. Manipur State is also facing acute shortage of specialists and other doctors and health workers. Vast majority of Specialist doctors and the medical college hospitals of the state are located in Imphal district (3 medical colleges) and 4th at Churachandpur district in the hills is at beginning stage.  

 

As there is crowding in the camps the chances of Measles epidemic are very lightly in such situations it is imperative that children be immunised against Measles. The team found that no special immunisation drives especially against Measles has been undertaken in the visited relief camps. Measles Vaccine Immunisation drive in children above 9 months along with Vitamin A oral suspension is imperative for relief camps according to United Nations Humanitarian Commissioner for Relief (UNHCR) SPHERE standards.   

 

Nutritional requirements of the peoples are far from being fulfilled. The inmates and nodal officer of a relief camp in the valley said that no green leafy vegetables/ eggs/ meat/fish has ever been supplied in the ration of inmates by the government; although, local community, Civil Society Organisations and few individuals provide few vegetables sometimes. Another nodal officer in a relief camp in hills told that they get one egg per inmate once every 13 days, but green vegetables are not supplied. Rice, Dal, Potatoes and cooking oil constitute the bulk of ration supply in the relief camps. The absence of green leafy vegetables and animal proteins in the diet of children for last four months may lead to night blindness which is caused by Vitamin A deficiency. 

 

Availability of potable drinking water and water for bathing/washing/in toilets are not sufficient in quantity. Sanitation needs to be improved by many folds. Supply of Sanitary napkins to maintain good menstrual hygiene in relief camps is insufficient. There has not been fogging for mosquito control in and around relief camps which threatens the danger of spread of Dengue and Malaria.  

 

The inmates informed that they are facing lots of mental stress by staying in relief camps for the last 4 months and they are not sure when they will go back to their homes or will they ever go back to their homes? Children are missing their schools and friends adding to their worries.

 

Many children are having nightmares. These are signs of Post-Traumatic Stress Disorder.

 

We found patients of Non Communicable Diseases like – Diabetes, High Blood pressure, Chronic Kidney Diseases etc in the relief camps. A couple of patients required haemodialysis of the patients in the hills. 

 

Much needs to be done to allay the situation. There is urgent need for robust referral systems after triage from primary health centres to higher relief centres both within the Manipur State and neighbouring state should be put in place at the earliest. Fabricated Operation Theatres should be made operational at district and sub district level with immediate effect. Blood storage units should be started around relief camps after cluster formation.

 

Internet services should be restored in all health facilities around relief camps so that tele-medicine services can be available to the inmates of relief camps at the nearest health facility. These tele-medicine facilities can also be used in training of Basic doctors in performing Peritoneal Dialysis (for Renal failure patients) and other skills like use of Ambu bags in case of Respiratory Distress Syndrome among children, counselling of mothers for breastfeeding of new born children etc. Both central and state governments should implement the UNHCR SPHERE standards on meeting the health needs of the displaced people sheltered in relief camps.

 

A strong medicine and vaccine supply system should be made functional and a real time monitoring of the stocks of medicine at ground zero level should be done. Immunisation against Measles and providing Vitamin A supplement to children should be undertaken immediately. Supply of good nutritious food like green leafy vegetables, milk, eggs, meat, fish should be ensured for all categories of the inmates in the camps. Fogging for mosquito control should be done in and around relief camps should immediately be undertaken. 

 

Mental health issues are invariably ignored in such situations. There is urgent need for psychological counselling of inmates so as to prevent Post Trauma Stress Disorder. This should be a regular feature in the relief camps. 

 

There is a huge lack of trust among people. So to create mutual brotherhood and trust between Kukki and Meitei groups a lot of work needs to be done. Peace committees should be formed to prevent violence. Constructive dialogue between the stake holders should be initiated. The government will have to be sensitive and take initiative about these things and take constructive steps along with people's organizations.

 

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29 Aug,2023

From Non Aligned Movement to G20

Date: 29.08.2023 

 

From Non Aligned Movement to G20 

Challenge of peace and health 

 

 

Much euphoria is being created about the upcoming G-20 meet in Delhi next week. The high pitch is particularly to project that it is because of Prime Minster Narendra Modi that India has got the chairmanship of the group. Truth of the matter is that in the G-20 there is a rotatory system of chairmanship. In fact India could have been the chair of the G20 last year but it was delayed by one year. The G20 has several agendas to discuss, but the most important ones are the global peace and health for all.  

 

World today is in a very critical situation because of on-going armed conflicts in several parts. The conflict between Russia and Ukraine is the most serious one at this juncture. As per the UNO over 14400 people have been killed including 3604 civilians. Over 8 million people have been displaced externally living as refugees in other countries. 

  

The issue has not remained just between Russia and Ukraine; with the explicit involvement of US and NATO the things have gone too far. Both sides have warned of use of nuclear weapons. After the US President Joe Biden issued the statement that they would supply cluster weapons to Ukraine, Russia has warned that in that case they would be left with no other option but to use nuclear weapons. This is a very dangerous situation because any nuclear exchange at this time on that border will not remain between Russia and Ukraine; it will be a nuclear exchange between Russia and USA & NATO. As per the latest scientific studies this would mean death of over 5 billion people which would be an end of modern civilization built through thousands of years of human labour. Study conducted by the IPPNW and the environmental groups has already shown with evidence that even a limited nuclear exchange, for example between India and Pakistan, would lead to death of over 2 billion people. But an exchange between Russia and US would be much more catastrophic.  

 

In addition there are conflicts going on in different parts of Africa and Asia. These internal strife have International support in one form or the other for various economic interests of the rich nations. The situation in Palestine or in Syria are examples of extreme human rights violations. It is therefore important that the G20 takes a firm decision on such issues of nuclear disarmament and check on the proliferation of small arms. 

  

However it seems unlikely because the G20 is not a homogenous group.  It is a group of countries with self-interests dominated by the multinational corporations and military industrial complex. This is in contrast to the Non-Aligned movement (NAM) which took effective steps and raised serious concerns on the issue of disarmament, development and human rights in different countries. It is well known that India had played significant role at that moment. NAM was founded at the initiative of Jawaharlal Nehru, Marshal Tito and Abdul Gamal Nasser. The NAMs  7th summit was held in Delhi in 1983 in which  heads of the states from 117 countries participated and there were 20 observers from several countries. In contrast, the G20 is a tiny event but with much hype.  

 

It seems unlikely that the G20 meet would come out with a firm declaration to abolish nuclear weapons which is now possible through a multilateral Treaty on the Prohibition of Nuclear Weapons (TPNW) passed by the UNO on 7th July 2017. There is a strong lobby within the G20 who opposed the TPNW in the UNO and put tremendous pressure on the members of the UN General Assembly. These countries are the protagonist of theory of nuclear weapons as a deterrent.  

 

It is very much unlikely that G20 will come out with a concrete decision on  health for all which requires equitable distribution of resources for healthcare. We have in fact witnessed how the Pharmaceutical companies particularly vaccine producing companies played havoc during the COVID  pandemic and blackmailed smaller countries who did not have either technical knowhow or resources to produce vaccines on their own. Big Pharma companies are known to have made huge profits during the period. For any talk on health for all, affordable drug pricing and equitable healthcare, the Pharma companies have to be regulated and their profits made transparent.  

 

It would be good to watch the on-goings of the G20 and outcome in various sectors. But the countries which are there the USA the England the France have pro corporate ideology and economic interests.  Will they be ready to part away with the arms or will they be ready to make effective changes in the world trade organization so as to meet the requirements of the developing countries for health for all.  

 

As chairperson of the 7th non-aligned summit India played a big role in organizing the developing countries on the one goal of this disarmament, equitable development, human rights, health for all etc. They passed resolutions supporting the cause of Palestinians and on other issues of human rights. 

 

For such decisions there is need of statesmanship. That statesmanship is lacking in our polity at present.  

 

Reference: 

 

https://www.google.com/search?q=numer+of+deaths+in+russia+ukraine+war&oq=numer+of+deaths+in+russia+ukraine+war+&aqs=chrome..69i57j0i13i512l6j0i13i30l3.9609j0j7&sourceid=chrome&ie=UTF-8 

 

Published in:

 

https://theshillongtimes.com/2023/09/01/major-issues-including-global-peace-and-health-on-agenda/

 

http://epaper.thenorthlines.com/articlepage.php?articleid=NLINE_MAI_20230901_7_2&width=553px&edition=&curpage=7

 

https://thehillstimes.in/epaper/02-september-2023-epaper

 

https://ipanewspack.com/from-non-alignment-to-g-20-summit-in-delhi-next-week/

 

https://tryxyz.com/article25969-FROM-NON-ALIGNMENT-TO-G-20-SUMMIT-IN-DELHI-NEXT-WEEK

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/from+non+alignment+to+g+20+summit+in+delhi+next+week-newsid-n533412092?listname=newspaperLanding&topic=ipaspecial&index=21&topicIndex=1&mode=pwa&action=click

 

21 Aug,2023

In the absence of appropriate policy, National Medical Commission’s directive to prescribe in generic names is meaningless

Date: 21.08.2023 

 

In the absence of appropriate policy, National Medical Commission’s directive to prescribe in generic names is meaningless  

  

Dr Arun Mitra 

 

The latest notification of the Board of Ethics of the National Medical Commission (NMC) has asked the doctors to prescribe medicines with pharmacological names. Earlier too The Indian Medical Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002, clause 1.5 mentioned use of Generic names of drugs. - “Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs”. But the difference is that the NMC notification has warned punitive action including fine even cancellation of license.   

 

This has generated debate among the medical professionals. It has been a long standing demand of the public health activists that medicines should be prescribed with their pharmacological names. This will exclude the branded drugs and bring down the cost.   

  

The concept of generic medicines arose because the branded medicines had high cost. 

 

The Pharmaceutical companies spend huge amount of money for promotion of their products.  The high cost of drugs seriously affects the healthcare of our population. As nearly 67% of out of pocket health expenditure in our country is on drugs. High out of pocket expenditure pushes 6.3 crore population below poverty line every year, a fact admitted in the National Health Policy document 2017.    On the other hand the generic drugs are non-branded so they save the money used in promotional activities.

   

Having sensed this, our first Prime Minister Jawahar Lal Nehru took initiative to produce the drugs in the public sector with the purpose to produce cheap bulk drugs. While inaugurating the Indian Drugs and Pharmaceuticals Ltd. (IDPL) in 1961 he said  “the drug industry must be in the public sector….. I think an industry of the nature of the drug industry should not be in the private sector anyhow. There are far too much exploitation of the public in this industry”. With this vision, Public Sector Unit Indian Drugs and Pharmaceuticals Ltd. (IDPL) was incorporated in April, 1961. IDPL played a pioneering infra-structural role in the growth of Indian Drug Industry base and produced cheap bulk drugs. It played a major role in the strategic National Health Programmes like Family Welfare Programme & Population Control (Mala-D & Mala-N) anti-malarial (Chloroquine) and prevention of dehydration (ORS) by providing quality medicines. Similarly the Hindustan Antibiotics Ltd (HAL),  Central Research Institute (CRI) Kasauli were founded.  

  

In addition to the actual generic drugs which are produced and sold solely by the pharmacological name, several companies have come out with brand names of low cost product; they are branded generics. They are cheaper than the branded drugs but more expensive than the actual bulk non branded generic drugs.

 

One of the contention of those opposing this is that the Generic drugs are low in quality. It is therefore important that these drugs should meet the criteria of bio-equivalence and efficacy. These criteria need to be regulated by the competent authorities in a similar way as for the branded drugs.     

 

To make doctors prescribe only the Generic names it is important that the branded drugs have to be banned. Otherwise doctors will write generic names but the patients will be left to the mercy of the chemists who will give the brand of his choice. This will obviously be the one which has high profit margin.  

 

To check the high trade margins, a committee was formed to look into High Trade Margins in the Sale of Drugs on 16 September 2015. This committee took serious note of the excess trade margins. They pointed out that in some cases the trade margin is as high as 5000%. This committee submitted its report on 9 December 2015. But it is now almost 8 years that the government has been sleeping over it.    

 

There has to be evolved a method to calculate the cost of drugs. It is important that the cost of the drugs be calculated as per the cost of production with a defined trade margin.  

  

There is a big flaw in the price of the many generic drugs. The difference between the Maximum Retail Price (MRP) and the actual purchase price of the drug is exorbitant. This has to be corrected.  

 

To curtail the profit margin in the drugs a powerful regulatory mechanism has to be made. The public sector units which produced cheap drugs should be encouraged. It is sad to note that the government has been pushing the drug production in the private sector. The public sector units like the IDPL have been made virtually non-functional.  The Union Cabinet’s recommendation in its meeting on 28th December 2016 to close down and sell the pharmaceutical PSUs is a big blow to the concept of the state ensuring affordable, and possibly free-of-cost, medicines for millions. 

 

Published in:

https://thenorthlines.com/national-medical-commissions-directive-to-prescribe-generic-drugs-is-flawed/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/national+medical+commission+s+directive+to+prescribe+generic+drugs+is+flawed-newsid-n530440892?listname=newspaperLanding&topic=ipaspecial&index=15&topicIndex=1&mode=pwa&action=click

08 Aug,2023

Doctors can play positive role in correcting social aberrations

Date: 08.08.2023

 

Doctors can play positive role in correcting social aberrations

 

Dr Arun Mitra

 

Recent happenings in several parts of the country have shaken the consciousness of saner elements in the society. At the time of independence education level was very low, poverty was at its peak, GDP was a mere Rs. 2.7 lakh crore for a population of 34 Crore which accounted for nearly 3% of world's total GDP. At that time the people of India chose to adopt a constitution based on secularism and democracy. This was despite that there were large scale communal riots and biggest ever migration of population in the world at the time partition.  These events did not deter people’s decision for a harmonious society. Baring a few incidents in between, people of the country have lived together without any hatred towards others since then. Now, when we have grown in all spheres and are aspiring to be a 5 trillion economy a section of our people are surcharged on communal lines and hate against others and have developed bias and prejudice in their minds. This mentality which a section of the society has developed is against the very concept of humanism that India has always stood for.

       

The people are being carried away by the   bigotry, false propaganda and manufactured history. Hate against others based on caste, religion, tribes, ethnicity can lead to serious repercussions. It leads to loss of empathy and compassion for others. History is on record that over 25 Lakh people died during communal riots at the time of partition of India. They belonged to all the three communities, the Hindus, Sikhs and Muslims. Hate breeds mistrust which gets further aggravated into violence against each other. We witnessed it in 1984 during the anti-Sikh riots, anti-Muslim pogrom in Gujarat in 2002. Similar situation developed in Kashmir when minority Kashmiri Pandits were forced to migrate under terrorist threat and state government’s attitude.

 

What is happening in India at present is therefore not a new phenomenon but a continuation of what such forces have been trying to do in the past. There is a systematic campaign against the minorities who are being perceived as a threat to the majority 80% population of Hindus. Myths like the appeasement of Muslims; that they grow like mushrooms and marry four wives and they would soon overtake the Hindu population are injected into the minds of the people. This hate campaign lacks logic or evidence. These absurd ideas are spread through electronic TV media, social media, print media and also whisper campaigns. Several TV serials which are said to be historical serials are in a very subtle manner being used to spread falsehood and hate.  

 

Women and children are the worst sufferers in such situations. Woman’s body has been used as a tool in the conflicts. Incident of Manipur where women were paraded naked and molested is to be seen with aversion, anger and as a reflection of serious aberration in our social order. State’s complete insensitivity to the situation raises scepticism whether these events have been well planned with some ulterior motive under the state patronage. 

  

Hate campaigns do not stop on their own. Now there have been engineered communal riots in Haryana. The hate campaigners are roaming around free while the victims are being persecuted. There are similar incidents in UP, Delhi and other parts of the country. If not checked right now, this can lead to large scale violence of the level of Gujarat or Manipur.

 

The forces who spearhead such hate campaigns always experiment as to how they can win over masses to their side. The incident of statue of Lord Ganesha drinking milk throughout the country in 1995 was a very successful trial. This message spread across the country in no time even though there was no social media network at that time. It stopped instantaneously when it was felt that the whole myth would be exposed. It is to be noted that violence in Gujarat occurred after that. It is astonishing that such unprecedented violence took place in the land of Mahatma Gandhi.   

 

Doctors can play a positive role in containing such situations. As the custodians of health of the society doctors are duty bound to speak and call spade a spade. They have to come out and make outreach programmes to preach harmony, love, brotherhood and sisterhood. Doctors can be a great instrument in developing confidence among the aggrieved in such situations. Viktor Frankl, an Austrian psychiatrist, who was a Holocaust survivor, did a great job to motivate prisoners in the Nazi concentration camps to never loose hope for a better future. With his persistent efforts he was able to save many from dying and survive after Hitler lost the war. Our voice matters; but our silence can be intriguing and dereliction of duty.  

 

Despite continued threats by the hate campaigners and the dubious role of the state, there is a change. Many scientists who were till date quiet, have started challenging the myths and unscientific ideas. The doctors who clapped and banged thaalies have now realised that, that was not the scientific way to get rid of the COVID. Ultimately we had to fight out the pandemic at the cost of 1600 doctors’ lives. No amount of Gau Mutra or Cow Dung campaign worked. Many doctors understand this, but now is the time that they should develop courage to speak.   

 

Hate campaigns have to be countered both politically as well as at societal levels. Doctors have not to sit quiet but find out means to bring the country out of this imbroglio. Doctors can communicate with their patients and in soft tone talk of love and compassion which is a part of our profession. Then follow up with them in their language. We must not shirk to identify the forces who are out to disturb harmony.   

 

We have to understand that such violence is an epidemic health problem and thus plan as we do for other diseases.  

Primary prevention approach: To stop situation from getting worse and stop violence before it starts to happen.  

Secondary prevention: To target the at-risk populations and underlying risk factors.   

 

A collective effort is needed because violent behaviour is contagious process and has to be dealt with in a similar manner. Social harmony is to be promoted through emphasizing love, sympathy, empathy and care for others. Expose the falsehood being spread. Talk on logic and evidence. Be humble to the vulnerable and deprived and firm against the fringes in our society that are trying to disturb the delicate equilibrium of social harmony in our country.  

 

It is time we break the silence. 

Never whisper in the presence of wrong.

05 Aug,2023

Reducing the risks of nuclear war—the role of health professionals

Date: 05.08.2023

 

 

 

EDITORIAL:  Reducing the risks of nuclear war—the role of health professionals 

 

In January, 2023, the Science and Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90 s before midnight, reflecting the growing risk of nuclear war.1 In August, 2022, the UN Secretary-General António Guterres warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War.(2) The danger has been underlined by growing tensions between many nuclear armed states.(1,3) As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet—and urge action to prevent it. 

 

Current nuclear arms control and non-proliferation efforts are inadequate to protect the world’s population against the threat of nuclear war by design, error, or miscalculation. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations ”to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control”.(4) Progress has been disappointingly slow and the most recent NPT review conference in 2022 ended without an agreed statement.(5) There are many examples of near disasters that have exposed the risks of depending on nuclear deterrence for the indefinite future.(6) Modernisation of nuclear arsenals could increase risks: for example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation. 

 

Any use of nuclear weapons would be catastrophic for humanity. Even a “limited” nuclear war involving only 250 of the 13 000 nuclear weapons in the world could kill 120 million people outright and cause global climate disruption leading to a nuclear famine, putting 2 billion people at risk.(7,8) A large-scale nuclear war between the USA and Russia could kill 200 million people or more in the near term, and potentially cause a global “nuclear winter” that could kill 5–6 billion people, threatening the survival of humanity.(7,8) Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly. The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem—by abolishing nuclear weapons. 

 

The health community has had a crucial role in efforts to reduce the risk of nuclear war and must continue to do so in the future.(9) In the 1980s the efforts of health professionals, led by the International Physicians for the Prevention of Nuclear War (IPPNW), helped to end the Cold War arms race by educating policy makers and the public on both sides of the Iron Curtain about the medical consequences of nuclear war. This was recognised when the 1985 Nobel Peace Prize was awarded to the IPPNW.10(http://www.ippnw.org). 

 

In 2007, the IPPNW launched the International Campaign to Abolish Nuclear Weapons, which grew into a global civil society campaign with hundreds of partner organisations. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. International medical organisations, including the International Committee of the Red Cross, the IPPNW, the World Medical Association, the World Federation of Public Health Associations, and the International Council of Nurses, had key roles in the process leading up to the negotiations, and in the negotiations themselves, presenting the scientific evidence about the catastrophic health and environmental consequences of nuclear weapons and nuclear war. They continued this important collaboration during the First Meeting of the States Parties to the Treaty on the Prohibition of Nuclear Weapons, which currently has 92 signatories, including 68 member states.(11) 

We now call on health professional associations to inform their members worldwide about the threat to human survival and to join with the IPPNW to support efforts to reduce the near-term risks of nuclear war, including three immediate steps on the part of nuclear-armed states and their allies: first, adopt a no first use policy;(12) second, take their nuclear weapons off hair-trigger alert; and, third, urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts. We further ask them to work for a definitive end to the nuclear threat by supporting the urgent commencement of negotiations among the nuclear-armed states for a verifiable, time bound agreement to eliminate their nuclear weapons in accordance with commitments in the NPT, opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons. 

 

The danger is great and growing. The nuclear armed states must eliminate their nuclear arsenals before they eliminate us. The health community played a decisive part during the Cold War and more recently in the development of the Treaty on the Prohibition of Nuclear Weapons. We must take up this challenge again as an urgent priority, working with renewed energy to reduce the risks of nuclear war and to eliminate nuclear weapons. 

 

1. Science and Security Board, Bulletin of the Atomic Scientists . A time of unprecedented danger: it is 90 seconds to midnight. 2023 Doomsday Clock Statement. Jan 24, 2023. (https://thebulletin.org/doomsday-clock/current-time/ (accessed June 1, 2023). 

 

2. UN. 2022. Future Generations Counting on Our Commitment to Step Back from Abyss, Lift Cloud of Nuclear Annihilation for Good, Secretary-General Tells Review Conference, Press Release Aug 1, 2022 SG/SM/21394 (https://press.un.org/en/2022/sgsm21394.doc.htm accessed 10 July 2023) 

 

3. Tollefson J. Is nuclear war more likely after Russia's suspension of the New START treaty? Nature 2023; 615: 386. 

 

4. UN. 2005 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). May 2–27, 2005. https://www.un.org/en/conf/npt/2005/npttreaty.html (accessed June 2, 2023). 5. Mukhatzhanova G. 10th NPT Review Conference: why it was doomed and how it almost succeeded. Arms Control Association. October, 2022. https://www.armscontrol.org/act/2022-10/features/10th-npt-review-conference-why-doomed-almost-succeeded (accessed June 2, 2023). 

 

6. Lewis P, Williams H, Pelopidas, Aghlani S. Too close for comfort, cases of near nuclear use and options for policy. Chatham House Report. April, 2014. https://www.chathamhouse.org/2014/04/too-close-comfort-cases-near-nuclear-use-and-options-policy (accessed June 1, 2023). 7. Bivens M. Nuclear famine. IPPNW. August, 2022. https://www.ippnw.org/wp-content/uploads/2022/09/ENGLISH-Nuclear-Famine-Report-Final-bleed-marks.pdf (accessed June 1, 2023). 

 

8. Xia L, Robock A, Scherrer K, et al. Global food insecurity and famine from reduced crop, marine fishery and livestock production due to climate disruption from nuclear war soot injection. Nat Food 2022; 3: 586–96. 

 

9. Helfand I, Lewis P, Haines A. Reducing the risks of nuclear war to humanity. Lancet 2022; 399: 1097–98. 

 

10. Nobel Prize Outreach AB. International Physicians for the Prevention of Nuclear War—facts. 1985. https://www.nobelprize.org/prizes/peace/1985/physicians/facts/ (accessed June 1, 2023). 

 

11. UN Office for Disarmament Affairs. Treaties Database. Treaty on the Prohibition of Nuclear Weapons, status of the Treaty. 2023. https://treaties.unoda.org/t/tpnw (accessed June 1, 2023. 

 

12. Center for Arms Control and Non-Proliferation. No first use: frequently asked questions. 2023. https://armscontrolcenter.org/issues/no-first-use/no-first-use-frequently-asked-questions/ (accessed June 2, 2023). 

 

Authors: 

Kamran Abbasi, Editor-in-Chief, British Medical Journal; Parveen Ali, Editor-in-Chief, International Nursing Review; Virginia Barbour, Editor-in-Chief, Medical Journal of Australia; Kirsten Bibbins-Domingo, Editor-in-Chief, JAMA; Marcel GM Olde Rikkert, Editor-in-Chief, Dutch Journal of Medicine; Andy Haines, London School of Hygiene and Tropical Medicine; Ira Helfand, Past President, International Physicians for the Prevention of Nuclear War; Richard Horton, Editor-in-Chief, The Lancet; Bob Mash, Editor-in-Chief, African Journal of Primary Health Care & Family Medicine; Arun Mitra, Past President, International Physicians for the Prevention of Nuclear War; Carlos Monteiro, Editor-in-Chief, Revista de Saúde Pública; Elena N. Naumova, Editor-in-Chief, Journal of Public Health Policy; Eric J. Rubin, Editor-in-Chief, New England Journal of Medicine; Tilman Ruff, Past President, International Physicians for the Prevention of Nuclear War; Peush Sahni, Editor-in-Chief, National Medical Journal of India; James Tumwine, Editor-in-Chief, African Health Sciences; Paul Yonga, Editor-in-Chief, East African Medical Journal; Chris Zielinski, University of Winchester, World Association of Medical Editors. 

 

Correspondence: czielinski@ippnw.org 

 

This Comment is being published simultaneously in multiple journals. For the full list of journals see: https://www.bmj.com/content/full-list-authors-and-signatories-nuclear 

 

 

 

31 Jul,2023

Need for complete abolition of nuclear weapons

Date: 31.07.2023 

 

Need for complete abolition of nuclear weapons

Now is the time to put history on the right track

  

Dr Arun Mitra 

 

As the 78th anniversary of the atomic bombing of Hiroshima and Nagasaki on 6th and 9th August 1945 is coming near, we are once again reminded of dreadful effects of the incident that wiped out two cities, killed over 2 lakh people and left the mankind to suffer from the effects of radiations for several decades to come. How the bodies melted in a fraction of second is beyond imagination. Those who survived envied the dead. They suffered both physical and mental trauma. It was horrifying to watch the images of effects of the atomic bombing during our visit to the Peace Museum in Hiroshima. 

 

Second World War had almost ended and it was imminent that Japan would not be able to sustain for more than a few weeks. There was no justification in using such weapons of mass destruction. But the US wanted to tell to the world that they were the most powerful. A secret Manhattan project was launched to make a powerful weapon.   

 

Modern science by then had given ample knowledge about the energy produced as a result of fission reaction.  On July 16, 1945, at 5:29:45 a.m. the first atomic bomb exploded at the Trinity test site in the desert of New Mexico. Robert Julio Oppenheimer was the physicist behind this nuclear explosion.  ‘The explosion resulted in an unprecedented release of energy - the equivalent of 20,000 tons of TNT exploding in less than 10 seconds. Even though the bomb was detonated from the top of a 30- meter steel tower, the blast created a crater over 2 meters deep and 40 meters wide. And all around the crater the ground was covered with a material never seen before’. (1)  

   

Oppenheimer watched from afar as the first atomic bomb was successfully detonated. The impact was more than any one’s guess. Oppenheimer developed the bomb, but its further use was not under his decision making. He was a scientist, who had no control over the application of the bomb. That is why, as shown in a recent film on him, he later remarked that the explosion brought to his mind words from the Hindu scripture Bhagavad Gita: "Now I am become Death, the destroyer of worlds". (2). This is a lesson for the scientists that they should not venture over such things which could have harmful applications.  

  

  

It had become clear that this weapon of mass destruction would add to the arms race. Soviet Union conducted it first nuclear weapon test at Semipalatinsk on 29th August 1949. A new study on the radiation impact of first nuclear explosion, says that the radiations reached 46 states, Canada and Mexico within 10 days of detonation. (3) At present we have 9 nuclear weapons possessing countries. There are several more countries who have the potential to develop such a device. Total number of nuclear warheads present on earth is estimated to be 13000.   

   

The world is however now much more informed about the twin existential threat due to climate change and nuclear weapons. A landmark report, Nuclear Famine (2022), published by International Physicians for the Prevention of Nuclear War (IPPNW) summarizes the latest scientific work which shows that a so-called “limited” or “regional” nuclear war would be neither limited nor regional. ‘A war that detonated less than 1/20th of the world’s nuclear weapons, would still crash the climate, the global food supply chains, and likely public order. Famines and unrest would kill hundreds of millions, perhaps even billions. Using less than 3% of the world’s nuclear weapons, a nuclear war between India and Pakistan could kill up to every 3rd person on earth, with average global temperatures dropping about 1.3 degrees Celsius. A full-scale nuclear war between the United States and Russia would kill an estimated 5 billion people worldwide within two years’. (4) This could be an end to the modern civilization built through thousands years of human labour.  

  

The findings come at a time of greatly heightened tensions among nuclear states and amid warnings that we are closer to nuclear war than we have ever been. The threat has increased manifold after the war began between Russia and Ukraine. The US & NATO’s explicit involvement shows their designs to increase their area of influence. In fact after dissolution of the Warsaw pact, the dissolution of NATO in a similar manner would have helped strengthen global peace. 

   

It is time that the mankind has to unite to not let the events take a shape to a catastrophe. That nuclear weapons serve as deterrence is a myth which needs to be broken. Even if the countries decide not to use these weapons, any technology issue could play havoc. Moreover the expenditure on their production, putting them on alert and their maintenance is costing our resources which could have otherwise been used for health, education and other social needs. It is not wise to see the damage done and then cry over it later. Prevention is always a better way. 

  

There are several movements around the globe working at international level as well as national level. Medical professionals have united under the banner of IPPNW to tell to the world about the health impacts of nuclear weapons. The International Campaign to Abolish Nuclear Weapons (ICAN) with 650 partner organisations is doing lot of work for lobbying and advocacy. In fact it was their intense work that led to passing of Treaty on the Prohibition of Nuclear Weapons by the UN General Assembly in July 2017.  World Peace Council and Pugwash are others working on this. International Anti-Nuclear Movement “Nevada-Semey” is highlighting jointly the impact of nuclear detonations with the aim to promote the rapprochement of cultures, practical implementation of ideas of peace and emergence of global consciousness under the leadership of  Suleimenov Olzhas.

 

All these movements have one common goal, to make the world free of nuclear weapons! Treaty on the Prohibition of Nuclear Weapons (TPNW) is the hope to be fulfilled collectively. India has been harbinger of peace movement under the banner of Non Aligned Movement (NAM). Time is again to show the statesmanship.

 

References: 

 

  1. https://www.forbes.com/sites/davidbressan/2023/07/21/humanitys-first-nuclear-explosion-changed-earths-history/?sh=11c193a45b27   
  2. https://www.history.com/news/j-robert-oppenheimer-facts-father-of-the-atomic-bomb     
  3. https://www.nytimes.com/2023/07/20/science/trinity-nuclear-test-atomic-bomb-oppenheimer.html    
  4. https://www.ippnw.org/programs/nuclear-weapons-abolition/nuclear-famine-climate-effects-of-regional-nuclear-war#:~:text=Ira%20Helfand%2C%20IPPNW%20co%2Dpresident,in%20jeopardy%20from%20mass%20starvation     

 

Published Link:

 

14 Jul,2023

Making only a few cities Smart is against the concept of equality and justice

Date: 14.07.2023

 

Making only a few cities Smart is against the concept of equality and justice

 

Dr Arun Mira

  

Much is being talked about making 100 cities throughout the country as smart cities. Focus of smartness is on digitalization, beautification, high rise buildings, big flyovers, wide spaces for cars to run on the roads, luxury parks etc. Little is being said about issues that relate to the needs of the common man.  With the urban population in India at 35.39% in 2021, there is need to develop the cities to fulfill the socio-economic requirements and quality of life of all sections of society.  

 

Concept of a smart city varies from person to person and among different strata of society. For a rich man, beautification of the city, big malls, wide roads to ply their cars, shining bright lights with glaring night life, big fly overs & under passes, decorated entry point to the city is the meaning of the smart city. But for a poor man and hut-met dweller, a moderate house, clean drinking water, sanitation, unbroken roads, regular electricity supply, footpath to walk on road side, lane for accident free cycling & two-wheeler ride would be a better city. A vendor would want, clean vending zones free from the threats of the Mafia and unnecessary glitches caused by the local body administration. A poor/low middle income family would be happy with a job and wage to be able to purchase a piece of land to live.  For the senior citizens security is the most important in view of the everyday increasing incidents of violence against them.

    

There is large scale migration to the cities in search of jobs and livelihood. They need place to live but in the absence of any government support they have to live in shanties in totally sub human unhygienic conditions. A smart city should ensure proper housing for them all.  

 

It is therefore important that the concept of smart city should cater to the needs of all citizens. The basics like clean drinking water supply, electricity, sanitation facilities, facilities for all types of waste management, good public transport, unbroken roads, low cost housing should be the priority. A common man also needs good hospitals to meet health needs at affordable cost and needs schools for affordable quality education.

 

There is also need for parks with green cover in all types of colonies. Subsidised Solar panels on buildings, so that everyone could afford their installation is the need of the hour. Footpaths for the disabled and ordinary pedestrians, Braille linked mobility facilities for the visually handicapped is essential. The digitalization, which in modern time is essential for the governance and communication should supplement and facilitate the above.  

 

But all the above is far off dream in the cities earmarked to be smart cities. Rains that inundated several parts of the northern region of the country have exposed the claims of Smart cities project conceptualised by the government of India. We have witnessed how there is water logging in the cities including the capital of the country.  With broken roads the commuters met with accidents. Several houses got submerged in the dirty water of sewerage drains. The smart city claim has been thus washed away in the rains.   

  

Larger question however is whether making 100 smart cities with a population of nearly 13 crore, which is less than 1/10th of total population of 142 crore in our country is justified? Does it stand the scrutiny of principles of justice and equality to all the citizens? The government of India has allocated nearly Rs.500/- crore per city to make them smart by June 2023. This deadline has already been missed. As against 100 proposed smart cities, there are 640930 villages in India which need to be brought under the focus, but are completely out of government’s priorities.    

 

This huge amount of 48000 crores for the smart city project if distributed evenly throughout the country would have solved the problem of housing, education, health and nutrition for low income group to an extent. Under the circumstances when the government admits abject poverty in the country and has to distribute 5 kg grains and 1 kg daal to 80 crore people, spending so much amount to make a few big cities as smart is completely unwarranted. It is time that the government reorients its priorities towards even development for all the cities and villages instead of focusing on few big cities to provide facilities to corporate business model. 

 

 

Reference: 

https://www.linkedin.com/pulse/concept-smart-city-india-sanket-menjoge   

 

Published Link:

https://epaper.live7tv.com/edition/1484/morning-india-ranchi/page/6

 

https://thearabianpost.com/making-only-a-few-cities-smart-goes-against-the-concept-of-equality/

 

https://ipanewspack.com/making-only-a-few-cities-smart-goes-against-the-concept-of-equality/

 

https://tryxyz.com/article25550-MAKING-ONLY-A-FEW-CITIES-SMART-GOES-AGAINST-THE-CONCEPT-OF-EQUALITY

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/making+only+a+few+cities+smart+goes+against+the+concept+of+equality-newsid-n518764422?listname=newspaperLanding&topic=ipaspecial&index=4&topicIndex=1&mode=pwa&action=click

04 Jul,2023

Doctors’ contribution in social change

Date: 04.07.2023   

 

Doctors’ contribution in social change

 

Dr Arun Mitra  

 

First July is always a happy day for the doctors when they get messages of good wishes from their family members, nears and dears and patients who have been successfully cured. This day is dedicated to the memory of Dr. Bidhan Chandra Roy born on 1st July 1882. He was physician, educationist, and statesman who served as Chief Minister of West Bengal from 1948 until his death on 1st July 1962. Several organisations of the doctors observe the day by organising technical lectures and hold discussions on health issues. Such an important day should not become just a ritual. It should be a day of introspection regarding the contribution which the doctors have made for the society. A continuous self-introspection and assessment by the public helps improve the professional outcome.     

 

Medical science has progressed from faith healing of the ancient times to the modern technological advanced care. In the process were developed new medical and surgical techniques and methods of prevention of illness through health education & vaccines.  However the cost of treatment with the modern technology has increased manifold. In the absence of required level of health care in the state sector, people have to shelve huge amount from their pocket on health. Many a times they have to borrow loans or sell their assets to meet even minimum healthcare needs. Increasing commercialisation in every sphere after the neo liberal economy has affected healthcare as well. It would be naive to believe that doctors will not be affected by this change. The entry of corporate sector in the healthcare has made the problem further complex because there is a conceptual change from health as social responsibility to health as a business. Medical education has become extremely expensive in the privately owned medical colleges. Attitude of a doctor who has been trained after spending so much from her/his resources is bound to have commercial tendencies.   

 

Unfortunately, such tendencies may lead to unethical medical practices by some. This becomes a cause of trust deficit between the doctors and patients. Due to lack of technical knowledge, sometimes the attendants of the patients start blaming the doctors on frivolous grounds. Such situation can take ugly turn with attendants resorting to violence against the doctors. There have been instances when such violent acts have even lead to death of the doctors.   There are several forums for redress of the grievances of the patients.  No doctor can effectively deliver his/her services in the atmosphere of stress and fear.  It is important therefore that laws are made and effectively implemented to offer protection to the doctors. With experience and time a doctor learns to be more empathetic, communicative, and transparent. This is important to strengthen the doctor patient relationship.  

 

During the pandemic several inequities were observed in the healthcare. The vaccine inequity became an issue of serious concern. It is now generally accepted that insurance based healthcare does not deliver well to the lower socio economic strata. The PPP mode adopted by the governments now-a-days, is in fact handing over doles to the private sector from the states exchequer.   

 

Equity can be achieved only by direct involvement of state in healthcare delivery system. Doctors have to continuously highlight the determinants of health with the decision makers. Important among these are nutrition particularly of pregnant and lactating mothers, potable water, sewerage facilities, healthy environment around, sufficient wages, job security and means of livelihood. Doctors have to come forward to suggest policies for equity in healthcare.  

 

 

In recent years we have witnessed increase in the spread of myths in healthcare in the name of our ancient scientific knowledge. Science is a dynamic process. It learns from past to advance further. Therefore unproven, non-evidence based methods in medical treatment do more harm than good. People visit the faith healers in the pursuit of better health. Some of the common diseases they look for remedy from such faith healers are Mumps, Chicken Pox, Bell’s Palsy, epilepsy, sexual problems, infertility etc. Many a times such beliefs cause delay in treatment and worsening of illness. Preaching to produce ‘customised babies through garbh vigyan sanskar’ by the organisations like “Arogya Bharti” is like pushing the society to medieval times. But when such practices are patronized by those at the helms of power it is a very serious issue. Not too long back two ministers of the Gujarat government felicitated the ‘tantriks’ in one of their conferences. During the pandemic use of Cow Urine and Cow dung was propagated as cure for the disease. The non-evidence based Coronil of Ramdev was propagated by none others than the then Health Minister Dr. Harsh Vardhan, who is trained ENT Surgeon in modern medicine. We have speak up against such efforts.      

 

At a time when the whole world is faced with excess spending on arms race which is bleeding the funds and resources from social needs to arms race. Doctors have to raise issues about climate change, abolition of nuclear weapons. Social disharmony adversely affects both physical and mental health. We have to speak against any effort to disturb the social harmony.   

 

Ironically health is not a major issue in the public discourse in our country. There is need to make debate on healthcare a day-to-day agenda of the public. The medical organizations have to play vital role for this.  

 

Medical professionals including Aanganwadi & Asha workers and local level social  activists have to come forward. Health committees should be formed  at the Mohalla and the Village level which should discuss the health concerns of the area as well as policy matters pertaining to health in general. Written information through pamphlets, group meetings and interactive sessions can pay real long term dividend. A real tribute to Dr B C Roy is to ensure health to all on scientific lines.  

 

Published Link:

https://thearabianpost.com/on-doctors-day-the-society-has-to-resolve-for-universal-healthcare/

 

https://ipanewspack.com/on-doctors-day-the-society-has-to-resolve-for-universal-healthcare/

 

https://tryxyz.com/article25435-ON-DOCTORS-DAY-THE-SOCIETY-HAS-TO-RESOLVE-FOR-UNIVERSAL-HEALTHCARE

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/on+doctors+day+the+society+has+to+resolve+for+universal+healthcare-newsid-n515349832?listname=newspaperLanding&topic=ipaspecial&index=0&topicIndex=1&mode=pwa&action=click

24 Jun,2023

The G20 Heath Agenda – India’s concerns

Date: 24 June 2023

 

The G20 Heath Agenda – India’s concerns

 

Dr Arun Mitra

 

The G20 Presidency to India has given ample opportunities to highlight the health problems facing the developing world in general and India in particular. This is also time to set the direction for global equity in health care. The Third Health Working Group (HWG) meeting of the G20 was held in Hyderabad in the first week of June 2023. Dr Ranga Reddy, President Infection Control Academy and Honorary Professor University of Hyderabad who was deeply involved in organizing this meeting pointed out that the Third HWG (Health Working Group) meeting had its focus on Health Emergencies, Prevention, Preparedness and Response. Also under serious debate is strengthening cooperation in Pharmaceutical sector with focus on Access and Availability to Safe, Effective, Quality and Affordable Medical Countermeasures.  

 

Smt S Aparna, Secretary, Department of Pharmaceuticals, addressing the HWG highlighted the role of initiatives like the Global R&D Network that we can collectively build a future where no one is left behind and access to life-saving medical countermeasures becomes a universal reality. She also talked about collaboration among nations, institutions, and stakeholders through a global R&D network that fosters innovation and accelerates research (1).

  

This is important because the world witnessed serious inequities and pressures during the Pandemic. As per the WHO we witnessed 6,943,390 deaths globally till 14th  June 2023. Unofficial figures could be even higher! The problem of unavailability of drugs, equipment and vaccines has been very acute. Smaller countries which lacked resources and knowhow to make vaccines or drugs suffered the most. Vaccine producing companies made huge profits during this period. There are reports of blackmail of the small countries by these companies. Many of the contracts between the companies and governments of these countries had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. The affected countries had to accept several clauses which would favour only the vaccine manufacturer, to the extent that the properties of the countries including their embassy buildings and cultural centres were mortgaged to these companies as a guarantee.

 

Developing countries which have so far been faced with burden of communicable diseases, are now feeling the burden of the non-communicable diseases as well. India is hub to both communicable and non-communicable diseases.

At a rank of 107 out of 120 countries in the Hunger Index it is easy to understand the health situation of our people. India is the largest contributor of undernourished people in the world (Worldometer), with around 194.4 Million people, or 14.37% of its population not receiving enough nutrition. India has one of the worst rates of child malnutrition in the world, with one third of malnourished children globally being Indian. As per the Government of India’s National Family Health Survey 5 (NFHS 5), ‘36% of children under age five years are stunted; 19% are wasted; 32%  are underweight; and 3% are overweight’.

 

Anemia, also referred to as low Haemoglobin; a condition that can make you feel tired and weak as you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues, affects a staggering 67% of children below the age of 5 years, higher than the 59% in the NFHS 4 survey (2).

 

 

As per the International Vaccine Access Center at John Hopkins Bloomberg School of Public Health Pneumonia & Diarrhea Progress Report 2022, under-5 pneumonia & diarrhoea burden number of deaths in India is 146,558 (3).

 

Unclean drinking water is the main cause for this. A new WHO report published in the media on 10 June 2023 says that in 2018, women in India spent an average of 45.5 minutes daily collecting water to meet household needs. Overall, households without on-premises water spent a staggering 666 lakh  hours each day collecting water, with the majority 558 lakh hours occurring in rural areas. The report has estimated that India’s on-going ‘Har Ghar Jal’ (water in every home) can avert nearly 400,000 diarrhoeal deaths and prevent loss of productive days caused due to unclean drinking water. “This achievement alone would result in estimated cost savings of up to $101 billion,” (4).

 

Tuberculosis, as a communicable disease, is an on-going global epidemic that accounts for high burden of global mortality and morbidity. Globally, with an estimated 10 million new cases and around 1.4 million deaths, TB has emerged as one of the top 10 causes of morbidity and mortality in 2019. India accounts for 28% of all TB cases in the world, according to the Global TB Report 2022. There were 21.3 lakh cases detected in 2021 Despite an increase in the budget to tackle Tuberculosis (TB), the interim estimated number of deaths due to the infectious disease in India rose by 10 per cent, from 500,000 in 2020 to 505,000 in 2021, noted the Global TB Report 2022 released by the World Health Organisation (WHO). This comes to 1383 deaths due to TB per day(5).

 

 

The Non Communicable Diseases (NCD) too are on the rise in our country to alarming level and their rate of increase is very high.  

 

The Indian Council of Medical Research–India, Diabetes (ICMR-INDIAB) study, found prevalence of diabetes among 11.4 per cent population, which comes to 101 million. This is 1.68 times higher than the previously estimated 60 million diabetics in India and a previously known 7.84 per cent national prevalence rate of diabetes.  

  

The new study published in The Lancet puts the prevalence of hypertension at 35.5 per cent; general obesity at 39.5 per cent and dyslipidemia (lipid imbalance which can cause heart diseases) at 81.2 per cent. One in every three Indians has hypertension and two in five are obese (6). 

 

Based on the above points it is important to envisage the steps required to bring down the disease burden particularly among the lower strata. It is important that each citizen of the country gets nutritious food which will help in developing immunity to fight back the disease. Most important is to ensure nutritious diet to pregnant women. ‘Progress towards universal maternity benefits, sluggish as it was in the first place, has gone into reverse gear in the last few years’ point out Jeane Drez and Ritika Khera in an article published on 14th  June 2023 in The India Forum (7). They further point out that the National Food Security Act passed 10 years back gave all pregnant women a right to maternity benefits. Initially the benefits were Rs.6000/- per child. Had the benefits been raised in tandem with nominal GDP, Indian women today would be receiving cash benefits of about Rs 20,000 in the event of pregnancy, as they do in Tamil Nadu. This would help to ensure that they are not deprived of adequate nutrition, rest and healthcare at this difficult time. According to them ‘the root of this fiasco is that pregnant women count for very little in public policy and electoral politics’. Situation of food security is so pathetic that 80 Crore people were given 5 Kg of grain and one kilo of daal to fill their stomach.

 

It is important to design disease prevention and control programmes based on the needs of lower strata of the society. The state should directly own the responsibility for heath of the citizens. The PPP (Public Private Partnership) model amounts to passing on the benefits to the private sector from the public exchequer. 

 

It is important to develop policies for inclusive growth which ensure jobs with proper remuneration and means of livelihood to all. This will help citizens to purchase food and not depend on the state for freebies. Clean drinking water, sanitation services and housing be available to all. 

 

There is need to revive the manufacture of drugs, vaccines and medical equipment in the public sector to produce them at lower cost. It would be pertinent to remember the statement by our First Prime Minister Shri Jawaharlal Nehru while inaugurating the Indian Drugs and Pharmaceuticals Ltd. (IDPL) in 1961.  He had said  “the drug industry must be in the public sector….. I think an industry of the nature of the drug industry should not be in the private sector anyhow. There are far too much exploitation of the public in this industry”.

To end the exploitation of the developing countries under the garb of various clauses of the World Trade Organisation (WTO) it is important to make necessary changes in the WTO.  The intellectual Property Rights and the Patent laws under the WTO at present benefit the big companies. This has to be changed. The founder of ORS, Dr Dilip Mahalanabis never patented his product saying that this is for public good and not for making profits. Will the companies and the governments follow suit? 

 

Finance allocation to health has to be substantially increased. It has been hovering around 1.2% of the GDP.  It should be increased to minimum of 5% of the GDP. Likewise allocation to R&D in health has to be increased.

 

Health and education of the people on scientific grounds is important so that they do not fall prey to the unscientific, non-evidence based treatment modalities like the use of Gau Mutra or Cow Dung.

 

Even though the G20 is dominated by the developed countries and the corporate sector, a forceful voice by India together with others can help change the situation. The outcome of the G20 meet on health has to be seen in that background. India can play a big role if our approach is not limited to mere electoral gimmickry.

 

  1. https://pib.gov.in/PressReleseDetail.aspx?PRID=1930273  
  2. https://www.feedingindia.org/blog/understanding-the-malnutrition-crisis-in-india/#:~:text=India%20is%20the%20largest%20contributor,population%20not%20receiving%20enough%20nutrition
  3. https://www.jhsph.edu/ivac/wp-content/uploads/2019/10/PDPR_2022.pdf
  4. https://www.tribuneindia.com/news/nation/har-ghar-jal-can-avert-4-lakh-diarrhoeal-deaths-says-who-515774
  5. https://www.businesstoday.in/latest/trends/story/despite-increased-budget-estimated-tb-deaths-rise-in-india-whos-global-tb-report-2022-351182-2022-10-29
  6. https://www.business-standard.com/health/over-11-4-indians-diabetic-35-5-suffer-from-hypertension-lancet-journal-123060900263_1.html
  7. https://www.theindiaforum.in/public-policy/maternity-entitlements-freefall

 

Published Link:

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/india+has+to+take+pro+active+role+in+formulating+health+strategy+at+g20+summit-newsid-n512896288?listname=newspaperLanding&topic=ipaspecial&index=5&topicIndex=1&mode=pwa&action=click

15 Jun,2023

Arms Race Vs Social security

Date: 15.06.2023

 

Arms Race Vs Social security

The threat looming large

 

Dr Arun Mitra

 

The recent report on the state of annual assessment of the state of armaments, disarmament and international security released by the Stockholm International Peace Research Institute (SIPRI) on 12th June 2023 is startling. The report highlights that the ‘number of operational nuclear weapons has increased because several countries have expanded their long-term force modernization plans’. At present it is estimated that there were 12 512 warheads in January 2023.  Out of this about 9576 were in military stockpiles for potential use which is 86 more than in January 2022. Of those, an estimated 3844 warheads were deployed with missiles and aircraft, and around 2000—nearly all of which belonged to Russia or the USA—were kept in a state of high operational alert, meaning that they were fitted to missiles or held at airbases hosting nuclear bombers.  The report further elaborates that Russia and the USA together possess almost 90 per cent of all nuclear weapons. 

 

The International Campaign to Abolish Nuclear Weapons (ICAN) in its  fourth annual report on nuclear weapon spending today: “Wasted: 2022 Global Nuclear Weapons Spending” has come out with the data of country wise spending on nuclear weapons in 2022.  The United States: $43.7 billion, $83,143/ minute; China: $11.7 billion, $22,219/ minute; Russia: $9.6 billion, $18,228/ minute; The United Kingdom: $6.8 billion, $12,975/ minute; France: $5.6 billion, $10,603/ minute; India: $2.7 billion, $5,181/ minute; Israel: $1.2 billion, $2,226/ minute; Pakistan: $1 billion, $1,967/ minute; North Korea: $589 million, $1,221/ minute.  

 

Comparing it with social needs the report says that the year 2022 Nuclear weapons spending for the entire year could have Covered 37% of climate change adaptation costs for developing countries or Set up 16 million homes with solar power or Paid the annual salary of 740 thousand nurses. Nuclear weapons spending per minute in 2022 could have Provided clean water sanitation for 2.4 thousand people or Paid for 3.9 thousand COVID vaccines or Hired three high-school science teachers or Paid for 20 U.S. public housing units.  

 

These reports point out the danger of existence to the mankind in case of their use. They also caution us about the resource crunch which is created as a result of wasteful expenditure on the arms race. 

 

The arms race is increasing at a time when the world has just come out of the pandemic. The global capacity to deal with the pandemic stands exposed. In the present world of science and technology we witnessed 6,943,390 deaths globally as per the WHO till 14th June 2023. Unofficial figures could be even higher. The problem of unavailability of drugs, equipment and vaccines has been very acute. Smaller countries which lacked resources and knowhow to make vaccines or drugs suffered the most. Vaccine producing companies made huge profits during this period. There are reports of black mail of the small countries by these companies. These countries had to accept several clauses which would favour only the vaccine manufacturer. In an article published in the Journal of Postgraduate Medicine, Education and Research, Dr Samir Malhotra, Professor of Pharmacology Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh has pointed that the COVID-19 scare forced many governments to enter into contracts with the companies developing vaccines. Many of these contracts had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. Not only that, and this is shocking, these countries should “put up sovereign assets as collateral to guarantee indemnity”. Such assets could include embassy buildings, cultural assets, etc.  While people were starving because of loss of jobs and means of livelihood, the corporate sector made huge profits.

 

It is a matter of anguish that the polity around the world has learnt little lesson from these events. Instead of serious introspection to divert wasteful expenditure from arms race to health needs, the expenditure on arms race continues to rise unabated. We need huge funds to plan future health of the planet. We have to meticulously design strategies to manage the communicable and non-communicable diseases.

 

Peace movement is faced with challenging tasks to save and promote health of the mankind. There is urgent need to build and strengthen the narrative for peace and disarmament. With the efforts of ICAN and scientific knowledge on the consequences on nuclear war by the IPPNW have been able get the Treaty on the Prohibition of Nuclear Weapons (TPNW) passed in the UN General Assembly on 7th July 2017. The treaty has already entered into force with the ratification by required number of countries. Now is time to convince the countries possessing Nuclear Weapons to join the treaty. In democratic societies the voice of the people matters. There is need for intense lobbying with the decision makers. We have to build public opinion for disarmament through the promotion of mutual dialogue and trust between nations. As an immediate task tireless efforts have to be made to stop Russia Ukraine War. Any delay in ending this war could lead to catastrophic happenings. We cannot let military industrial complex to take the world for granted and make huge profits at the cost of people’s lives.    

 

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Published link:

https://ipanewspack.com/global-initiative-is-needed-to-stop-immediately-russia-ukraine-war/

 

https://tryxyz.com/article25260-GLOBAL-INITIATIVE-IS-NEEDED-TO-STOP-IMMEDIATELY-RUSSIA-UKRAINE-WAR

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/global+initiative+is+needed+to+stop+immediately+russia+ukraine+war-newsid-n509943896?listname=newspaperLanding&topic=ipaspecial&index=4&topicIndex=1&mode=pwa&action=click

13 Jun,2023

Customised Babies Through Garbh Sanskar

 

Date: 13.06.2023

 

Customised Babies Through Garbh Sanskar

Say goodbye to scientific thoughts !

          Dr Arun Mitra

 

The news item published in the media on 12th June 2023 that an NGO affiliated with the RSS women’s wing, the ‘Rashtriya Sevika Samiti’  has launched a documentary and guidance titled “Garbha Sanskar” to help the women bear customized “Cultured and Patriotic Children” is highly alarming. This is total negation of science and a move to push the society into utter backwardness and obscurantism. Shri Tamilisai Soundararajan the Governor of Telengana participated in the meeting of Rashtriya Sevika Samiti on 11th June 2023 giving it at official colour. The guidance prepared by the organization highlights that the chanting of mantras, shalokas, Ramayana and Mahabharata will create positive vibration and connect with the baby in the womb. This connect will produce Sanskari and Patriotic babies. Such approach of the RSS is not new but the aggressive nature with which such myths are being propagated is dangerous and a matter of grave concern.

 

Commenting on this Dr Ms Param Saini, a leading Clinical Psychologist, said that “positive feelings and thoughts during pregnancy or listening to soothing music be it Ragas have always been promoted to help relieve stress and stay  calm during pregnancy as this results in  producing  endorphins in the body and a happy mom connects well with her baby. A higher level of endorphins also helps in relieving pain during labor”. We all know that the pregnant woman impacts her baby with her diet, oxygen saturation, stress, anxiety, mental and physical activities. Indian women have always been listening to all kind of Garbh Sanskar mantras and still fail to produce “Most Sanskari & Patriotic Children”.

It is the nature influenced by genetic inheritance and other biological factors and external factors such as what kind of exposure, experience and learning play a crucial role in influencing child development. This is another attempt by RSS to promote their agenda.

Dr Narjit Kaur a leading Gynaecologist at Ludhiana said that the documentary and guidance designed by the Rashtriya Sevika Samiti is not supported by any scientific evidence. It is only promoting the myths which do not stand anywhere in the modern scientific world.  

 

The “Arogya Bharti”, another RSS outfit established in November 2002 has been holding workshops to prepare women to deliver  “Uttam Santati” — a perfect, “Customised Child” with the purpose of making strong India.

 

Arogya Bharti claims that through giving good food and advise about the time of sexual intercourse based on planetary configurations they do “Shuddhikaran” (purification) which leads to transformation of genes and production of healthier superior babies. According to them recitation of religious hymns helps in production of healthier babies. By doing this they claim that generations to come will improve. (1) 

 

As per a report published in Indiatimes on 08 May 2017, the claim that through this exercise, Arogya Bharti has been able to produce 450 such babies so far, has to be followed up in time to find out whether the children produced in such a manner are superior to other children! There has to be an epidemiological study on the claims by comparing the results with control groups. That all this is being done under the shield of Ayurveda is exploiting people's faith in our traditional system of medicine. (2 & 3)   

 

The RSS patronised Arogya Bharti claim that they got this knowledge from Nazi Germany which preached the concept of superiority of German race. This they claim is through the production of strong babies which was done by mother of Germany. One of leading surgeons from Germany and leading member of the German affiliate of International Physicians for the Prevention of  Nuclear War (IPPNW),  Dr Christopher Kreamer whom I contacted to substantiate this claim said that there is nothing like mother of Germany. “Though I have never heard of this ‘Mother of Germany’ -but it was so interesting for me to hear with a right wing movement (and government!) that I wanted not only to tell you that, in my eyes, this ‘Mother of Germany’  story is misleading. Germany's resurrection has several other reasons which are political and economic and in no way based on the concept of mother of Germany". (4)

 

In a highly patriarchal society in our country large number of people give preference to male babies. The  whole concept of Uttam Santati is  patriarchal and masculine. We are already fighting hard to restore gender balance in the population. There are ample laws which prohibit sex determination tests because it is illegal and against the constitutional obligations of equality among genders, now even trans-genders. Then, how and why, such a campaign is being allowed? Among the 450 super babies which the proponents of this exercise claim to have produced, how many are male and how many females must be made public. Since many of these babies have grown by now their comparison with other average children must be done.

  

However such an exercise to talk of Garbha Sanskar meets several objectives of some outfits to spread obscurantism, medieval ideas & myths and hate campaigns against other religious groups. It is for the medical bodies, rationalist societies and right thinking people with scientific outlook to question such absurdities.

 

Modernity cannot be achieved through medieval ideas. Health of our people, particularly of the women and children cannot be left to be exploited by the people with irrational ideas. There has to be a concerted effort to develop a healthy India through scientific outlook. We cannot let our country  be again looked as a country of serpents but be seen globally as a nation marching forward  in post independent period as a modern industrially, agriculturally  educationally fast growing  country with the efforts of scientists, technocrats, workers, peasants, professionals and other sections of intelligentsia with achievements in medicine, space and nuclear science. The health of women and children must be a priority with special emphasis on their nutrition, education, empowerment and socio-economic security.      

 

 

References:

  1. https://www.india.com/news/india/rss-customised-baby-plan-get-intimate-as-per-sevaks-instructions-to-have-a-stronger-taller-fairer-and-smarter-child-2106298/
  2. https://www.indiatimes.com/news/india/rss-medical-wing-aarogya-bharati-shares-ancient-secrets-on-how-women-can-deliver-customised-super-babies-to-make-a-samarth-bharat-315434.html
  3. https://indianexpress.com/article/india/rss-wing-has-prescription-for-fair-tall-customised-babies-4644280/
  4. https://www.india.com/news/india/rss-customised-baby-plan-get-intimate-as-per-sevaks-instructions-to-have-a-stronger-taller-fairer-and-smarter-child-2106298/

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Published Link :

https://dailyheadlinestoday.com/epaper/view/686/headlines-today/7

 

https://ipanewspack.com/rss-ngo-spreading-dangerous-theory-about-producing-customised-babies/

 

https://tryxyz.com/article25236-RSS-NGO-SPREADING-DANGEROUS-THEORY-ABOUT-PRODUCING-CUSTOMISED-BABIES

 

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/rss+ngo+spreading+dangerous+theory+about+producing+customised+babies+-newsid-n509290470?listname=newspaperLanding&topic=ipaspecial&index=4&topicIndex=1&mode=pwa&action=click

 

 

18 May,2023

DOCTORS WARN OF TWIN EXISTENTIAL THREAT CALL FOR TIMELY ACTION

Date: 18.05.2023

 

DOCTORS WARN OF TWIN EXISTENTIAL THREAT

CALL FOR TIMELY ACTION

 

Threat to the existence of mankind has never been so acute as today. We are faced with twin existential crisis due to climate change and nuclear war. Extreme changes in the weather are a cause of grave concern. Untimely rains, storms and hitherto lesser known events like Tsunami, El-Nino etc., have become common occurrence. It is well known by now that human activities are the cause of these speedy changes in the ecology.   

 

Unchecked and unplanned growth coupled with greed is adding to the climate crisis. There is hardly any respite from ever increasing carbon emissions. Global energy-related CO2 emissions grew by 0.9% in 2022, reaching a new high of over 36.8 Gt (1).  

  

Countries with some of the highest per capita emissions – and therefore high total emissions – are the United States, Australia, and Canada. Australia has an average per capita footprint of 17 tonnes, followed by the US at 16.2 tonnes, and Canada at 15.6 tonnes. The carbon foot print is related to the economic level of a country. For example in just 2.3 days the average American or Australian emits as much as the average Malian or Nigerien in a year (2).     

 

Despite several international conferences, countries responsible for high emissions since long and which has affected the ecology have not agreed to change the course. The ecological changes lead to higher activity by various micro-organisms posing serious challenge to manage new diseases. Millions of deaths from Covid-19 has exposed our capacity to deal with a public health emergency of that magnitude. Vector borne diseases like Malaria, Dengue, Chikungunya have appeared in many new areas.  

  

Displacement of people as a result of extreme weather changes becomes a cause for several demographic changes, even conflicts. These changes affect food security in the affected areas. Despite the fact that world is producing nearly 1.5 times the food required to feed all the people, there is extreme hunger and malnutrition in several parts of the world. 

 

It is unfortunate that even in the situation of extreme global health crisis we found inequities in access to vaccines and treatments between wealthy and struggling nations. A section of the people made huge profits of the crisis. For example in India when people in the cities had no food or shelter and were migrating to their native places, walking hundreds of kilo meters on foot, the income of corporates Ambani increased by 128% and Adani by 480%.  

 

This is the time when the world should have united to fight the Pandemic and learn lesson for a lasting cooperation. On the contrary tensions around the world have been increasing. It is estimated that more than 110 conflicts are going in different parts of the world.   

 

It is more than a year that war between Russia and Ukraine started after Russian invasion of Ukraine. As per estimates several thousand people including more than 20,000 non-combatants have died and over 8 million displaced to other countries. With explicit entry of US and NATO the conflict has attained new dimension. It is no more a conflict between Russia and Ukraine but is becoming conflict between the two major nuclear powers. The Military Industrial Complex (MIC) is out to make huge profits from the situation. NATO and the US are looking forward to increase their area of influence. Already Finland and Sweden have declared to join the NATO. Any continuation of the war adds to the possibility of use of nuclear weapons, which in such situations would be catastrophic.  Unsurprisingly, the Doomsday Clock has recently been reset to 90 seconds before midnight, the closest it has ever been to global catastrophe.   

 

Doctors around the globe gathered at Mombasa in Kenya under the banner of International Physicians for the Prevention of Nuclear War (IPPNW) at its 23rd World Congress and cautioned the world not to be complacent about the catastrophe in waiting from the twin existential threat. They warned in clear terms that medical fraternity has no remedy to offer in the event of such an eventuality.  The Mombasa Declaration pointed out ‘Whether they are used in Ukraine, in South Asia where two nuclear-armed states, India and Pakistan, have fought four full-fledged wars, or during any other conflict, the use of nuclear weapons, for whatever reason, would almost certainly escalate into a nuclear war that would kill millions of people outright. Nuclear war would cause a climate disaster of another kind, plunging the world into a nuclear winter where agriculture would collapse and food scarcity would threaten billions of people with starvation, no matter how far removed they were from the conflict itself’.   

 

The declaration further said “Nuclear power, which is an expensive, ineffective, and dangerous response to the climate crisis, also fuels nuclear proliferation by inextricably increasing fissile materials and the capacity to produce them. As we are seeing in Ukraine, nuclear power reactors are vulnerable military targets—essentially huge, pre-positioned radiological disasters-in-waiting. Misplaced investments in nuclear power, besides exacerbating this danger, delay the rapid scale-up of renewable energy, increased energy efficiency, and energy storage”.   

 

Doctors expressed serious concerned at that “Military and nuclear weapons spending divert massive resources and create enormous opportunity costs that diminish and delay climate action and also steal resources from many other areas of human and environmental need, including health, shelter, and education. Militarization and armed conflict fuel tensions that diminish international cooperation in many areas, including climate action and disarmament”.   

  

We urgently need to change course if we are to avoid the catastrophic consequences of either a nuclear war or an environmental collapse. The diplomatic and political processes that produced the Treaty on the Prohibition of Nuclear Weapons (TPNW) showed the world that a well-organized group of non-nuclear-armed nations, armed instead with scientific evidence and medical expertise about nuclear weapons and nuclear war, and supported by an informed and energized civil society, could effectively make the case that possession of nuclear weapons is illegitimate and that nuclear deterrence is not only foolhardy, but also immoral. Our responsibility is to prevent what we cannot cure.

 

References:

  1. https://www.iea.org/reports/co2-emissions-in-2022
  2. https://ourworldindata.org/per-capita-co2

 

Published Link 

https://ipanewspack.com/doctors-warn-the-developed-nations-of-twin-threats-of-climate-change-and-nuclear-war/

 

https://tryxyz.com/article25020-DOCTORS-WARN-THE-DEVELOPED-NATIONS-OF-TWIN-THREATS-OF-CLIMATE-CHANGE-AND-NUCLEAR-WAR

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/doctors+warn+the+developed+nations+of+twin+threats+of+climate+change+and+nuclear+war-newsid-n501251378?listname=newspaperLanding&topic=ipaspecial&index=1&topicIndex=1&mode=pwa&action=click

09 May,2023

Bigotry a serious threat to peace, harmony and health

Date: 09.05.2023

 

Bigotry a serious threat to peace, harmony and health

 

News as reported in the Nav Bharat Times dated 12 April 2023, referring to a post in which the mother of a child had mentioned that her daughter came home today crying asked me ‘are we Muslims so dirty’? This is after her class fellow in the 6th class spat on her face after the latter told her that she belongs to Muslim religion. This is a matter of great worry and is a reflection of what is being constantly discussed in some homes and fed into the children’s mind. Children of that age have no such concept of religious differences, least to talk about hating someone on the basis of religion, caste, creed, ethnicity or gender. But constant negative discussions have a long term impression on the developing mind of the child. Such observations were also made after the riots in Gujarat. The Times of India dated May 7, 2002 had reported “Secularism is gasping for that one last breath of hope. Especially with children starting to spit fire against the opposite community. The seed of hatred is sown young and in some case even before the child reached puberty. A child told his father, who wanted to help Muslim family, that he did not feel bad for the victims of riot and that the family should seek help from those who burnt alive passengers of the Sabarmati express. Children of Muslims who were affected due to the large scale riot speak of revenge the Hindus” (1).

 

In our society where the prejudices based on the caste and religion already existed, it is easy to arouse the feelings of hatred against others. The German Nazi politician Paul Joseph Goebbels who was the chief propagandist for the Nazi Party, and then Reich Minister of Propaganda from 1933 to 1945 worked on the dictum “If you repeat a lie often enough, people will believe it, and you will even come to believe it yourself. A lie told once remains a lie but a lie told a thousand times becomes the truth”. 

 

He unleashed a systematic propaganda against the Jews. It was propagated that Jews grow like mushrooms and they are the cause for ills facing Germany. After that the Nazis successfully carried out pogrom of the Jews. Not much far back the propaganda against Tutsis by the Hutus led to tribal war in Rawanda which  killed over 800,000 people in a span of just 100 days in 1994. During the partition of India 2.5milion people, Hindus, Sikhs and Muslims, were killed as a result of mob frenzy. Recent incidents of violence in Manipur will alienate Kukis and Meiteis from each other for decades to come.

 

It was most disgusting to note that even during Pandemic when people needed to be united, a false propaganda was launched against Tablighis and they were hounded out after being blamed for spreading COVID without any evidence. They were however exonerated by the court at a later stage.

 

When some women held a sit in Dharna at Shaheen Bagh against the Citizens Amendment Bill, they were ridiculed. Only a few months back the murders and rapists of family of Bilkis Bano were released by the Gujarat government right at the same time when the Prime Minister was talking from the Red Fort on 15th August 2022 about his commitment to save the honour of women. Now we are watching women sitting on Dharna at the Jantar Mantar New Delhi demanding arrest of Brij Bushan Sharan Singh whom they are accusing of sexual harassment of the female wrestlers. These women do not belong to any minority community. They come from Jat community. This is a clear message that perpetrators of narrative of hatred spare no one.  

 

        

It is time to understand that the narrative of hatred does not stop at one community or ethnic group. It becomes a mind set against the vulnerable sections who are blamed for all ills and are then persecuted. Hitler wanted to eliminate Jews and prove himself to be true Christian. But at the end of the day out of over 55 million people killed in the 2nd world war, vast majority of them happened to be Christians.

 

Bigotry is not part of human behaviour. People have always yearned to live in peace. The hatred against others is spread with ulterior motive. There are few reports of Hindus and Muslims fighting against each other before the British came to India. With a purpose to rule the country the colonial power used all tools to divide the society so as to strengthen their hold on the country. They even succeeded in dividing the country.  However it is important to note here that despite killing of over 2.5 million Hindus, Sikhs and Muslims in the riots during partition, people of India rebuffed the politics of hatred and defeated the communal divisive forces in the first ever elections in free India and opted to build the country based on the ideals of humanism and dignity for all irrespective of religion, caste or gender. That was the ‘idea of India’ and a reflection of collective freedom movement against the colonial power.

 

What has happened now is big question? Why the people of India are being swayed away by the forces who never took any part in the freedom struggle, rather sided with the colonial masters? 

 

Social learning and psychological make up in the process of growing up makes a great difference in future behaviour patterns of young minds. They  are influenced by prejudices, hatred and many other negative ideas during the course of their upbringing.  It is therefore important to study this with seriousness and prevent such disorderly behaviour from happening. People have to decide now what type of country- divided or united we have to develop further? Hatred will split the society, break the cohesion, destroy the idea of India and peaceful coexistence. Such forces will not hesitate to enter into full fledged war and put the health and lives of the people at high risk particularly when the region is nuclear powered.

 

References:

  1. http://timesofindia.indiatimes.com/articleshow/3010902.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

 

Published link:

https://ipanewspack.com/bigotry-poses-a-serious-threat-to-peace-harmony-and-health-in-india/

 

https://tryxyz.com/article24933-BIGOTRY-POSES-A-SERIOUS-THREAT-TO-PEACE-HARMONY-AND-HEALTH-IN-INDIA

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/bigotry+poses+a+serious+threat+to+peace+harmony+and+health+in+india-newsid-n498350904?listname=newspaperLanding&topic=ipaspecial&index=2&topicIndex=1&mode=pwa&action=click

 

13 Apr,2023

Food not weapons

Date: 13.04.2023 

   

Food not weapons    

   

Dr Arun Mitra 

 

As per the reports, Somalia with a Population of 17 Million is passing through serious crisis of food security.  Over 200,000 people are facing catastrophic levels of food insecurity. ‘Due to starvation they are dying, falling prey to diarrhoea, measles or malaria etc. Number of deaths last year is estimated to be 43,000 (1). At least half of the deaths were children under the age of 5’, according to the report by health researchers, the United Nations and the Somali government. This is the worst drought in decades. Many were forced to leave their homes to seek humanitarian assistance in urban centers or across the border in Kenya and Ethiopia. Already at the end of 2022, three million people were internally displaced, and at least 20,000 Somalis had crossed into Kenya.   

   

The drought has wiped out millions of livestock animals, adversely affecting income of large number of families. This has left nearly half of Somalia’s population hungry. Climate change, leading to recurring droughts, flash floods, cyclones and increasing temperatures in Somalia and adjoining areas has worsened the situation.     

   

The researchers had warned that in the first six months of the year between 18,000 and 34,000 people are likely to succumb to the drought. Despite knowing gravity of the situation not adequate attention was paid to the crisis.    

     

Having a diet which is both sufficient in terms of energy (caloric) requirements and additional nutritional needs is essential for good health. Undernourishment, especially in children and mothers, is a leading risk factor for death and other health consequences.    

   

The UN has set a global target as part of the Sustainable Development Goals to “end hunger by 2030“. Currently we are far from reaching this target.    

    

The world produces 150% more food on only 13% more land compared with 1960, thanks to many innovations in food production made over the years. We produce enough food to feed 1.5 times the global population. That's enough to feed 10 billion yet we are at just over 7 billion currently. There is enough for everyone (2). 

 

Not only Somalia but several countries of the world are facing crisis of Hunger. India which claims to be rising economy and aspires to be super power with 5 trillion US$ economy is at 107 out of 120 countries in hunger index. Similar is the situation in many countries of Asia and Africa  

  

Unnatural death of any person, from any country or community is a cause of serious concern. But truth of the matter is that little attention is paid towards the death of the poor. Not many in the world even know that over 8 million people died in Rwanda as a result of ethnic violence in a span of just 100 days from 7thApril to 15 July 1994. That in the so much connected world today such events are occurring is a matter of shame.     

   

It is high time the world realizes the gravity and makes a complete review of the priorities. There is need to spend more on food  production and its equitable distribution to all the citizens of the world.    

 

Total global military expenditure increased by 0.7 per cent in real terms in 2021, to reach $2113 billion. The five largest spenders in 2021 were the United States, China, India, the United Kingdom and Russia, together accounting for 62 per cent of expenditure, according to new data on global military spending published by the Stockholm International Peace Research Institute (SIPRI) (3). 

 

In the present circumstances when several parts of the world are in tension, war between Russia and Ukraine does not seem to ending soon, the existing weapons pose a serious threat to humanity. Use of Nuclear weapons in any escalation of existing tensions cannot be ruled out.    

   

At one time India has been the harbinger in the movement for disarmament. As leader of the Non-Aligned Movement (NAM), India played a significant role in raising the voice for nuclear weapons abolition. Even though the G20 is much different from the NAM, India as its President can play a significant role in bringing mind set change among the G20 leaders from the arms race to diversion of funds to health, education and other social needs.    

   

The International Physicians for the Prevention of Nuclear War (IPPNW) is holding its 23rd World Congress in Mombasa, Kenya on the theme ‘Disarmament, Climate crisis and Health’ from 26 to 30 April 2023. The deliberation will be reflection of the physicians concern for the survival and good health of the human kind. The congress will formulate strategies of action by the civil society to reverse the trend of arms race and ensure food to every person on earth.     

   

References: 

  1. https://www.nytimes.com/2023/03/20/world/africa/somalia-drought-death-famine.html#:~:text=About%2043%2C000%20people%20died%20last,the%20Horn%20of%20Africa%20nation
  2. https://news.thin-ink.net/p/we-produce-enough-food-to-feed-15#:~:text=Today%2C%20the%20world%20produces%20150,There%20is%20enough%20for%20everyone.     
  3. https://www.sipri.org/media/press-release/2022/world-military-expenditure-passes-2-trillion-first-time#:~:text=(Stockholm%2C%2025%20April%202022),2021%2C%20to%20reach%20%242113%20billion.   

04 Mar,2023

Declare Right to Health a Fundamental Right

 

Date: 4.03.2023 

Declare Right to Health  

a Fundamental Right  

   

   

Passing of Right to Health Bill by the Rajasthan Assembly is a long overdue requirement of the citizens and demand of the health care organizations. This Act gives the residents of Rajasthan right to free healthcare. The right to health thus becomes justiciable, that is the government is now answerable in eyes of law. The Act primarily puts the onus on the state to ensure healthcare to the people and through guarantee of nutrition, safe drinking water, sewerage facilities etc. The patients will have the facility to avail of OPD or indoor care free of charge in the public health facilities.  

 

Since major part of the health care has been developed in the private sector in our country, the act involves the private sector also to provide emergency care to the needy and in case of emergency delivery even if the person is not able to pay. The doctors of Rajasthan have been agitating against the Act. The government has agreed to the demand of doctors and has excluded health facilities with less than 50 beds and those who have not taken any grant from the government from the purview of the Act.  

Rajasthan has shown the way; it is now important that such an act is passed at the central government level and health is declared as a Fundamental right. 

 

This is essential because the health care indices in our country are dismal. That every year out of a population of  100,000 in our country 36.11   persons die due to Tuberculosis (1);  large number of  children fall prey to Encephalitis, Diarrhea, Malaria and many other communicable diseases, is a matter of grave concern. Needless to mention the havoc caused by the COVID Pandemic where we failed to prevent several thousand deaths because of mismanagement and skewed priorities. Non-communicable diseases too are on the rise. It is estimated that 29.8% of Indians have hypertension. India is soon likely to become the diabetes capital of the world.   

  

 

It is very unfortunate that several patients die in case of an emergency because of denial of treatment for want of money or due to some technicalities. This is deplorable and complete violation of the right to life which is a basic human right. The Supreme Court of India as long back as 1989 observed in Parmanand Katara v. Union of India AIR 1989 SC 2039 that when accidents occur and the victims are taken to hospitals or to a medical practitioner, they are not taken care of for giving emergency medical treatment on the ground that the case is a medico-legal case and the injured person should go to a Government Hospital. The Supreme Court emphasized the need for making it obligatory for hospitals and medical practitioners to provide emergency medical care. The Apex court further observed that this is not the only reason for not attending on injured persons or persons in a medical emergency, for sometimes such persons are turned out on the ground that they are not in a position to make payment immediately or that they have no insurance or that they are not members of any scheme which entitles them to medical reimbursement (2).  

  

Despite the above information well in the knowledge of those responsible to manage the health affairs, we have failed to take steps to provide healthcare to all the citizens. The Joseph Bhore committee report had recommended way back in 1946 the need to ensure equitable healthcare to all citizens irrespective of their capacity to pay.  India has been a signatory to the Alma Ata declaration of 1978 whereby our country committed to ensure health for all by the year 2000. But we failed in that. Presently 75% of healthcare expenditure comes from the pockets of households. Every year 6.3 crore population of India is pushed towards poverty due to out of pocket expenditure, a fact admitted in the Health Policy 2017. This catastrophic healthcare cost is an important cause of impoverishment which further adds to poor health.  Our public health spending is one among the lowest in the world that is nearly 1.1% of the GDP against the required minimum of 5% as recommended by the WHO.    

 

 

On the contrary there has been a paradigm shift in the approach to healthcare. The National Health Policy 2017 showed concern on the healthcare situation in the country but it offers the solution on the insurance based healthcare. The existing insurance based schemes cover only the indoor care while nearly 67% of the health expenditure is incurred on OPD care. With entry of corporate sector in healthcare system, healthcare has been turned into business rather than a social responsibility.  Moreover those not covered under any government insurance scheme have to shelve huge amount for insurance. Senior citizens are the worst affected. The insurance based schemes have in fact turned into doling away public money to the insurance companies.   

 

Health was recognized as human right way back in 1966. The erstwhile USSR declared health as a right of every citizen and responsibility of the state in 1936. In the year 1948 the UK government took a similar step to establish National Health Services (NHS).  But ironically till date the Constitution of India does not expressly guarantee a fundamental right to health. However references to the state’s responsibility to health of the people are mentioned in the directive principles in Part IV of the Indian Constitution. These provide a basis for the right to health.  Article 42 directs the State to just and humane conditions of work and maternity relief.  Article 47 casts a duty on the state to raise the nutrition levels and standard of living of people and to improve public health. Article 21 guarantees the right to life.       

       

A subject like healthcare cannot be left to the market forces alone. It will further exclude the low income strata from quality healthcare. Organisations like the Indian Doctors for Peace and Development (IDPD) and the Alliance of Doctors for Ethical Healthcare have been demanding such an Act from the central government to declare the Health as a Fundamental Right. It is the primary duty of all doctors as custodian of health to press for the demand for Health as a Fundamental Right. This will also help in reducing trust deficit between patients and doctors.  

With Rajasthan Act in force it is time now for the central government to follow. References: 

  1. https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-021-01740-y  
  2. https://indiankanoon.org/doc/100042716/?type=print  

  

 

11 Feb,2023

THE COW AS A POLITICAL TOOL

Date: 11.02.2023

 

THE COW AS A POLITICAL TOOL

 

Dr Arun Mitra

 

The cow is in picture again, this time with the approval of competent authority and on the direction of the Department of Animal Husbandry and Dairying, Ministry of Fisheries, Animal Husbandry and Dairy. With emphasis on aiming to celebrate the 'Vedic tradition' and the immense benefits a cow possesses, the Animal Welfare Board of India has urged people to celebrate 'Cow Hug Day' on February 14 which is celebrated as Valentine's Day. "We all know that the Cow is the backbone of Indian culture and rural economy, sustains our life, and represents cattle wealth and biodiversity. It is known as "Kamdhenu" and "Gaumata" because of its nourishing nature like mother, the giver of all providing riches to humanity," the Animal Welfare Board informed in a statement. The body said that the Vedic traditions are on the verge of "extinction" due to the progress of western culture. "The dazzle of western civilization has made our culture and heritage almost forgotten," the Board stated. As per the Animal Welfare Board, owing to its immense benefits, hugging cows will bring emotional richness and increase ‘individual and collective happiness’.  "Therefore, all the cow lovers may also celebrate February 14 as Cow Hug day keeping in mind the importance of mother cow and making life happy and full of positive energy," the statement added.

 

This statement needs  to be analysed scientifically as earlier too the issues have been raised about the use of cow urine and cow dung as cure of several diseases.

 

Ms. Pragya Thakur, BJP member of Parliament from Bhopal had claimed that her cancer was cured by cow urine. Dr. S.S Rajput, a surgeon at Ram Manohar Lohia Institute of Medical Sciences in Lucknow however confirmed that he had done three radical operations to get her rid of the cancer of the breast. The doctor’s statement exposed the claim of Sadhvi about cow urine as a cure of her breast cancer.

 

There was lot of talk of use of cow urine as cure of Corona virus infection. The cow dung too has been claimed to be possessing qualities to cure Corona infection. Even more it is being claimed that the cow dung is a powerful protection from the nuclear radiations in case of nuclear war.   So much so it has been claimed that cows exhale oxygen therefore breathing the air exhaled from cow will cure several diseases.

 

Science is based on evidence and is always ready for debate and amenable to suggestion. It is not dogmatic as many believers are. Modern scientific system of medicine enhanced the knowledge gained in the past and developed the health care system further on the basis of new scientific innovations.  Anatomy and Physiology made us understand the basic structure and functioning of the life systems. Our body has an elaborate system to utilize whatever is needed and to excrete those materials which are either not required or are harmful. It is a common knowledge that part of the food which we consume is digested and rest is excreted through the gastrointestinal track. After the food has been metabolized in the body, other waste products are excreted in urine. It is therefore important to compare the chemical composition of urine of cow and human beings and to prove on evidence the usefulness and superiority of cow urine for human health.  Urine is a liquid produced by the kidneys to remove waste products from the bloodstream.  Basic composition of cow/human urine are Water, Urea, Sodium, Chloride, Sulfate, Potassium, Phosphate, Creatinine, Ammonia, Uric Acid, Calcium, Magnesium. Since the composition of human and cow urine are similar, it is difficult to believe how cow urine is useful for human body?

 

Information under RTI was obtained from the Department of Animal Husbandry, Dairying and Fisheries, government of India about the usefulness of cow urine for human body. They replied that “the information is not maintained by this CPIO of cattle Division”. Simultaneously same information was sought from the Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana. The information received from 22 departments of the GADVASU denied any such information with them. It is worth mentioning here that GADVASU, Ludhiana, has been ranked first among the 14 state veterinary universities in the country, as per the ranking of agricultural universities and research institutes conducted by the Indian Council of Agricultural Research (ICAR), New Delhi, for 2016-17.

 

 

The claim that exhaled air from Cow is useful stands no scrutiny if we examine the content of gases in the exhaled air.  When we exhale, the composition of the air remains almost the same as the air we inhale, only the percentage of carbon dioxide and oxygen changes. The amount of inhaled air contains 21% of oxygen and 0.04% of carbon dioxide, while the air we breathe out contains 16.4% of oxygen and 4.4% of carbon dioxide. This is true for all animals. That is why it is recommended to give mouth to mouth respiration in case of serious emergency as part of resuscitation if no other equipment is available.

 

We should love not only the cow but all life forms and try to preserve them. Nature has given us an eco-system whereby a balance is maintained. The statement on cow hug day is full of contradictions. It has been said that we should preserve our Vedic culture. It is unfortunate that the scientific body like the animal husbandry department has forgotten that life is a dynamic process. We have Vedic culture as past with due respect and learning from it. But the life has moved ahead. No one can go the life style that we had even 25 years ago what to talk of ancient times. Science is for all humanity. Those who talk of Vedic culture and ancient times are using modern gadgets developed in the west by modern science and lead life in ‘western style’. They do not wear ‘Kharawans’  instead of shoes nor do they wear the dress as worn during the Vedic days. 

 

The whole propaganda about cow in the recent period is connected to the Hindutva Agenda of the RSS and its outfits. The whole game plan is to spread obscurantism, exploit people’s faith and use it for political ends. Having failed on all fronts these forces are now spreading such myths.

 

One gets happiness from any pet that one possesses. Maximum happiness and strength however comes from hugging fellow human beings and care for the people around. Animals are a ‘Pashu Dhan’ to be cared for in that sense. Humans are our own species.

 

As we learn that the order to observe 14th February as Cow Hug day has been withdrawn, we must be cautious that the forces of obscurantism will come out with some other idea. Let us not forget that these forces made the Ganesha statue drink milk in 1995, convinced the people to bang thalies or clap to get rid of corona virus infection.

 

It is high time we develop and spread scientific temper which is the basis for sustainable development as per modern times.

 

 

02 Feb,2023

Poor allocation to health in the budget will have serious implications

Date: 02.02.2023

 

Poor allocation to health in the budget will have serious implications

 

Dr Arun Mitra

 

Much was expected from the budget presented by the Finance Minister Smt.Nirmala Sitaraman on 1st February 2023. As this was the last budget of the present government before the upcoming elections to the parliament next year, people had high hopes of relief in various sectors including the health. Thumping the chest by the BJP members and its allies in NDA apart the allocation to health in the budget has completely belied people’s aspirations. This is apparently because health and education are not taken as assets by the governments in power in our country. 

 

It is in this context to utter dismay that there is decrease in allocation to health sector in the budget presented by the FM. In the budget presented last year out of 39.45 lakh crores rupees of total budget the health was allocated Rs.86606/- crores that is 2.19 % of the budget.  But this year health has been allocated Rs.88956/- crores out of total budget of 45 lakh crores rupees which means 1.97 % of the budget. There is decrease 0.22% despite high inflation during this period. 

 

Budgetary allocation to the National Health Mission (NHM) has seen a meagre 0.21% rise. Budget for National AIDS (Acquired Immunodeficiency Syndrome) and STD (Sexually Transmitted Diseases) Control Programme has seen an increment of 11.61 per cent – Rs. 2,622.75 crore (BE) from Rs. 2349.73 crore which was the revised estimate for 2021-22. However, if we  compare it to the actual money spent in 2020-21 on National AIDS (Acquired Immunodeficiency Syndrome) and STD (Sexually Transmitted Diseases) Control programme  there has been a drop of 6.84 per cent.

 

The whole exercise is to promote digital agenda instead of the infrastructure and employment of doctors and paramedical staff in the rural health centres.  It is beyond comprehension that how without actual ground level infrastructural development digitalization is going to help.

 

The WHO has pointed out time and again that to meet the health needs it is important that the public health spending should be 5% of the GDP. But unfortunately the public health expenditure in our country has been much lower for several years. According to the Oxfam’s “Commitment to reducing inequality report 2020” India ranks 154th in health spending, 5th from the bottom. It was therefore expected that the government would be serious in budgetary allocation towards health. But it was not to be.

 

‘Oxfam India’s Inequality Report 2021: India’s Unequal Healthcare Story’ further points out that growing socio-economic inequalities in India are disproportionately affecting health outcomes of marginalized groups due to the absence of Universal Health Coverage (UHC). The report shows the general category performs better than SCs and STs; Hindus perform better than Muslims; the rich perform better than the poor; men are better off than women; and the urban population is better off than the rural population on various health indicators.

 

The budget nowhere indicates increase in allocation for the emoluments of the doctors and paramedical staff. Services of the front line health workers, ASHA, Aanganwadi etc. have not been given due recognition. They have not been given the status of a worker in this budget. 

 

The allocation to Poshan Abhiyan was reduced last year from Rs.3700 crore to Rs.2700 crore. This is affecting nutrition of the marginalized sections. The allocation for MGNREGA is cut from Rs 89,400 crore to Rs.60,000 crores. Further, rural development allocation has been reduced from Rs 2,43,317 crore in the revised estimate to Rs 2,38,204 crore of the total budget expenditure, it is getting 5% and that shows the low priority of the government for the rural sector. Poor allocation to the rural sector and MGNREGA will reduce the purchasing capacity of the people thus effecting their nutrition. With under nutrition it would be naïve to expect better health indictors among the people. 

 

There is talk of increasing nursing colleges. But unless this is accompanied with job employment for them they will be left to work in the private sector at very low wages or migrate to other countries for better opportunities.

 

The Community Health Centres (CHCs) which are the first referral centres and are supposed to have a surgeon, an obstetrician-gynaecologist, a paediatrician, a physician and an anaesthetist. But there is over 80 % shortfall in surgeons and paediatricians, and an over 70 % shortfall in physicians and obstetrician-gynaecologists. There is no plan or direction to fill these vacancies despite that number of doctors coming out every year has increased but because of lack of infrastructural facilities in the rural areas most of them opt for private sector or migrate to other countries. 

 

There is emphasis on Public Private Partnership (PPP) mode in the health sector through which money will be shelved to the private players. 

 

Whole exercise of budgetary allocation is not going to improve health services in the country and shows no sign of universal health care. There is need to increase the budgetary allocation to 10% of the revenue budget if the health services have to be made inclusive for all sections of the society

 

 

Reference:

https://www.oxfamindia.org/knowledgehub/workingpaper/inequality-report-2021-indias-unequal-healthcare-story

31 Jan,2023

The danger of Nuclear clouds getting dark

 

Date: 31 January 2023

 

The danger of Nuclear clouds getting dark

 

Dr Arun Mitra

 

The World Health Organization (WHO) has recently updated the list of medicines and drugs recommended to treat exposure to radiological and nuclear emergencies. Last time it was done in the year 2007. Maria Neira, the director of the WHO’s Department of Public Health and Environment has reminded the world about various health emergencies in case of exposure to radiations. The new list has number of such medicines which could be of use in case of a large scale radiation exposure from nuclear war, damage to nuclear power plants to low level exposure from other radiological exposures. Among the recommended drugs are stable iodine to reduce the exposure of the thyroid to radioactive iodine; chelating agents to reduce radioactive cesium from the body which can form during nuclear fission and cytokines to mitigate damage to the bone marrow. Medicines used for diarrhoea, vomiting, physical injuries are also included in the list with an advice to make them available for use without delay. Damage to DNA causing cancer and other diseases are issue of serious concern as these are potentially fatal effects. Dr Niranjan Bhattacharya from the School of Tropical medicine Kolkata has been advocating use of blood taken from

umbilical cord in such emergencies.

 

As we know medical science has no effective remedy to the nuclear fallout, but that the WHO has cautioned the world about the danger, is a reflection of its perception that the world is faced with a serious threat of nuclear weapons at present. 

 

The WHO advisory coincides with the report of Dooms day clock having been moved to 90 seconds or 10 seconds closer than last year when it was at 100 seconds. The Doomsday Clock is a symbol that represents the likelihood of a human-made global catastrophe, in the opinion of the members of the Bulletin of the Atomic Scientists. The idea was conceived after the 2nd world war. Interestingly Artist Martyl Langsdorf, the wife of Manhattan Project physicist Alexander Langsdorf, designed the clock to  warn that time is running out to avert the danger of nuclear catastrophe. The clock was at 7 minutes to midnight in 1947, it was moved to 17 minutes in 1991 when it was thought that the nuclear threat has receded after the end of cold war. This made the world complacent, but the arms race including the nuclear arms race continued unabated and the clock has been moved to just 1.5 minutes on 24th January 2023.

 

Needless to say the danger arising out of the war between Russia and Ukraine poses a grave threat. It does not seem to be coming to an end in the near future. It has instead escalated further with the reports of increased arms supply of arms by the European countries which includes tanks and other equipment to Ukraine. Russia has intensified its attacks on the Ukrainian cities. Ukraine’s infrastructure has suffered gravely. Exact number of human casualties can never be known in the war but it must be very high including some soldiers of the Russian army too. Large scale fatality of non-combatants in Ukraine has once again proved the dangerous consequences of the modern day warfare. Dr.Barry S Levy Adjunct Professor of Public Health, Tufts University School of Medicine in a presentation at an event organized by the International Physicians for the Prevention of Nuclear War (IPPNW) on 19th February 2022 has warned of serious consequences of conventional war. According to him in case of war there is increase in the malnutrition particularly among women and children. There is rise in the communicable diseases like diarrhea, cholera, respiratory diseases, Tuberculosis. Mental disorders like depression, post-traumatic stress disorder and suicides. Reproductive health suffers badly. The non-communicable diseases like heart diseases, cancers, kidney diseases increased.  Since Ukraine has 17% population above the age of 65. So there is a danger that indirect death rate would be much higher than in case of invasion of Iraq since the elderly group of population in Ukraine is more vulnerable.  

 

It is unfortunate that despite research and warnings of the catastrophe in the event of the nuclear exchange the countries with nuclear weapons are consciously ignoring the warning. They are out to increase their armaments budget and updating the nuclear weapons system. With continuing tensions in different parts of the world the number of nuclear weapons countries may not remain limited to nine. There are several countries at the threshold of developing nuclear weapons. 

 

Large parts of the world are faced with political instability, growing economic crisis and internal social conflicts coupled with tensions with the neighbours. Unable to solve the problems the governments in power are very likely to promote nationalist narrative and jingoism which has potential threat of escalation and use of nuclear weapons.

 

Peace movement around the world has lot of work to do in terms of mobilisation of public opinion and lobbying with the governments in the nuclear weapons possessing countries. External forces intervening in the conflicts have dangerous connotations. Blatant intervention by the NATO and the US is clearly preventing any solution to the on-going war between Russia and Ukraine which could be very well resolved through negotiations. Ironically the Non-Aligned movement is nowhere to be seen. Countries which used to lead this movement have taken U turn in their policies. The G 20, a conglomerate of countries with different interests is dominated by those who are involved overtly or covertly in various conflicts around the globe. Role of China increasing military expenditure too is very dubious. The military industrial

complex is however making huge profits at the cost of human lives.

 

Danger is grave, so the task before the peace movements, saner elements in the society and for the non-nuclear weapons countries is challenging. However at a time when the Treaty on the Prohibition of Nuclear Weapons (TPNW) has been passed by the UNO over six years back, opportunity is ripe.

 

 

22 Jan,2023

The G20 Health Agenda and India’s concerns

Date: 22 January 2023 

 

The G20 Health Agenda and India’s concerns

 

Dr Arun Mitra

(With gross differences in the health needs of the G20 countries it is to be seen how India gets its and other developing countries’ concerns addressed as priority in the G20 health agenda). 

 

The first health working group meeting under India’s G-20 presidency was held at Thiruvananthapuram on 18 January 2023 to discuss about the global health concerns. The focus of discussion was bound to be around Pandemic and response to it at various levels. The discussion in the meeting as reported was on Pandemic management, emergency preparedness and vaccinations. Also under discussion were the issues of increasing antimicrobial resistance, developing blue print for vaccines, therapeutics and diagnostics. There was also discussion on harmonising a global network for countries through consensus on digital health and to mobilise funds for the same. In addition concerns were expressed over ensuring safe effective quality and affordable medicines and medical equipment. 

 

The G20 is a heterogeneous group of countries at different level of economic development including Australia, Canada, United Kingdom, United States, France, Germany, Italy, Japan, Republic of Korea, European Union, Saudi Arabia, China, Russia, Argentina, Brazil, South Africa, Mexico, Türkiye, India and Indonesia. In the economic development, countries of the G-20 have different rankings. Whereas India and Indonesia belong to the Lower Middle income group countries, Argentina, Brazil, China, South Africa, Mexico, Russia and Turkey belong to Upper Middle income group of countries. Rest are from High income group countries.  So the priorities in health agenda of each country are also different accordingly. This is reflected in prevailing gross inequity already existing in the healthcare delivery among the countries as well as for the different strata of population within the countries representing G-20 

 

Health indicators among these countries also vary. For example in the Global Hunger Index which is based on the criteria of Inadequate food supply, Child mortality and Child under-nutrition. India is at 107 out of 120 countries compared to Indonesia at 77, South Africa at 59, Mexico at 42, Argentina at 31 and Brazil at 27. Rest of the countries are among better performers with the rankings at less than 17. 

 

Nutrition is the basic pre requisite for good health. It means to have sufficient amount of Protein, Carbohydrate and Fats as well as micronutrients like vitamins and minerals. For better health it is thus important to have sufficient food supply, sufficient remuneration, housing and good environmental conditions. It is duty of the government to ensure that all population gets its share of healthy nutrition. That 81 Crore people are being given 5 Kg of food grains free of cost which just enough for subsistence, is a matter of grave concern. How can one expect vast majority to have good health as the grains only are not sufficient to fulfil nutritional requirements for a good health and immunity from diseases? Earlier under the National Food Security Act (NFSA)  a family was entitled to get 50 Kg of grains,  25 Kg food free of cost and rest 25 Kg at Rs. 3 per Kg. This means the family was spending only Rs. Seventy five  in buying this.  But under the new order of the government only 25 Kg will be given free and the rest will have to be purchased at market price which is no less than Rs.20 per Kg. This  will cause a burden of Rs. 500/- per month on their bybudget if we calculate the grain price at Rs. 20 per Kilogram.  This will deprive the poor of basic food further adding to malnutrition and poor health. This is an important agenda for our country but representatives from the high income group countries in the G20 may not be able to comprehend this. 

 

Moreover to have better health indicators, it is important to have more spending on health. Out of the G 20 countries India is spending 3.1% of the GDP on health. But in terms of spending on health by the government it is just 1.28%. Rest of the spending is by patients from their pocket. As a result 60 million people are pushed to poverty. In comparison   Brazil spends 9.59% of th GDP on health, Argentina 9.51%, South Africa 9.11%, Indonesia 7.58%, Mexico 5.43%, China 5.35%, Turkey 4.34%. Russian expenditure is 5.65%, UK 10.15 %, Germany at 11.70% and the USA at 16.77%. 

 

Pandemic had a negative effect on the situation of jobs and livelihood. The government hardly paid any assistance to the affected 54 crore workers and MSMEs, the nutritional health status of the low income group population was affected adversely. To add to their woes budget on Poshan Abhiyan was reduced from 3700 crore to 2700 crore rupees. These are issues of little important to several G20 countries.

 

The disease pattern is also quite variable. For example In 2021, eight countries accounted for more than two thirds of global TB cases: India (28%), Indonesia (9.2%), China (7.4%). Number of TB cases in High income group countries is minimal in comparison. Therefore focus has to be different in different countries. 

 

The pandemic has seen gross inequity in global vaccine supply. The vaccine manufacturers in the high income countries were reluctant to supply the vaccines to small developing countries.  They demanded guarantees from the recipient countries which included even property of the embassy buildings of those countries. 

 

As is evident there are gross differences in the health needs of the G20 countries it is to be seen how India gets its and other developing countries’ concerns addressed as priority in the G20 health agenda. 

 

 

10 Jan,2023

COVID affected Health Workers’ families need empathy and support

 

 

Date: 10.01.2023

 

COVID affected Health Workers’ families need empathy and support

 

It is to utter to dismay that only about 23.8 % families of the doctors who lost their life fighting COVID-19 have received the insurance amount announced by the Prime Minister under the Pradhan Mantri Garib Kalyan Package (PMGKP). This is as per the information received by Dr Babu K V, an Ophthalmologist from Kannur, Kerala on 26th September 2022 from The New India Assurance Company Ltd. in reply to an RTI filed by him. As per this reply total number of beneficiaries under PMGKP, who died of COVID during 30th  March 2020 to 30th September 2022 is 1988 and amount for them comes to be Rs.994 crore. Only 428 beneficiaries have got the benefit so far which amounts to 214 crore rupees.   

 

According to Dr Jayesh Lele, the Hony. Secretary General of Indian Medical Association,   more than 1800 doctors succumbed to Covid 19. During the first wave 757 and during the second wave 839 lost their lives. Rest 204 died later. While all 29 COVID martyr doctors of Kerala are compensated, just  27 out of 150 Delhi doctors have been compensated.     

 

In another case a notice was issued on 31st March 2020 by the Commissioner of the Navi Mumbai Municipal Corporation to Dr Bhskar Surgade to keep his dispensary open for the treatment of patients suffering from COVID-19 during the period of the lock down.   Unfortunately he succumbed to COVID on 10th June 2020. Kiran Bhaskar Surgade, the spouse of Dr Bhaskar Surgade filed a petition before the High Court of Bombay for compensation. The High Court however rejected the Petition for compensation to the family of Dr Surgade on ground that the services of Dr Surgade were not requisitioned for COVID-19 duties and that the notice that was issued on 31st March 2020 cannot be construed as a notice requisitioning his services for the specific purpose of treating COVID-19 patients and the notice did not mandate that the dispensary was required to be kept open for Covid-19 patients. The issue now has been listed in the Special Leave Petition in the Supreme Court of India. As per the Apex Court, Prima facie the object of the Scheme is to provide a measure of social security to the health professionals because of the exposure to the COVID-19 virus which they are liable to suffer in the course of the discharge of their medical duties both in public and private institutions. The Apex court also observed that the matter raises an issue of nation-wide concern.   

 

The whole issue has raised a serious question as to whether only those doctors and other healthcare workers of  a specially requisitioned institution for the purpose of giving services to the COVID-19 effected patients are liable to the compensation, or any healthcare worker who dedicated her/his life during the extreme health crises deserves to receive insurance compensation. Under any health emergency it is the duty of the medical personnel to discharge their duty with dedication to the society. We have seen that most of the healthcare workers including doctors, nurses, paramedical staff, ASHA workers, Aanganwadi workers from both public and private sector were in the fore front to prevent the disease through public education and active treatment. This they did even at the cost of verbal or physical humiliation at some places. 

 

In case of an unfortunate mishap the family comes to cross roads. There are many instances where the deceased person was the sole bread earner. It is therefore important that all such health workers whether requisitioned for the special purpose or not should be given insurance benefit without delay because they laid down their life serving the sick. Thousands of workers who were hired for short term during the COVID are now out on lurch. They need to be looked after. ASHA workers and Aanganwadi workers should be at least given recognition as regular workers . 

 

India is already hub to several communicable as well non communicable diseases. The government owes responsibility to care for the affected. In fact the disease spread very fast forcing lakhs of people to migrate because there were no jobs or means of livelihood left. . Firstly the lockdown was imposed without any notice and then the government did not pay heed to the demand for compensation to the poor families. Trade unions demand to pay Rs.7500/- to each family of the workers went completely ignored. At a later stage only 5 Kg of grain and one Kg. Daal was offered as help. This is in contrast to many governments around the world who paid special allowances to the people during the COVID-19 because the jobs and means of livelihood were affected. 

 

Indian state should wake up and develop a sympathetic attitude towards the COVID warriors. Gimmicks like showering of flowers or words of praise do not mean anything if there is no practical help. All the families who lost their members need to be looked after with due compensation and support.  

 

 

31 Dec,2022

Health and Education should be based on scientific outlook

Date: 31.12.2022 

 

Health and Education should be based on scientific outlook

 

Dr Arun Mitra

 

A few days ago, while addressing the 75th Amrit Utsav of Swami Narayan Gurukul Rajkot Sansthan, Prime Minister Narendra Modi said that education has been completely neglected after independence. Therefore, it has become necessary that the government should bring forward the importance of ancient educational system. When previous governments faltered, he said, saints came forward and Swami Narayan Sansthan is an example. He said that in ancient times our education system was exemplary which gave importance to knowledge. “Our Gurukuls have been representing equity, equality, care and a sense of service for centuries”. 

 

Educational system in a particular period depends on the social and economic conditions prevailing at that time. It is well known that in ancient times education was reserved for a special type of caste and the so-called upper class. A large section of the society did not have the right to education. When Eklavya mastered the art of archery on his own, Guru Dronacharya asked for his Thumb in Dakshina because he belonged to so-called lower caste, and his caste people did not have the right to education. There are also examples that even if a so-called low caste person overheard any educational talk, his ears were filled with lead so that he would not be able to hear any more. 

The modern society spread education even among the economically and socially backward sections of the society by breaking these obscurantist ideas and breaking those bonds of religion and caste which prohibit right to education to all. Although there are many weaknesses and shortcomings in the education system of our country, but one thing is clear that after independence, due to the persistence of campaigns by the progressive movements, government high schools were opened on a large scale in many parts of the country where it became possible for the children of low socio economic groups to get education under one roof along with others. In 1968, the Kothari Commission gave specific recommendations for common school system to end disparity in education. Unfortunately these have not been implemented till date.

 

We hardly find mention of education among women in the ancient history. Even in the last century, Savitri Bai Phule, who was born in 1931 and who was encouraged by her husband Jyotiba Phule to study, she had to face many hardships. She was ridiculed and even stones were thrown so as to stop her from pursuing education. Social reformers, Raja Ram Mohan Roy and Swami Dayananda Saratwati did a lot for the education of women. After independence, many girls' schools and colleges were opened in the government sector to encourage education among women. 

In the same speech, the Prime Minister goes on to say that the new education policy will produce new type of ideal citizens. But when we take a look at the new education policy, we find that this will lead to complete privatization of education further increasing inequality in education. This will also deprive large part of the society of quality education. Presently only about 2% of the GDP is spent on education as against the required 10%. Such type of education is intended to prepare a class of  specially educated persons to serve the corporate sector as was done by the education system introduced by the British in our country to produce ‘Bhadra Lok’ to serve the masters.  

Similar is the story of health services. India has to its credit the contribution in medical science by Charaka, a great physician of the time around 300BC. Accordingly, the Charaka Samhita mandates the physician to lead a life of celibacy, grow beard and hair, pray for cows and Brahmins. It forbids the doctor from treating those who are in opposition to the King or whom the physician or society may despise. But that was the period of Kings where Brahmins were at the top in the social Hierarchy. The modern oaths, belonging to the present, with tremendous advances in modern science bind that every human shall be treated equally and the physicians must be committed to treat fellow humans to the best of their abilities under any circumstances.

 

The health policy 2017 promotes insurance based healthcare system. This far from universal healthcare system as envisaged by several health experts. Because of exorbitant cost, quality health care is getting out of reach of people. Government expenditure on health is only 1.28 percent of GDP, while according to the World Health Organization it should be 5%. Ironically health and education are taken as liability not as an asset by our policy makers. Both health and education should be fundamental right of every Indian citizen.  No wonder we are at a rank of 107 out of 121 in Hunger Index as a result of the exclusive policies. Our dismal performance in managing COVID Pandemic is not an old story. 

I have given these two examples because there is persistent attack not only in the political and economic sphere but all the aspects of life. There has developed strong linkage between forces of obscurantism and the corporate sector. There is concentration of wealth in few hands while vast majority is deprived of basic needs. The ruling clique use coercion, oppress people and try to divide the people through false propaganda. The Prime Minister had in 2014 said that in ancient times science in our country was so much advanced that the head of an elephant could be transplanted on a man's head and also that genetic science was so developed in our country that Karan could be born without mother's womb. Many scientists also started expressing similar views. The Vice Chancellor of Andhra Pradesh University G. Nageswara Rao said in the Indian Science Congress at Jalandhar that the Kauravas who numbered 100 were born due to advanced stem cell research and technology in our country. Recently, the Indian Space Research Organization - ISRO and the Indian Council for Historical Research - ICHR have started working together on how to integrate ancient science with modern science. 

 

 

When the forces in power fail to act in the interests of the common people, then they try to highlight the achievements of the society in the past in such a way that the people forget the failures of the ruling circles and are obsessed with the glory of the achievements of the past.

 

It is time we understand how such forces thrive on concocted stories and false propaganda. A lie spoken time and again appears to be truth and becomes part of people's psyche. The struggle against the forces of obscurantism is not only political or economic but there is a need to struggle at every level including developing scientific outlook in education and healthcare based on present day developments in medical science.

 

 

 

 

22 Dec,2022

LESSONS LEARNT FROM PANDEMIC

Date: 22.12.2022

 

LESSONS LEARNT FROM PANDEMIC

 

Dr Arun Mitra

 

With the news that few cases of new Omicron variant which is said to have shorter incubation period and faster spread than the previous COVID infections is a matter of concern. However we have enough experience now from the past and should utilise that for prevention from COVID and promotion of good health. In the past even though a few scientists had predicted that Pandemics come and go every time and then. That time we had probably forgotten the Spanish Flu Pandemic nearly 100 years ago which had caused immense misery and millions of deaths. That time the knowledge of medical science was not as advanced as we have now. Despite the warning of a few scientists the issue was not taken that much seriously. Therefore the world was ill prepared to meet such eventuality. There was lack of medicines, hospital staff, equipment as well as vaccines to prevent the COVID in future. As a result we faced several serious issues globally, but in our country the poor people were at receiving end. The governments all over tried to hide their data pertaining to COVID.  For example the Indian government said that 4 lakh people died but independent studies have pointed out the deaths to be between 25 to 40 lakhs. The government instead of treating it as health emergency brought in disaster act to tackle the situation. Totally un-thoughtful lockdown was suddenly imposed giving time of four hours only. This led to very precarious situation. People were suddenly left with no job, no means for livelihood and became shelter less. Poor workers decided to go to their village to live with their kith and kin. Instead of helping them the government stopped all the means of transport which forced them to walk hundreds of kilometres on foot, bicycles, carts and other personal/hired means of transport paying exorbitant amount. On the way they were treated like criminals by the administration at many places. Several accidents took place in this biggest ever migration after the independence. Unfortunately none of the ministers or government officials uttered a word of sympathy for them. The economy came to a standstill. Workers’ trade unions demanded Rs.7500/- to be given to each family to enable them to have minimum food to eat. This could have also let the economy going to an extent. But the government gave only few kilograms of grain, daal and a bit of oil. The non governmental organisations and religious institutions particularly Gurudwaras gave some respite to the people in the form of cooked or uncooked ration. The public sector health workers including the ASHA and Aangwadi were in the forefront to the help of people even though they do not have work man status.

 

It is painful to note that the pharma companies made huge profits even during such a serious health catastrophe. Medicines, masks, sanitizers and other such equipment were sold at higher prices. Glaring inequity was observed in Healthcare and the vaccines between the developed and the developing countries. Smaller countries who were forced to procure vaccines from the big vaccine producing giants were blackmailed. Pointing out this Dr Samir Malhotra from PGI Chandigarh said that the COVID-19 scare forced many governments to enter into contracts with the companies developing vaccines. Many of these contracts had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. “Purchaser hereby agrees to indemnify, defend and hold harmless [the company and] each of their affiliates from and against any and all suits, claims, actions, demands, losses, damages, liabilities, settlements, penalties, fines, costs and expenses caused by, arising out of, relating to, or resulting from the vaccine.” Not only that, and this is shocking, these countries were asked to “put up sovereign assets as collateral to guarantee indemnity”. Such assets could include embassy buildings, cultural assets, etc. We still remember the threat given by the then US President Trump to India if it did not supply Chloroquine to the US.

 

We expect such inequities not to happen in future but there is no guarantee to it. The companies have profit only as their motive. They justify high pricing of drugs because they have to spend on research. This claim of the Pharma industry that they have to bear high cost in developing new drugs as a justification for such high prices is totally flawed because virtually 100% of initial research leading to new drugs occurs with the support of public funding. A vaccine that requires a few dollars to manufacture brings in profits worth billions of dollars to the company. To continue their exploitation the global powers brought in Trade Related Intellectual Property Rights (TRIPS) under the various clauses of the World Trade Organisation (WTO) The situation at present demands a complete revamping of such clauses which prohibit the developing countries from manufacturing cheap medicines/vaccines. The clause of compulsory licensing should be made simple in favour of the developing countries without long debates specially when we are in serious health crisis worldwide due to Pandemic. For our country it is all the more important to rejuvenate and strengthen our own public sector pharmaceutical industry with a purpose to produce cheap drugs/vaccines for local and global supply. We have national emergencies for several diseases, communicable as well as non-communicable.

 

It is all more important to avoid unscientific ideas like the use of cow urine and cow dung to treat Corona infection. False hopes can be counter productive. The Prime Minister in his speech in March 2020 had said that we will defeat corona in 21 days. Such unscientific utterings do not help. In case of health emergency let the health science prevail. 

 

 

 

13 Dec,2022

Nuclear Disarmament should be priority agenda of G 20

 

Date: 13 December 2022 

 

Nuclear Disarmament should be priority agenda of G 20 

 

Dr Arun Mitra 

The group of 20 countries, nick named as G20 includes Argentina, Australia, Brazil, Canada, China, France, Germany, India, Indonesia, Italy, Japan, Republic of Korea, Mexico, Russia, Saudi Arabia, South Africa, Turkey, the United Kingdom, the United States and the European Union. So far seven summits of the G20 have been held. The first one was hosted by the US in the year 2008. The presidency of the summit goes to each country by rotation. This year it is India’s turn to lead the G20.  

The world is faced with several serious challenges at this juncture. However there are opportunities too if the group moves in a proper direction and honest commitment under India’s leadership. We have the history of initiating the Non-Aligned movement (NAM) led by Jawahar Lal Nehru, Marshal Tito and Gamal  Abdel Nasser of India, Yugoslavia and Egypt respectively. The NAM had 120 Member States, 17 Observer Countries and 10 Observer organization. This was the biggest organization of the developing countries at one time. Most of these countries had been liberated from the colonial yoke all of whom were deprived of even basic amenities for their population as a result of extreme exploitation by the colonial masters these countries. Collective development and inclusive growth was their necessity and common agenda. They could not afford war and waste resources at any cost. So they decided to remain away from the NATO or the Warsaw Pact. Their main thrust was against nuclear arms race and for general disarmament besides economic cooperation. This group therefore posed a challenge to the imperialist powers who continued with their agenda of economic exploitation of the developing world. Even though the countries in the NAM were not global economic powers, but their collectiveness was always a concern to the developed world, particularly the erstwhile colonial powers and the NATO. The collective wisdom of the NAM helped in containing arms race and also promoting several treaties for peace and disarmament.  

 

The times have however changed. With the global political changes newer types of blocks have come up. The G20 is a mix of highly developed and developing economies. The US, Russia, UK, France and China are big military powers. Six out of this group of twenty are nuclear weapons possessing countries. So in this heterogeneous group there are different aspirations, approaches and solutions to the problems faced by the world today.  Under the circumstances India has big responsibility in promoting the concept of One Earth, One Family, One Future, as conceived by the Indian Prime Minister who is to lead the group this year.  

 

The recently held COP27 could not take final decisions for effective steps to mitigate the climate change, even though there has been agreement on the raising funds for the developing countries so as to check carbon prints.  

 

Global economic gaps are increasing day by day. We could see how even during the time of COVID Pandemic the rich grew richer while the low economic groups were deprived of basic needs like food, shelter, medicines and even vaccines. Vaccine inequity was glaring. African countries were at the receiving end while the big Pharma companies made billions and put stringent conditions for the supply of vaccines.  

 

Against the expectations, the arms race has not abated during or when the Pandemic is receding. According to new data on global military spending published on 25th April 2022 by the Stockholm International Peace Research Institute (SIPRI), total global military expenditure increased by 0.7 per cent in real terms in 2021, to reach $2113 billion. The five largest spenders in 2021 were the United States, China, India, the United Kingdom and Russia, together accounting for 62 per cent of expenditure. Therefore the G20 has the biggest challenge of disarmament as all the above countries are members of the group.   

 

According to ICAN, “$82.4 billion, that’s how much the nine nuclear-armed states spent on their nuclear weapons in 2021 during a global pandemic, raising global food insecurity…..’ Nine countries have prioritized spending $156,841 per minute on nuclear weapons, as millions of their own citizens struggle to access healthcare, heat their homes, and even buy food. Spending on nuclear weapons is violence that costs lives.  

 

The U.S. spent three times more than the next in line- a whopping $44.2 billion. China was the only other country crossing the ten billion mark, spending $11.7 billion.  Russia had the third highest spending at $8.6 billion, though the U.K.’s $6.8 billion and the French $5.9 billion weren’t so far behind.  India, Israel, Pakistan also each spent over a billion on their arsenals, while North Korea spent $642 million.  

 

The peace groups have been demanding complete nuclear abolition. According to the IPPNW report Nuclear Famine, based on research conducted by climate scientists Alan Robock, Lili Xia, and their colleagues, a nuclear exchange between India and Pakistan using 100 Hiroshima-sized nuclear bombs will put more than two billion people at risk of starvation because of the impact on global food supplies. Such a war would kill up to 20 million people outright as major cities of the subcontinent would be destroyed and it would blanket much of South Asia with radioactive fallout.

There is also a global demand for commitment to no first use of nuclear weapons by all the nuclear weapon states. But not all have agreed to this, not even Russia and NATO-US in the on-going war in Ukraine. Even though India is committed to the policy of no first use of nuclear weapons, but  recently, in August, 2022, the Union Defence Minister Rajnath Singh gave a hint that the policy can be changed depending upon the situations in future.  US which spends maximum on the arms race is further updating its budget. It is also  a matter of concern that Indian government’s pursuit for becoming an arms exporter at a time when the country is faced with several problems like hunger, malnutrition, unemployment, inequity in health and education. In this connection the decision to export Brahmos missiles to Philippines is a dangerous trend that India is adopting. Already India has signed international agreements to manufacture arms with a purpose to export them and Israel is our major partner in this endeavour.  There is also demand for nuclear weapons free zones particularly in the South Asia in the present juncture.  

 

It is indeed a big challenge for India to raise the voice for nuclear disarmament and join the Treaty on the Prohibition on Nuclear Weapons (TPNW). It is testing time for the G20 if it wants to fulfil the desired goal of One Earth, One Family, One Future. All these countries have also to prove their commitment for inclusive growth, a harmonious society and respect of human rights of all sections in their own countries.   

 

 

 

 

05 Dec,2022

Perpetuating Myth as Science

 

 

Date: 5 December 2022

 

Perpetuating Myth as Science

 

Dr Arun Mitra

  

Recent reports that Indian Space Research Institute (ISRO) is collaborating with Indian Council for Historical Research (ICHR) to study India’s contribution to science and to establish that India has been ‘Vishwa Guru’ (World leader) in the advancement of science have to be viewed with caution. As reported in HindustanTimes by Fareeha Iftikhar, the  ICHR and ISRO will shortly sign a Memorandum of Understanding (MoU) to take up the project titled "History of Indian Science and Technology".  The project will cost Rs.1.5 crore. The information about India’s rich history of science and technology will be collected from the ancient religious scriptures. RSS outfit Vijnana Bharati, which promotes "swadeshi science, had conceived the idea of “Akash Tatva,” conference with the aim to introduce the youth to the ‘wisdom of ancient science along with modern scientific advancements’. 

 

It is always a matter of pride to trace one’s history in every field including in science. But all such work has to be based on evidence and not on prejudiced beliefs. Looking at the track record of those who are out to promote such ideas, one wonders whether such an exercise will be purely scientific as is being said or only to eulogise our past with the aim to arouse ultra nationalist feelings. 

 

In a society where belief system is very powerful, many a times blind, it is not difficult to mobilize people on myths. A very authoritative example of this is when in 1995 the statues of Lord Ganesha suddenly started drinking milk. There was mad rush outside the temples to offer the Lord’s statue with milk to earn favours and blessings. Before the whole story could be unfolded, the statues stopped drinking milk in a few hours. Who conceived this idea, is still not known? But message is that in blind belief people get swayed away even by an idea like this which on the very thought appears to be unscientific and absurd.

   

Many controversial papers have been presented at the Indian Science Congresses (ISC) – the largest gathering of its kind in the country in the recent years. In 2015, the first ISC held after Narendra Modi became the Prime Minister, there was huge controversy when one speaker invited to the plenary claimed that “planes were invented in the Vedic Age by a sage”.    Even before the speaker delivered the talk, an online petition endorsed by 200 had demanded that the scheduled lecture should be cancelled as it “mixes mythology with science and misleads people”.    

    

In 2019, Andhra University vice-chancellor G. Nageshwara Rao and independent researcher K.J. Krishnan also made a series of unfounded claims, including that the Kauravas were “born with the help of stem cell and test tube technologies”; Ravana had “24 types of aircraft and airports in Lanka”; and that “guided missiles were present in India thousands of years ago”. The promoters of these ideas mince no words. Prime Minister Shri Narendra Modi has also said that the science in India was so much developed in the past that we could transplant the head of an elephant on the human body. No wonder Gau mutra and cow dung were promoted as cure for the COVID and non-evidence based  Coronil of Ramdev was promoted by Dr Harsh Wardhan.  

   

    

That some scientists and educationists subscribe to such ideas is a matter of serious concern. Astrophysicst Jayant Narlikar, has criticised these Indian scientists who have made outlandish claims about scientific knowledge that ancient Indians had. This only diminishes the respect for achievements that are backed by evidence. “But we shouldn’t claim things of which there is no evidence or proof as it reduces the credibility of what our scientists have achieved in the past. Even the West recognizes the knowledge of mathematics held by Indians. If we start making outlandish claims, the scientific community of world will not look up to us as it does now,” he said in 2015.    

 

      

We all are proud of the contributions of our scientists in the ancient times. We have on record the contribution of Aryabhatta (476 to 550 AD) author of several treatises on mathematics and astronomy; Charak, the physician around 100 BCE; Sushruta, the surgeon around 800 BCE. The concept of Zero which Indian mathematician gave to the world is a matter to be proud of.   The civilizations of Harappa and Mohenjedaro are amazing. We have marvellous archaeological monuments. The paintings in Ajanta Ellora are a big scientific feat in addition to the art they exhibit. One gets astonished how at the time when we had very little technology, all this happened.  

     

Science is a dynamic process. It has taught us that everything is in motion. Science is never dogmatic and amenable to accept newer ideas, thoughts and developments. For example the smallest particles in the ancient times were considered to be Panchbhuta (Earth, Water, Fire, Air and Space). This means that are the elements which form the life system. But with the advancement of science we have come to know that the much smaller atomic particles form the basis of whole living and non-living in the universe.

 

Mankind has progressed from the primitive times to the modern human society through human labour. Every step forward taken by the human society from the primitive time is based on contemporary scientific work.  Primitive man used stone as the basic tool. He learnt to kill the animal with that tool which he had to do earlier with hands. He learnt to light the fire by striking two stones against each other. The process never stopped. Much of scientific developments occurred during the period of renaissance in Europe. The speed of scientific developments changed from time to time. With the present technology of microchips this speed has increased in multiples.   

 

Spreading falsehood persistently will make the upcoming generations to believe in these things as truth. More so because opposite ideas will be made to disappear from the discourse in the media or even scientific gatherings.  

 

Scientists have lot many challenges in the present times and have to make a louder voice to call spade a spade and expose the subtle designs of these forces. It is unfortunate that even several doctors and scientists were out in the streets to ‘clap’ and ‘bang thalies’ in the belief to quell the Novel Corona virus at a call given by the Prime Minister. This was probably yet another test of people’s mind-set after the incident of statues drinking milk.  

 

 

18 Nov,2022

Falling hunger index in India - A cause of concern

Date: 18 November 2022      

     

Falling hunger index in India  - A cause of concern

       

Dr Arun Mitra  

   

Perplexed with the report that India has further fallen in the Hunger Index to 107th position out of 121 countries, the government of India, instead of debating corrective measures is out to criticise the agencies Welthungerhilfe (WHH) or Concern Worldwide, who calculate this index every year. The government is challenging the methodology of calculating the hunger index. It is therefore important to know how this index has been calculated in the successive years and why the government is up in arms this time. Not only that the statement has come from ministry of Women and Child Development, there is a lobby systematically justifying the stand of the government and is trying to find faults with the methodology of calculating hunger index. 

    

From a Global Hunger Index (GHI) score of 27.5 last year, our country has fallen to 29.1. According to the GHI a rank of  ≤ 9.9 is considered to be low, 10.0–19.9 moderate, 20.0–34.9 serious, 35.0–49.9 alarming, ≥ 50.0 extremely alarming. The Hunger Index is based on the criteria, Inadequate food supply, Child mortality and Child under-nutrition. Last year the report had pointed out that 1/4th of the total malnourished in the world live in India. 

     

Supply of balanced food to all the citizens of the country is the basic requirement to reduce malnutrition. A balanced diet means sufficient number of proteins, fats, carbohydrates and micro nutrients in the form of vitamins and minerals. At the present market price the cost of nutritious food per person comes to be around Rs.225/- per day. This means that a family of five members should spend Rs.1125/- per day or Rs.33750/- per month on food only.    

      

The government’s scheme to give 5 kg of grains and one kg daal and a bit of oil does not fulfil the nutritional requirements. The government’s bandwagon is harping on that this scheme has done away with hunger. Firstly the scheme is not operational throughout; It is in practice only during the elections. That people are satisfied with this much food is a matter of even more concern. It points out to the fact that there is so much poverty that even this much food which is far from being nutritious and is barely sufficient for subsistence is a big relief to the people.  It does not at all meet the requirements of micro nutrients like vitamins and minerals essential for physical and mental growth. With 15 crore people out of a population of 23 crore in Uttar Pradesh queuing up to get this much ration free of cost is a projection of extremely dismal state of affairs of nutritional security.   

   

Recent economic surveys have pointed out that 90% of families spend less than Rs.10000/- per month. A balanced diet for them is only a dream which does not seem to come true in the present circumstances. By imposing taxes on the essential food items, cost of filling the belly has increased. The wages on the other hand are showing a downward trend as the employment is shifting to contractual labour with no job security nor any employment benefits like the provident fund or the ESI. Small scale sector which provides livelihood to large number of people is at a receiving end under the neoliberal economic policy.    

  

To meet the requirements of 2300 calories and a healthy food and clothing for a young adult, various workers organizations have demanded minimum wage based on the principle of these caloric needs. They have demanded a minimum wage of Rs.21000/- per month.  To utter dismay, the government announced a floor level wage as  Rs.178/- per day or Rs.4628/- per month. This is despite an internal labour ministry committee recommendation of Rs.375/- per day. This is even against the government’s own notification for Rs.18000/- per month for contract workers in the government’s establishments which comes to about Rs.650/- per day wage. The government is now contemplating to change the calculation from calorie based wages to time rate. The government’s intention to introduce time based work wage is against the medical advice and health needs of a person.      

     

Large number of our population in our country is in the unorganised sector where the legal formulations are hardly implemented. The farmers and agriculture labour who are the producers are among the worst sufferers. Agriculture labourers have to face double oppression, economic as well as social. Farmers protested against the new Farm Laws fearing these will not only adversely affect their economic conditions but the food security of the citizens too will be compromised.       

      

It is therefore imperative that essential food items are cost effective and within the reach of low socio-economic groups. Wages for all sections be revised as per the caloric needs, balanced diet, clothing, health, education, housing and recreation. In this context the GST levied on food and other day to day needs items be withdrawn to prevent further malnutrition.       

   

Moody's India's GDP growth projections for 2022 have been slashed to 7 per cent from 7.7 per cent earlier because of the global slowdown and rising domestic interest rates. This will further dampen economic momentum and impact the food security. The government is likely to reject this as well. But it is important that economic policies are revised with an inclusive growth in mind.  There is a thin line between under nutrition and hunger. It is worthless talking of some technical jargons and finding excuses to reject the global hunger index report. The GHI report is not new. Since the last few years our rank has been declining. There is day in and day out talk by the government to make India a 5 trillion economy. Such reports belie the government’s claims and bring down the image globally.

The only way is to raise the purchasing capacity of the people by ensuring sufficient wages and means of livelihood to meet the requirement of quality food for the citizens.     

 

References:      

  1. https://www.globalhungerindex.org/india.html 

 

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11 Nov,2022

COP27 should take serious cognizance of Nuclear Weapons abolition for climate crisis mitigation

Date: 11.11.2022  

 

COP27 should take serious cognizance of Nuclear Weapons abolition  

for climate crisis mitigation   

Humanity is on a “highway to climate hell with our foot on the accelerator”, the UN secretary general has warned, saying ‘the fight for a liveable planet will be won or lost in this decade.’ He told world leaders at the opening of the Cop27 UN climate summit in Egypt, “We are in the fight of our lives and we are losing … And our planet is fast approaching tipping points that will make climate chaos irreversible”. He warned the world faced a stark choice over the next fortnight of talks: either developed and developing countries working together to make a “historic pact” that would reduce greenhouse gas emissions and set the world on a low-carbon path – or failure, which would bring climate breakdown and catastrophe. 

Governmental representatives and civil society organisations from around the globe are meeting at the Conference of Parties - COP 27 in Egypt. According to the provisional list published by the United Nations Framework Convention on Climate Change (UNFCCC), 33,449 participants have registered for COP27. 

 

The issue has gained importance because the world is witnessing repeated natural calamities as a result of rise in temperature of the earth and melting of glaciers causing rise in the sea level. This summit is in continuation of several such meets held earlier to discuss and impress upon the governments to take steps to mitigate the factors responsible for climate change. Half-hearted measures by the governments, particularly the developed or fast developing economies in taking steps to control climate crisis have added to the crises. 

 

Increase in military activity is one among the major causes for the production of gases responsible for climate crises. Production of arms, their maintenance, their transport and use, all involve energy. Extensive use of munitions in the war between Russia and Ukraine is adding to climate crisis. There is no sign of war coming to an end in the near future. Threat of use of nuclear weapons has not completely ended despite assurance from Russia. Nuclear power plants are in persistent danger.  

 

It is therefore important that the countries should debate on reducing tensions in different parts of the world so that production, sale and use of the armaments is put under check.    

 

 A study, “Climate Consequences of Regional Nuclear War” conducted by Ira Helfand former Co-President International Physicians for the Prevention of Nuclear War (IPPNW) and Alan Robock from the Department of Environmental Sciences, Rutgers University, USA has pointed out that the present nuclear weapons numbering about 17000 on earth pose a serious risk to climate and thus risk to all life forms.  

 

According to the study a nuclear exchange between India and Pakistan using 100 Hiroshima sized nuclear bombs will put over two billion people at risk. Such a war would kill up to 20 million people outright as major cities of the subcontinent would be destroyed and it would blanket much of South Asia with radioactive fallout. But the global consequences are even more alarming. Soot and debris injected into the atmosphere from the explosions and resulting fires would block sunlight from reaching the Earth, producing an average surface cooling of -1.25ºC that would last for several years.  Even 10 years out, there would be a persistent average surface cooling of -0.5ºC.  This will reduce rainfall globally by 10%.  

 

The study further cautions that in such situations, there will be reduction in crop yields. The food shortage will lead to increases in food prices further affecting the already malnourished poor people across the globe. There are more than one billion people in the world whose daily caloric intake falls below the minimum requirements. Even a modest, sudden decline in agricultural production could trigger massive famine. If famine conditions persisted for a year or more, it seems reasonable to fear that the total global death toll in the Global South could exceed one billion from starvation alone.   

 

There is a very high likelihood that famine on this scale would lead to major epidemics of infectious diseases. Illnesses such as plague, which have not been prevalent in recent years, might again become major health threats.   

 

According to the estimates in the study the food crisis is likely to trigger internal and external conflicts. In such situation the use of nuclear weapons between the two nuclear super powers, the United States and Russia cannot be ruled out.  Huge swaths of both countries would be blanketed by radioactive fallout and their industrial, transportation, and communication infrastructures would be destroyed. Most Americans and Russians would die in the succeeding months from radiation sickness, epidemic disease, exposure and starvation.   

  

The International Physicians for the Prevention of Nuclear War (IPPNW) and the International Campaign to Abolish Nuclear Weapons (ICAN) have highlighted this issue and tried to impress upon the participating parties in the Egypt summit to take serious cognizance of nuclear weapons and ask all nuclear weapons possessing countries to join the Treaty Prohibiting Nuclear Weapons (TPNW) and abolish these weapons for good.  

  

 

Persistent increase in the expenditure on the nuclear arms, despite the UNOs passing Treaty Prohibiting Nuclear Weapons (TPNW), which has declared the nuclear weapons illegal and has called for their complete abolition is a cause of concern. This is in our hand. Huge expenditure on nuclear weapons is costing several welfare needs of our people. It is unfortunate that the narrative to the effect is not being given due importance including in our country. This should have been one of the main focus of the debate, but is not seen on the top of the list. It is the duty of all peace loving citizens to raise the voice. The participating parties at the COP-27 should debate this issue seriously as a priority. 

 

Published in 

https://www.nationalheraldindia.com/opinion/cop27-must-take-cognisance-of-nuclear-weapons-abolition-issue

 

25 Oct,2022

Political parties should ensure health as a fundamental right

 

Date: 25.10.2022 

 

Political parties should ensure health as a fundamental right 

  

Dr Arun Mitra 

 

Democracy is a means to decide how we want to be governed. To woo the voters political parties therefore decide their agenda which they feel will fetch them votes to reach the seat of power. They give populist slogans, whether they can fulfill them or not is another question. In poverty stricken society of our country even little amount of relief has lot of meaning. Education and health are assets for any society and form basis for inclusive growth and over all development.  But they have not been given due attention by successive governments.       

 

Health is the primary requisite for any person to work and contribute in man-days to full capacity. An Infant Mortality Rate (IMR) of 27.7 deaths per 1000 live births and under 5 year mortality rate of 32 and Maternal Mortality Rate (MMR) of 103 per 100,000 live births are worrisome. It is a shame that in the Global Hunger Index, India stands at 107 out of 120 countries. Because of poor planning and infrastructure the diseases like Malaria, Tuberculosis, Cardiac illnesses, Diabetes, Cancer etc. got ignored during the COVID Pandemic, even though as per many independent estimates we lost 25 to 40 lakh people due to COVID. Therefore instead of piecemeal approach we need comprehensive healthcare for or citizens.   

    

The insurance based healthcare system introduced after the Neo-liberal economic policies, has failed to deliver comprehensive healthcare to the people, instead it has become means to divert money from the public funds to the corporate sector. All the insurance systems including Ayshman Bharat cover only the indoor care, while nearly 70% of the out of pocket expenditure is on OPD care. Only the ESI scheme, ECHS and CGHS cover both outdoor and indoor care to the patients. The government instead of owning responsibility for the healthcare is outsourcing various healthcare centers to the private sector. There is effort to bring government hospitals including district hospitals, Primary Health Centers (PHCs) under private control. This will further devoid the quality health care of low and middle income group people.     

     

Even worse is that unscientific and non-evidence based methods of treatment are being promoted. Cow urine, Cow dung and Ramdev’s Coronil had been recommended as treatment of various diseases including the COVID-19 by the obscurantist forces with the support of the then union Health Minister Dr Harsh Vardhan, who is an ENT surgeon trained in the modern scientific medicine. It would be naïve to believe that the Prime Minister had no knowledge of all this, as no decision under this government is taken without the knowledge of PMO.   

  

Out of pocket spending on drugs comes to nearly 67% of the total expenditure on health. But till date we lack a rational Drug Policy. As a result the Pharmaceutical companies are making huge profits. To put a check on the high trade margins in the sale of drugs the government had appointed a committee which submitted its report in December 2015. The committee had recommended capping of the trade margins. But no steps have been taken even after seven years.   

 

 

It is therefore of utmost importance that state owns the responsibility for health with commitment to evidence based scientific healthcare. Unfortunately health is not a priority agenda for any political party. Dr Tejbir Singh, former Director Health Services Punjab in a seminar organized by the Indian Doctors for Peace and Development (IDPD) had pointed out that healthcare should be made justiciable; For this healthcare has to be declared a Fundamental Right. After reviewing the constitution of various political parties, he said that it is unfortunate that no political party  has asked for health to be a fundamental right. The BJP has advocated expansion of health insurance system. The Congress has demanded right to health act and doubling of public health expenditure. The left parties have demanded to raise the public expenditure on health to 6% of the GDP. The Aam Admi Party is advocating Mohalla clinics. The Communist Party of India (CPI) has lately resolved to demand Health as a Fundamental Right. This is a welcome step which all political parties should follow.   

  

The political parties should strive for a comprehensive healthcare to all for which they must come forward vociferously to demand health to be declared fundamental right. This should become their core agenda. Public expenditure on health should be increased from the present 1.28% to 6% of the GDP; All drugs, vaccines and medical devices should be produced by Union and state Governments through Public sector units to ensure drugs security without profit as the sole motive. Active pharmaceutical ingredients should also be produced by public sector units to ensure self-reliance in drugs production.      

    

Insurance based healthcare system should be abandoned and public health system should be strengthened. All treatments, investigations and services should be given free of cost. Medical staffs including doctors, nurses, paramedics, ASHA workers and Aanganwadi workers should be appointed on permanent basis. All temporary workers should be made permanent. Equitable distribution of doctors should be ensured in rural and urban areas. Medical education should be imparted in state sector only. Instead of Mixopathy an evidence based Scientific method of medical system alone should be permitted. Good nutrition should be ensured through proper measures under the Food Security Act. In schools Mid-day meal, free breakfast scheme should be provided in all states.  Universal Immunization Programme (UIP) should be expanded to adults. Provide Human papilloma Virus (HPV) vaccination for all girls and young  women to prevent Cervix cancer. Newer vaccines like influenza vaccines, Pneumococcal vaccine, zoster vaccine should be included in Universal Immunization Programme. 

 

Political parties go by the public opinion. It is therefore for the civil society to be more vocal on the issues of health for all and health a fundamental right and force every political party to take Health to be Fundamental Right as their priority agenda.    

 

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04 Oct,2022

I can't hate anyone

Date: 04.10.2022

I can't hate anyone

 

Dr Arun Mitra

 

During training as a doctor we are told to be empathetic, compassionate and caring for anyone who visits us for advice. This becomes part of the value system of most of the doctors. To treat, to care and to advise in a scientific manner to any person without any bias for caste, creed, religion, gender or socio-economic status is duty of a physician. This is because medical science has proved all human beings to have similar blood. Therefore doctors have been in the fore front to speak against discrimination and violence of any kinds. They have raised voice for the check on the proliferation of small arms which are used in violent incidents. It’s also natural for us to speak against nuclear power and doctrine of threat of violence with nuclear weapons and seek total abolition of weapons of mass destruction. The doctors have been serving people without caring for the borders. They have worked in the most arduous conditions of natural and manmade calamity. It therefore hurts when someone talks of bias against people from other religion, caste, ethnic groups or gender.  

 

This bias is not inherent to the human feeling but is inculcated and developed during the period of growth from childhood to adolescence through our talks with those who have such feelings. The atmosphere prevailing around us helps build our thought process to a large extent. Such bigot feelings can ultimately turn into hate to the extent of committing extreme kind of violence towards those who disagree or question. We have been witnessing this in several places at different times around the globe.  

 

Nazis had no remorse in killing Jews or others who did not conform to their ideology. Over 8 lakh people died in 100 days of violence from 7th April to 15th July 1994 where Hutu led government targeted Tutsi and moderate Hutus in Rawanda. Hatred was to the extent that even husbands killed wives from other tribe. More than 20 lakh people are supposed to have died  during communal violence at the time of partition of India in which Hindus, Muslims and Sikhs killed each other for no reason. What happened during the pogrom of Muslims in Gujarat in 2002 or anti Sikh riots in 1984 are a slur on our democracy.

 

In the present day times of science and technology there are forces who change laws to suit the structures in power in the name of religion or race. In a patriarchal society, women bear maximum brunt through miss-interpretation of religion by those who desire to continue to subjugation the women. It is easy to impose sanctions, the dress code and other things on women. Events in Iran are a pointer to this. Looking at the pictures of women in a museums in Iran, in the ancient times Iranian women never used a purdah. Therefore they have not accepted hijab as part of their dress. So they are rejecting the hijab despite extreme repression by the religious fundamentalist government. But those in power have no remorse in killing a 22 years young woman just because she spread her hair out and removed the hijab. The protests continue even though the girls in more number are out to face the killer squads. Worse is that the law makers in the Parliament shout in favour of police who is out to kill.

 

Rituals of worship have become stereotypical and lost the essence of humanity/religious value system. On many occasions extreme indoctrination about certain practices have been enforced on immature minds and made to follow dictates. Like any other thing religion too needs to be updated. Dogmatic approach in religion will kill its essence. 

 

Swami Vivekanada in his speech at Chicago had said ‘I am proud to belong to a religion which has taught the world, tolerance and universal acceptance. We accept all religions as true...I am proud to belong to a nation which has protected all persecuted...’  "Sectarianism, bigotry and its horrible descendant, fanaticism, have long possessed this beautiful earth. They have filled the earth with violence, drenched it often with human blood, destroyed civilization" 

Rabindra Nath Tagore had said the same in a different manner ‘that we must wake up in a country where fear does not exist, we must not put people in fear’.  The great martyr Bhagat Singh had out rightly condemned communalism as it was an impediment in uniting the people for anti-colonial struggle. 

 

By promoting hate, enjoying wounds being afflicted to others we loose our humanness and develop bizarre mind and a sick personality. Bigotry is a   mental illness. Duty of a doctor is not only to be free of hate against others, but also preach love and compassion and inculcate fearlessness among the people to speak the truth under any circumstances. This is important because several doctors sided with Nazis in conducting experiments on the prisoners. Reports that some doctors refused to treat patients from other community during the violence in Gujarat is totally unethical and unexpected of a doctor. Let us all understand that if we inflict wounds on others, one day they bounce back.

 

Published in :

 

https://dailyheadlinestoday.com/epaper/view/476/headlines-today/7

https://tryxyz.com/article23174-DOCTORS-HAVE-TO-CARE-OF-ALL-PATIENTS-IRRESPECTIVE-OF-RELIGION-AND-COLOUR

https://ipanewspack.com/doctors-have-to-care-of-all-patients-irrespective-of-religion-and-colour/

30 Sep,2022

Overcharging by the corporate hospitals

Date: 30.09.2022

 

Overcharging by the corporate hospitals

Dr Arun Mitra

 

The issue of overcharging by the corporate hospitals has been a matter of much concern. In 2017 it came to highlight when a child suffering from Dengue Fever could not be saved in the Fortis hospital, Gurgaon but the parents were billed Rs.15 Lakhs. The family alleged that the hospital charged for 660 syringes, 1600 gloves for the period of 15 days for which the child was admitted. The hospital authorities clarified that all protocols were followed during the treatment. Negligence was not the issue in this case but lack of empathy on the part of the hospital administration and overcharging perturbed the family of the patient. Since the treatment for the advanced care has become expensive, many a times the charges become a cause of contention between the patient and the hospital authorities. Now this has been officially confirmed by the Competition Commission of India (CCI) who has found some corporate hospitals to be violating the competition laws and over charging on the medicines, consumables, room rent and other services etc. This affirms people’s perception of the fleecing of patients by the corporate hospitals. The CCI has found that the Apollo Hospitals, Max Healthcare, Fortis Healthcare, Sir Ganga Ram Hospital, Batra Hospital & Medical Research and St. Stephen’s Hospital have been indulging in this practice of overcharging. They have been abusing their dominance through exorbitant pricing of medical services and products in contravention of competition laws. A report published in the moneycontrol.com says that the CCI has found these hospitals charging the room rent even more than three or four star hospitals.

 

According to this report, as per the powers with the CCI it can impose a penalty up to 10% of the average of the annual turnover for the previous three years. Apollo Hospitals posted an average turnover of Rs 12,206 crore and Fortis Rs 4,834 crore in the past three financial years. Whether the patients who have been over charged will get any benefit is not yet known, but any proactive decision by the CCI  can deter these hospitals to an extent from over charging. The CCI is yet to review the response from the hospitals and take a decision accordingly.

 

The question however is whether the healthcare has to be treated as an industry where profit making is the sole aim or it has to be prioritized as service to the ailing people. There is a conceptual difference between the two. The policies on the healthcare will depend on what the concept of the healthcare is being followed by the state. Such concepts not only affect the advanced healthcare but also primary and secondary care, medical education system and also the issue of drug pricing. In the last few years we have seen exorbitant growth of the corporate hospitals. In our country 90% of the families spend less than Rs.10000/- per month and people earning Rs 25,000 per month fall in top 10% of wage earners. In the present economic scenario, one can easily presume that over 95% of the population cannot even dream of visiting these hospitals.

 

There is thus urgent necessity to review the whole healthcare system and public health spending in our country. Presently nearly 75% of the healthcare is in the private sector where people have to spend from their pockets. It is accepted by the government’s own documents that this out of pocket expenditure on health is pushing 6 crore people into poverty every year. Poverty adds to sickness thus starting a vicious cycle of people borrowing for healthcare and landing up into serious debts.  Knowing fully well the state’s spending on health is not increasing. In fact it has come down from 1.35% to 1.28% of the GDP.

 

Need is that the government should come forward in a big way in providing advanced healthcare at  the district level so as to prevent fleecing by the corporate hospitals who have no empathy towards the sick; their only interest is profit making. Insurance based healthcare is no answer as this system has failed in the USA whose public health spending is much high, but still its health indicators are not as good as several countries who spend less than the US. In our country it is pertinent that the government should increase spending on health from 1.28% of the GDP to 6% to ensure basic minimum healthcare to all.   

 

Publishded in :

https://www.imphaltimes.com/pdf/2022/October/2%20October.pdf

 

https://www.thenorthlines.com/corporate-hospitals-are-fleecing-common-patients-by-overcharging/

 

https://ipanewspack.com/corporate-hospitals-are-fleecing-common-patients-by-overcharging/

 

https://tryxyz.com/article23120-CORPORATE-HOSPITALS-ARE-FLEECING-COMMON-PATIENTS-BY-OVERCHARGING

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/corporate+hospitals+are+fleecing+common+patients+by+overcharging-newsid-n427848734?listname=newspaperLanding&topic=ipaspecial&index=13&topicIndex=1&mode=pwa&action=click

19 Sep,2022

Hate mongering has serious physical and mental health impact

 

Date: 19.9.2022 

 

Hate mongering has serious physical and mental health impact 

 

Dr Arun Mitra

Health refers to a state of complete emotional and physical well-being. It is therefore important that social and environmental milieu is conducive and fulfils the criteria of better nutrition, equitable distribution of resources and affordable healthcare facilities. There have to be sufficient conditions to prevent mental health issues.  For all this, it is imperative to imbibe and practice democratic values for rapprochement of cultures, freedom of expression, right to dissent and right to demand for better life. But when these conditions are disturbed because of political and economic interests of a few, physical and mental health are bound to suffer.     

Nature has bestowed upon us the life of finest creature on earth with a promise to live in peace, harmony, care for other life forms and preserve ecology for a sustainable development. Diversity is the essence of human civilization. In our country we have different cultures, languages, customs, dress code and above all will and strength to assimilate other viewpoints. We collectively have maintained unity in diversity.  

Since last few years we are witnessing persistent attack on these values. Concocted stories are being projected, history is being distorted and false propaganda is being unleashed against those who disagree. These circumstances have created prejudice & bias against others in the mind of people. These cause of feeling of alienation and become cause of physical and mental trauma.  

During a visit to the North East Delhi where the communal violence was perpetrated we could find several health problems in the make shift arrangements for the victims of violence. As in all refugee camps, these health issues were a result of lack of proper food, lack of hygiene facilities, lack of family atmosphere and privacy of a home. The sense of insecurity could be seen in the minds of all, particularly among women and children.  It was evident that the violence was engineered by some vested interests. Similar situation was witnessed during violence against the Sikhs in 1984. Terrorist violence during that period also had similar overtones.  

Worst kind of massacre in our country occurred during partition in 1947 when Hindus, Sikhs and Muslims killed each other because a propaganda of hate was unleashed against each other. Over 1.5 crore persons migrated from one place to the other, the biggest ever in the history of mankind. Trains were full with people sitting even on their roof top. At many places they were looted, killed and women were raped. Many perished on the way because of lack of food and absence of medical care. Several pregnant women lost their life died because they did not get timely care. The violent nature of the partition created an atmosphere of hostility and suspicion between India and Pakistan that affects their relationship to this day. The sense of mistrust against each other generated through hate mongering against other community resulted in killing of about 20 lakh people.  

That was the time of colonial rule who had conspired to split the continent on communal lines both in terms of geography and social relations. But now we have our own elected government and we expect the government to be impartial and work as per our constitution. But when the state supports falsehood and hate, situation is bound to get worse. It was unexpected of the Prime Minister to speak the words like ‘recognize them form the clothes they wear’. This was a clear signal to the bandwagon to go berserk and be rest assured of no punitive action. When a minister of state gave an open call  ‘Goli Maro Saalon Ko’, he should have been reprimanded. But instead he has been promoted as a cabinet minister. What happened during Godhra we do not exactly know, but what happened in other places of Gujarat when killing hundreds of Muslims with overt and  

covert support of the then Chief Minister occurred, is not hidden from anyone. The then Prime Minister Atal Bihari Vajpayee at that time had to ask the Chief Minister to do Raj Dharma.   

The resultant effect is the incidents of mob lynching, hitherto unknown in our country. Instead of punishing the accused it is the victim who have been put behind bar in many instances. Release of the rapist and the killers of family of Bilkis Bano is a clear cut signal. It was well synchronized with date and time when the Prime Minster spoke of respect to women and stringent punishment to the rapists from the Red Forte on 15th August 2022 that all the 11 accused were released. 

A letter by Umar Khalid published in The Wire telling his anguish for being jailed without reason or investigation has to be taken seriously. The judgment of Allahabad High court while granting bail to Dr Kafeel about his illegal detention should be an eye opener.  

It is not just the people of minority community, who at present form nearly 50% of the under trials under UAPA, but people from majority community also who question the wrong will meet similar fate. Subodh Kumar, the police inspector killed in Bulandshahar by the unruly mob belonged to majority community.  

It is time to speak now otherwise with such incidents on the rise, social cohesion, which is so essential for health, education, and inclusive growth will suffer. It would be naïve to think that we cannot become Germany of Nazis. It must also be remembered that post hatred towards any community is not forgotten for generations.  

 

Published in:


https://www.nationalheraldindia.com/opinion/is-india-headed-the-same-way-as-nazi-ruled-germany-2

 

https://themeghalayan.com/hate-mongering-and-mental-health-impact/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/hate+mongering+has+serious+physical+and+mental+health+impact-newsid-n424377834?listname=newspaperLanding&topic=ipaspecial&index=3&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article23016-HATE-MONGERING-HAS-SERIOUS-PHYSICAL-AND-MENTAL-HEALTH-IMPACT

 

https://ipanewspack.com/hate-mongering-has-serious-physical-and-mental-health-impact/

 

 

06 Sep,2022

Doctors have to be proactive in the present imbroglio

 

Date: 6.9.2022 

 

Doctors have to be proactive in the present imbroglio

 

Dr Arun Mitra

 

Medicine is not a profession but a passion. To uphold the dignity of medicine and to ensure commitment to the health care of the people, the World Medical Association (WMA) Declaration of Geneva was adopted in its 2nd General Assembly at in September 1948. The declaration highlights a physician's dedication to the humanitarian goals of medicine. The declaration was especially important in view of the medical crimes which had just been committed in German-occupied Europe. As per this declaration the doctor commits and declares, ‘I solemnly pledge to dedicate my life to the service of humanity; I will maintain the utmost respect for human life; I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient’.  

 

The medical personnel have to identify with the society and social concerns at every step. Dr. Rudolf Virchow who is considered to be the father of  pathology stressed that ”If medicine is to fulfill her great task, then she must enter the political and social life.”  He believed in the concept that 'medicine is a social science,' and that physicians are responsible to work on behalf of the poor. This means the physician must be sensitive to various issues of the society.   

 

Besides the study of normal structure and working of the human body that is the anatomy, physiology, in medicine doctors have to learn the factors for causation of disease and the abnormality produced in the structure and functioning of the body. It is only after this elaborate study that one learns the art of treating the patient. 

 

However prevention of disease forms the core of the curriculum throughout. Therefore in medicine one has to learn about the social determinants of health which include economic stability, employment, housing, poverty, food security, education, neighbourhood environment, healthcare access etc. Basic needs like clean air, clean drinking water, adequate sewerage facilities are essential to promote good health. A physician must engage on these issues if the WMA Geneva declaration is to be put into practice ideally. It is to the credit of medical profession that it raised voice against female foeticide; informed the public about the harmful effects of smoking and alcohol. Several doctors risk their lives by going deep into the areas of conflict to serve the sick and the infirm. Many doctors have also rendered yeoman’s services in natural and manmade calamities. 

 

While treating the patients the doctors learn that peace and stability are most important for good health of the people.  Violence prevention has become a public health issue. Scientifically outlined steps for its prevention have been outlined since health is the biggest calamity during such situation. The International physicians for the Prevention of Nuclear War (IPPNW) has conducted scientific studies on the climatic consequences of nuclear war and vociferously called for the complete abolition of nuclear weapons. This was instrumental in passing Treaty on the Prohibition of Nuclear Weapons (TPNW).    

 

Unfortunately peace and stability are under threat in large parts of the world today. There are forces globally who are out to create external and internal conflicts with the intention to make huge profits by selling arms. There are forces that are out to create communal and caste conflicts for political gains. Doctors can play an effective role in getting the society rid of such menace. It is therefore important that we have to shed pre-conceived ideas and biases based on gender, caste, religion and other prejudices which have been made prevalent in the society by such vested interests. It is understandable that many a times the doctors have to work in the situations under pressure and threat particularly during the conditions of conflicts, strife and social unrest. But we have to brave through these situations.  

 

In India we are faced with a very precarious situation today. Obsolete ideas and myths are being spread by the forces spreading obscurantism for narrow political gains. These have to be opposed.  It is an important task for a physician to strengthen scientific temper in the society. As an example the use of cow urine and cow dung in treating COVID-19 was opposed by several medical organisaitons. But it is unfortunate that the same organisations kept mum or joined the chorus to make the virus runway by banging ‘thalies’, clapping and lighting ‘Diyas’. This is something totally unexpected of a doctor. Not many medical organisations or personnel came forward to side with Dr Kafeel who was falsely implicated for raising the issue of flaws in Oxygen supply at Gorakhpur hospital. Neither did they come out in open to oppose communal violence in Delhi and other places. This was due to conviction or fear, we do not know, but one thing is certain that keeping mum amounts to giving strength to communal and divisive ideas. We have to be bold  enough to shed fear and speak the truth, while doing so we would be promoting right kind of politics. It is true that in the present commercialised atmosphere doctors have become part of the whole game. But we must stick to the Geneva declaration and not let any blot happen on our profession as happened during Nazi regime. 

 

Published in :

https://www.nationalheraldindia.com/india/it-doesnt-behove-medical-practitioners-to-let-political-rhetoric-override-scientific-temper

 

https://www.thenorthlines.com/arvind-kejriwals-national-aspirations-depend-on-gujarat-assembly-polls/

 

https://dailyheadlinestoday.com/epaper/view/452/epaper-headlines-today/6

 

https://thearabianpost.com/medical-doctors-have-to-identify-with-society-and-peoples-concerns/

 

https://ipanewspack.com/medical-doctors-have-to-identify-with-society-and-peoples-concerns/

 

https://tryxyz.com/article39241-MEDICAL-DOCTORS-HAVE-TO-IDENTIFY-WITH-SOCIETY-AND-PEOPLE-S-CONCERNS

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/medical+doctors+have+to+identify+with+society+and+people+s+concerns-newsid-n420492756?listname=newspaperLanding&topic=ipaspecial&index=16&topicIndex=1&mode=pwa&action=click

27 Aug,2022

Any nuclear exchange would push the world to a point of no return

Date: 27.08.2022 

 

Any nuclear exchange would push the world to a point of no return 

Climate Crisis of unprecedented degree as a result of nuclear war would extinct the modern civilization, cites a new study 

    

The war between Russia and Ukraine with an overt involvement of the NATO has killed thousands, pushed millions to refugee status and caused immense destruction of resources. Much in danger are the nuclear power plants in Ukraine which if damaged by intentional attack, accident, technology failure or the modern day cybercrime, would become potential nuclear bomb. The Plant at Zaporhizhzhia which has been occupied by the Russian forces can be a flash point. Ukraine has a history of dreadful Chernobyl nuclear accident. Moreover the danger of a use of nuclear weapons in case the war continues is real as both NATO and Russia have threatened each other with the use of these weapons if the situation arises. The collateral damage in such a situation will be catastrophic. An evidence based new scientific study “Nuclear Famine - Even a "limited" nuclear war would cause abrupt climate disruption and global Starvation” highlights the gravity of humanitarian consequences in case of use of nuclear weapons even at a smaller scale.  

    

This report released on 15th August 2022 and published in Peer Reviewed Journal ‘Nature Food’ summarizes the latest scientific work by Lili Xia and Alan Robock of Rutgers University together with colleagues around the globe. It shows just how dangerous even a “limited” nuclear war in one part of the world would be. The report says that ‘a so- called “limited” or “regional” nuclear war would be neither limited nor regional. On the contrary, it would be a planetary-scale event. In fact, it would be far more dangerous than we understood even a few years ago. A war that detonated less than 1/20th of the world’s nuclear weapons would still crash the climate, the global food supply chains, and likely public order. Famines and unrest would kill hundreds of millions, perhaps even billions’.     

   

When a nuclear weapon detonates, it briefly creates temperatures four times hotter than at the center of the Sun. Such detonation would start firestorms, injecting large amounts of soot into the upper atmosphere, which would spread globally and rapidly cool the planet.       

 

An abrupt cooling event of 1.3°C that would follow after sun rays to the earth are blocked due to soot and smoke in the atmosphere would be a massive planetary shock and take back the earth to ice age temperature. The latest ice age peaked about 20,000 years ago, when global temperatures were likely about 10°F (5°C) colder than today.

  

Added to this, damage to the Ozone layer would increase levels of UV radiation. This would cause more sunburns, cancers, cataracts, immunosuppression, and photo-aging (skin damage that includes wrinkles, loss of skin tone, and pigmentation spots). Perhaps more importantly, increased UV radiation would also hinder crop growth.     

  

All this would lead to crop failure leading to extreme starvation worldwide.

   

As a result unprecedented global famine would follow. Under every scenario, total available food calories would decline precipitously for the next seven to eight years. Xia and colleagues use 1,911 kcals/day as a starvation cutoff. They calculate – not just for the world, but nation by nation – how many people would inevitably end up persistently below that number and so would die of hunger.   

      

For example, during the Great Bengal Famine in 1943, available food decreased only 5% – but panic-buying ensued, food prices soared and 3 million people starved to death. That resulted from a drop in available food of 5%. One can only imagine how unevenly life-sustaining food would be distributed in a world where available food had dropped 23%, 33%, 41% or 48%.      

      

The Rutgers-led international team that modeled expected starvation deaths after a regional India-Pakistan nuclear war  has also calculated, for the first time, the deaths that would result from the even worse mass famine that would follow a full-scale nuclear conflict between Russia and the United States. They estimate that 5 billion people out of 6.7 billion worldwide would be dead within two years. India and Pakistan both are expected to have 160 plus nuclear weapons.    

 

Assuming the weapons and targets are of similar size, the consequences would be similar in the event of a nuclear exchange in any part of the world. It has been calculated that if 100 nuclear weapons of 15 kilotons each are detonated, would push 5 Tg of soot into the atmosphere. This would lead to 27 million direct fatalities and 260 million deaths as a result of nuclear famine at the end of two years. But in case of nuclear exchange between major powers 500 nuclear weapons of 100 kilotons each if detonated would push 47 Tg of soot into the atmosphere would lead to 164 million direct fatalities and 2.5 billion deaths after the end of two years as a result of nuclear famine.  

 

(The researchers used a 2010 population dataset that assumed a total world population of 6.7 billion people. (Total world population estimates today are higher at about 8 billion people). The calculated death tolls of up to 2.6 billion people indicate that a nuclear war between India and Pakistan could kill up to every 3rd human.)   

      

The direct consequences predicted in these scenarios would be unprecedented.   

There would be 50 million to 125 million prompt fatalities – more deaths in hours or days than during all of World War II. In this newly calculated prediction – three out of every four people in the world would be dead in two years. The report expresses concern at nuclear arsenals with Russia and the US remain enormous, they are again on the rise, and collectively represent more than 90% of the world’s nuclear weapons stocks.      

      

There is thus need to build a strong narrative globally for the complete abolition of nuclear weapons. The International Physicians for the Prevention of Nuclear War (IPPNW) has been vociferously raising the issue of humanitarian consequences of nuclear war. This was the mainstay for the adoption of Treaty on the Prohibition of Nuclear Weapons (TPNW) passed by the UN General Assembly on 7th July 2017. The International Campaign to Abolish Nuclear Weapons (ICAN) was awarded Nobel Peace Prize for this. The treaty delegitimizes and declares illegal the production possession, trade or use of the nuclear weapons in any form. This is the only multi-lateral treaty for nuclear weapons’ abolition. It is an opportunity for the global community particularly the nuclear weapons possessing countries to join the treaty and prove their intent for nuclear weapons free world. Countries of the world are meeting in the New York at Nuclear non Proliferation Treaty (NPT) review conference, the NPT RevCon. As a reports are coming the nuclear weapons possessing countries lack seriousness on the implementation of Article VI according to which ‘Each of the Parties to the Treaty undertakes to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control’. The major nuclear must answer what they have done till date in the last 52 years.   

 

 

It is unfortunate that after four weeks of meetings, the 10th Nuclear Non-Proliferation Treaty Review Conference has failed. If the world does not learn lesson now we would enter into a point of no return. Nuclear weapons if present on earth will always pose the danger of being used resulting into catastrophic collateral damage for which medical science has no remedy to offer.

 

 -----------------------

 

A paper in 2020 led by Jonas Jägermeyr, a scientist at NASA’s Goddard Institute for Space Studies, used six leading crop models to assess how agriculture would respond to the field’s most common hypothetical: 100 smaller (15 kiloton) nuclear detonations in India and Pakistan. (Again: Any number of different “limited” scenarios could be imagined – a war between China and North Korea, say, or perhaps an exchange of nuclear weapons between Russian and NATO forces over Ukraine. Assuming the weapons and targets are of similar size, the consequences would be similar. If scientists have often defaulted to war-gaming India-Pakistan scenarios, that’s in part because keeping one variable constant – the war zone – allows for easier comparisons of results across studies.)

 

In the NASA team’s models, 5 Tg of soot resulted in steep global cooling of 1.8°C, and at least five years of bad harvests. Hardest hit were more temperate northern regions, including the United States, Europe, Russia and China, collectively the world’s breadbasket. Corn and wheat – two of the world’s most important food crops – drop by 13% globally, with “adverse consequences for global food security unmatched in modern history.”²7

 

 

The NASA team's models found steep global cooling of 1.8°C, and at least five years of bad harvests, leading to world hunger “unmatched in modern history".

 

Scientists working for the U.S. nuclear weapons program at Los Alamos National Laboratories recently published a lonely dissenting view.²8 The Los Alamos team did not make its internal models available for independent review. They addressed the same hypothetical war between India and Pakistan. But they ran their simulations not using a Pakistani or Indian urban area, but a U.S. suburb, for which they included satellite imaging. In a rebuttal, Robock and colleagues note the imaging shows “a target area of

 

suburban Atlanta that includes a golf course, playground, and individual houses with large yards, with little material to burn, which is not representative of densely populated cities in India and Pakistan.”²? Other scientists have calculated the Los Alamos team under-estimated the fuelavailable in those dense Asian cities by at least 10- fold.³° The Los Alamos model assumed a city fire duration of only 40 minutes, when major World War II city fires lasted for hours or days; did not simulate gas line breaks as seen at Hiroshima; and set various weather and climate conditions that critics say, and the Los Alamos team concedes, prevented the development of firestorms.²? (The

U.S. military does believe in firestorms, and during World

War II both accidentally and intentionally created them – most spectacularly in the intentional firestorm created at Tokyo, but also in the bombing of Hiroshima. Despite this, there has been a well-documented, decades-long history of the Pentagon either minimizing or only belatedly appreciating the potential for nuclear weapons-initiated firestorms.5)

 

Meanwhile, nature itself seems to have risen up in protest against the Los Alamos claims. In their 2018 paper, the weapons lab team had asserted that soot and smoke from a regional nuclear war would be “highly unlikely” to make it into the stratosphere, “a conclusion supported by examination of … large forest fires.” Even as that was being written and published, large forest fires in Canada in 2017, and Australia in 2019 and 2020, were throwing massive amounts of soot high into the stratosphere. The soot and smoke from the Australian bush fires was tracked in the stratosphere for months, in quantities comparable to that seen after a volcanic eruption.³¹ Soot from the Canadian fires rose to 12 kilometers as a pyrocumulonimbus – a vertically-developing, fire-fed cloud – but then, as the black soot absorbed sunlight and warmed, it was lofted steadily higher over the next two months, to 23 kilometers.³² The forest fire observations contradicted Los Alamos, and were consistent with the models of Mills, Robock and other independent scientists.

 

Published in:

https://www.thenorthlines.com/any-limited-nuclear-war-will-lead-to-unprecedented-climate-crisis-and-famine/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/any+limited+nuclear+war+will+lead+to+unprecedented+climate+crisis+and+famine-newsid-n417804466?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

https://ipanewspack.com/any-limited-nuclear-war-will-lead-to-unprecedented-climate-crisis-and-famine/

20 Aug,2022

Urgent need for drugs price regulation

Date: 20.08.2022

Urgent need for drugs price regulation 

  

Dr Arun Mitra

 

The news that the company producing Paracetamol in the trade name of ‘Dolo’ spent 1000 crore rupees as freebies to the doctors for the promotion of their drug is a matter of concern. It shows the total failure of the government in regulating the pharmaceutical marketing practices. It is well known that Pharma companies spend huge amount of money for promotion of their products. Much of this is spent in organizing medical conferences in the name of continued medical education programmes many a times at lavish scale. This ultimately adds to the cost of drugs and adds to out of pocket expenditure of the patients. The government framed Uniform Code of Pharmaceutical Marketing Practices  (UCPMP). A letter of the ministry of chemicals and fertilizers, department of pharmaceuticals dated 12 December 2014 had mentioned that this will be voluntary for a period of six months with effect from 1st January 2015 and will be reviewed thereafter.  Obviously the voluntary clause did not yield noticeable results.       

  

Admitting this fact, Shri H.N. Ananth Kumar, the then Union Minister for Chemicals and Fertilizers,  said in the Rajya Sabha in June 2016 that the voluntary code introduced in 2015 had not yielded desired results and that the government would make it mandatory because the Pharmaceutical companies did not take any tangible steps to implement the code. Clauses 6 and 7 of the code prohibit the Pharma companies from giving freebies to the medical professionals.  But despite several representations from the public health activists and civil society groups the practice has not stopped. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) regulation also warns the doctors against such practices to receive financial benefits in any form including for attending education programs. Taking cognizance of the matter even the central board of direct taxes (CBDT) in its Circular No. 5/2012 [F. NO. 225/142/2012-ITA.II], Dated 1-8-2012 had said that any such expenditure by the Pharma company will not be considered for tax deductions.  After ten years the order has been reconfirmed by the Apex court. 

Expressing concern over pharmaceutical companies giving freebies to doctors, which push medicine prices up, the Supreme Court on 22nd February 2022 held that they are not entitled to claim tax exemption on the expenditure incurred in giving incentives to medical practitioners to promote their medical products and it would be considered as part of their income. 

         

As per the guidelines in the UCPMP the companies have to adopt stipulated procedures laid down by the competent authority for involving doctors in their research projects. These companies then use doctor’s reference including her/his photograph in their promotional literature. The UCPMP prohibits such work.     

  

Ironically statement by the Minister of Chemicals & fertilizers DV Sadananda Gowda  in the Parliament in September 2020 that the Union government has no plans to make the Uniform Code of Pharmaceutical Marketing Practices (UCPMP) mandatory is very disappointing. He said this in reply to a question by K. Muraleedharan, Congress MP from Kerala in the Lok Sabha.  

     

The u-turn on making UCPMP mandatory raises suspicion of lack of will on the part of the government to keep its commitment and smacks of some unfair deal between the government and the Pharma companies. When a delegation of the Alliance of Doctor for Ethical Healthcare had submitted its opinion to the drugs price regulating body, the National Pharmaceutical Pricing Authority (NPPA) in February 2020, they were told that the NPPA has no jurisdiction to check the companies. This has to be done through changes in the law at the ministerial level.       

     

The high cost of drugs seriously affects the healthcare of our population. As nearly 67% of out of pocket health expenditure in our country is on drugs. High out of pocket expenditure pushes 6.3 crore population below poverty line every year, a fact admitted in the National Health Policy document 2017.  But the government has not taken any tangible steps to control the excess trade margin in the sale of drugs and medical devices.

        

A committee was formed to look into High Trade Margins in the Sale of Drugs on 16 September 2015. This committee took serious note of the excess trade margins. They pointed out that in some cases the trade margin is as high as 5000%. This committee submitted its report on 9 December 2015. But it is now almost 7 years that the government has been sleeping over it. 

        

The pricing of the drugs should be calculated on the basis of the cost involved in its production. The market based pricing, calculating the average of the highest selling drugs is totally a flawed approach.      

     

Therefore it is high time the government makes the UCPMP mandatory and comes out with an effective control on drug prices.   

 

Having sensed that private sector in the pharmaceutical sector would be exploitative, our first Prime Minister Jawahar Lal Nehru took initiative to produce the drugs in the public sector with the purpose to produce cheap bulk drugs. While inaugurating the Indian Drugs and Pharmaceuticals Ltd. (IDPL) in 1961 he said  “the drug industry must be in the public sector….. I think an industry of the nature of the drug industry should not be in the private sector anyhow. There are far too much exploitation of the public in this industry”. With this vision, IDPL was incorporated in April, 1961 It was established with main objectives of creating self-sufficiency in respect of essential life saving medicines, to free the country from dependence on imports and to provide medicines to the millions at affordable prices and not to make millions from the medicines. IDPL played a pioneering infra-structural role in the growth of Indian Drug Industry base. It played a major role in the strategic National Health Programmes like Family Welfare Programme & Population Control (Mala-D & Mala-N) anti-malarial (Chloroquine) and prevention of dehydration (ORS) by providing quality medicines. During the country’s calamity of outbreak of Plague in 1994, IDPL was the only company which played the sheet anchor role in supplying Tetracycline for the entire Nation. Similarly, company had made uninterrupted supply of Chloroquine to combat Malaria epidemic in different parts of the country. In 2005 to combat national emergency (leptospirosis) arising due to flood in Maharashtra, IDPL had supplied required Doxycycline Capsules within no time. IDPL has always supplied quality medicines and its presence has played a price balancing role in the competitive & business environment. World Health Organisation had made its observations on IDPL as follows:-“IDPL had achieved in 10 years what others have in 50. IDPL products have been examined for quality very carefully by the developed countries and many of them want to buy from here”.

  

Similarly the foundation stone of Hindustan Antibiotics Ltd (HAL) was laid by Prime Minister Jawaharlal Nehru. Central Research Institute (CRI) Kasauli is pioneer in the field of vaccines not only in India but in the world. Founded on 3rd of May 1905  the institute was originally established with a mandate of research work in the field of medical and public health, manufacture of vaccines and antiserum, human resource development and to act as a national referral centre for public health problems.  

    

But when there was shift in the economic policies and there were changes in the patent rights laws under the WTO after it was founded on 1st January 1995, the whole scenario started changing. Indian companies had to bear the brunt and major impact was on the Public Sector Units (PSUs). The IDPL, HAL and Kasauli were financially constrained. Cheap vaccines produced by these companies now became very expensive and out of reach of common man.   

  

The Union Cabinet’s recommendation in its cabinet meeting dated 28th December 2016 to close down and sell the pharmaceutical PSUs is a big blow to the concept of the state ensuring affordable, and possibly free-of-cost, medicines for millions.  It is time to raise voice to build public opinion for strengthening the pharmaceutical PSUs if the country really wants affordable medicines for the people.    

 

As per the NPPA order dated 25th March 2020 there are 856 drugs whose ceiling price has been fixed by the NPPA. Since the drug (Medicine and medical device) is not a luxury there should be ceiling on price of all the drugs without exception. The public sector units should be rejuvenated and strengthened to ensure affordable drug prices.

 

Published in:

https://dailyheadlinestoday.com/epaper/view/439/epaper-headlines-today/4

 

https://www.nationalheraldindia.com/opinion/crony-capitalists-behind-modi-govts-failure-to-check-spiralling-cost-of-medicines

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/reduction+of+prices+of+essential+drugs+is+imperative+for+common+people-newsid-n415720122?listname=newspaperLanding&topic=ipaspecial&index=3&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article39113-REDUCTION-OF-PRICES-OF-ESSENTIAL-DRUGS-IS-IMPERATIVE-FOR-COMMON-PEOPLE

 

https://ipanewspack.com/reduction-of-prices-of-essential-drugs-is-imperative-for-common-people/

 

03 Aug,2022

Nuclear dangers – challenge to work with undaunted spirit

Date: 3.8.2022 

 

Nuclear dangers – challenge to work with undaunted spirit 

 

Dr Arun Mitra 

 

As we approach 6th August we remember 8.15 am on that day in 1945 when the US exploded first ever nuclear weapon on human population at Hiroshima in Japan. This was followed by another attack on Nagasaki on 9th August. Over two lakh people died on these two days in these two cities. Number of people injured, rendered destitute, homeless and orphaned far exceeds this number.  Effect of radiations on the generations after that is still felt. That was the time of unprecedented humanitarian crises and agony never heard of before.   

 

Dr. Dr. Marcel Junod, the new head of the ICRC's delegation in Japan was the first foreign doctor to reach Hiroshima on 8 September 1945, one month after the dropping of the atom bomb. He described that ‘the center of the city was a sort of white patch, flattened and smooth like the palm of a hand. Nothing remained. The slightest trace of houses seemed to have disappeared. The medical care was in shambles and rudimentary; dressings are made of coarse cloth. A few jars of medicine lying around on a shelf. The injured often have uncovered wounds and thousands of flies settle on them and buzz around. Everything is incredibly filthy. Several patients are suffering from the delayed effects of radioactivity with multiple haemorrhages. They need small blood transfusions at regular intervals; but there are no donors, no doctors to determine the compatibility of the blood groups; consequently, there is no treatment’.    

  

Dr Junod noted the consequences of the bomb for Hiroshima's medical corps; out of 300 doctors, 270 died or were injured; out of 1,780 nurses, 1,654 perished or were injured. He made an appeal for the bomb to be banned outright, just as poison gas was outlawed in the aftermath of the First World War. (1) 

 

Ironically  the number of nuclear weapons has been increasing and it is assumed that there are nearly 17000 nuclear weapons on earth today. The number of countries which possess these weapons also increased from one to nine. These include USA, Russia, Britain, France, China, North Korea, India, Pakistan and Israel.   

  

The nuclear weapons are a real threat to not only the human population but the whole flora and fauna on earth. The very presence of these weapons is fraught with the danger of their use.  

 

The destructive power of nuclear weapons is well documented now.  Ira Helfand, Co President of IPPNW in a study on Climate Consequences of Regional Nuclear War has pointed out that even a limited nuclear war between India and Pakistan using 100 Hiroshima sized nuclear weapons could put over two billion people at risk. Up to 20 million people would be killed outright as the great cities of the subcontinent would be destroyed and it would blanket much of South Asia with radioactive fallout. But the global consequences are even more alarming. This limited nuclear conflict would even affect weather patterns throughout the world. Soot and debris injected into the atmosphere from the explosions and resulting fires would block sunlight from reaching the earth, producing an average surface cooling of -1.25ºC that would last for several years.  Even 10 years out, there would be a persistent average surface cooling of -0.5ºC.  This would lead to crop failure and affect the size of available food stocks. If the soot injected into the atmosphere in a nuclear war caused significant ozone depletion that could cause a further major decline in actual food production. The combination of failed harvests and a collapsed distribution system would prevent essential foods from reaching the areas which require these. This scenario will affect the poor countries more and the poor people in these countries even worse.  

    

It is therefore imperative that nuclear weapons are abolished for good. As proved in Hiroshima-Nagasaki medical science has no remedy to offer in the event of a nuclear exchange. The situation is much worse now as the present day weapons are much more deadly.  

 

It is in this background that the Review Conference of the Nuclear Non-Proliferation Treaty, the NPT  RevCon has begun in New York in which 191 member countries will deliberate on the progress made in the Nuclear Non Proliferation since the treaty came in to force  in 1970. The participants include five major nuclear powered countries. The deliberations are expected to include various aspects of the treaty including the obligations by the major nuclear powered countries to take steps towards nuclear abolition. Article VI of the NPT is important as according to it ‘Each of the Parties to the Treaty undertakes to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control’. The major nuclear must answer what they have done till date in the last 52 years.  

 

It is important to note that the event is taking place for the first time after the Treaty for the Prohibition of Nuclear Weapons (TPNW). The TPNW was passed by the UN General Assembly in 2017 with 122 votes in favour and only one vote against. The treaty has delegitimized the   nuclear weapons and declared them illegal as per the international law. Secretary General of the UN, Antonio Gutteres has on the occasion said that ‘Humanity is just one misunderstanding, one miscalculation away from nuclear annihilation’ This is genuine feeling of a person who is duty bound to keep the world united and in peaceful co-existence.    

 

Adoption of Treaty Prohibiting Nuclear Weapons (TPNW) by the UNO is a big step forward and a real hope. The treaty has been already signed by the 86 countries and ratified by 60 countries. It is time now that ‘all states must condemn the recent threats to use nuclear weapons, the increase and modernization of nuclear arsenals, and the increased role of nuclear weapons in security doctrines’.   

 

The war between Russia and Ukraine is a big threat to peace at  the moment. Russia and NATO have threatened to use these weapons. It is therefore very urgent that Russia Ukraine war should stop immediately. Russian President Putin’s letter to the participants in the NPT RevCon as reported by Reuter that ‘there could be no winners in nuclear war and no such war should ever be started’ is  welcome. But he must explicitly denounce the use of nuclear weapons under any circumstances during the ongoing war with Ukraine. Tension between the US and China after the arrival of the US House speaker Nancy Pelosi in Taiwan is a worrisome issue.  

 

Some ideologues are stressing that  nuclear weapons serve as deterrence.  They say had Ukraine not taken the nuclear weapons off from its territory Russia won’t dare to attack. So, more countries should become nuclear weapons countries.       

 

The Nobel laureates ICAN, IPPNW and several other civil society organizations are actively lobbying in New York at the NPT review conference with data of Humanitarian consequences of Nuclear War with the hope that the RevCon will

have a positive outcome to convince the nuclear powered countries to join TPNW.  

 

Reference: 

 

  1. https://www.icrc.org/en/doc/resources/documents/misc/hiroshima-junod-120905.htm#:~:text=Marcel%20Junod%2C%20the%20first%20foreign,treat%20some%20of%20the%20victims.&text=Dr.,-Junod%2C%20the%20new

Published in:

https://thearabianpost.com/remembering-august-6-1945-for-first-atomic-bombing-on-hiroshima/

 

http://epaper.thenorthlines.com/viewpage.php?edn=Main&edid=NLINE_MAI&date=2022-08-05&pn=1#Article/NLINE_MAI_20220805_7_2/574px/11B7596

 

https://ipanewspack.com/remembering-august-6-1945-for-first-atomic-bombing-on-hiroshima/

 

https://tryxyz.com/article39008-REMEMBERING-AUGUST-6-1945-FOR-FIRST-ATOMIC-BOMBING-ON-HIROSHIMA

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/remembering+august+6+1945+for+first+atomic+bombing+on+hiroshima-newsid-n410475756?listname=newspaperLanding&topic=ipaspecial&index=5&topicIndex=1&mode=pwa&action=click

01 Aug,2022

Do not take doctors for granted

 Date: 01.08.2022

 

Do not take doctors for granted 

 

Dr Arun Mitra 

 

The incidence where Health Minister of Punjab rebuked the Vice Chancellor of Baba Farid University of Health Sciences and asked him to lie down on the bed with torn mattress has brought shame to the nation. Dr. Raj Bahadur Gaur, the Vice Chancellor is an upright person against whom not a single finger has been pointed for any misdeed. He has always been working in the interest of the students and has tried his best to streamline the examination system. A Surgeon Par excellence who despite busy schedule as administrator attended to the patients and has been performing spine surgery, which is his expertise.  That he did not react to the unruly behavior of the minister is a reflection of that the doctors are trained to be soft to the patients and this becomes a general behavior of most of them. Dr. Raj Bahadur should not feel humiliated, rather he has shown that he is one among those who have been steeled by persons of eminence in the medical field in the prestigious institution, the PGI Chandigarh, to be empathetic and compassionate. The minster’s act is not only condemnable but demands open apology from him from not only Dr. Gaur but from society in general. 

  

Improving infrastructure is direct responsibility of the minister. The vice chancellor is an administrator and executioner. He would work under the given circumstances with the funds provided. With a meager budget of 3.03% allocated to health out of total budget against the required of 11%, for improving the public healthcare in the state, one can expect only torn mattresses and bed sheets. The out of pocket expenditure on health by the people of Punjab is one among the highest in the country. The minster should have targeted the Finance Minister or the Chief Minister instead of the vice chancellor.   

 

This has shown how a section of our polity thinks of the medical personnel, howsoever upright they may be. 

 

Such incidents have been happening earlier too. Minsters’ rebuking, even slapping the teachers, have been witnessed in the past. They also do not stop their personal staff from using unconstitutional powers. When persons at the high level in the state apparatus resort to such acts, how do we expect violence against the doctors by unscrupulous elements, many a times at the behest of political bosses to stop! 

 

There is need for united effort by the medical personnel and the other saner sections of the society against such incidents. Unity shown by all sections among the doctors in condemning the Health Minister’s act must continue in future as well. The Chief Justice of India (CJI) had recently applauded the role of the doctors and had said “they (doctors) need a better and more secure working environment”. He said that “this is where professional medical associations assume great significance” and advised them “to be proactive in highlighting the demands”. The CJI further said that the doctors’ profession “perhaps is the only profession which follows Gandhiji’s principle – service to man is service to God”. 

 

In addition to the law for violence against the doctors, some code of conduct must be made for the ministers too. It is equally important to sensitize the police to abide by the law and behave professionally, not act on the directions of the political bosses. The incident of suicide by Dr Archna Sharma, a senior Gynaecologist of Dausa in Rajasthan shook the medical fraternity. A patient is reported to have died during a procedure after which the attendants reportedly under the patronage of a BJP leader created ruckus. The police instead of controlling the mob registered a case of murder against the doctor U/s 302 IPC. Perturbed over this, the doctor committed suicide. 

 

When political persons thrust their whims it leads to erosion of democratic values for which India has always held itself in high esteem. In the recent years this has increased. Democratic institutions are under tremendous pressure from the higher ups in the government which affects their professionalism. Such situations can have backlash in later years. Therefore it is time to persistently strengthen professionalism and the constitutional bodies.   

                   

 

However it is also time for the medical professionals to stay connected with issues of public concern on the health issues. This will   integrate them with the society. Not many medical bodies reacted to deaths of children in Muzaffarpur and Gorakhpur few years back. The medical bodies failed in supporting Dr.Kafeel who had to languish in the lock up because he raised the faults in the healthcare infrastructure at Gorakhpur.  The incidents of Punjab can be a learning experience.

 

Published in 

https://windobi.com/punjab-incident-involving-dr-gaur-speaks-badly-of-the-state-government/

 

https://news.bloggyer.com/punjab-incident-involving-dr-gaur-speaks-badly-of-the-state-government-1491.html

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/punjab+incident+relating+to+dr+gaur+speaks+bad+of+the+state+govt-newsid-n409827014?listname=newspaperLanding&topic=ipaspecial&index=3&topicIndex=1&mode=pwa&action=click

21 Jul,2022

GST on food will further add to malnutrition

Date: 21.07.2022

 

GST on food will further add to malnutrition

 

Dr Arun Mitra

 

In the 2021 Global Hunger Index (GHI) report, India ranks 101st out of the 116 countries. With a score of 27.5, India falls into the category of serious level of hunger. According to the GHI a rank of  ≤ 9.9 is considered to be low, 10.0–19.9 moderate, 20.0–34.9 serious, 35.0–49.9 alarming, ≥ 50.0 extremely alarming(1). That we are at a serious level of hunger is a cause of concern for us. It requires pro active planning to ensure nutrition to all the citizens.   

 

The report has pointed out that number of malnourished has increased globally in the past by 15 crorres i.e 24.3%. In 2019 the number of malnourished was 61.8 crore while it increased 76.8 crore in 2021.  

 

The Hunger Index is based on three criteria, Inadequate food supply, Child mortality and Child under-nutrition. The report also points out that 1/4th of the total malnourished in the world live in India. This is at a time when our country is aspiring to be global leader in economic development with a 5 trillion economy.  

 

According to Food and Agriculture Organisation (FAO) of the UNO estimates in ‘The State of Food Security and Nutrition in the World, 2020 report, 189.2 million people are undernourished in India. By this measure 14% of the population is undernourished in India’, this means nearly 20 crore people.  Also, 51.4% of women in reproductive age between 15 to 49 years are anaemic; 34.7% of the children aged under five in India are too short for their age; while 20% suffer from wasting, meaning their weight is too low for their height. Malnourished children have a higher risk of death from common childhood illnesses such as diarrhoea, pneumonia, and malaria.   

 

The National Family Health Survey 5 report is startling. That even after much advertised Poshan Abhiyan  the children of our country remain stunted in such a large number calls for review of the efforts to provide nutrition to all the countrymen particularly the children. There are three  criteria for malnutrition, low height for the age called as stunting,  low weight for the height labeled as wasting and low weight for age that is underweight. According to these criteria 31.96 % children were found to be stunted 17.29 %  children are wasted and 26.95 % children are underweight. In its report, The State of the World’s Children 2019, UNICEF has pointed out that Malnutrition caused 69% of deaths of children below the age of five in India.

 

Supply of balanced food to all the citizens of the country is the basic requirement to reduce malnutrition. A balanced diet means sufficient number of proteins, fats, carbohydrates and micro nutrients in the form of vitamins and minerals. Prestigious medical journal Lancet had formed a committee to go into nutritional requirements of a person. It has suggested intake of 232 grams of whole grain, 50 grams of tubers or starchy vegetables like potato, 300 grams of vegetables, 200 grams of fruits, 250 grams dairy food, 250 grams of protein sources in the form of meat, egg, poultry, fish, legumes, nuts, 50 grams saturated and unsaturated oils 30 grams of sugar. At the present market price the cost of these food items per person comes to be around Rs.225/- per day. This means that a family of five members should spend Rs.1125/- per day or Rs.33750/- per month on food only. 

 

Barring a miniscule population our people are far from this target.  The government’s scheme to give 5 kg of grains and one kg daal and a bit of oil does not fulfil the nutritional requirements. It is just not enough even for proper sustenance. It does not at all meet the requirements of micro nutrients like vitamins and minerals essential for physical and mental growth. With 15 crore people out of a population of 23 crore in Uttar Pradesh queuing up to get this much ration free of cost is a projection of extremely dismal state of affairs of nutritional security.      

 

It is pertinent that the purchasing capacity of the people is raised through poverty alleviation, sufficient wages and ensure means of lively hood to meet the requirement of quality food for the citizens.  Several economic experts including the Nobel Laureate Abhijeet Banerjee have suggested several means to alleviate poverty. 

 

Recent economic surveys have pointed out that 90% of our population earns less than Rs.10000/- per month. A balanced diet for them is only a dream which does not seem to come true in the present circumstances. By imposing taxes on the essential food items cost of filling the belly is bound to increase. The wages on the other hand are showing a downward trend as the employment is shifting to contractual labour with no job security nor any employment benefits like the provident fund or the ESI. Small scale sector which provides livelihood to large number of people is at a receiving end under the neoliberal economic policy.  

 

To meet the requirements of 2300 calories and a healthy food and clothing for a young adult, various workers organizations have demanded minimum wage based on the principle of these caloric needs. They have demanded a minimum wage of Rs.21000/- per month.  To utter dismay, the government announced a floor level wage as  Rs.178/- per day or Rs.5340/- per month. This is despite an internal labour ministry committee recommendation of Rs.375/- per day. This is even against the Supreme Court ruling on works demand for Rs.650/- per day wage, where the Hon’ble court added further 25% for health and education. The government’s intention to introduce time based work wage will be detrimental economically as well as against the medical advice and health needs of a person.

 

Large number of our population in our country is in the unorganised sector where the legal formulations are hardly implemented. The farmers and agriculture labour who are the producers are among the worst sufferers. Agriculture labourers have to face double oppression, economic as well as social. Farmers protested against the new Farm Laws fearing these will not only adversely affect their economic conditions but even the food security of the citizens too will be compromised. 

 

As per the UNICEF,  India has 5,772,472  children below five years affected by severe wasting — the most in the world. The global body called the situation an ‘overlooked child survival emergency’ in its May 2022 child alert. Severe wasting, also known as severe acute malnutrition, is defined as low weight-for-height.

 

It is therefore imperative that essential food items are cost effective and within the reach of low socio-economic groups. Wages for all sections be revised as per the caloric needs, balanced diet, clothing, health, education, housing and recreation. In this context the GST levied on food and other day to day needs items be withdrawn to prevent further malnutrition.  

 

References:

  1. https://www.globalhungerindex.org/india.html   

 

Published in 
https://www.nationalheraldindia.com/india/levying-gst-on-essential-food-items-will-only-further-add-to-severe-malnutrition-levels-among-poor

 

https://theshillongtimes.com/2022/07/23/essential-items-for-consumption-must-be-affordable/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/gst+on+food+will+further+add+to+malnutrition+among+indian+poor-newsid-n406522812?listname=newspaperLanding&topic=ipaspecial&index=7&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article38896-GST-ON-FOOD-WILL-FURTHER-ADD-TO-MALNUTRITION-AMONG-INDIAN-POOR

 

https://ipanewspack.com/gst-on-food-will-further-add-to-malnutrition-among-indian-poor/

 

14 Jul,2022

Make toys not guns

 

 

Date: 13.07.2022

 

Make toys not guns

Gun violence is serious public health crisis

 

The investigations into murder of Punjabi Singer Shubhdeep Singh Sidhu, popularly known as Moosewala in the Punjab state of India should not be limited only to tracing the murderers and members of the gangs involved, or that how was the AK 94 gun used to kill was procured by them? This is time to think beyond that and pin point the manufacturers and traders of the small arms who in the so called modern day civilized society are dealing with something that is made solely to kill. 

 

Moosewala case has come to limelight because he was a popular singer. Otherwise there are hundreds of gun violence killings taking place around the world every day. It is atrocious to hear about firing by school children in the USA. The children who should be studying and playing are instead carrying guns and are on a firing spree killing their own mates ! 

 

Killer gangs have been associated with drug smugglers and other mafia groups around the globe. Guns are sold to various groups illegally worldwide and are used for creating internal strife, ethnic conflicts and to create instability. Rwanda, Somalia, Afghanistan are few recent examples of such blatant use of small arms. Women and children are the worst sufferers in such situations.

 

Despite demands for banning illegal trade in small arms, such trade continues to flourish. Sales of weapons and military services by the world's 100 biggest arms companies reached a record $531bn in 2020, an increase of 1.3 per cent in real terms compared with the previous year, according to the Stockholm International Peace Research Institute (SIPRI). World's top 100 arms producers increased their sales — even in the pandemic year of 2020 when the global economy was contracting. United States has 39% share in the arms exports, Russia 19%, France 11% and China 4.6% (1).

 

The International Physicians for the Prevention for Nuclear War (IPPNW) has been in the forefront of raising awareness about the harmful effect of the gun violence. At the  8th Biennial Meeting of States of the UN Programme of Action (UN PoA) on Small Arms and Light Weapons at the UN headquarters in New York City the IPPNW expressed anguish at that even after over two decades of the international agreement of 2001 to reduce human suffering the goal has not been realized. Health effects of the horrific gun violence that continues worldwide range from death to physical injury to mental and emotional consequences that can last a lifetime.

 

IPPNW has advocated for decades that gun violence is a public health crisis, not just a police and security issue. The IPPNW in the statement submitted to States Parties of the UN PoA said that “IPPNW is a non-partisan federation of national medical groups in 55 countries representing tens of thousands of health professionals who share the common goal of preventing nuclear and armed violence. We urge delegates to the BMS 8 to understand and accept that small arms violence is a preventable public health crisis as determined by the World Health Organization. Limiting access to guns, and stemming the illegal gun trade, are two preventable measures. Another is reducing demand for guns”. 

 

Gun violence changes the life of the effected persons and their families.

The injuries affect their ability to work and function in society, often both physically and mentally. Gunshot survivors have an increased risk of mental illness, including depression, Post-Traumatic Stress Disorder, suicide and substance abuse disorders. The risk of developing or worsening chronic illnesses such as heart diseases increases due to the stress of recovery. Intimate partner violence, coupled with guns, poses an even more significant risk to the health and well-being of women and men. Survivors of intimate partner violence have higher rates of at-risk pregnancies and sexually-transmitted diseases. 

 

To many worldwide, the threat of gun violence has become a “way of life.” Living in this culture of fear can lead to negative health effects similar to those who have sustained a gunshot wound. The most important aspect of gun violence that should never be forgotten is that every case is a face, a family, and a community, and sadly, a long journey of rehabilitation and significant expense, from the individual to the government levels. 

 

Gun violence has to be treated like a public health issue and managed in the same way as other diseases such as polio and smallpox, by identifying the problem and its impact on society, its risk factors, and developing interventions, policies and programs aimed at targeting those risk factors. 

 

The IPPNW has pointed out that arms control measures need to be part of a wider spectrum of policy solutions – intersecting security, crime, human rights, health, and development.  As such, healthcare professionals and policymakers can be powerful allies in armed violence prevention worldwide.  

 

The IPPNW has been proactively advocating complete check on the manufacturing of guns and their trade. For this the organisation has carried awareness campaigns in different parts of the world. In June 2013 the IPPNW organised a protest march outside the gun making factory Heckler & Koch near Villingen-Schwenningen in Germany.  The slogan is “make toys not guns”. 

 

 

Reference:

  1. https://www.sipri.org/media/press-release/2021/business-usual-arms-sales-sipri-top-100-arms-companies-continue-grow-amid-pandemic 

  

 

 

Published

 

https://ipanewspack.com/gun-violence-is-a-serious-public-health-crisis-in-india-also/

 

https://tryxyz.com/article38831-GUN-VIOLENCE-IS-A-SERIOUS-PUBLIC-HEALTH-CRISIS-IN-INDIA-ALSO

 

https://tryxyz.com/article38831-GUN-VIOLENCE-IS-A-SERIOUS-PUBLIC-HEALTH-CRISIS-IN-INDIA-ALSO

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/gun+violence+is+a+serious+public+health+crisis+in+india+also-newsid-n404087270?listname=newspaperLanding&topic=ipaspecial&index=16&topicIndex=1&mode=pwa&action=click

 

 

 

13 Jul,2022

Make toys not guns

 

Date: 13.07.2022

 

Make toys not guns

Gun violence is serious public health crisis

 

The investigations into murder of Punjabi Singer Shubhdeep Singh Sidhu, popularly known as Moosewala in the Punjab state of India should not be limited only to tracing the murderers and members of the gangs involved, or that how was the AK 94 gun used to kill was procured by them? This is time to think beyond that and pin point the manufacturers and traders of the small arms who in the so called modern day civilized society are dealing with something that is made solely to kill. 

 

Moosewala case has come to limelight because he was a popular singer. Otherwise there are hundreds of gun violence killings taking place around the world every day. It is atrocious to hear about firing by school children in the USA. The children who should be studying and playing are instead carrying guns and are on a firing spree killing their own mates ! 

 

Killer gangs have been associated with drug smugglers and other mafia groups around the globe. Guns are sold to various groups illegally worldwide and are used for creating internal strife, ethnic conflicts and to create instability. Rwanda, Somalia, Afghanistan are few recent examples of such blatant use of small arms. Women and children are the worst sufferers in such situations.

 

Despite demands for banning illegal trade in small arms, such trade continues to flourish. Sales of weapons and military services by the world's 100 biggest arms companies reached a record $531bn in 2020, an increase of 1.3 per cent in real terms compared with the previous year, according to the Stockholm International Peace Research Institute (SIPRI). World's top 100 arms producers increased their sales — even in the pandemic year of 2020 when the global economy was contracting. United States has 39% share in the arms exports, Russia 19%, France 11% and China 4.6% (1).

 

The International Physicians for the Prevention for Nuclear War (IPPNW) has been in the forefront of raising awareness about the harmful effect of the gun violence. At the  8th Biennial Meeting of States of the UN Programme of Action (UN PoA) on Small Arms and Light Weapons at the UN headquarters in New York City the IPPNW expressed anguish at that even after over two decades of the international agreement of 2001 to reduce human suffering the goal has not been realized. Health effects of the horrific gun violence that continues worldwide range from death to physical injury to mental and emotional consequences that can last a lifetime.

 

IPPNW has advocated for decades that gun violence is a public health crisis, not just a police and security issue. The IPPNW in the statement submitted to States Parties of the UN PoA said that “IPPNW is a non-partisan federation of national medical groups in 55 countries representing tens of thousands of health professionals who share the common goal of preventing nuclear and armed violence. We urge delegates to the BMS 8 to understand and accept that small arms violence is a preventable public health crisis as determined by the World Health Organization. Limiting access to guns, and stemming the illegal gun trade, are two preventable measures. Another is reducing demand for guns”. 

 

Gun violence changes the life of the effected persons and their families.

The injuries affect their ability to work and function in society, often both physically and mentally. Gunshot survivors have an increased risk of mental illness, including depression, Post-Traumatic Stress Disorder, suicide and substance abuse disorders. The risk of developing or worsening chronic illnesses such as heart diseases increases due to the stress of recovery. Intimate partner violence, coupled with guns, poses an even more significant risk to the health and well-being of women and men. Survivors of intimate partner violence have higher rates of at-risk pregnancies and sexually-transmitted diseases. 

 

To many worldwide, the threat of gun violence has become a “way of life.” Living in this culture of fear can lead to negative health effects similar to those who have sustained a gunshot wound. The most important aspect of gun violence that should never be forgotten is that every case is a face, a family, and a community, and sadly, a long journey of rehabilitation and significant expense, from the individual to the government levels. 

 

Gun violence has to be treated like a public health issue and managed in the same way as other diseases such as polio and smallpox, by identifying the problem and its impact on society, its risk factors, and developing interventions, policies and programs aimed at targeting those risk factors. 

 

The IPPNW has pointed out that arms control measures need to be part of a wider spectrum of policy solutions – intersecting security, crime, human rights, health, and development.  As such, healthcare professionals and policymakers can be powerful allies in armed violence prevention worldwide.  

 

The IPPNW has been proactively advocating complete check on the manufacturing of guns and their trade. For this the organisation has carried awareness campaigns in different parts of the world. In June 2013 the IPPNW organised a protest march outside the gun making factory Heckler & Koch near Villingen-Schwenningen in Germany.  The slogan is “make toys not guns”. 

 

 

Reference:

  1. https://www.sipri.org/media/press-release/2021/business-usual-arms-sales-sipri-top-100-arms-companies-continue-grow-amid-pandemic 

  

Published

 

https://ipanewspack.com/gun-violence-is-a-serious-public-health-crisis-in-india-also/

 

https://tryxyz.com/article38831-GUN-VIOLENCE-IS-A-SERIOUS-PUBLIC-HEALTH-CRISIS-IN-INDIA-ALSO

 

https://tryxyz.com/article38831-GUN-VIOLENCE-IS-A-SERIOUS-PUBLIC-HEALTH-CRISIS-IN-INDIA-ALSO

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/gun+violence+is+a+serious+public+health+crisis+in+india+also-newsid-n404087270?listname=newspaperLanding&topic=ipaspecial&index=16&topicIndex=1&mode=pwa&action=click

 

05 Jul,2022

Nuclear weapons possessing countries must listen to powerful global voice for nuclear weapons abolition

 

 

Date: 04.07.2022

 

Nuclear weapons possessing countries must listen to powerful global voice for nuclear weapons abolition    

   

Dr Arun Mitra 

 

The world is on the edge of a serious threat of use of nuclear weapons by Russia and NATO as both have threatened their use during the on-going war between Russia and Ukraine. Presently there are approximately 13,000 nuclear weapons on earth, many of which are on high alert and could be launched within minutes. Concerned with this threat in mind the members of the state parties who have clearly voted for nuclear weapons abolition and the Treaty Prohibiting Nuclear Weapons (TPNW) along with other organisations working for the cause decided to gather at Vienna in Austria to reinforce their commitment and to chart out an action plan to make the world nuclear weapons free.  

 

Highlighting the humanitarian consequences of the nuclear war it was categorically stated in the first meeting of the state parties on TPNW that ‘the catastrophic humanitarian consequences of nuclear weapons cannot be adequately addressed, transcend national borders, pose grave implications for human survival and well-being and are incompatible with respect for the right to life. They inflict destruction, death and displacement, as well as profound long term damage to the environment, socioeconomic and sustainable development, the global economy, food security and the health of current and future generations, including with regard to the disproportionate impacts they have on the poor in the developing countries and women and girls in particular’.   

   

TPNW passed by the UNO five years back on 7TH July 2017 with an overwhelming majority, 122 votes in favour and only one against is a reflection of the voice of all peace loving people who want life on earth to continue and progress. That this happened despite tremendous pressure, allurements intimidation and blackmail by the major nuclear powered states is a big achievement. Study conducted by the IPPNW on climatic impact of nuclear war has made the world community to realise the  fact that even a nuclear exchange between India and Pakistan using 100 Hiroshima sized nuclear bombs would put over 2 billion people at risk. A nuclear exchange between major nuclear powers could be end of modern civilization built through thousands of years of human labour. It is this realization which is making all saner elements to raise their voice for nuclear weapons abolition. That is why they are quite vocal on the need to impress upon Russia and NATO to commit not to use nuclear weapons during the on-going war because in such circumstances the nuclear weapons could be launched intentionally or by accident !        

 

The Vienna meet made it clear that ‘far from preserving peace and security, nuclear weapons are used as instruments of policy, linked to coercion, intimidation and heightening of tensions. This highlights now more than ever the fallacy of nuclear deterrence doctrines, which are based and rely on the threat of the actual use of nuclear weapons and, hence, the risks of the destruction of countless lives, of societies, of nations, and of inflicting global catastrophic consequences. We thus insist that, pending the total elimination of nuclear weapons, all nuclear-armed states never use or threaten to use these weapons under any circumstances’.   

 

‘It is however a matter of regret and deep concern that despite the terrible risks, and despite their legal obligations and political commitments to disarm, none of the nuclear armed states and their allies under the nuclear umbrella are taking any serious steps to reduce their reliance on nuclear weapons. Instead, all nuclear-armed states are spending vast sums to maintain, modernize, upgrade or expand their nuclear arsenals and are placing a greater emphasis on and increasing the role of nuclear weapons in security doctrines. These resources could be better utilized for sustainable development’. The global arms spending is increasing at a rapid rate and surpassed the two trillion US dollar mark for the first time, reaching $2113 billion in 2021(SIPRI). This takes away resources from health, education, development and other social needs and also reduces security and increases uncertainties in life.   

 

It is a matter of satisfaction that by now 66 countries have ratified the TPNW which came into force from 22nd January 2021.The task now is to bring the nuclear weapons possessing countries into its fold. For this whereas the UNO has to play a proactive role the International Red Cross and Red Crescent Movement, other international and regional organizations, the International Campaign to Abolish Nuclear Weapons (ICAN) and other non-governmental organizations, religious leaders, parliamentarians, academics, indigenous peoples, victims of the use of nuclear weapons (Hibakusha),  as well as those affected by nuclear testing and youth groups all have to be involved to strengthen the voice for nuclear weapons abolition. Science is based on evidence and we have evidence of humanitarian consequences of nuclear war as researched by the IPPNW.

 

It is also important to continue collaborate at regional level and build Nuclear Weapons Free Zones which could play a significant moral and ethical role. 

 

We have to move ahead with optimism despite several challenges and obstacles. There is no bigger challenge than to preserve and promote life on earth. Every means have to be utilised with a persistent work.

 

 

https://ipanewspack.com/time-to-implement-treaty-prohibiting-use-of-nuclear-weapons-by-any-country/

 

 

 

https://dailyheadlinestoday.com/epaper/view/399/epaper-headlines-today/7

 

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/time+to+implement+treaty+prohibiting+use+of+nuclear+weapons+by+any+country-newsid-n401432590?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article38766-TIME-TO-IMPLEMENT-TREATY-PROHIBITING-USE-OF-NUCLEAR-WEAPONS-BY-ANY-COUNTRY

 

 

04 Jul,2022

Nuclear weapons possessing countries must listen to powerful global voice for nuclear weapons abolition

 

Date: 04.07.2022

 

Nuclear weapons possessing countries must listen to powerful global voice for nuclear weapons abolition    

   

Dr Arun Mitra 

 

The world is on the edge of a serious threat of use of nuclear weapons by Russia and NATO as both have threatened their use during the on-going war between Russia and Ukraine. Presently there are approximately 13,000 nuclear weapons on earth, many of which are on high alert and could be launched within minutes. Concerned with this threat in mind the members of the state parties who have clearly voted for nuclear weapons abolition and the Treaty Prohibiting Nuclear Weapons (TPNW) along with other organisations working for the cause decided to gather at Vienna in Austria to reinforce their commitment and to chart out an action plan to make the world nuclear weapons free.  

 

Highlighting the humanitarian consequences of the nuclear war it was categorically stated in the first meeting of the state parties on TPNW that ‘the catastrophic humanitarian consequences of nuclear weapons cannot be adequately addressed, transcend national borders, pose grave implications for human survival and well-being and are incompatible with respect for the right to life. They inflict destruction, death and displacement, as well as profound long term damage to the environment, socioeconomic and sustainable development, the global economy, food security and the health of current and future generations, including with regard to the disproportionate impacts they have on the poor in the developing countries and women and girls in particular’.   

   

TPNW passed by the UNO five years back on 7TH July 2017 with an overwhelming majority, 122 votes in favour and only one against is a reflection of the voice of all peace loving people who want life on earth to continue and progress. That this happened despite tremendous pressure, allurements intimidation and blackmail by the major nuclear powered states is a big achievement. Study conducted by the IPPNW on climatic impact of nuclear war has made the world community to realise the  fact that even a nuclear exchange between India and Pakistan using 100 Hiroshima sized nuclear bombs would put over 2 billion people at risk. A nuclear exchange between major nuclear powers could be end of modern civilization built through thousands of years of human labour. It is this realization which is making all saner elements to raise their voice for nuclear weapons abolition. That is why they are quite vocal on the need to impress upon Russia and NATO to commit not to use nuclear weapons during the on-going war because in such circumstances the nuclear weapons could be launched intentionally or by accident !        

 

The Vienna meet made it clear that ‘far from preserving peace and security, nuclear weapons are used as instruments of policy, linked to coercion, intimidation and heightening of tensions. This highlights now more than ever the fallacy of nuclear deterrence doctrines, which are based and rely on the threat of the actual use of nuclear weapons and, hence, the risks of the destruction of countless lives, of societies, of nations, and of inflicting global catastrophic consequences. We thus insist that, pending the total elimination of nuclear weapons, all nuclear-armed states never use or threaten to use these weapons under any circumstances’.   

 

‘It is however a matter of regret and deep concern that despite the terrible risks, and despite their legal obligations and political commitments to disarm, none of the nuclear armed states and their allies under the nuclear umbrella are taking any serious steps to reduce their reliance on nuclear weapons. Instead, all nuclear-armed states are spending vast sums to maintain, modernize, upgrade or expand their nuclear arsenals and are placing a greater emphasis on and increasing the role of nuclear weapons in security doctrines. These resources could be better utilized for sustainable development’. The global arms spending is increasing at a rapid rate and surpassed the two trillion US dollar mark for the first time, reaching $2113 billion in 2021(SIPRI). This takes away resources from health, education, development and other social needs and also reduces security and increases uncertainties in life.   

 

It is a matter of satisfaction that by now 66 countries have ratified the TPNW which came into force from 22nd January 2021.The task now is to bring the nuclear weapons possessing countries into its fold. For this whereas the UNO has to play a proactive role the International Red Cross and Red Crescent Movement, other international and regional organizations, the International Campaign to Abolish Nuclear Weapons (ICAN) and other non-governmental organizations, religious leaders, parliamentarians, academics, indigenous peoples, victims of the use of nuclear weapons (Hibakusha),  as well as those affected by nuclear testing and youth groups all have to be involved to strengthen the voice for nuclear weapons abolition. Science is based on evidence and we have evidence of humanitarian consequences of nuclear war as researched by the IPPNW.

 

It is also important to continue collaborate at regional level and build Nuclear Weapons Free Zones which could play a significant moral and ethical role. 

 

We have to move ahead with optimism despite several challenges and obstacles. There is no bigger challenge than to preserve and promote life on earth. Every means have to be utilised with a persistent work.

 

https://ipanewspack.com/time-to-implement-treaty-prohibiting-use-of-nuclear-weapons-by-any-country/

 

 

 

https://dailyheadlinestoday.com/epaper/view/399/epaper-headlines-today/7

 

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/time+to+implement+treaty+prohibiting+use+of+nuclear+weapons+by+any+country-newsid-n401432590?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article38766-TIME-TO-IMPLEMENT-TREATY-PROHIBITING-USE-OF-NUCLEAR-WEAPONS-BY-ANY-COUNTRY

28 Jun,2022

Myths, mass hysteria and health

 

Date: 28.06.2022

 

Myths, mass hysteria and health

 

Dr Arun Mitra

 

Good health is essential not only for the progress of an individual but even more so for the society as whole. Since times immemorial mankind has looked into various methods and developed different techniques to impart effective healthcare. Primitive society attributed the causation and treatment of diseases to super natural powers. This was because human society lacked knowledge of causes of various events around. With the passage of time different theories and hypothesis were propounded to promote wellbeing. These developments took place almost during the same time periods in different parts of the world. It was considered that disorders in the body occurred due to natural causes. Treatment modalities were developed based on the natural products in the form herbs, shrubs and sometimes animal material. Ayurveda system developed in India, Unani in Egypt and Babylon, Sidha in Tamil Nadu, Accupuncture in China and Acupressure in Japan and so on. Modern scientific medicine developed out of continuous research for centuries. Hippocrates from Greece is considered to be its father.  

 

The modern medicine has broken several beliefs and myths in the medical care through evidence. However belief system and myths still hold ground and have not fully been replaced by the scientific way of thinking from the minds of many people.

 

 

The belief in the faith healers is very powerful and many a times become the cause of delay in the treatment. Almost all patients of Mumps invariably go to faith healers and delay the allaying of troublesome symptoms. The faith healers presses upon the swelling on the face, recites some mantras and puts mud  on the swelling. Similarly the patients of Bell’s palsy (a type of one sided paralysis of the face) also must consult the faith healers. Interestingly one such faith healer focuses bright sun light on the patient’s neck with a convex lens. This causes burn on the skin which heals in a few weeks and by that time the paralysis of the face also heals. Bell’s palsy and mums most of the times recover on their own with some supportive measures and counseling to prevent complications and allaying fear and stress from the patient’s mind as these, like many other diseases, are self-limiting disorders. Many diseases are linked to religious connotations. For example the patients of Chicken Pox (Chhoti Mata) would spend long hours in praying to the mother god. It has been observed that sometimes even literate persons would not visit a doctor on some specific days of the week which day consider not auspicious for them. 

 

There are innumerable such instances in different parts of our country. When some such myths are propagated forcefully in the society, these tend to become part of the social thinking which sans logic. During the ongoing pandemic of COVID-19 we have witnessed how the use of ‘Gau Mutra’ (Cow Urine) and ‘Gobar (Cow Dung) was propagated.  Some religious rituals too were promoted as the cure for the disease. One MP Pragya Thakur emphatically stated that her cancer was cured by Cow urine. The impact is that many ‘Gau Shalas’ (Cow care centers) are lined up by people to collect the Cow urine. Baba Ramdev went to the extent to criticize modern medical care and promote his own Coronil with no evidence about its effectiveness.

 

Propaganda is so effective that when the Prime Minister Shri Narendra Modi appealed to the people to bang ‘Thalies’, play ‘Shankhs’,  millions  of people of the country followed his directive not only once but twice with the hope that this will dispel the Corona virus. This type of mass hysteria has been studied in the past. In 1995 people throughout the country believed in that statues can drink milk. The Ganesha statue drinking milk miracle was a phenomenon which occurred on 21 September 1995, in which statues of the Hindu deity Ganesha were thought to be drinking milk offerings. That appears to be an experiment done to study the mass psychology and that if could be used for some socio-political purpose as well. People carrying out the directives of the Prime Minister about beating Thalies etc. about COVID can be very well linked to that experiment on statue of lord Ganesha. That people in England in 18th century would kill the women who had been denigrated to be witches by some vested interests and were said to be cause of evils in the society. The incident of all members of the family committing suicide at the behest of some preacher in the Burari area of Delhi few years back shook the whole country.   Similar mass hysteria was generated by the Nazis in Germany against Jews and dissenters. It was used to kill and justify the killings without any remorse.  

 

This is a very complex situation in which various sections of the society have to come forward to spread health education on scientific basis. The message needs to be percolated down to the village level. Medical organizations and doctors can play a vital role in this. We have to educate the society to respect all human beings irrespective of caste, creed, religion or gender. We must learn to respect everyone of our species; and that all humans have same blood.

 

 

 

 

21 Jun,2022

Super profiteering in drugs cannot be allowed

Date: 18.06.2022

 

Super profiteering in drugs cannot be allowed

Drastic changes needed in international laws to make drugs affordable

 

Dr Arun Mitra

 

The COVID-19 Pandemic has brought to the fore necessity to bring about changes in the international agreements on drugs/vaccines keeping the public health priorities uppermost. Latest data points out that 66.2% of the world population has received at least one dose of a COVID-19 vaccine while this number in low income countries is only 17.7% (1).    

 

In the African continent only 18% have received the full dose in comparison to 70% & 65% in Asia and Europe respectively. Inequality in certain countries is glaring and a cause of serious concern. In Afghanistan only 12%, Somalia 9% and Sudan 8.3% got full vaccination (2). During this period of crisis the world community and the relevant organizations including the UNO should have ensured equity in the supply of the vaccines to save human lives. It is not possible for small countries to produce their vaccine in sufficient supply. So they have to purchase from the manufacturers in developed world. This makes it imperative that international trade agreements on the drugs/vaccines should concentrate on the equity concerns.   

   

The General Agreement on Trade and Tariff (GATT)  signed in 1948 existed till 1995 after which World Trade Organization (WTO) came into being.  It took steps to protect the rights of the innovator and coined Trade-Related Aspects of Intellectual Property Rights (TRIPS) (3). Under the Intellectual Property Rights (IPR) it was agreed upon that the innovator/inventor has to be given some incentive for the work in monetary terms. Thus patent rights were reformed and protected by the legal frame work. Different countries were to formulate their own patent laws in accordance with the guidelines laid down by the WTO. Before these changes the patent rights were based on the process patent, which meant that a product could not be produced by any other company through the same process for the period of 7 years but it could be done through other process. The new WTO patent regimen however changed this to Product patent for 20 years, meaning thereby that no other company can manufacture the same product for 20 years through any process. The developing countries argued that pharmaceutical industry is connected with the public health which is the basic human right. These patent laws will limit their citizens’ access to drugs at affordable prices and that patent laws needed some flexibilities. To make use of this flexibility clause countries were given the right for compulsory licensing so as to produce some products under special provisions (4).

   

  

The process patent enabled the Pharmaceutical industries in India to grow enormously between 1970 and 2005 and produce cheap & low cost generic medicines not only for our country but for several low income nations as well.    

  

In 2003 decision was made which enabled the countries which cannot manufacture medicines themselves to import the medicines made under a compulsory license given to the other countries so as to promote ‘access to affordable medicines for all’. This declaration highlighted the potential of a nation to exploit the flexibilities included in the TRIPS Agreement, including the compulsory licensing and agreed to expand exemptions to protect pharmaceutical patents for least developing countries by 2016.     

   

Compulsory licensing means that a third party is authorized to make, use or sell a patented invention without the patent owner’s consent. If the patented drugs are not priced reasonably and are out of reach of the population then the country can apply for a compulsory license.  An application for compulsory license can also be filed under a circumstances of national emergency, extreme emergency and a case of public non-commercial use.     

 

During the Pandemic since the big companies refused to share the technical know-how even with WHO, it was difficult for many developing countries to produce the vaccines. They were thus dependent on import. The problem was more with smaller countries with limited resources. That is how we find today that many developing countries are still lagging far behind in the vaccination of their population. These countries had to accept several clauses which would favour only the vaccine manufacturer. Pointing out the dangers involved Dr Samir Malhotra from PGI Chandigarh said that the COVID-19 scare forced many governments to enter into contracts with the companies developing vaccines. Many of these contracts had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. “Purchaser hereby agrees to indemnify, defend and hold harmless [the company and] each of their affiliates from and against any and all suits, claims, actions, demands, losses, damages, liabilities, settlements, penalties, fines, costs and expenses caused by, arising out of, relating to, or resulting from the vaccine.” Not only that, and this is shocking, these countries were asked “put up sovereign assets as collateral to guarantee indemnity”. Such assets could include embassy buildings, cultural assets, etc.    

   

The claim of the Pharma industry that they have to bear high cost in developing new drugs as a justification for such contracts is totally flawed because virtually 100% of initial research leading to new drugs occurs with the support of public funding. A vaccine that requires a few dollars to manufacture brings in profits worth billions of dollars to the company.   

 

During the Pandemic India and South Africa proposed temporary waiver on the TRIPS proposals for the COVID vaccine so as to make it possible for many countries to produce vaccines, essential medicines, and testing kits. There is also need to provide concession on therapeutics, diagnostics and ingredients, and processes (5).  

 

As per the reports India and South Africa are not sticking firmly to their proposals. India appears to be keen to conclude a pact now as has been pressed by the US and the EU.  This would be detrimental for the production of such drugs/vaccines even during the emergencies (6).  

 

 

The situation at present demands a complete revamping of the clauses of compulsory licensing to make them easy without long debates specially when we have passed through serious health crisis worldwide due to Pandemic. For our country it is all the more important to rejuvenate and strengthen our own public sector pharmaceutical industry with a purpose to produce cheap drugs/vaccines for local and global supply. We have national emergencies for several diseases, communicable as well as non-communicable.

 

The economic surveys point out that 90% population is earning less than Rs.10000/- per month. With very poor spending by the government on the public health it is becoming impossible for the people to purchase healthcare. Therefore India should press upon a permanent waiver for all the drugs/vaccines needed for emergencies. Whereas we were successful in producing Covaxin indigenously and also Covishield locally, their price issue always remained contentious. People had to pay large amount in the private sector while the companies reaped huge profits. In contrast the public sector companies which used to  produce vaccines at one time did not have profit as a prime motive. It is well known that public research laboratories played a significant role in developing Covaxin. That India refrained from sharing this technical knowhow with other developing countries does not go well with our past approach for international collaboration on health. Even worse is that the government refused to license the vaccine even to public sector concerns. 

 

 

  1. https://ourworldindata.org/covid-vaccinations?country=SOM
  2. https://ourworldindata.org/covid-vaccinations
  3. https://madhyapradesh.pscnotes.com/mppcs-paper-iii-technology/patents-and-intellectual-property-rights-trips-trims/
  4. https://www.lawctopus.com/academike/impact-of-trips-on-pharmaceutical-industry/
  5. https://www.orfonline.org/expert-speak/compromised-trips-waiver/
  6. https://www.downtoearth.org.in/blog/health/covid-19-india-trips-on-its-patent-waiver-proposal-81477

 

 

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/super+profiteering+in+essential+drugs+cannot+be+allowed-newsid-n397077124?listname=newspaperLanding&topic=ipaspecial&index=4&topicIndex=1&mode=pwa&action=click

 

31 May,2022

Time is now to combat climate change to promote health

 

Date: 31.05.2022   

 

Time is now to combat climate change to promote health

 

Dr Arun Mitra   

    

I very vividly remember when 30 years back in the year 1992 we wanted to hold a public function as a part of campaign for the promotion of healthy environment and preservation of ecology, not many people took it seriously. However we carried out with our activities and soon our actions drew attention of the public as well as the administration. We organized school education programmes, formed Eco Clubs in schools and conducted several other outreach events.

 

Society is more sensitized now. Environment has been an issue of serious debate among the scientists who have warned from time to time that if steps are not taken now and carbon emission is not reduced then we can land into serious climate crisis. Recently large number of scientists organized climate protests globally. Peter Kalmus, who studies biological systems and climate change at NASA's Jet Propulsion Laboratory and three others were arrested in Los Angeles after they chained themselves to the doors of a Chase Bank office building. Kalmus said, "We've been trying to warn you guys for so many decades that we're heading towards a fucking catastrophe, and we've been being ignored. The scientists of the world are being ignored, and it's got to stop. We're not joking. We're not lying. We're not exaggerating”.

 

  

These protests followed the release of report of the Intergovernmental Panel on Climate Change (IPCC), ‘Mitigation of Climate Change’, on 4 April 2022. It concluded that the world must peak emissions of heat-trapping gases like carbon dioxide in less than three years to have a chance of limiting global warming to 1.5 degrees Celsius above the preindustrial standard.  The report found that the world's governments and corporations are far from meeting the emission-reduction goals that would help limit that extreme weather. We are already witnessing wildfires, hurricanes, droughts, and floods across the planet. 

 

António Guterres, the UN secretary general, was very forthright in a press briefing when he said "Climate activists are sometimes depicted as dangerous radicals, but the truly dangerous radicals are the countries that are increasing the production of fossil fuels,".    

 

To highlight the issue World Environment Day is observed every year on 5th June. The sufferings caused due to COVID-19 Pandemic have made us to think that the issue of environmental degradation and climate change cannot be just a ritual discussion but it has to be taken very seriously.   

     

Climate Change is a significant change in temperature, wind patterns and precipitation that may occur in cycles over decades, hundreds, thousands and millions of years; however in the recent years we are witnessing the impact of climate change occurring much faster and in much shorter period.   

    

In the last century scientists detected that the temperature of earth was rising abnormally. It was found that oceans were warming up and snow was melting leading to rise in level of oceans. It was also found that there was perceptible rise in the carbon dioxide in the atmosphere.      

    

Greenhouse Gases (GHGs) resulting from mainly industrial development and urbanization, agriculture and changes in land-use patterns are the cause of global warming.  Different gases have different Global Warming Potential (GWP) which means how much damage they cause to the environment. The Carbon Dioxide (CO2) has  GWP of 1; Methane - GWP of 21 and Nitrous oxide - GWP of 310.    

    

The effects of climate change have been felt in India as well. There was all India drought in 2002 and  2009. The year 2010 was one of warmest years. In the year 2013 there were Extreme rainfall events in Uttrakhand.  Then there were floods in the Kashmir valley in 2014. We have seen mountains becoming baron due to large scale cutting of trees. This is resulting in hills becoming weak.  Tsunami, Amfan and  Nisarga all occurred due to climate change.   

    

Climate and weather have always had a powerful impact on human health and well-being. Global climate change is a newer challenge to the ongoing efforts to protect human health. In the past few years there has been increase in Mosquitoes breeding, Malaria, Dengue and Yellow Fever. Increase in temperature by 2-3º C would increase the number of people who, in climatic terms, are at risk of malaria by around 3-5 %, which means several hundred million people globally. According to World Health Report 2002, climate change was estimated to be responsible in 2000 for approximately 2.4% of worldwide diarrhoea, and 6% of malaria in some middle-income countries.   

    

Changes in atmosphere coupled with vehicular and industrial emissions lead to smog and poisonous gases which cause difficulty for those with cardio vascular disease, respiratory disorders as asthma, emphysema, chronic Bronchitis and allergy problems.   Similarly water pollution related diseases are on the rise leading to bacterial, viral, Protozoal and Parasitic diseases.   

    

As a result of rising sea levels and flooding of the coastal areas, there occurs increase in population density in safe areas due to migration of people to these places. People have to live in make shift camps in poor, unhygienic living conditions which cause several infectious diseases. Children lose their school. There may be violence for want of food and other basic amenities. This may lead to mental health problems like Psycho Trauma and Post Traumatic Stress disorder.   

    

Arms race is an important cause of release of gases responsible for global warming. This occurs right from manufacture to transport, deployment and the use of arms. Extreme changes in the climate may occur in the event of a nuclear fallout.  A study conducted by Dr Ira Helfand and Alan Robock et al on the ‘Climatic Consequences of Regional Nuclear War’ shows clearly that even a “limited” nuclear conflict, involving as few as 100 Hiroshima-sized atomic bombs will produce average surface cooling of -1.25ºC leading to crop failure, shortage of food which would put two billion people at risk.  

 

Human-induced depletion of ozone may cause diseases of skin like Malignant Melanoma, Non-Melanocytic Skin Cancer – Basal Cell Carcinoma, Squamous Cell Carcinoma, Sunburn, Chronic Sun Damage, Photodermatoses.   

  

People who are socially, economically, culturally, politically, institutionally, or otherwise marginalized are especially vulnerable to climate change.   

    

There is urgent need to take steps to prevent climate change. “We have the means to limit climate change,” said R. K. Pachauri – Former Chair of the IPCC. “The solutions are many and allow for continued economic and human development. All we need is the will to change, which we trust will be motivated by knowledge and an understanding of the science of climate change.”   

 

  

It is a matter of grave concern however that various governments have not kept the commitment to mitigate carbon emission. Developed countries are major defaulters. Developing countries have their own problems of growth. The Carbon credit system may mitigate carbon emission but it does not help self-reliant development of the poor countries.  

 

People’s movements are required to force governments to take effective measures in this regard. Laws have to be amended and implemented. In last 10 years over 10 crore trees were cut in our country for widening roads and highways; But not more than a lakh trees have been planted by govt. or public. Let us all pledge to plant trees,  which is a big contribution for combating climate change. We are not sure when the governments will learn. But as citizen concerned with life and health we have to do our bit for a better future for the generations to come.

 

 

 

 https://www.nationalheraldindia.com/opinion/global-catastrophe-looms-on-horizon-due-to-institutional-indifference-to-climate-change

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/climate+change+has+a+big+impact+on+the+healthcare+system+of+all+countries-newsid-n391543538?listname=newspaperLanding&topic=ipaspecial&index=0&topicIndex=1&mode=pwa

 

 

26 May,2022

Doctors Upfront for Social Harmony

 

Date: 26.05.2022

 

 

Doctors Upfront for Social Harmony

 

Peace and Harmony helped in development and growth in the human society most of the time; there have however been incidents of violence against others from time to time which have hampered socio-economic growth. Such incidents do not occur spontaneously. Studies have shown that most of the time they are instigated by some vested interests with political, economic, social and cultural motives.

 

The Homo Sapiens are supposed to be most intelligent of all species. It is beyond comprehension how and why they are swayed away and resort to violence that is undoubtedly detrimental. This has been seen in all societies and countries.   To understand this phenomenon and to find remedial measures we must look for pathophysiology and epidemiology of such incidents.  

 

Misinformation, distortion of facts and malicious propaganda form the basis of such happenings. This creates mass hysteria in the society. Goebbels’ thesis ‘Repeat a lie a thousand times and it becomes the truth’ is well known. A systematic campaign is launched against the other groups based on ethnicity, religion, linguistic background or other matters. They are blamed for all ills prevailing at the given time. This has been seen in Germany in 1930s against Jews and all others who disagreed; in Rawanda during Hutu and Tutsi violence. In South Africa, during apartheid regime. This is also evident in the racially charged killings in the USA recently. In South Asia it happened during partition of India in 1947 when nearly 25 lakh people from all major communities, the Hindus, Sikhs and Muslims killed each other.  We witnessed worst form of rioting against Sikhs in 1984 when mobs burnt the people alive. Similar things happened in Gujarat in 2002.  Besides this, terrorist violence continues unabated in Jammu and Kashmir and North East India. Incidents of violence between Shia and Sunni among Muslims are on record in Pakistan and other places.  

  

Citing reports of the National Crime Records Bureau (NCRB) the Minister of State for Home Affairs, Shri Nityanand Rai told in the Parliament that 857 communal or religious riot cases were registered in 2020, 438 in 2019, 512 in 2018, 723 in 2017 and 869 in 2016 that is a total of 3399 during this period of four years from 2016-2020. 

 

As a result of hate campaign in the recent period we have witnessed mob lynching, something hitherto almost unknown in our society. Most of those killed are Muslims while Dalits and others too have been killed. These are done on moral background by the so called vigilante groups. Killing of cows has been an excuse by such unruly mobs. They would not spare anyone and take no mercy even on their co-religionists. Police inspector Subodh Kumar a Hindu by religion was killed by the mobs in Bulandshehar. In the Neemuch district of BJP ruled Madhya Pradesh, Dinesh Khushwaha, the husband of former BJP councillor Bina Khushwaha killed Bhawarlal Jain suspecting him to be a Muslim.

 

There is a concerted effort in such situations to push the vulnerable groups into economic crisis. They are being prohibited from carrying out their jobs outside the places of worship of other communities. Ironically this was done even during the COVID pandemic when the vendors from minority communities were ridiculed and beaten and asked to stop coming to the societies of particular community.  

 

Youth, who should have been contributing to national development are being pushed to the task of violence. Unfortunately communally surcharged violent incidents by the so called Hindu nationalists occurred even in the capital city of Delhi.

 

It has been observed that most those indulging in such rioting belong to lower economic groups. Youth from the rich or the upper middle classes are never to be seen as part of these riot mobs. This also proves the point that unemployed or underpaid youth are used by the perpetrators of violence. Having failed to meet the demands of the people, the ruling dispensations divert attention of the people towards issues which have no relevance in our day to day life. Glorifying the past and distorting the history becomes a tool to create division and disharmony. We are witnessing how the issues of Mandir and Masjid are being raked up. Every day a new such issue is added.  

 

The end result of such incidents is injury and death of human beings in addition to economic crisis particularly among the lower income groups. This may help some groups for political or economic gains but ultimately it is the life form that suffers. 

 

For the medical professionals who are trained to preserve and promote health this is a very serious situation. Persistent hatred for others in the mind leads to sadistic behaviour and such person at one stage forgets any compassion, empathy or love for fellow human beings including the children. Therefore several medical groups from around the globe have come forward to rescue in such situations because doctors have to take care of the injured in such situations. Therefore by the very professional commitment the doctors are against any circumstance that create dis-harmony in the society. In fact many people have risked their lives in preventing incidents from taking ugly turn.  

 

Doctors have researched on how and why human brain gets affected by the dangerous slogans of breaking instead of uniting. How is it that knowing fully well the truth that we are all humans alike, people are made to feel different from others, even from those with whom they dwell every day, to the extent that they get motivated to kill  them. Killing of school children in Texas or in a mall in the US should be eye opener. Doctors have also through researches rejected the  supremacy theory of certain races, ethnic / religious groups and even gender and have found that when we mix more with each other we develop more empathetic and sympathetic attitude.

 

Time demands formidable struggle to work for social harmony. Medical bodies can always talk of health effects of the violence with focus on women, children and the elderly. We should encourage mixing of various social groups so as to understand each other’s cultural values and respect them. We should demand History to be taught in right perspective. Sometimes bitter past must be forgotten so as to move forward together. Different socio cultural groups should be encouraged to live in common localities instead of segregation. Common school system with children from various communities study together should be made compulsory.   

 

The Indian Doctors for Peace and Development has been continuously working on these issues and has decided to hold outreach programmes for social harmony.

 

It is the duty of the state to curb such incidents and take effective measures to prevent such happenings. The criminal mind is encouraged if it goes unpunished for a violent act. If the perpetrators of violence are eulogised, the situation gets worse. It is therefore important that those in power must come forward. Silence of top brass in the government including the Prime Minister over such incidents is sceptical.

 

 

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/social+and+communal+harmony+is+always+helpful+for+healthcare-newsid-n389871574?listname=newspaperLanding&topic=ipaspecial&index=2&topicIndex=1&mode=pwa&action=click

 

19 May,2022

SERVICE TO MAN IS SERVICE TO GOD

 

Date: 19.5.22

SERVICE TO MAN IS SERVICE TO GOD

Dr Arun Mitra

 

Speaking at a book release in New Delhi, the Chief Justice of India (CJI) N V Ramana pointed out that “several false cases are being lodged against upright and hardworking doctors” and that “they need a better and more secure working environment”. He said that “this is where professional medical associations assume great significance” and advised them “to be proactive in highlighting the demands”. He further said that the doctors’ profession “perhaps is the only profession which follows Gandhi ji’s principle – service to man is service to God”. Medical professionals have to a large extent proved this during the Pandemic. As healthcare soldiers they served the society not caring for their lives. Over 1600 doctors lost their lives to COVID-19.

Scientists did commendable job by giving timely warnings and preventive updates about COVID-19 from time to time. The way vaccine has been developed in an emergency is a clear reflection of dedication of medical professionals who have proved that they take the health of the people as their utmost duty.

It is also worthy to note that the unscientific ideas like Gau Mutra, Cow Dung and even Tantra Mantra as cure for the disease were propagated. These myths  hampered management of COVID. But the scientific medical opinion countered it timely and effectively.   Medical organisations contested the promotion of Coronil by the Union Health Minister. They also contested Ramdev’s statement that people died despite the doctors, despite oxygen and due to vaccines.

The society on the whole recognized doctors’ efforts. But despite the fact that doctors played glorious role during Pandemic they and other health workers had to face unruly behaviour at some places. A doctor couple in Delhi had complained that the people living in the society where they have their house avoided them just because they are on the COVID duty and they feared that this couple will infect them too. Similarly some nurses were not allowed to enter their place of stay fearing that other persons in the locality will catch infection. Undeterred however the health workers continued to work for which they need appreciation and encouragement.

Ironically there have been several incidents of violence against the doctors, targeted by the unscrupulous mobs, some times with support of  so called local leaders who instigate for extracting money. Many a times it is the young doctors, who are on regular duty, working tirelessly day and night in the hospitals, without food, rest or break  have to face such violent attacks. Still under training to develop communication skills to gain trust of the patients they become soft targets. There are laws to deal with grievances against doctors. Violence under any circumstances cannot be excused and emotions cannot be allowed to turn into violent behavior. Unfortunately several times media too paints the doctors’ image in a bad light.  

The National Human Rights Commission of India has come out with a 17 point charter of rights of the patients. The charter has also specified duties of the patients which include that the patient should respect the dignity of the doctors and other hospital staff as human beings and as professionals, whatever the grievance may be. Patient or caregivers should not resort to violence in any form and damage/destroy any property of the hospital or the service provider.

A national level law against violence on doctors can be a strong deterrent. Information about such laws should be percolated down to the citizens and the law enforcing agencies through media. It has been observed that the police at the Thanas is unaware of such laws in the states where these laws exist.

During violent situations the doctors have to face dilemma many a times. If the doctor treats the patient brought by the militant group – It is professional and ethical duty of the doctor to give medical care but the security forces take it otherwise and doubt her/his integrity. The doctor is thus at many times under double pressure.   

Nobel Laureate Dr Denis Mukwege, who has worked for decades with great courage and compassion to address the needs of survivors of sexual violence in strife ridden Democratic Republic of Congo (DRC) and around the world, faced a deadly assault in which he narrowly escaped but his guard was killed. Undeterred he never gave up. This is true for situation in several parts of our country as well.

Poor health indicators in our country are a matter of worry. India’s Infant Mortality rate is 29 per 1000 live births and Maternal Mortality rate 103  per 100,000 live births. There occur death of 32 persons per one lakh population per year due to Tuberculosis. We lose children to Dengue fever, Encephalitis, Diarrhoea and Malaria. Non communicable diseases too are on the rise; 29.8% of Indians have hypertension. India had 72.9 million diabetes patients-second only to China (114.3 million), and is soon likely to become the diabetes capital of the world.  It is therefore important that all citizens of the country get required healthcare, both preventive and curative.

The WHO is forthright in saying that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion and political belief, economic or social condition”.       It is pertinent that health has to be a fundamental right. This means these are justiciable, i.e. enforceable through law in case of their violation, the individual can approach courts for redress.   

India is signatory to Alma Ata declaration of 1978.  The conference held at Almaty in Kazakhstan strongly reaffirmed that “health, which is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.”  As a signatory to this declaration India is duty bound to implement the clauses. 

Equity in healthcare is an important factor for the progress of society. No one should get sick and die just because they are poor, or because they cannot access the health services they need.   

Determinants of health   include access to safe drinking water and sanitation, nutritious foods, adequate housing, education, safe working conditions and proper remuneration.   Poverty alleviation is essential for good health. Poverty leads to poor health which in turn is a cause for poverty. In the present scenario   75% of healthcare expenditure has to be met with from the pockets of households – 80% OPD, 60% Indoor.  National Health Policy 2017 document and a recent document by the NITI Ayog admit that every year 63 million population of India is pushed towards poverty due to out of pocket expenditure.   

 

The doctor-population ratio in India is 1:1200.   The government doctor-population ratio – 1:10926 against the desired 1:1,000. This has to be changed to meet people’s health needs. But it is a worrying factor that real income of people is going down. Whereas the Russia Ukraine war and COVID have added to the prices of essential commodities, the prices of these items in our country have been going high every day for a long time. According to Krishna Raj, Professor Institute for Social and Economic Change Bengaluru, the prices of essential food items have increased by 50% in the last 7 years whereas the real wage rate has increased by 22% only. This is seriously affecting the poor people as food which is essential to sustain life is getting out of reach forcing them to borrow. As a result according to NSSO the consumption expenditure on food in rural India has come down drastically. 

Such situations are a cause for health bodies. In the absence of support from the state the doctors are many a times left with no option but to underperform.

Doctors have done wonders and have earned worldwide applaud. Doctors without Borders is providing selfless service worldwide and the International Physicians for the Prevention of Nuclear War (IPPNW) has earned Nobel peace Prize for its relentless work for global peace.  

Health can form a bridge of peace at various levels. Negotiations around healthcare delivery cultivate informal channels of communication that can contribute indirectly and directly to the peaceful settlement and confidence building. Such activities can change the dynamics of the situation. Doctors have to thus work on various fronts to promote social harmony, socio-economic uplift of the toiling masses, protection of rights of vulnerable sections of the society, promote global peace & disarmament and provide healthcare in arduous conditions. True, Gandhi Ji said that  ‘Service to Man is Service to God’.

 

https://ipanewspack.com/most-indian-medical-professionals-are-doing-a-splendid-job-in-their-area/?utm_source=rss&utm_medium=rss&utm_campaign=most-indian-medical-professionals-are-doing-a-splendid-job-in-their-area

 

https://techy-job.com/most-indian-medical-professionals-are-doing-a-splendid-job-in-their-area/

 

https://newsindiareviews.com/most-indian-medical-professionals-are-doing-a-splendid-job-in-their-area/

 

https://novonite.com/most-indian-medical-professionals-do-a-great-job-in-their-area/

 

https://thearabianpost.com/most-indian-medical-professionals-are-doing-a-splendid-job-in-their-area/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/most+indian+medical+professionals+are+doing+a+splendid+job+in+their+area-newsid-n387793774?listname=newspaperLanding&topic=ipaspecial&index=0&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article38487-MOST-INDIAN-MEDICAL-PROFESSIONALS-ARE-DOING-A-SPLENDID-JOB-IN-THEIR-AREA

12 May,2022

Nuclear Weapons Free Zone for regional security in South Asia

 

Date: 12.5.22 

 

Nuclear Weapons Free Zone for regional security in South Asia  

 

Dr Arun Mitra 

Co-President IPPNW 

      

In 1998 that is 24 years back on 11th May India carried out first nuclear weapon test under the Vajpayee government. The event was celebrated with fanfare; public was jubilant over that India has now become a power to reckon with. Those who termed the event as a step towards mutually assured destruction were ridiculed. But just after 17 days on 28th May Pakistan too did the same. Observers felt that Pakistan has became at par with India in nuclear weapons race. Mood of the supporters of nuclear weapons in the country got subdued. Some experts argued that India who had superiority over Pakistan in conventional warfare has lost that since both countries have become nuclear armed. Exact figure unknown but there are estimates that both have 100 plus nuclear weapons each.  The nuclear lobby argued that these weapons will serve as deterrent to war between the two countries who have been having perpetual tension since long. This hypothesis however was proved wrong as in about a year there was war between India and Pakistan at Kargil front in 1999.  Terrorism from across the border continues unabated. There was terrorist attack on the Indian Parliament after which armies of the two countries were face to face on high alert with fear of use of nuclear weapons looming large. Possession of nuclear weapons has not deterred standoff between India and China either. There were skirmishes between the two at Galwan in June 2020. Now the nuclear lobby is actively propagating that if Ukraine had nuclear weapons,  Russia would have not attacked.  

      

South Asia comprises of eight nations: India, Pakistan, Bhutan, Nepal, Bangladesh, Afghanistan and the island nations Sri Lanka and the Maldives. Although South Asia occupies only 3.4% of the world’s land area, the region is home to approximately 24% of the world’s population, making it the most densely populated place on earth. Despite being rich in natural resources, it is among the poorest regions of the world in terms of per capita income, with 40% of the world’s poor living here. Still countries of the region especially India and Pakistan spend lot on arms race.  Expenditure on nuclear weapons adds to their defence budget. As a result the countries of the region are left with little to spend on health, education and development.  

 

Arms race in the region on the rise. With the ambition to become arms exporter India has already signed a $375 million agreement with Philippines to supply supersonic shore-based anti-ship BrahMos missile system with a range of 290 km developed jointly with Russia. Reports are that more such  agreements are likely to be signed with Vietnam and Indonesia. With China acquiring advanced weapons system India has the excuse to manufacture and export arms. After China made its first nuclear bomb in 1964, there was lot of pressure on India to build nuclear weapons.   

  

 

There is need to reverse this situation through mutual dialogue and confidence building among the nations. Civil society can play a big role in highlighting the humanitarian impact of nuclear weapons and build public opinion in India and Pakistan to join the Treaty Prohibiting Nuclear Weapons and for diversion of funds from arms race to development.      

   

 

The peace movements have multifaceted tasks ahead. They have to build strong public opinion for disarmament. Medical peace activists have to explain how the arms race is affecting our health adversely. The message of the study by Dr. Ira Helfand, Co-President IPPNW on climatic consequences of limited nuclear war using 100 Hiroshima sized atomic bombs between India and Pakistan, which would put over two billion people at risk, has to be taken down to the masses as well as the decision makers.        

      

Steps need to be taken for a lasting peace and nuclear disarmament in the region. Structural drivers for war have to be identified and peace activities have to be designed accordingly. India has been the harbinger of the non-aligned movement, which was initiated by the first Prime Minister Jawahar Lal Nehru along with Marshal Tito of Yugoslavia and Gamal Abdel Nasser of Egypt. The basic thrust of this movement has been non alignment from any blocks, based on the principle of respect to sovereignty and integrity of other nations. India also proposed the Rajiv Gandhi action plan for nuclear disarmament in 1988.      

  

  

However given the aggressive nationalism and macho approach towards militarization, the task of peace making has become all the more difficult. India and Pakistan have not been receptive to the idea of nuclear disarmament. The ministers of the present government at the centre did not have the courtesy to meet with a delegation from IPPNW, a Nobel Laureate organization, in March 2018 at the time of an international seminar on the TPNW in New Delhi. Previously, all ministers, including the President and the Prime Minister, had shown a willingness to engage with such delegations.     

   

Under these circumstances it has become important to initiate discussion on making south Asia a Nuclear Weapons free Zone (NFZ). Presently such zones exist in Latin America, Caribbean, South Pacific, Southeast Asia, whole of African continent and Central Asia which cover 39% of world population.   

  

Chairman of an NGO, Blue Banner,      Dr. J. Enkhsaikhan of Mongolia is quite vocal on the necessity of Nuclear-weapon-free zones (NWFZs). According to him these are recognized as important and practical regional measures of non-nuclear-weapon states (NNWSs) in promoting the goals of nuclear non-proliferation and strengthening confidence among states. Whereas the concept covers the regional areas but Mongolia set an example by declaring its territory as a single state Nuclear Weapons Free Zone in 1992.    

   

It is imperative for the non-nuclear states in the south Asian region to build pressure on India and Pakistan to abolish their nuclear weapons and make the region NWFZ. With a long history of non-alignment and with people of India and Pakistan having same cultural values and language, even relations they will be overwhelmed with the idea. Peace activists and organisations have to carry it forward and initiate a dialogue on the issue. This appears to be a task difficult but not impossible. Humanitarian benefits for this would be manifold. It is well known now that nuclear weapons could not save us from Pandemic. They have utterly failed to even alleviate poverty and hunger so much rampant in our region. Even if India and Pakistan are unwilling, other non-nuclear weapons countries of the region can  declare south Asia as NWFZ and put pressure on the two countries. 

 

 

https://themeghalayan.com/s-asia-should-be-free-of-n-weapons/

 

https://www.thenorthlines.com/south-asia-should-be-made-into-a-nuclear-weapons-free-zone/

 

https://dailyheadlinestoday.com/epaper/view/352/epaper-headlines-today/9

 

https://ipanewspack.com/south-asia-should-be-made-into-a-nuclear-weapons-free-zone/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/south+asia+should+be+made+into+a+nuclear+weapons+free+zone-newsid-n385663386?listname=newspaperLanding&topic=ipaspecial&index=2&topicIndex=1&mode=pwa&action=click

 

 

28 Apr,2022

We will not let mankind vanish

Date: 28.04.2022

 

We will not let mankind vanish

Dr Arun Mitra

 

With repeated rhetoric of use of nuclear weapons between Russia and Ukraine, fear has gripped the minds of people around the globe. Rightly so, as the use of nuclear weapons would lead to unprecedented catastrophe. If the war doesn't stop soon there is likelihood of direct involvement of other countries particularly the US and NATO. In such situation the use of nuclear weapons will be more imminent. Studies conducted by the International Physicians for the Prevention of Nuclear War (IPPNW), Nobel Peace Prize winner in 1985 have shown with evidence that a nuclear exchange between major nuclear powers, would be end of modern civilization built through thousands of years of human labor. The nuclear exchange would lead to formation of huge amount of smoke and suit in the atmosphere. This would in turn obstruct sunlight from reaching the earth surface. It will cause drop in temperature of earth leading to nuclear winter. As a result there would be crop failure and  starvation of billions of people and livestock. 

 

Bombardment by the Russian army has already caused  immense loss of lives and resources in Ukraine. Reports suggest Ukraine’s mounting death toll includes a growing number of researchers, Physicists, chemists, and mathematicians among the thousands killed. ( https://www.science.org/content/article/ukraine-s-mounting-death-toll-includes-growing-number-researchers)  There have been reports of deaths of several Russian soldiers as well. Several cities of Ukraine have been virtually turned into rubble. Millions have fled Ukraine and are living in refugee camps in Poland, Romania and other countries. As always happens in the refugee camps these people are facing several hardships, physical and mental trauma with reports of increasing abuse of women and children.

 

This is the time for vigorous peace talks, but they seem to have taken back seat. International efforts to end the war too have dimmed.

 

Whereas Russia is losing a lot on the economic front as a result of sanctions, other countries too are bearing  the brunt.  Russia is the main source of Gas supply to the European countries. Any cut in the supply will lead to shortage of gas in the Europe with detrimental effect. The war can cause serious crisis of food security in the world. According to economist Aunindyo Chakravarty both Russia and Ukraine together are responsible for 1/4th of global export of Wheat, 1/6th of Maize and 3/4th share in the Sunflower oil.  The two together also supply 1/5th of fertilizers to the world. As a result of war the prices of all these have increased.

 

It was expected that in the COVID times the world will unite together to formulate future strategies to prevent such diseases and their health and economic impacts.  But it was not to happen. Instead the world has been plunged into arms race and threat of nuclear weapons. Several countries are already on the line to increase their arms budget as a guarantee to security. They are purchasing the weapons in large number. Some countries are in the weapons manufacturing spree. Indian government has already decided to become an arms exporter. Boris Johnson the British Prime Minister who was on a visit to India recently called Indian Prime Minister Narendra Modi as his ‘special friend’ and assured that UK will provide India knowhow on manufacturing  ‘battle-winning’ fighter aircraft. The arms race is going to increase causing further misery in the poor countries.

 

Whereas people want immediate cessation of war through resumption of dialogue between the warring parties, it appears the arms manufacturers and sellers around the world will not let the war to end soon. Instead of taking initiative for necessary steps to end the war, the US and the NATO are instigating Ukranian Prime Minister Zelensky by clapping at his speeches sitting in their Parliaments. They are supplying arms to Ukraine to keep on fighting even at the cost of the lives of hundreds and thousands of the people.

 

Whereas Vladimir Putin’s action of aggression cannot be condoned, the role of NATO and the US is highly conspiratorial. The very existence of NATO is questionable. NATO came into existence on 4th April 1949 after the Second World War. In fact, the alliance's creation was part of a broader effort to serve three purposes: deterring Soviet expansionism, forbidding the revival of nationalist militarism in Europe through a strong North American presence on the continent, and encouraging European political integration. The major reason was to counter Soviet Communist block. The Warsaw Pact came into being on 14th May 1955, six years after the formation of NATO with the purpose to counterbalance the NATO.  Since the Warsaw Pact does not exist anymore, there is no justification in continuation of NATO but for serving the interests of global military industrial complex. Unfortunately after the fall of Soviet block, instead of dissolving the NATO, number of countries in the NATO has increased. The war has given excuse to some governments to join NATO to get security umbrella. Reports that Sweden and Finland intend to join NATO are a dangerous signal. There is fear that more military blocks will come up in Asia and other continents, further leading to increase in the arms race. We are already witnessing the groups like AUKUS and QUAD. However the role of India in not aligning with any side is appreciable and represents carrying forward the legacy of Non Aligned Movement (NAM) started by Nehru, Tito and Nasser which is much needed in the present day world.

 

The IPPNW is persistently highlighting the humanitarian crisis and trying to educate the public, even the governments that nuclear weapons are the weapons of mass destruction. There is never a win-win situation in the use of nuclear weapons, rather this is a mutually assured destruction. The only way is to abolish the nuclear weapons, as medical science has no remedy to offer in case of a nuclear fallout.  The IPPNW of which the author is a Co-President, as a partner in the International Campaign to Abolish Nuclear Weapons (ICAN) has repeatedly called upon all the countries including the nuclear weapons possessing countries to join Treaty Prohibiting Nuclear Weapons (TPNW) to save life on earth. The Doctors affiliated to IPPNW have taken a pledge to not let this catastrophe happen. The message from the recent Board and International Council meetings of the IPPNW is that people are a big force and they will not let their species to vanish from Earth? They have decided to forcefully raise this in the first Meeting of States Parties (1MSP) to the TPNW scheduled for 21-23 June 2022 in Vienna, Austria. 

 

 

https://themeghalayan.com/fear-real-over-russia-ukraine-war-escalating/

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/continuing+russia+ukraine+war+is+leading+to+apprehensions+about+escalation-newsid-n382031752?listname=newspaperLanding&topic=ipaspecial&index=8&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article38384-CONTINUING-RUSSIA-UKRAINE-WAR-IS-LEADING-TO-APPREHENSIONS-ABOUT-ESCALATION

 

https://ipanewspack.com/continuing-russia-ukraine-war-is-leading-to-apprehensions-about-escalation/

 

 

 

22 Apr,2022

Never Whisper in the presence of wrong

Date: 22.04.2022

                   

Never Whisper in the presence of wrong

Sharpen your opposition to divisive politics

 

Dr. Arun Mitra

  

‘Never Whisper in the presence of wrong’ is a quote attributed to Dr Bernard Lown, the founder president of the International Physicians for the Prevention of Nuclear War (IPPNW) from 1980 to 1993, who said ‘The ticking of numerous time bombs demands critical re-examination of the existing world order. The new way of thinking must be a final awakening to our common origins, to our shared problems as well as to our common fate. If we all are to prevail, we must never delegate in the presence of challenge and never whisper in the presence of wrong’.  

 

Lown said it in relation to the nuclear weapons, but it is true for several other situations as well.  Any type of violence is a cause of concern as it causes both physical and mental trauma. Violence is not just a law and order problem but an issue of public health importance. The world has seen catastrophic impact on human health in 1945 when the cities of Hiroshima and Nagasaki were atomic bombed by the USA. The Second World War led to loss of over 50 million lives and left over 90 million wounded. The USSR alone lost 18 million people.

(https://www.google.com/search?q=number+of+deaths+in+2nd+world+war&oq=number+of+dead+in+2nd+world+war&aqs=chrome.1.69i57j0i13j0i390.9167j0j15&sourceid=chrome&ie=UTF-8 )

 

The conflicts have not stopped thereafter. Dr.Barry S Levy Adjunct Professor of Public Health, Tufts University School of Medicine in a presentation at an event organized by the IPPNW on 19th February 2022 pointed out that the studies have revealed that since 1990-2017 there have occurred 50000 direct deaths annually as a result of armed conflicts while the indirect deaths have been more than one million.

 

Many a times the conflicts are engineered by the interested groups. They use   divisive ideology and spread hared in the society. Harping on nostalgia of the past glory and hyper-nationalism they incite violence. In the recent years pushing the society into violence has become a tool for some to remain in power.

 

 

 

Ethnic strife between the Hutu and Tutsi tribes was the cause of death of nearly 800000 people in Rawanda. So much was the hatred spread against the each other that husbands killed their wives who belonged to the other tribe and with whom he must have been in extreme love that decided to marry. Nearly 2.5 million Hindus, Sikhs and Muslims were killed in the communal violence following partition of India in 1947 causing serious humanitarian crisis. Religious fundamentalism of the type of Taliban is danger to the society. What will be the end result of Russia Ukraine conflict, we do not know!

 

Fearing similar situation in the country due to on-going acts of some bigots and at many places with overt or covert support of the state machinery, several saner elements have expressed anguish at the events. Numerous videos have been circulating on social media condemning these moves to break the social fabric of the society by targeting minorities, especially Muslims, by the ‘Hindutva’ brigade in many places. They have been appealing to the Prime Minister to break persistent silence on these incidents as it makes one sceptical of his support to such elements. It appears as a member of the RSS and its pracharak at one time he is faithfully carrying forward the agenda put forth by the second Sarsanghchalak (chief) of the RSS,  M S  Golwalkar who in his book ‘We and Our Nationhood Identified’ clearly states that whenever they come to power, first of all hand over the government property, state lands and forests to the 2-3 trusted rich people of the country. Make 95% people beggars and after that power will not be lost for seven generations. He also said that ‘all his life I am ready to be enslaved by the British but I do not want such freedom which gives equal rights to Dalits, backward classes and Muslims’. Narendra Modi believes and practices this ideology of his Guru! Everyone can see how the nation’s wealth is being handed over to two families, namely Ambani and Adani. This is reminiscent of Nazis. 

 

Therefore it would be naïve to appeal to and to expect from him to take such elements to task. It is time to stand up and fight against this kind of ideology that splits the social fabric. This is not the time to be silent, but to speak up and remember the quote ‘never whisper in the presence of wrong’.

 

 

 

https://www.nationalheraldindia.com/opinion/its-imperative-to-speak-up-against-divisive-forces-out-to-tear-indian-societys-fabric-before-its-too-late

                   

https://www.imphaltimes.com/pdf/2022/April/24%20April.pdf

 

https://ipanewspack.com/never-whisper-in-the-presence-of-wrong/

 

https://tryxyz.com/article38332-NEVER-WHISPER-IN-THE-PRESENCE-OF-WRONG

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/never+whisper+in+the+presence+of+wrong-newsid-n379904054?listname=newspaperLanding&topic=ipaspecial&index=7&topicIndex=1&mode=pwa&action=click

 

 

11 Apr,2022

Emerging challenges in healthcare

Date: 11.04.2022   

   

Emerging challenges in healthcare 

    

Dr Arun Mitra   

   

Healthcare today is faced with several challenges right from medical education, primary prevention of disease, delivery of healthcare, funding for healthcare, scientific inputs, drug pricing etc. In the ancient times promotion of good health was learnt through day-to-day experience, so developed the concept of developing resistance to diseases through healthy nutrition or through specific methods like the use of herbs or other natural products. Modern scientific medicine carried forward that knowledge through extensive research to find normal functioning of the body, the causation of disease and methods of management of the disease and promotion of good health. 

 

In India health planning started with the formation of a committee popularly known as Bhore committee under the chairmanship of Sir Joseph Bhore  in 1943 to survey the then existing position regarding health conditions and health organizations in the country. The committee in its report in 1946 recommended that “the health programme should be developed on a foundation of preventive health work and that ‘if the nation’s health has to be built, such activities should proceed side by side those concerned with treatment of patients’.  It was based on the principles that  ‘no individual should be denied to secure adequate medical care because of inability to pay; health programme must lay special emphasis on preventive work; health service should be located close to the people; medical services should be free to all without any distinction and doctor should be a social physician’. The committee also observed that ‘health and development are inter-dependent and improvement in other sectors like water supply, sanitation, nutrition, employment led to improvement in health status’. Interestingly this is also the period when the British government introduced National Health Services in England. The Soviet Union had already introduced the concept of state’s responsibility of healthcare to all in 1936. 

   

In the first few decades after independence, direction of the healthcare in our country was based on these principles which gave priority to public health. During that period much of the health care was developed in state sector with a special emphasis on the need for basic healthcare services. As a follow up India signed Alma-Ata Declaration in 1978 which identified primary healthcare as the key to the attainment of the goal of Health for all and conceptualized ‘health as the core function of development, encompassing the securities of life, livelihood, and basic services including food, health, education, housing, sanitation, drinking water, electricity, and transportation’.  

   

In 1980s when neo-liberal economic policies were adopted there occurred a policy shift towards health that treats health as ‘techno-dependent and amenable to commodification’. Even the World Health Organisation (WHO) started working under the influence of international monopoly corporates and took position to increase privatization and partnership with multinational companies.  In our country we find that the public sector is now responsible for the preventive services while the private sector on the other hand is investing heavily in secondary and tertiary care with a profit motive making the advanced care out of reach of low and even middle income group population.   

   

 

There has been a paradigm shift in the approach from the first National Health Policy – 1983   which emphasized on promotive, preventive curative and rehabilitative services. The National Health Policy (NHP)  2017 however made a leap forward to corporate centric and insurance based healthcare system. As a result public funds are being diverted to the private insurance and health care sector.   This is a period following World Trade Organisation which was founded on 1st January 1995.  

          

Presently 75% of healthcare expenditure comes from the pockets of households – 80% for OPD care and 60% for Indoor care. This catastrophic healthcare cost is an important cause of impoverishment which further adds to poor health. No wonder the government recognises the fact that every year 6.3 crore people are pushed below poverty line because of out of pocket expenditure on health. 

    

India has roughly 20 health workers per 10,000 population. Total doctor-population ratio including the doctors of modern medicine and AYUSH as told  by Shri Mansukh Mandaviya, Union minister of health and family welfare in the Rajya Sabha April 5, 2022,  is 1:834. It is to be noted that Govt. doctor-population ratio is 1:11,926 in contrast to the desired 1:1,000. This is a major cause of inequality in healthcare to the marginalized sections who are dependent solely on state healthcare system. WHO recommends minimum of 5% of the GDP as expenditure on health, while in contrast our public  health spending is hovering around 1.1% of GDP.    

   

That out of a population of 100000 in our country 32 persons die due to Tuberculosis every year, is a matter of grave concern and shame. Similar is the condition of other communicable and non – communicable diseases. Because of poor planning the diseases like Malaria, Tuberculosis, Cardiac illnesses, Diabetes, Cancers etc. got  ignored during the COVID Pandemic. Despite all the above happenings, the Constitution of India does not expressly guarantee a fundamental right to health. 

   

There is need to set up Primary Health Centre at every 30000 population, with 24-hour service, a Health Sub-Centre at every 5000 population and a fully staffed Community Health Centre with all facilities at every 100000 population. Establish round-the-clock ambulance service at every 30000 population. Post women medical and paramedical personnel in all health centres and hospitals in adequate numbers. All Government health facilities should adhere to Indian Public Health Standard (IPHS) norms. 

 

Medical education too is on the same lines.   In the last few decades there has been shift from opening the medical colleges in the state sector to the private sector.   

According to the website of the National Medical Commission (NMC) presently India has 605 medical colleges with 90825 seats for the under graduate course. Out of this 306 colleges with 45035 seats are  in the state sector. The number of colleges in private sector is 289 with 43965 seats and others 10 colleges with 1825 seats.  The tuition fee in the private colleges ranges from 60 Lakh to over one crore rupees. This is far beyond the capacity of even the middle classes. Therefore the students look for relatively cost effective institutions. For study in the colleges abroad total cost including the travel and stay is around 30 Lakh rupees. This is pushing the students to study abroad. We have seen how the students in Ukraine had to suffer during the on-going war with Russia.     

 

Since nutrition is the key to good health, it is imperative that Malnutrition is eliminated by implementing National Food Security Act 2013 which aims to provide subsidised food grains to approximately two thirds of India’s people and ensures maternity entitlements to all pregnant women. Set up Nutrition Rehabilitation Centre at each block to address the issue of severely malnourished children.   

    

 

Even though expenditure on drugs forms nearly 63% of the out of pocket expenditure on health, till date we lack a Rational Drug Policy that allows drugs to be sold only under their generic names. The drugs pricing policy is faulty that lets the pharmaceutical companies fix up prices at their own will. There is need to ensure improved availability, accessibility and affordability of drugs including vaccines and sera in the public health system through quality conscious pooled procurement systems and promotion of manufacture of essential medicines. Drugs prices should be calculated based on their cost of production. Recommendations of the report of ‘Committee on High Trade Margins in Sale of Drugs’ submitted on 9th December 2015 need to be implemented. The National Pharmaceutical Pricing Authority should be strengthened further.  

   

It is disgusting that unscientific non evidence based methods of treatment are being spread in health care. Promotion of Cow urine, Cow dung and Ramdev’s Coronil as treatment of various diseases including the COVID-19 has been done by the higher ups in the government including the union health minister Dr Harshvardhan, who himself is an ENT Surgeon. Latest decision of the NMC to introduce Charak Shapath instead of a scientific oath by the doctors of modern medicine is totally unscientific. The Charak Samhita written 300 BC says that a physician has to live a life of celibacy and grow beard. He has not to see a patient who is not liked by the king. This means women cannot be doctors.  

 

Some colleges have made it compulsory for the internes of modern medicine to get raining in the AYUSH.  It may be understood that there is conceptual difference about causation and treatment of disease not only between modern medicine and AYUSH but also between various constituents of AYUSH. The National Medical Commission (NMC) has also decided that the medical students of modern medicine should undergo training of Yoga under a yoga teacher and observe 21st June as Yoga day. 

    

There has to be a concerted effort to develop a healthy India through scientific outlook, otherwise health of vast majority of our poor population will continue to be exploited through false beliefs and myths in healthcare and exorbitant charging. State has to come forward to take responsibility for health to all and for that declare health as a fundamental right.   

 

 

https://www.nationalheraldindia.com/india/right-to-health-must-be-declared-a-fundamental-right-state-must-act-to-serve-common-man

 

https://dailyheadlinestoday.com/epaper/view/327/epaper-headlines-today/8

 

https://www.thenorthlines.com/indias-healthcare-policy-needs-a-paradigm-shift-to-serve-the-commoners/

 

 

01 Apr,2022

The death of a doctor !

Date: 01.04.2022   

  

The death of a doctor !  

  

Dr Arun Mitra  

  

Suicide by Dr Archna Sharma, a senior Gynaecologist of Dausa in Rajasthan has shaken the medical fraternity. A patient is reported to have died during a procedure after which the attendants under the reportedly under the patronage of a BJP leader created ruckus. The police instead of controlling the mob registered a case of murder against the doctor U/s 302 IPC. Perturbed over this, the doctor committed suicide. Police role in this case is highly condemnable and demands of registering case of abetment to suicide against the concerned police officials.   A doctor is more than a healer. She/He is not just adding to the economic development but also addressing the emotional part of the patient and the family. Her/his loss cannot be counted in terms of money. With the death of a doctor thousands of patients get devoid of sympathy and empathy they were getting from a trusted person. Loss of Dr Archna Sharma has to be viewed in this context. 

  

This is not for the first time that violence has taken place against the doctors. Maximum of such incidents have occurred in Maharashtra. The violent incident in Bengal two years back got so much highlighted because the political atmosphere was highly surcharged. Doctors can be booked for negligence U/S 304A only after a thorough enquiry into the incident. Registering murder charge on a doctor without enquiry is equivalent to a criminal offence on the part of the law enforcing agency. How can one work in the atmosphere of uncertainty, particularly so when it comes to treating a person which requires lot of concentration, care and empathy.   

  

We need to ponder over the reasons for such repeated acts of violence, immediate measures required to prevent such acts and the long term solutions to ameliorate the situation?   

  

When death of a near and dear occurs emotional outburst is understandable. This does not in any way mean that they should resort to violence. There are several ways to redress the grievances. Many a times the young doctors in the hospitals have to work continuously for up to 36 hours or more. This puts them under lot of stress and strain.  At the beginning of their career they are learning to develop communication skills to satisfy the patient’s attendants. Whatever the reason, the society has to understand that those giving treatment are trained to heal, not to kill. As medical students they are taught to be modest and sympathetic. Barring a few black sheep negligence is not a rule but an exception. As negligence cannot be condoned, so is the violence never justifiable.  

  

A national level law against violence on doctors can be a strong deterrent. But many a times those perpetrating violence are ignorant of laws. Unfortunately it has been found that the law enforcing agencies too lack such information.   

Our health care facilities in state sector lack required infrastructure. With a meager 1.1% of the GDP spending on health in the public sector, the patients have to look forward to the private sector for secondary and tertiary care which costs them exorbitant amount. This becomes another point of discord.    

  

It is time the doctors take interest in the public concerns on the health issues. This will   integrate them with the society. Not many medical bodies reacted to deaths in Muzaffarpur, nor in Gorakhpur. The medical bodies failed in supporting Dr.Kafeel who had to languish in the lock up because he raised the faults in the healthcare infrastructure at Gorakhpur.   

  

Medicos should be in the front rows to help the needy in the event of natural calamities or other situations of public health crisis. Such gestures help to remove negative feelings about medical professionals in the society.  

  

Culture of violence is being made a norm in our country. Calling ourselves followers of Buddha, Guru Nanak and Gandhi we have seen violence to the extreme in 1984, 2002 in which even the doctors were not speared. Now we are witnessing it in the form of vigilantes and mob lynching. Some of the law makers have been issuing very irresponsible statements, even rewarding those involved in mob lynching. Those at the helms of affairs should show more responsible behavior. If violence is eulogized then it becomes a norm and part of psyche which does not spare anyone, even the perpetrators.  Violence prevention has to be a public health issue. The doctors have to stand against all sorts of violence. Unfortunately we react only when it happens to us. The communal frenzy being raised will further deteriorate the situation. Medical professionals have to be in the fore front to lead movements for social harmony. History is witness to how a section of doctors helped Nazis in eliminating the opponents. 

  

Pledge by the doctors to raise collective voice against any kind of violence and efforts to change the culture of violence being promoted by the vested interests will be the real tribute to Dr Archna Sharma.  

 

https://themeghalayan.com/harassment-haunts-medical-profession/

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/death+of+a+doctor+harassment+haunts+medical+profession-newsid-n373477058?listname=newspaperLanding&topic=ipaspecial&index=1&topicIndex=1&mode=pwa&action=click

https://tryxyz.com/article38180-DEATH-OF-A-DOCTOR-HARASSMENT-HAUNTS-MEDICAL-PROFESSION

https://ipanewspack.com/death-of-a-doctor-harassment-haunts-medical-profession/

 

21 Mar,2022

Medical ethics must be updated on the basis of scientific evidence

 

 

Date: 21.03.2022

 

Medical ethics must be updated on the basis of scientific evidence 

 

Dr Arun Mitra

 

The Under Graduate Medical Education Board (UGMEB) of the National Medical Commission (NMC) in its video conference meeting held on 17th February 2022 has decided to replace the Hippocratic Oath taken by the doctors to affirm their commitment to medical ethics while treating the patients. This will be replaced by the Charak oath. Charak is a legendary figure in the history of medicine of our country. There are two names which are taken with reverence while remembering the history of medicine of ancient India. Charka was a physician in 300 BC and Sushruta, a surgeon in 600AD. We have all the respect and reverence. for their work in the contemporary time. Same is true for Hippocrates a Greek doctor who lived in 460 BC. Even though the name Hippocratic Oath is commonly used, in fact it is a declaration that the medical professional has to give at the time of entry into the medical practice. The Medical Council of India has formulated medical ethics for the doctors under the ‘Professional Conduct, Etiquette and Ethics’. According to this a doctor has obligation to serve the patients to the best of her/his ability and knowledge without consideration of financial returns as a primary motive. It is therefore important. To review why the above decision to replace Hippocratic Oath by the Charak Oath has been taken by the NMC, whether it has any medical background/logic or any scientific basis, or it has some other motives behind it ? 

 

A group of doctors including Dr B Srinivas Kakkilaya, Consultant Physician, Mangaluru, Karnataka, Dr Yogananda Reddy, Consultant Paediatrician, Ballary, Karnataka, Dr. P Venkataraya Bhandary, Consultant Psychiatrist, Udupi, Karnataka, Dr Shashidhar Bilagi, Consultant Psychiatrist, Bengaluru, Karnataka, Dr Prakash C Rao, Senior Family Physician, Bengaluru, Karnataka in a letter to Dr. Suresh Chandra Sharma, Chairman, National Medical Commission have expressed their serious reservations over the move of the NMC. They have pointed out that the NMC is concerned with imparting modern scientific medicine and that the modern scientific medicine belongs to the whole world, including India, and that it has continuously evolved, and evolving, absorbing the best of medical knowledge from ancient times, including Ayurveda, Greek Medicine, Chinese Medicine, Persian Medicine etc. Similarly, the Oath of Medical Ethics, that every practitioner of modern medicine swears by, has also evolved keeping pace with changing times and socio-political systems, from the ancient times of Charaka to Hippocrates to the modern pledge adopted as the Declaration of Geneva, the latest one being adopted by the World Medical Association in 2017.

 

 

The Hippocrates swears by Apollo Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses of Greece. All this is not relevant in the modern day world of science. The ancient Hippocratic Oath makes a physician duty bound to his patients, without considering political positions or gender, however it restrains from performing abortions. It asks physicians not to use “knife, not even, verily, on sufferers from stone”. 

 

The 300 BC in India was the period of Kings where Brahmins were at the top in the social Hierarchy. Accordingly, the Charaka Shapath mandates the physician to lead a life of celibacy, grow beard and hair, pray for cows and Brahmins. It forbids the doctor from treating those who are in opposition to the King or whom the physician or society may despise. The modern oaths, belonging to the present, with tremendous advances in modern science bind that every human shall be treated equally and the physicians must be committed to treat fellow humans to the best of their abilities under any circumstances.

  

‘As the graduates of modern scientific medicine are now taking the modern pledge, and not the ancient Hippocratic oath, which is actually not in use now, replacing the modern oath, by erroneously terming it as Hippocratic Oath, with what is being termed as Maharshi Charaka Shapath, which is completely out of sync with modern scientific medicine, modern social practices, and modern socio-political values, is unnecessary. Implementing the original Charaka Shapath would automatically disable every woman medical graduate from practicing, making it only men’s profession, who in turn would need to grow beard and hair and follow the other norms as was mandated in the ancient oath’. 

 

Not only that, some other   decisions taken by the UGMEB too are shocking.   According to these a 10 days  yoga training by allotting one hr/day for all the batches in a college in the form of Surya Namaskar, Pranayam, Breathing exercise, Meditation etc will be mandated. All doctors of modern medicine are to compulsorily celebrate the International Day of Yoga on 21st June. This is done ostensibly to allay depression, suicidal tendencies ragging activities along with de-stressing the Faculty & everybody in the loop.    

 

Modern scientific medicine, is evidence-based. It is appalling that the NMC is mandating unproven and unrelated methods for the students and faculty of modern scientific medicine. It is even more shocking and dangerous that the same are being suggested as methods to allay depression, anxiety, and suicidal tendencies, for stress management, and even for ragging! This is completely ridiculous and not based on any evidence. Prevention of ragging needs stringent law enforcement. Management of depression, anxiety, suicidal tendencies require well-proven methods in modern scientific medicine. Using unproven non-scientific methods to treat mental disorders can do serious harm to the patient.

 

Considering all these the NMC should reconsider and rescind the decision to replace the modern oath which is based on the present day socio political conditions and scientific knowledge.

 

 

https://thearabianpost.com/medical-ethics-must-be-updated-on-the-basis-of-scientific-evidence/?utm_source=rss&utm_medium=rss&utm_campaign=medical-ethics-must-be-updated-on-the-basis-of-scientific-evidence

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/medical+ethics+must+be+updated+on+the+basis+of+scientific+evidence-newsid-n370020804?listname=newspaperLanding&topic=ipaspecial&index=7&topicIndex=1&mode=pwa&action=click

 

https://ipanewspack.com/medical-ethics-must-be-updated-on-the-basis-of-scientific-evidence/

 

https://tryxyz.com/article38061-MEDICAL-ETHICS-MUST-BE-UPDATED-ON-THE-BASIS-OF-SCIENTIFIC-EVIDENCE

 

 

14 Mar,2022

Need to review medical education following Ukraine crisis

Date: 14 March 2022 

  

Need to review medical education following Ukraine crisis  

 

Dr Arun Mitra  

  

That Indian students have finally reached home is a matter of great satisfaction not just for the family but for the country as a whole. Better late than never; finally the Indian government woke up and took effective steps to plan the  evacuation from Sumy where probably last batch of our students was stranded. War between Russia and Ukraine is threatening the lives of innocent citizens and destruction of resources. The danger of use of nuclear weapons in case of escalation of war cannot be ruled out.  

 

Evacuation of the citizens from the war zones is extremely difficult task. Foreign nationals who want to go back to their families are hard put. Indian citizens, particularly the students, most of them under going education in the medical courses, have been facing difficult time. Whereas most of the countries took away their citizens back home from Ukraine, the government of India failed to act on time. This is despite several requests from the students to the embassy in Kyiv. When the war started, instead of organising evacuation of the students the Indian embassy in Ukraine only kept on issuing advisories to the students to reach borders of Poland or Romania. It was a horrendous task for the students since from some places these borders are over 1500 kilo meters away. Several young boys and girls braved through the harsh weather and shelling to reach the borders. Patting his own back the Prime Minister and his cabinet colleagues however left no stone unturned in taking credit for what they had not done.  Evacuation means to bring a persons out from the crisis area. But here the students walked several kilometres or paid exorbitant amount to hire vehicles to reach the borders from where they could take the journey back home safely. It is however unfortunate that instead of praising the students for showing bravery in crossing the borders, the question being raised is about their studies, their capabilities, their level of knowledge etc. So much is the lack of empathy at this hour of crisis that Union Minister for Parliamentary Affairs Pralhad Joshi instead of helping, castigated the students that 90 per cent of Indians who study abroad fail to pass qualifiers in India. He does not know that even to go abroad for MBBS studies the students have to pass the NEET.  

 

  

The pertinent issue which has come to the fore now is why should Indian students opt for admission in the colleges abroad in such a large number ? They are studying not only in Ukraine but in much larger number in the USA, Canada and China. Many are in Philippines, Kazakhstan,  Kyrgyzstan and Bangladesh.    

  

According to the website of the National Medical Commission (NMC) presently India has 605 medical colleges with 90825 seats for the under graduate course. Out of this 306 colleges with 45035 seats are  in the state sector. The number of colleges in private sector is 289 with 43965 seats and others 10 colleges with 1825 seats.  The tuition fee in the private colleges ranges from 60 Lakh to over one crore rupees. This is far beyond the capacity of even the middle classes. Therefore the students look for relatively cost effective institutions. For study in the colleges abroad total cost including the travel and stay is around 30 Lakh rupees.   

  

To get registered with the NMC these students have to clear the Foreign Medical Graduates Exam (FMGE). Those who pass this exam become at par with others. So to raise such frivolous issues of their standard of education is to hide the failure to provide medical education at affordable rates inside the country. Prime Minister has said that more medical colleges need to be opened in the country to prevent our students from going abroad and has called upon the private sector to come forward. This will not be helpful as the private sector’s motive is profit making. He has also said that half of the seats in these colleges will be free. This is not something that can be monitored easily. We have the experience of how the private sector corporate hospitals who have reaped several benefits from the government and for which they are supposed to give affordable treatment to 25% beds, are evading their responsibility with impunity. The government had earlier come up with a proposal to hand over district hospitals to the medical colleges which will be operated by the private sector. It has been proposed that 50% patients will be given free treatment in these hospitals. Those interested in getting free treatment will have to get authorisation from the designated authority. This will leave the poor people running here and there for authorisation.   

  

It is important to see that the career of these young students does not suffer. IT Cell trollers who are out to defame these students should be taken to task. Such words at a time when the students and their families are in so much trauma after the nightmarish experience and prevailing uncertainty can have adverse effect. They are now much worried about their future. Government should reassure that they will take up the matter with empathy. All efforts should be made for the continuation of their studies in Ukraine once the situation improves. It would be apt to wait for a period of six months. The decision of the NMC to allow internees to do internship in India is a welcome step. Others who are still in the graduation process should be assured that if things do not improve in Ukraine, they would be adjusted here in government colleges while charging the same fee as they had to pay in Ukraine. More medical colleges need to be opened in state sector.  To ameliorate the health crisis in remote areas an undertaking can be taken from the students to serve in the remote areas in state sector for a period from 5 to 10 years.   

 

In the nearly 35 years after independence the medical education was imparted mainly by the state sector. It was only after the neo-liberal economic policies that the private sector got a push. In 1980 there were 112 colleges out of which 99 were in state sector while only 13 were in the private sector. But from 1980 to 2022 number of colleges that were added in state sector is 207 while the private sector college number 276. Many of these private colleges lack basic facilities for training despite charging hefty amounts. This trend has to be reversed to give a boost to the medical education based on the criteria of medicine as service - not for profit making as primary motive.   

 

https://www.thenorthlines.com/need-to-make-a-thorough-review-of-medical-education-following-ukraine-crisis/

 

https://vremeabucuresti.info/need-for-a-thorough-review-of-medical-education-following-the-crisis-in-ukraine/

 

https://ipanewspack.com/need-to-make-a-thorough-review-of-medical-education-following-ukraine-crisis/

 

https://www.thehillstimes.in/editorial/medical-education-outside-india

 

https://tryxyz.com/article37973-NEED-TO-MAKE-A-THOROUGH-REVIEW-OF-MEDICAL-EDUCATION-FOLLOWING-UKRAINE-CRISIS

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/need+to+make+a+thorough+review+of+medical+education+following+ukraine+crisis-newsid-n366472102?listname=newspaperLanding&topic=ipaspecial&index=35&topicIndex=1&mode=pwa&action=click

 

 

22 Feb,2022

Russia Ukraine conflict would lead to serious global health and humanitarian crisis

Date: 22.02.2022

 

Russia Ukraine conflict would lead to serious global health and humanitarian crisis

 

Dr Arun Mitra

 

Whole world has suffered due to humanitarian crisis due to COVID-19 pandemic. The threat is not yet completely over as we are still not certain about the new variants of the rapidly mutating virus. Even though vaccination has given some respite, but glaring inequity in vaccination of the population in different countries hampers the fight against the COVID-19. We need immense resources to meet the challenge  not only for the pandemic but also for other diseases, both communicable and non-communicable which have been largely ignored during this period. Patients with diseases like Tuberculosis, Dengue, Malaria, Diarrhea, Diabetes, Cancer, Chronic Kidney problems suffered due to changed priorities. The effect has been seen more in the developing countries who are already short of resources.

 

This is a time when the whole world should get together and put in all efforts to conserve resources for the healthcare of the people. But even before this crisis has ended, we are on the brink of another humanitarian disaster that could happen in case of conflict between Russia and Ukraine.

 

Such a war at this moment may not remain localised to Europe alone.  As it appears that USA along with NATO countries will directly or indirectly enter into the conflict, which will further Increase the crisis and lead to involvement of other countries in the time to come. Therefore it is urgently needed that the two countries reach a diplomatic solution to the crisis through mutual dialogue and confidence building measures.

 

It may be difficult to assess the humanitarian damage in case of war between Russia and Ukraine, but the effect is similar in case of any war. We have our experience of collateral damage caused following invasion of Iraq by the US and allies.

 

In any war scenario, the civilian deaths outnumber the death of soldiers as more deaths now occur due to indirect impact of war than direct effect of weapons. In war situation essentials like the food supply, water supply, healthcare and public health services, power generation, communication, transportation and other infrastructure are affected adversely. In addition there occurs displacement of population who have to live in make shift camps. This increases the risk of disease and deaths. The studies have revealed that since 1990-2017 there have occurred 50000 direct deaths annually as a result of armed conflicts while the indirect deaths have been more than one million.  

 

Recently the US government officials estimated that the fighting could kill 25,000 to 50,000 civilians, 5,000 to 25,000 Ukrainian military personnel, and 3,000 to 10,000 Russian soldiers. It could also generate 1-to-5 million refugees. Any escalation could lead to use of nuclear weapons which would be catastrophic.

 

Dr.Barry S Levy Adjunct Professor of Public Health, Tufts University School of Medicine in a presentation at an event organized by the International Physicians for the Prevention of Nuclear War (IPPNW) on 19th February 2022 has warned of serious consequences of conventional war. According to him in case of war there is increase in the malnutrition particularly among women and children. There is rise in the communicable diseases like diarrhea, cholera, respiratory diseases, Tuberculosis. Mental disorders like depression, posttraumatic stress disorder and suicide increase. Reproductive health suffers badly. The non-communicable diseases like heart diseases, cancers, kidney diseases.  Since Ukraine has 17% population above the age of 65. So there is a danger that indirect death rate would be much higher than in case of invasion of Iraq since this group of population is more vulnerable.  

 

In case of Russia and Ukraine conflict danger of use of nuclear weapons cannot be ruled out. Such a situation would have extremely dangerous consequences and would put billions around the world at risk warned Dr Ira Helfand – Former Co President IPPNW in the event mentioned above.   

 

Linda Pentz Gunter founder of Beyond Nuclear has cautioned of extremely serious catastrophe if the nuclear power plants in Ukraine are damaged in the war. We have to learn from the previous incidents of nuclear power plant accidents like Chernobyl and Fukushima she says. 

 

Knowing well all these dangers the world is still increasing expenditure on arms. As per SIPRI world military expenditure was $1981 billion in 2020, an increase of 2.6 per cent on 2019 in real terms. https://sipri.org/sites/default/files/2021-04/fs_2104_milex_0.pdf

 

As the war between Russia and Ukraine is likely to spread further, in that scenario population in low income group countries will have serious adverse impact which could be long lasting on their economy.

 

People in both the countries yearn for conflict resolution from dialogue and lasting peace, as pointed out by Olga Mironova, MD, PhD, who is working as Associate Professor of the chair of Internal Diseases in Sechenov University while speaking in the above mentioned IPPNW event. Therefore it is needed that while on one hand urgent diplomatic efforts are made, the civil society should raise its concerns worldwide.

 

 

https://www.thenorthlines.com/russia-nato-confrontation-over-ukraine-has-implications-for-health-system/

 

https://www.nationalheraldindia.com/india/world-can-ill-afford-russia-nato-war-over-ukraine-when-pandemic-continues-to-put-health-of-millions-at-risk

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/russia+nato+confrontation+over+ukraine+has+implications+for+health+system-newsid-n362042356?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

https://tryxyz.com/article37831-RUSSIA-NATO-CONFRONTATION-OVER-UKRAINE-HAS-IMPLICATIONS-FOR-HEALTH-SYSTEM

  

03 Feb,2022

Health Budget belies people’s aspirations

Date: 03.02.2022

 

Health Budget belies people’s aspirations 

  

Dr Arun Mitra 

 

We have faced serious health crisis in the last two years particularly due to the COVID Pandemic which has cost dearly precious lives, economy and pushed millions of people into joblessness and loss of livelihood adding to the already existing poverty.  Large number of population could not get required treatment for COVID due to lack of preparedness on the part of the government. They were unable to go to the private hospitals due to exorbitant cost. In addition, the already existing diseases, both communicable and non-communicable faced serious the resource crunch. Whereas the affluent section of the society could get treatment for the above the lower income group, who are largely dependent on the state for their health needs were deprived of the treatment for diseases like Tuberculosis, Dengue, Malaria, Diarrhoea and even Vaccination to the children.  

 

The WHO has pointed out time and again that to meet the health needs it is important that the public health spending should be 5% of the GDP. But unfortunately the public health expenditure in our country has been hovering around 1.1% for several years. According to the Oxfam’s “Commitment to reducing inequality report 2020” India ranks 154th in health spending, 5th  from the bottom. It was therefore expected that the government would be serious in budgetary allocation towards health. But it was not to be. 

  

 

The budgetary allocation to health in this year’s budget is Rs.82600 crore out of total fiscal budget of Rs.39.45 lakh crore. This amounts to 2.07% of the total budget. Last year this allocation was 2.04%. This miniscule increase is not even sufficient to meet the inflation. As percentage of the GDP the allocation to health budget has in fact come down. This is a serious issue which concerns health of our people.  People close to the government claim that there has been a constant increase in the health budget. They forget that health budget has increased along with the total budget. For example, in the 2013 – 14 budget health was allocated Rs.37335 Crore out of a total budget of Rs.16.65 lakh crores, this amounts to 2.24%.  Then in the next two years this budget fell to1.95%, 1.86 % and 1.93%. In the subsequent years it was raised to 2.20% and 2.16 % in 2017-18 and 2018-19. Now in fact it has come down again.  

 

There has been special mention of Mental Health. It is true that the mental health has always been a serious issue. The situation during COVID Pandemic  pushed people into poverty due to joblessness caused serious problems among the people. Children who lost school days have been the worst sufferers. The digital solution offered may not serve the desired purpose. There is need to increase the number of personnel in the field. A meager increase of budget allocation from Rs. 597 crore to Rs. 610 crores is too low.  

 

Similarly a minor increase from Rs.2663 crore to Rs.3200 on Health research should have been increased much more. Faced with several health problems we need to develop our own innovative methods through research and development. This needs more monetary allocations.  

   

Various studies have concluded that to ensure comprehensive primary healthcare there is need to enhance public health spending on health to minimum of 5% of the GDP. Government had committed that it will spend 2.5 % of the GDP on health. If that is to be done there has to be increase in budgetary spending to 3.5 lakh crore rupees. 

 

Much has been talked about digitalization of healthcare system. This would mean maintaining digital record of the people. But this is not the priority. What is needed is creation of trained manpower in health sector at all levels. Health is a multi-sectoral issue which requires better nutrition, education, maternal and child healthcare, job opportunities, better work environment, housing, clean drinking water supply, sewerage facilities etc. With food security being undermined and spending on schemes like MGNREGA reduced, it would be naïve to expect health of the people to improve.   

 

It is a matter of satisfaction that we have successfully vaccinated large number of our population. But still our record is less than global average of 52.56 persons fully vaccinated per 100 people. Our number stands at 50.23 whereas China has vaccinated 83.27 persons fully per 100 population. Many more countries have done better than us.  

 

   

The budget has completely failed to meet the expectations for a direction towards comprehensive universal healthcare rather there seems to be a hidden agenda of corporate push in the healthcare through PPP mode which has been so much talked about by the present dispensation in power.   

  

 

 

https://www.readwhere.com/read/3372223#page/6/1

 

https://www.nationalheraldindia.com/opinion/poor-budgetary-allocation-to-healthcare-sector-dovetails-with-modi-govts-preoccupation-with-corporatisation

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/health+allocation+in+2022+23+budget+much+below+the+needs+of+the+present+challenge-newsid-n355852984?listname=newspaperLanding&topic=ipaspecial&index=6&topicIndex=1&mode=pwa&action=click

 

https://ipanewspack.com/2022/02/health-allocation-in-2022-23-budget-much-below-the-needs-of-the-present-challenge/

 

https://www.thehillstimes.in/featured/health-allocation-in-2022-23-budget-much-below-the-needs-of-the-present-challenge

 

 

23 Jan,2022

Health should get due place in the budget

 

Date: 23.01.2022

 

Health should get due place in the budget

 

Dr Arun Mitra

 

Needless to say that health and education form the basis of development of any society. Investment in these two sectors is an asset for the present as well as future. Unfortunately the successive governments have ignored these two sectors. Public health spending is far from the required, thus causing serious impact on the health of the people of our country. Whereas the first National Health Policy 1983 emphasized on promotive, preventive curative and rehabilitative services, the  National Health Policy - 2002   shifted its emphasis towards the provision of health care through private sector and opening up secondary and tertiary level health care for private investment.  As a result the spirit and principles of Primary health care was compromised. This resulted in a setback to the equitable distribution of healthcare. All this was a reflection of neo-liberal economic model adopted by our country and the World Trade Organisation after it was founded on 1st January 1995. 

 

The National Health Policy (NHP) 2017 however made a leap forward to corporate centric and insurance based healthcare system. It also highlighted on strategic purchase of non govt. secondary and tertiary care services.  Insurance system was further strengthened and public funds diverted to the private insurance and health care sector.  

 

Presently 75% of healthcare expenditure is borne by the people from their own pockets. Out of this nearly 70% is spent on OPD care. This is pushing 6.3 crore population of India to poverty every year. This catastrophic healthcare cost is an important cause of impoverishment which in turn adds to poor health.  

 

India has roughly 20 health workers per 10,000 population, with 39.6% doctors, 30.5% nurses and midwives, and 1.2% dentists. Total doctor-population ratio 1:1445. It is to be noted that Govt. Doctors-population ratio is 1:11,926 in contrast to the desired 1:1,000. This is a major cause of inequality in healthcare to the marginalized sections who are dependent solely on state healthcare system.    

 

WHO recommends minimum of 5% of the GDP as expenditure on Health. The  Planning Commission of India had said that the state spending on health will be 2.5% of GDP by end of 12th five year plan and 3% by 2022. Interestingly under the present BJP government the 2015 NHP draft mentioned this to be  2.5% GDP by 2020. The revised NHP 2017 pushed the time frame further to 2025. National Health Mission budget was decreased by 10%. The  ICDS budget has been decreased. Nutriton budget decreased by Rs.1000 crores from 3700 to 2700 crores rupees in the 2021-22 budget. 

 

Investment in health insurance has increased. The Ayushman Bharat is an insurance based system. The whole healthcare concept is insurance based which fails to provide comprehensive healthcare. Senior citizens are the worst affected. The Ayushman Bharat covers only 50 crore population while the rest 88 crores are left out. Moreover it is applicable for indoor care only, whereas 70% of the out of pocket expenditure on health is on OPD care. There are several conditions attached to get registered with this scheme. Eligible people also find it very hard to make the card. Other state run insurance schemes offer a limited benefit. For a person to get insured with private or public sector company, one has to shelve huge amount. The ESI started in 1952, CGHS in 1954 and ECHS in 2003 provide comprehensive healthcare to the employees to an extent. There is a move to dilute the ESI. The government is planning to handover district hospitals to the private sector to open medical colleges. In these hospitals 50% patients will get free treatment while the rest will have to pay. The free patients will have to get authorization from a designated authority, thus creating several hurdles for them.    

 

Much was expected from the budget presented last year. An outlay of 223846 crore rupees on health in the budget for the year 2021-22 appeared very encouraging. It was said to be 137% increase from the previous budget of 94452 crore. However a detailed review of this brought forward the truth. The actual amount was a marginal increase in the allocation to department of Health and Family Welfare from rupees 65012 crore in 2020-21 budget to 71269 crore rupees; a meagre 10% increase and only 2.04% of the total budget of Rs.3483236 crores. 

 

Most worrying factor in the budget was reduction in the spending on Nutrition from 3700 to 2700 crore rupees. This is at a time when India is at 102nd position in hunger index out of 117 countries, worse even than our neighbouring south Asian countries.  

 

Various studies have concluded that to ensure comprehensive primary healthcare there is need to enhance public health spending on health to minimum of 5% of the GDP. 

 

More than 40 per cent of the population has to borrow or sell assets for treatment. This is totally against the principles of equity and justice. Already marginalised sections, Dalits, Muslims and other socio-economically weaker groups are worst affected.  

The concept of universal comprehensive health care was first of all realized by the Soviet Union who in the Soviet constitution 1936 guaranteed that the Citizens of the USSR have the right to health protection. The National Health Services (NHS) was launched in the UK on 5 July 1948, by the then Health Secretary, Aneurin Bevan. This gave huge benefit of free healthcare to the population. The Cuban government adopted the concept of social medicine into practice. Its effect is well recognised globally. The government of Cuba spends approximately Rs.25000/- per person each year on healthcare, while India spends around Rs.1753/- on the health per capita with a corresponding expenditure of Rs.2.65 lakh in the UK.

 

The Economic Survey 2020-21 had strongly recommended an increase in public spending on healthcare services from 1% to 2.5-3% of GDP, as envisaged in the National Health Policy 2017. It also noted that this can significantly reduce the Out-of-Pocket-Expenditure (OOPE) from 65 per cent to 35 per cent of the overall healthcare spend. (1)

 

It is therefore imperative that the public health spending has to be increased to minimum of 5% of the GDP. An immediate increase to three times of the present budget allocation to health is need of the hour in the upcoming budget.   

 

References:

 

https://pib.gov.in/PressReleasePage.aspx?PRID=1693225

 

09 Jan,2022

Ensure vaccine equity to control the third wave of COVID pandemic

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/ensure+vaccine+equity+to+control+the+third+wave+of+covid+pandemic-newsid-n349069774?listname=newspaperLanding&topic=ipaspecial&index=1&topicIndex=1&mode=pwa&action=click

 

Date: 9.01.22

 

 

Ensure vaccine equity to control the third wave of COVID pandemic

 

 

As predicted by the scientists, the third wave of SARS COV -2 is spreading fast around the world. First case of the variant of the virus, the Omicron was reported in South Africa only a few weeks ago. Soon it spread to Europe, America and now it is spreading tentacles in Asia including our country. The United Kingdom recorded 1.40 lakh new cases on 8th January 2022. The number of new cases in the USA on the same day stood at 4.43 lakh and India 1.59 lakh. This number is likely to go high by the middle of February. During the second wave of Delta variant the highest number in India was 4.14 lakh cases on 6th May 2022. The Delta variant was highly deadly and was the cause of loss of human lives in large number. The Omicron is said to be not as deadly; however it may be too early to give a firm opinion on this as the mutations in viruses are well known. More over at present there is a combination of SARS COV -2 viruses causing the infection.   

 

The Delta variant virus attacked the lungs causing respiratory crises. Therefore the number of people who required admission in the hospitals was very high. In contrast the Omicron virus has been found to affect more on the nose and throat so the symptoms resemble ordinary flu. However the World Health Organization (WHO) has warned that it should not be taken lightly. The WHO Director General Tedros Adhanom Ghebreyesus said that “the more infectious Omicron variant of coronavirus appears to produce less severe disease than the globally dominant Delta strain, but should not be categorised as "mild".  

 

Laxity by any one, the government or the people can be dangerous. The COVID appropriate behaviour in the form of using masks, washing hands, sanitising and maintaining 6 feet distance from one and another must be followed. Respiratory droplets can be transmitted through coughing, sneezing, contact with contaminated surfaces, or even through inhaled aerosols; therefore, each individual must take adequate steps to reduce their exposure to these particles by wearing masks and practicing safe social distance measures. 

 

Wearing of proper mask is very important. The mask must fit on the face properly s that air cannot enter from sides but has to pass through the surface of the mask. Diameter of the virus has been found to range between 50 nm to 140 nm. Certain masks are considered more effective at minimizing the risk of exposure, particularly N95 masks. The protective capabilities offered by N95 masks are considered as it can remove at least 95% of all particles with an average diameter of 300 nm or less.  The surgical masks are tripe layered masks which offer protection. The cotton masks have large sized pores and would be porous to SARS-COV-2 particles, though it may render limited protection by blocking aqueous micro-droplets of saliva (1). Simple measures as per the scientific information about COVID appropriate behaviour are the saviours. 

 

If the Omicron does not cause serious harm then it may turn out to be boon as if large number people get infected, but not taken seriously ill, there may develop herd immunity in the population which could be the beginning of end of the Pandemic.  

 

In the last two years when the first case of SARS COV-2 was reported we have become much wiser in terms of its diagnosis, management and prevention.  Vaccination is a big step forward. Omicron can infect the double vaccinated person as well but the effect is relatively milder.  Therefore it is important that the vaccine targets are achieved globally. Recently addressing a press briefing, the head of global health body, the WHO repeated his call for “greater equity globally in the distribution of and access to Covid-19 vaccines”.  But he cautioned ‘based on the current rate of Covid-19 vaccine rollout, 109 nations will miss the WHO's target for 70% of the world's population to be fully vaccinated by July’. The number of vaccinated population varies drastically among the nations. Performance of some countries in vaccination is a real cause of concern.  

 

Syria has vaccinated only 12% of its population by 6th January 2022. Similarly percentage of population vaccinated in Afghanistan is 10%, Sudan 8.9%, Ethiopia 7.9% and Somalia only 7.4%. This is in contrast to 99% vaccinated in UAE, 92% in Cuba, China 87%, UK 76% and Sri Lanka 74%. India has vaccinated 63% population (2).  Since the world is well connected these days, it is important that all the countries around the world must achieve the vaccination target by July as envisaged by the WHO. This is not so difficult a task. It requires political will on the part of the world leaders. In fact the UNO should monitor the whole process and ensure that the vaccines reach the poorly performing countries in sufficient numbers so that they can vaccinate the population on time. If needed, even the trained man power for the job should be made available in these countries.  Any inequity in vaccination will hamper the objective of getting rid of the Pandemic soon. 

 

 

References: 

  1. https://www.nature.com/articles/s43246-021-00160-z
  2. https://ourworldindata.org/covid-vaccinations 

24 Dec,2021

In quest of peace and health in the new year

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/in+quest+of+peace+and+health+in+the+new+year-newsid-n344021596?listname=newspaperLanding&topic=ipaspecial&index=2&topicIndex=1&mode=pwa&action=click

 

Date: 22.12.2021

 

In quest of peace and health in the new year

  

Dr Arun Mitra 

 

The year 2022 is going to be full of challenges for peace and health. On one side the mankind has been grappling with COVID Pandemic for the last two years on the other increasing expenditure on arms race is draining away resources which are desperately needed to meet the challenge of Pandemic. Developing countries are the worst sufferers in such situation.

 

The COVID-19 Pandemic has exposed the already existing shortcomings in the health care system. Diseases like Tuberculosis, Malaria, Dengue, Chikungunya, Diarrhoea and non-communicable diseases like Diabetes, Hypertension got ignored during this period. Vaccination of the children was affected as well. The situation has brought forward the fact that to meet the healthcare needs we require meticulous planning and funds.  

 

After the first case was reported two years back, the COVID-19 took the shape of Pandemic and caused havoc around the globe. The medical fraternity was fast enough to meet the challenge to understand about the pattern of disease, to find methods of its early diagnosis & treatment and also to spread the message of prevention of diseases through simple measures like maintaining six feet distance, washing and sanitizing hands and wearing masks. This saved millions of lives around the world. Vaccines too were developed in an emergency manner. Fighting like brave soldiers more than 1600 doctors lost their life in our country while taking care of the sick.  

  

Majority of population recognized and appreciated the role of medical fraternity during this difficult period.  But as a result of ignorance and panic we witnessed bizarre behaviour of the people at some places. A doctor couple in Delhi complained that the people living in the society where they had their house avoided them because they were on COVID duty. Similar complaints were received from some nurses who were not allowed to enter their houses because the people feared them to be potential carriers of the disease.  

 

Violence against doctors is well known in normal conditions as well. Young doctors, who are always under lot of stress of work and have not yet, developed communication skills become target of the mobs. Even though some states have made laws to check violence against the medical personnel, there is no such law at national level. National human rights commission of India in its 17 point charter of rights of patients has specified the duties of the patients as well. The commission has categorically stated that the patient or caregivers should not resort to violence in any form and damage or destroy any property of the hospital or the service provider. A national level law against violation doctors can be a strong deterrent to such situations.

 

Intolerant behaviour is not limited to India only. Nobel laureate Dr Dennis Mukwege who has worked for decades with great courage and compassion to address the needs of survivors of sexual violence in Democratic Republic of Congo, was attacked seriously; fortunately he survived but his guard was killed. He however never gave up and continues to work. In many places affected with violence, the doctors have to face double crises. Professional ethics and morals teach them to take care of any individual who is sick. In the violent situations when some militant groups bring the patients to them they have to take care but then they have to face the wrath of the security forces.

 

Fallout of the violent conditions in the society can have serious repercussions on health. Children who watched their kith and kin being subjected to violence, develop behavioural problems, depression, anxiety and post-traumatic stress disorder. Therefore the prevention of violence is now accepted as a public health issue.

 

 

To meet the health needs of society as a whole, Health has to be declared as a fundamental right. A fundamental right is justiciable that means it is enforceable through law and in case of violation of this, individual can approach court of law for protection. World health organization has categorically stated that “enjoyment of highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

 

Good health is determined by other basic human rights like access to safe drinking water, sanitation, nutritious food, adequate housing, education, safe working conditions and sufficient remuneration. Therefore poverty alleviation is essential for good health. Poverty leads to poor health which in turn is a cause of poverty.  

 

The International conference held at Almaty, Kazakhstan in 1978 came up with a declaration popularly known as the Alma Ata declaration. The conference strongly declared that “health which is a state of complete physical mental and social wellbeing and not merely the absence of disease or infirmity is a fundamental human right and the attainment of the highest possible level of health is the most important worldwide social goal whose realisation require the actions of many other social and economic sectors in addition to health sector”.  

 

Constitution of India does not explicitly guarantee a fundamental right to health. But there are directive principles which give us some relief. India got its first national health policy in 1983 which emphasised on promotive, preventive, curative and rehabilitative services. It attempted shift from vertical health programs to strengthening of primary health care network. In the next national health policy in 2002 there was a paradigm shift. It emphasised on secondary and tertiary health care services through private investment. In 2015 the national health policy draft mentioned to make health a fundamental right. However the final draft was a complete change. The 2017 health policy made a shift to insurance based healthcare causing diversion of public funds to the insurance companies. This is a cause of inequitable distribution of healthcare.   

 

India has a doctor population ratio of one doctor for 1445 people. The government doctor population is one doctor for 11926 persons against the desired of one to 1000. Therefore 75% of the healthcare expenditure comes from the pockets of the household. Out of this 80% goes for the OPD care. This catastrophic healthcare expenditure is an important cause of impoverishment. Whereas the WHO mandates GDP expenditure on health at a minimum of 5%, it is only around 1.1% in our country. The budget on National Health Mission has been cut down by 10%; ICDS budget too has been decreased. The nutrition budget was reduced from 3700 crore to 2700 crores that is a reduction of 1000 crores in this year’s budget. 

 

Insurance based health care is unaffordable more so for the senior citizens who are faced with financial problems. Their income by that age gets reduced or they become dependent on children. This makes it impossible for them to pay high premiums of the insurance companies which increase with the age.

 

Therefore it is important that health is declared as a fundamental right government has responsibility to provide healthcare to all. For this a strong people’s movement is needed. But this is unfortunately lacking. Health is never an issue in our elections.  

  

South Asia is one among the most deprived regions. Our rank in Global Hunger Index is cause for worry. India stands at a rank of 102 among 117 counties. Sri Lanka at 65, Nepal and Bangladesh 76 and Pakistan at 92nd position.

 

We need lasting peace so as to utilise our resources for health and education. Unfortunately perpetual tension between India and Pakistan has led to both the countries amass arms. Both are nuclear armed states. This poses a serious threat to the people of the region. The studies conducted by International Physicians for the Prevention (IPPNW) have highlighted that any nuclear exchange between the two countries using 100 atomic weapons would put two billion people at risk. Concerned physicians in the region have been demanding complete abolition of nuclear weapons and declare South Asia as nuclear weapons free region.  

 

It is imperative that peoples movements for peace and health in South Asia are strengthened. We have lot to learn from each other which is possible only through mutual dialogue and trust building. It is important to move in that direction in the coming new year.   

 

 

08 Dec,2021

Nuclear Power Plant at Fatehabad, Haryana

https://www.readwhere.com/read/3312624#page/6/2

 

 

Date: 04.12.2021

 

Nuclear Power Plant at Fatehabad, Haryana

A word of caution!

 

Dr Arun Mitra

 

The climate crisis has forced the global community to debate over viable alternatives to the fossil fuels about which there is consensus that these are major cause of carbon generation responsible for climate crisis. There is also consensus on that renewable resources are the best alternative to the fossil fuels. But there is no such consensus on the use of Nuclear energy for power generation as it is fraught with several dangers. All this was evident in the debates in the COP26 at Glasgow. Yet in some parts of the world nuclear power is being fancied for this task. Therefore the news of the first nuclear power plant in north India in Gorakhpur village near Fatehabad in Haryana is to be read with caution. 

 

Electricity forms the major source of energy to move the society in the present times. India is the third largest producer of electricity in the world. The national electric grid in India has an installed capacity of 388.134 GW as of 31 August 2021 (https://en.wikipedia.org/wiki/Electricity_sector_in_India). This generation is met from Fossil Fuels, Nuclear, Hydro and Renewable Energy Sources (RES). The fossil fuels i.e Coal, Gas and Diesel contribute about 60% of the total generation; Hydropower contributes 11.9%, RES 26.40% and Nuclear energy 1.7% (1).

 

Pursuit for nuclear power in India began in 1950s. Expected power production according the predictions made in 1950s India should have been producing 43,500 Megawatts.  But actual installed capacity from nuclear power plants in 2021 is 6780 MWs only. For this we have built 22 nuclear power plants. Even after 70 years the nuclear power is producing only 1.7% of total installed capacity of electricity in our country.

 

The drawbacks of nuclear energy are costs, security, waste, water, radiation, proliferation and safety record. The cost of generating electricity from the nuclear power is more expensive than the other sources. According to world nuclear industry status report the cost of generating solar power ranges from $36 to $44 per megawatt hour (MWh), while onshore wind power comes in at $29–$56 per MWh. Nuclear energy costs between $112 and $189 (2).

 

According to Daria Iurshina, Nikita Karpov, Marie Kirkegaard, Evgeny Semenov “The design and construction of a new nuclear power plant requires many highly qualified specialists and often takes many years, compounding financing costs, which can become significant. Design changes or lawsuits can cause delays that further increase the financing charges, which in some cases exceed the actual construction costs.

 

The high cost of constructing plants has made it difficult for nuclear power to compete with other energy options in the United States, particularly natural gas. The high cost of nuclear power has led to a significant decline in the construction of new  plants—with just one plant, Watts Bar 2, entering commercial operation in the past 20 years” (3).

 

 

Every nuclear power station needs to be decommissioned after 30-40 years of operation. Currently, it takes 6-12 years to build a nuclear station, and up to 20 years to decommission, involving extreme safety issues and huge costs.

 

One nuclear reactor plant requires about 20.5 km2 (7.9 mi2) of land, located near a massive body of coolant water, but away from dense population seismic and natural disaster zones. Massive opposition at sites currently selected show how challenging this task is. 

 

Another area of concern is water which is required for uranium mining and for cooling of reactors. There is danger of water contamination. Uranium Mining needs huge amounts of water as well. 

 

There is no fool proof method of nuclear waste management. No single nuclear waste repository exists today. High level waste of Plutonium is a problem. It is usually kept in basins; may catch fire or explode, as it happened in Kysthym/ Chelyabinsk in the former Soviet Union in 1957, when a tank with Plutonium waste exploded. Even though about 9,000 square miles (23,000 square km) of land were contaminated, more than 10,000 people were evacuated, and probably hundreds died from the effects of radioactivity (4).

 

These plants are also a cause of security concern. That is why there is total secrecy about these. Terrorism nowadays is a threat everywhere. Terrorists just need to cut the circuitry of the plant and the cooling system may go out of control. A direct hit or the melting of the core can potentially cause widespread radioactive contamination and make a region uninhabitable for centuries.

 

The world has by now realized that the nuclear power plants are fraught with danger. There is enough evidence for this.  We have seen some major Nuclear accidents in Fukushima Daiichi, Japan, March 2011, Chernobyl, Ukraine (former Soviet Union), April 26, 1986, Three Mile Island, Middletown, Pennsylvania, USA, March 28, 1979 Enrico Fermi Unit 1, Frenchtown Charter Township, Michigan, USA, October 5, 1966  , SL-1, Idaho Falls, Idaho, USA, January 3, 1961,      Sodium Reactor Experiment, Los Angeles, California, USA, July 1959, Windscale, Cumberland (now Cumbria), UK, October 10, 1957 (5).

 

 

Impact of exposure to nuclear radiation are a cause of serious concern. These may range from dizziness, disorientation or confusion, weakness, hair loss and baldness, vomiting blood or dysentery, low blood pressure. The impact may last for several years.  Health risks are for entire population, but in particular for  small children and fetus of pregnant women. Increasing  scientific evidence of damage due to chronic low level  radiation in and around mining site has been documented by a study on the health effects on the people living around Jafugoda Uranium mines in Jharkhand state of India. The study was carried out by the Indian Doctors for Peace and Development (IDPD).

 

Nuclear power plant is a potential threat for proliferation. Pu239 is one of the deadliest substances known with a Half life of 24000 years. A few micro grams cause  cancers.    Pu serves to generate energy or manufacture nuclear weapons. High grade (highly enriched, pure) Pu can sustain fission reaction and is used to ignite Nuclear bombs.

 

Track record of nuclear facilities in India is unsatisfactory. But most of these have remained official secrets so far. With the data available till 2006 tthere have been accidents at Kalpakkam, Tarapur, Maharashtra, Tarapur, Maharashtra, Bulandshahr, Uttar Pradesh, Kota, Rajasthan, Kalpakkam which have cost 910 million US$(6).

 

Another issue of grave concern is unfair compensation in case of a nuclear accident. According to Clause 6 of the nuclear liability bill agreed upon by the Indian government, the maximum financial liability in case a nuclear accident is $458 million (Rs. 2,087 crore). It is less than the compensation in Bhopal Gas Tragedy. The amount is considered meager in comparison to the destruction caused by a nuclear accident. A same kind of law in U.S. has set the financial liability for such accident at $10.5 billion.

 

People around Fatehabad raised serious objections to the plant after its proposal. They are much worried that the government may not pay them due compensation for land acquired and also for the health security of people and the livestock.

 

Fatehabad does not have any large natural water body around to meet the water requirements of the area.

 

Concerns of the people are real. Important issue is that why the government is out to embark upon the failed technology. 

 

 

Reference:

  1. https://powermin.gov.in/en/content/power-sector-glance-all-india).

 

  1. https://www.reuters.com/article/us-energy-nuclearpower-idUSKBN1W909J).

 

  1. https://thebulletin.org/2019/06/why-nuclear-power-plants-cost-so-much-and-what-can-be-done-about-it/

 

  1. https://www.britannica.com/event/Kyshtym-disaster)

 

  1. https://www.ucsusa.org/resources/brief-history-nuclear-accidents-worldwide

 

  1. https://en.wikipedia.org/wiki/List_of_nuclear_power_accidents_by_country)

 

03 Dec,2021

Lessons from Pandemic - Collaborative effort for Peace and health in south Asia

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/collaborative+effort+needed+for+peace+and+health+in+south+asia-newsid-n337924590?listname=newspaperLanding&topic=ipaspecial&index=2&topicIndex=1&mode=pwa&action=click

 

Date: 01.12.2021

 

Lessons from Pandemic - Collaborative effort for Peace and health in south Asia 

 

Dr Arun Mitra

 

Harbouring nearly 1/4th of world’s population in 3.5% of the land surface area of the earth, South Asia  is confronted with serious issues of health and development. These have been increasing due to persistent tension and internal and external conflicts and wasteful expenditure on ever increasing arms race which is divesting the region of resources required for growth. Health indices of the region are very poor as is reflected in the Human Development Index report released by the UNO from time to time. Out of 189 countries South Asia ranking is India 131, Pakistan 154, Bangladesh 133, Nepal 142 and Sri Lanka 72. Poverty, illiteracy, malnutrition, maternal and child deaths are quite high. Whereas the poverty, social disparities, and marginalisation lead to poor health, poor health in turn adds to poverty thus causing a vicious circle.  

 

Main contention in the region even after 75 years of ousting the British imperialism lies between India and Pakistan. The two countries have fought four wars. There is excess spending on the military which ranges from 14 to 18 % of the government’s budget. Possession of nuclear arms by these two countries has further accentuated the enormity of the situation. Maintaining the nuclear arsenals and its delivery system causes huge amount to India and Pakistan.  In addition these pose constant threat to life in the Sub-continent. The region has been the centre of various communicable and non-communicable diseases. But the COVID pandemic has exposed the hollowness and vulnerability of our healthcare systems. 

 

Under such circumstances it is important for the countries of south Asia to collaborate with each other in containing the impact of COVID 19 and planning a long term strategy to jointly sort out health care issues by learning through each other’s experience. Basic determinants of health like poverty, good nutrition, employment and livelihood have to be identified and tackled with. Unfortunately not much has been done in this regard. There are not much reports of data exchange on health scenario among the countries of South Asia.  

 

The economic hardships faced by the people during the lock down have been unprecedented. We have seen large scale migration of the people in India and  Bangladesh. Loss of jobs and livelihood led to pressure on the food security to  the people. 

 

The opportunity has been missed but lessons must be drawn and steps taken for future. The reports of New Variant of concern the Omicron is a wakeup call. Public health experts and physicians from various streams from the countries of South Asia should organise interactive sessions among them. Such actions help in strengthening the people to people relationship which from the ultimate basis of Lasting peace and harmony.  The new innovations of digital exchange programmes should be made use of.

 

Sensing the urgency of the situation a group of doctors from South Asian countries have collaborated to meet the challenge hence spread the message of peace, disarmament, nuclear weapons free zone and diversion of wasteful expenditure on arms race to health and development (1). Need of the hour is to organise digital dialogue among medics of the region to exchange information and design future tasks for betterment of health indices. There is need to rid of militarist attitude, instead develop humanist outlook and collectively fight back fundamentalist, extremist, obscurantist and narrow nationalist  ideas. SAARC should be revitalised to promote multi-sectoral technical and economic cooperation.   The refusal of the vaccine manufacturing Multi National Corporations (MNCs) to share the technical knowhow about vaccine production had put many countries in hardship in procuring vaccines. A collaborative effort can help in meeting such needs to save the life of the people.

 

Reference:

  1. https://www.bmj.com/content/375/BMJ-2021-067384

 

25 Nov,2021

Vaccine inequity and Super-profiteering

 

Date: 23.11.2021

 

Vaccine inequity and Super-profiteering

 

Dr Arun Mitra

The statement by the Indian Council of Medical Research (ICMR) that at present booster dose against COVID-19 vaccine is not a priority and administering two doses is the present priority goes along the line of World Health Organisation (WHO). Dr Balram Bhargav, director of the council has also said that there is no scientific evidence to support need for the booster dose.  This assessment is based on the studies that antibody level alone is not the way to check the immunity because all kinds of immunity develops post vaccination, the cellular and mucosal etc. So the understanding that the immunity provided by the vaccination is short lasting may not be correct. But despite WHO’s view point some countries are already into giving booster dose to its citizens. The US government has decided to give third dose. The UK is giving the booster to the health workers.    

 

Vaccines have given protection from the diseases and scientists around the globe need to be patted for their concerted effort in producing Vaccine against COVID-19 as an emergency. Vaccination has given some reprieve from what was a big scare one year ago. Vaccines have allayed fear reduced stress & strain, saved many lives and has helped in bringing back normal activities. The process has however not been easy. For the product to reach inoculation level after several rounds of scientific trials with assured safety is normally 7 to 8 years process. But this was accomplished in a few months period. Medical scientists have successfully reassured the society that people’s health is their utmost priority.

 

India too was in the forefront and successfully produced its own vaccine. With all efforts we have been able to give first dose to 56% population that is 77 crore people and second dose to 29% population ie 40 crore population with a total doses  of 117 crore as on 22nd November 2021. China from where the disease was first reported has inoculated  126 crore or  90% prople with first dose and  107 crore or 76% population with second dose totaling 233 crore doses. Data from our south Asian neighbours shows that both doses have been given to 22% in Pakistan, 26% in Nepal, 20% in Bangladesh and 62% in Sri Lanka. The developed countries the U K, USA have vaccinated 68% and 62% population respectively with two doses.  The picture in some of the least developed countries is highly grim with Ghana at 2.7%, Somalia 3.6%, Syria 4% and Afghanistan at 8% with both doses.

 

 

Since the big companies refused to share the technical know-how even with WHO, it was difficult for many developing countries to produce these vaccines. They were thus dependent on import. The problem was more with smaller countries with limited resources. That is how we find today that many developing countries are still lagging far behind in the vaccination of their population. These countries had to accept several clauses which would favour only the vaccine manufacturer. In a recently published article in the Journal of Postgraduate Medicine, Education and Research, Dr Samir Malhotra, Professor of Pharmacology Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh has pointed that The COVID-19 scare forced many governments to enter into contracts with the companies developing vaccines. Many of these contracts had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. “Purchaser hereby agrees to indemnify, defend and hold harmless [the company and] each of their affiliates from and against any and all suits, claims, actions, demands, losses, damages, liabilities, settlements, penalties, fines, costs and expenses caused by, arising out of, relating to, or resulting from the vaccine.” Not only that, and this is shocking, these countries should “put up sovereign assets as collateral to guarantee indemnity”. Such assets could include embassy buildings, cultural assets, etc.

 

He further points out that the claim of the pharma industry that they have to bear high cost in developing new drugs as a justification for such contracts is totally flawed because virtually 100% of initial research leading to new drugs occurs with the support of public funding. A vaccine that requires a few dollars to manufacture brings in profits worth billions of dollars to the company.

 

In India whereas the vaccination programmes earlier have been free of cost to the recipients, this time the government allowed 25% vaccines to be given on payment. Adar Poonawala, CEO of the Serum Institute of India had said that even at Rs.150/- per dose the company makes profit. But the government of India fixed the rate of vaccination at Covishield Rs.780/-, Covaxin Rs.1410/- and Sputinik V Rs.1145/- thus allowing the vaccine manufacturers super profit at the cost of human lives. Till date the government has not come out with data of number of people who purchased the vaccine.

 

There is need for controlling such super profits by few companies. The vaccine technology should be transparent so as to enable developing countries produce their own vaccines. Poor countries should be helped in the vaccination process through the UN agencies. India should rejuvenate the vaccine manufacturing public sector units so as to eliminate the profit clause and ensure equitable distribution of the vaccines.

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/vaccine+inequity+is+a+major+concern+for+the+pandemic+hit+at+global+level-newsid-n335561720?listname=newspaperLanding&topic=ipaspecial&index=5&topicIndex=1&mode=pwa&action=click

14 Nov,2021

No one is secure in the atmosphere of violence

Date: 14 November 2021 

 

No one is secure in the atmosphere of violence 

 

Dr Arun Mitra 

 

The story of Wolf and the Lamb where the Wolf cooks up an excuse to eat the lamb applies to the present day human society as well. The use of force by the powerful to suppress the people whom they dislike or think to be ‘inferior’ to them, to maintain their supremacy, they would not mind even pushing the whole society into violence. Such situations have very serious implications on the society including on health. This has been observed in several parts of the world. 

 

In the past, the kings used force against those who would question them on any issue. During the period of Chandragupta Maurya the then king Dhananand did the same, he even tried to kill Chanakya, the wise man of the period. 

 

It is said that king Ashoka  killed 100,000 people during the Kalinga war. When foreign invaders came to India they took no mercy on people. Mughals used force as well as diplomacy to control this region. Later on they declared themselves to be Indians and stayed back here and got assimilated in the Indian society and Indian culture. But the British imperialism was different; they overpowered India through diplomacy and force. They plundered our wealth and took everything to England and enriched themselves at the cost of our people. List of their violent oppression of our freedom fighters is very long. 

 

After independence, to build a nation based on democratic principles was a big challenge which was however met with successfully. Every citizen of the country belonging to any religion, caste or gender was given equal rights in the constitution. Not only that, those who were oppressed since ages were given special privileges. As a result despite shortcomings many from them could be uplifted to an extent. This led to reduction in discrimination in the society and increased harmony. But the situation is again getting worse and there is all out effort to minimise and destroy these achievements. 

  

A narrow thinking is being imposed and there is dissolute effort to build a monolithic society in the name of nationalism. Those who attempt this forget that all those countries who assimilated others have progressed while those which were built on sectarian principles lagged behind. 

 

Presently we find that to fulfil their nefarious designs such forces are targeting the minorities and sending out misleading information on the religious conversions. Young people aspiring for love and affection are being refrained and for pursuance of this, acts like ‘love jihad’ have been enacted. Gangs are being promoted for such acts who indulge in violence with prudence. It is being propagated that Muslims are anti-nationals and they should be thrown out and sent to Pakistan. Many of them have been arrested on frivolous charges and put in jails for long.  

 

Farmers protests are being labelled as being run and led by the Khalistanis. Several conspiracies are being hatched against this movement. Recently when son of the minister of state for Home affairs Ajay Mishra allegedely killed the farmers under his vehicle at Lakhimpur Kheri, his father tried to belittle the crime by saying that these farmers belong to Babbar Khalsa.  

 

Mob lynching, hitherto unknown in this country, is occurring  on one pretext or the other. Most of the time, such events go unnoticed by the police as well as the judiciary. Many times the victims have been made accused. Such forces have been emboldened by the backing of the state which is all out to suppress people’s movements. Nazi mind set is apparent from the recent statement by the Chief of Defence Staff, General Bipin Rawat in an interview to Times Now which justifies and promotes lynching. 

 

There is now a very subtle effort to spread communal venom amongst Hindus. But it is now becoming clear that Hindus too are their target. Those who question them are labelled as anti-nationals and targeted. Many have been put to jail by terming them as urban Naxals . Kalburgi, Dabholkar, Gauri Lankesh and Govind Pansare were all Hindus, but they were eliminated by the forces of Hindutva. Police inspector Subodh Kumar who was killed by the mob at Bulandshahr too was a Hindu. Manish Kumar, a businessman from Kanpur who was killed by the surcharged police with fearless violence at Gorakhpur was also a Hindu. Recently violence against film maker Prakash Jha and his team members, all Hindus, in Madhya Pradesh is a reflection of their hate against anyone who questions them. All this is being done to silence the voice of peace, love, brother/sisterhood and harmony in the society among the people of same community. The same happened during the period of terrorist violence in Punjab or is happening in Jammy and Kashmir.  

 

Violent mind set can breed serious outcome. People or organisations with such mind set first of all kill and threaten people from their own community so as to make them shut. This has been witnessed in Somalia where nearly 800000 people died during Tribal warfare between Tutsi and Hutu tribes. Neighbours killed neighbours, friends killed friends, even husbands killed their wives saying that otherwise they will be eliminated by the mob from their own tribe.  The same happened in Jammu and Kashmir or in Punjab in 1980s during the period of terrorism. At the time of partition in 1947, 2500000 Hindus, Muslims and Sikhs all were killed. During the 2nd world war, the perpetrators and the victims of war both were killed. In fact nothing is achieved through violence. King Ashoka realised this; he adopted and spread Buddhism thinking it a religion of peace.  

There is need to increase mass movements against the concept of violence. India’s freedom struggle has essentially been non-violent. There are several issues like the health education employment etc which must be raised effectively to counter these communalists. Movement has also to be built and strengthened for reforms in police as well as the judiciary so that they are not misused. Health is the biggest victim in the event of violence. People are injured, displaced and several lose their life. The madness of communal frenzy which promotes violence has to be countered by collective effort. There is no other way to save the human rights of all. 

 

 

06 Nov,2021

Nuclear arms pose grave threat to climate

Date: 06.11.2021

Nuclear arms pose grave threat to climate

Countries from around the globe are meeting at the Conference of Parties - COP 26 at Glasgow. The Inter-Governmental Panel on Climate Change – IPCC and several civil society organisations have raised serious concerns over deteriorating climatic conditions. The issue has gained importance because the world is witnessing repeated natural calamities as a result of rise in temperature of the earth and melting of glaciers causing rise in the sea level. This summit is in continuation of several such meets held earlier to discuss and impress upon the governments to take steps to mitigate the factors responsible for climate change. Rapid industrialization with half-hearted measures by the governments, particularly the developed or fast developing economies have added to the crises. Increase in military activity is one among the major causes for the production of gases responsible for climate crises. It is therefore important that the countries should debate on reducing tensions in different parts of the world so that production, sale and use of the armaments is put under check.

Persistent increase in the expenditure on the nuclear arms, despite the UNOs passing Treaty Prohibiting Nuclear Weapons (TPNW), which has declared the nuclear weapons illegal and has called for their complete abolition is a cause of concern. This should have been one of the main focus of the debate, but is not seen on the top of the list.

A study “Climate Consequences of Regional Nuclear War” conducted by Ira Helfand former Co-President International Physicians for the Prevention of Nuclear War (IPPNW) and Alan Robock from the Department of Environmental Sciences, Rutgers University, USA has pointed out that the present nuclear weapons numbering about 17000 on earth pose a serious risk to all life forms. According to their study a nuclear exchange between India and Pakistan using 100 Hiroshima sized nuclear bombs will put over two billion people at risk. Such a war would kill up to 20 million people outright as major cities of the subcontinent would be destroyed and it would blanket much of South Asia with radioactive fallout. But the global consequences are even more alarming. Soot and debris injected into the atmosphere from the explosions and resulting fires would block sunlight from reaching the Earth, producing an average surface cooling of -1.25ºC that would last for several years.  Even 10 years out, there would be a persistent average surface cooling of -0.5ºC.  This will reduce rainfall globally by 10%.

The study further cautions that in such situations there will be reduction in crop yields. The food shortage will lead to Increases in food prices further affecting the already malnourished poor people across the globe. There are more than one billion people in the world whose daily caloric intake falls below these minimum requirements. Each year some five million children in this group starve to death. A small further decline in available food would put this entire group at risk. A number of factors suggest that the accessible food for those who are already malnourished would decline dramatically. Many counties who depend on import of food will be equally affected. Given these conditions, even a modest, sudden decline in agricultural production could trigger massive famine. If famine conditions persisted for a year or more, it seems reasonable to fear that the total global death toll in the Global South could exceed one billion from starvation alone.

There is a very high likelihood that famine on this scale would lead to major epidemics of infectious diseases. Illnesses such as plague, which have not been prevalent in recent years, might again become major health threats.

According to the estimates in the study the food crisis is likely to trigger internal and external conflicts. In such situation the use of nuclear weapons between the two nuclear super powers, the United States and Russia cannot be ruled out as long as these weapons exist.  Huge swaths of both countries would be blanketed by radioactive fallout and their industrial, transportation, and communication infrastructures would be destroyed. Most Americans and Russians would die in the succeeding months from radiation sickness, epidemic disease, exposure and starvation.

The lesson here is that the entire world really is targeted by the weapons of the nuclear-armed states, even if the missiles themselves are not pointed at our cities. Working to end this threat is not only responsible global citizenship, it is a vital interest for everyone on Earth.

 

The International Physicians for the Prevention of Nuclear War (IPPNW) and the International Campaign to Abolish Nuclear Weapons (ICAN) have highlighted this issue and tried to impress upon the participating parties in the Glasgow summit to bring this on top of the list and ask all nuclear weapons possessing countries to join the Treaty Prohibiting Nuclear Weapons (TPNW) and abolish these weapons for good. This is in our hand. Huge expenditure on nuclear weapons is costing several welfare needs of our people. It is unfortunate that the narrative to the effect is not being given due importance including in our country. It is the duty of all peace loving citizens to raise the voice. The participating parties at the COP-26 should debate this issue seriously as a priority.

 

https://m.dailyhunt.in/news/india/english/indiapressagencynews-epaper-indpres/nuclear+arms+pose+grave+threat+to+climate-newsid-n331000520?listname=newspaperLanding&topic=ipaspecial&index=5&topicIndex=1&mode=pwa&action=click

 

https://news.anypursuit.org/article37010-NUCLEAR-ARMS-POSE-GRAVE-THREAT-TO-CLIMATE

28 Oct,2021

India’s poor ranking in Global Hunger Index an issue of concern

Date: 28.10.2021

 

India’s poor ranking in Global Hunger Index an issue of concern

 

 Dr Arun Mitra

 

After the sad happenings during COVID-19 which led to the death of 4 lakh people according to official figures (even though some independent agencies point out this number to be between 25-40 lakh), the news of vaccinating 100 crore people with first dose and 30% population with second dose gave some respite. The data on how many doses were paid and how many free of cost is yet to be released by the government. In the past too India has to its credit several successful immunization programmes 100% free of cost including the most worked out door to door Pulse Polio as well as small pox eradication.

 

At this juncture it is extremely disturbing to note that India’s ranking in Global Hunger Index has further declined to 101 among the 116 countries surveyed. The government’s objections to the scoring method do not hold good as it is not for the first time that this data has been released. It is an annual affair based on the similar methodology. (https://www.globalhungerindex.org/about.html )  

 

Irony is that our rank is lower than all our South Asian neighbours with  Sri Lank at 65, Nepal & Bangladesh at 76 and Pakistan at 92. Even Rwanda which has seen deadly internal strife for several years is better than us at 98. The countries below us are  Papua New Guinea, Afghanistan, Nigeria, Congo (Republic of),  Mozambique, Sierra Leone, Timor-Leste, Haiti, Liberia, Madagascar, Democratic Republic of the Congo, Chad,   ,Central African Republic , Yemen, Somalia. All these countries are either faced with civil wars or are at very low level of economic development. 

Data on the GHI score reveals that from 2000 to 2012 the GHI score for India improved by 10 points. From 2012 to 2021 this improvement is only 1.3. Our neighbouring countries have fared better with Bangladesh 9.5 points, Sri Lanka 4.6, Nepal 4 and Pakistan 7.4 points.  

 

Undernourishment means that caloric intake is insufficient. This has serious effect on children. It causes wasting among the children which means that the child has low weight for height. This occurs as a result of acute under nutrition. Other impact is that the child does not gain enough height expected for that particular age. This is labelled as stunting and occurs due to chronic under nourishment. The poor nourishment leads to high percentage of mortality among the children.  

 

A balanced diet means sufficient number of proteins, fats, carbohydrates and micro nutrients in the form of vitamins and minerals. Lancet had formed a committee to go into nutritional requirements of a person. It has suggested intake of 232 grams of whole grain, 50 grams of Tubers of starchy vegetables like potato, 300 grams of vegetables, 200 grams of fruits, 250 grams dairy food, 250 grams of protein sources in the form of meat, egg, poultry, fish, legumes, nuts, 50 grams saturated and unsaturated oils 30 grams of sugar. At the present market price the cost of these food items per person comes to be Rs.154/- per day. This means that a family of five members should spend Rs.770/- per day or Rs.23100/- per month on food. Barring a miniscule population our people are far from this target. The government’s scheme to give 5 kg of grains and one kg daal and a bit of oil does not fulfil the nutritional requirements. It is just enough for sustenance. It does not at all meet the requirements of micro nutrients like vitamins and minerals essential for physical and metal growth.     

 

Therefor increasing purchasing capacity of the people and poverty alleviation with sufficient wages is the only answer to meet the requirement of quality food for the citizens.  Several economic experts including the Nobel Laureate Abhijeet Banerjee have suggested several means to alleviate poverty. The basic principle however remains that buying capacity of the people should increase and the government should ensure food security to all citizens. 

 

Various workers organizations have formulated their demand for minimum wage based on these principles. They have demanded a minimum wage of Rs.21000/- per month.  To the utter dismay the government has fixed national minimum wage as  Rs.178/- per day or Rs.5340/- per month. This is despite an internal labour ministry committee recommendation of Rs.375/- per day.

 

This low minimum wage will further increase inequality and poverty.  Large number of our population is in the unorganised sector where the legal formulations are hardly implemented. The farmers and agriculture labour who are the producers are among the worst sufferers. Agriculture labourers have to face double oppression, economic as well as social. The farmers are protesting as they fear that with the new acts not only their economic conditions will go worse but food security of the citizens too will be compromised.   

 

Unfortunately instead of increasing budgetary allocation for the nutrition programmes and increasing the wages the government is further cutting them down. The government reduced financial allocation for the mid day meal and the Integrated Child Development Services (ICDS) programmes in its 2015-16 budget. The central budget for mid-day meals was Rs.13000 crore in 2014-15 budget and is now down to Rs 11,000 crore. The allocation for ICDS has also fallen below than 2015. The allocation for the Poshan Abhiyaan, which had a meager budget of Rs 3,700 crore which has also been reduced by Rs.1000 crore to Rs.2700 crore in the annual budget 2021-22.

  

Nutrition forms the basis of developing immunity. A poorly nourished person is more likely to fall prey to diseases.

 

With the skewed policies we will never achieve a hunger free India. There is need to have the public discourse around such issues. The government has to ensure increase in financial allocation to nutritional programmes, increase and ensure minimum wage as demanded by the workers’ orgaisations, sort out issue of farming community, ensure food security to all, good housing, healthy environment, clean drinking water supply, proper sanitation and job security. People should not be made dependent like stop gap arrangements of aata  daal scheme instead they should be remunerated well so as to increase their purchasing capacity. 

 

 

 

19 Oct,2021

National Digital Health Mission and Healthcare in India

Date: 19 October 2021   

 

National Digital Health Mission and Healthcare in India   

Dr Arun Mitra    

  

The Prime Minister launched National Digital Health Mission (NDHM) on 27th September 2021 giving high hopes that it will bring about drastic improvement in healthcare of our people. The mission is basically to collect and compile health data which has been made easy by the  modern technology. Maintaining database on health can be helpful in planning for healthcare. It is also useful for the epidemiologists and research workers in health to analyze health situations from time to time. Already several IT organizations have come up with systems to maintain such details. Patient does not have to carry several pages of her/his medical record as these can be obtained with click of a button. Many corporate hospitals have such systems installed.   

But the present mission which is supposed to cover all citizens has several contentious clauses. There are several issues which need to be addressed. Whether this data collection in present form will address to the healthcare needs of our people; whether confidentiality of patients will be maintained; has the issue of cyber hacking been addressed; health is a state subject, how will this matter be sorted out; whether this mission will take care of inequities in healthcare?   

As per the NDHM, health care providers will collect data which will then be shared with the state health authority and the central health authority. The medical ethics demand a patient’s health status a confidential issue between him/her and the doctor. No doctor should share it with anyone unless permitted by the patient himself/herself. By sharing the data with three parties this basic ethical issues has been completely ignored and flouted. With a poor track record of controlling cybercrime in our country how can it be guaranteed that the data will not be leaked? 

The health care provider will give consent for his/her enrollment in this mission to collect the data. Similarly the consent of the principal, the person/individual, will be necessary to collect data about his/her health status and share it with the state and central health authorities. There is also provision that the health care provider or the principal will have the right to opt out of this mission. But according to the mission the person’s record isn't erased after they have opted out but it is simply locked. Moreover it cannot be erased for a certain period of time.     

Extensive due diligence is required by all stakeholders to ensure that a right balance is created between the public healthcare needs and the legal rights of the citizens, specifically the right of privacy and data protection. One of the main concerns with the NDHM is that it suggests a framework that severely overlaps with the fundamental right to privacy as per the the privacy principles recommended by the Group of Experts on Privacy (Justice A.P. Shah Committee) and the more recent, Justice B.N. Srikrishna Committee report whose recommendations on data protection form the core foundation for the draft Personal Data Protection Bill, 2018.   

The argument of maintain confidentiality is belied by the fact that the job of compiling/managing the data will be given to private setups thus completely negating the security issue. With this a person's privacy will be completely undermined under this mission. There is no provision of sufficient safeguards against commercial exploitation of sensitive personal data which may be caused by private entities that will be linked to public entities under this system. These include insurers, pharmaceutical companies, and device manufacturers.    

Many issues mentioned under "sensitive personal data" are perplexing. It says that “such personal data, which may reveal or be related to, but shall not be limited to, financial information such as bank account or credit card or debit card or other payment instrument details; physical, physiological and mental health data; sex life; sexual orientation; medical records and history; biometric data; genetic data; transgender status; intersex status; caste or tribe; and religious or political belief or affiliation”. Why sensitive personal data should include religious or political belief or affiliation of data principals or about their sex life or sexual orientation for that matter?   

The fear that such a data could be used by the state on some pretext or the other is not unfounded. We have the example of Aadhaar Card which is now compulsory to be linked with almost any activity and the state has complete knowledge and control of the activities of the people in our country. Gradually the digital health card will be made compulsory to join the Ayushman Bharat/RSBY/CGHS/ECHS/ESI or any other government sponsored scheme or the insurance by the companies. It is difficult to comprehend that when there is Aadhar card for every citizen, what is the rationale behind another card.    

Health is a state subject. Collecting data by the centre will be complete infringement on the rights of the state.    

The contention of the government that this will help us improve the health policies is unacceptable. The government already knows the problems of health care in our country but it needs political will to sort out those problems. Several health activists/civil society groups and experts have already given their view point on how to improve healthcare system. 

Health is a basic human right, but despite so much talk, health is not a fundamental right in our country.  Healthcare is based on holistic approach covering safe drinking water supply, sewerage facilities, clean air, healthy nutrition, good working environment, guarantee of job and sufficient remuneration etc. All these require planning with priorities towards health. 

Our patients are highly burdened with the cost of the health care. The National Health Policy document clearly admits that 6.3 crore people are pushed below poverty line due to out of pocket expenditure on health. With meager spending of 1% of the GDP by the state sector on public health as against required minimum of 5% recommended by the WHO, the patients are left to remain at the mercy of private sector which accounts for nearly 80% of the health care in our country. It is no secret how the patients have ben fleeced even during Pandemic by the corporate sector.

 

Universal healthcare system is the only answer. There is enough information now on how the corporates hospitals fleeced the patients during COVID Pandemic. The pharmaceutical industry minted money at the cost of seriously ailing people. In the Pre COVID period there were 100 billionaires in India whose number increased to 140 during COVID. These billionaires earned 12.7 lakh crore rupees between March 2020 and March 2021. During 2nd wave of COVID pandemic 24 of these 140 companies who deal in health sector were doing business of 500 crore rupees per day in April - May 2021. In contrast despite several difficulties, the public sector institutions provided service to the people with healthcare workers risking their lives.     

 

The NDHM type of exercise is useful in a health care system which is comprehensive and universal. In the system like ours health care delivery is so much diverse, right from the faith healers, alternative medicine to the system of modern scientific medicine. The medical practitioners vary from small scale sector to corporate sector. For the small scale single person clinic it is extremely difficult to maintain such records. They will have to employ new people for the job cost of which will ultimately fall upon the patients. This will further create inequities as elite section will get NDHM benefits because they will link themselves to the corporate health facilities. To ensure equity in the benefits of NDHM inequality in the healthcare has to be abolished through a universal state owned healthcare system.   

The whole exercise in no way seems to be of help in improving the health needs of our people; it will rather be another means to give power for surveillance of the people. People will be carrying just another card in their pocket.

 

As of now, there is need to increase budget on health from 1% of the GDP to 5% immediately if the people’s health issues are to be addressed in the real sense. Several countries invest 10-15% of the GDP on the health of the people. Why can’t we?   

 

https://www.nationalheraldindia.com/opinion/instead-of-pro-corporate-plans-like-ndhm-modi-govt-needs-to-scale-up-spending-on-public-sector-healthcare

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/national+digital+health+mission+is+not+the+only+answer+to+india+s+problem-newsid-n325214326

 

https://news.anypursuit.org/article36868-NATIONAL-DIGITAL-HEALTH-MISSION-IS-NOT-THE-ONLY-ANSWER-TO-INDIA-S-PROBLEM

12 Oct,2021

Right to Health

Date: 12.10.2021

 

Right to Health

 

Dr Arun Mitra

 

That out of a population of  100000 in our country 32 persons die due to Tuberculosis every year (1),  is a matter of grave concern and shame. Recently we have seen death of large number of  children having fallen prey to Dengue fever and Encephalitis in Uttar Pradesh. Similar is the situation with Diarrhoea, Malaria and many other communicable diseases. Needless to mention the havoc caused by the COVID Pandemic where we failed to prevent several thousand deaths because of mismanagement and skewed priorities. It is not only the communicable diseases, the non-communicable diseases too are on the rise. It is estimated that 29.8% of Indians have hypertension, with 33% prevalence in urban and 25% in rural India (2). As of 2017, India had 72.9 million diabetes patients-second only to China (114.3 million), and is soon likely to become the diabetes capital of the world. About one in every two Indians (47%) living with diabetes is unaware of their condition, and only about a quarter (24%) manage to bring it under control. Rural men with low household wealth and low education levels had a higher incidence compared to other groups (3).   Nearly 26 people die of diabetes per 100,000 population (4). 

 

All this requires a comprehensive health planning by the state with resolve to provide equitable health care to the citizens. The World Health Organisation (WHO) has termed “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

 

Despite the fact that India is an active participant in the WHO affairs, health has not been declared as a fundamental right in our country till date. Hence the citizen does not have a right to challenge the government in the court of law for its failure to meet health needs of the people. 

 

To promote a wider discussion and  implementation of the goals for equitable health a declaration was signed by  the participants including India in the international conference at Alma Ata in 1978 – and concluded with the Alma Ata declaration. Health planning in our country started way back in mid 1940s when Joseph Bhore Committee submitted its report in 1946. It had highlighted that health services should be based on equity. Safe drinking water & sanitation, adequate nutrition, proper housing, quality education, safe working conditions and sufficient wages form the basis of health for all. 

 

Addressing a Webinar organised by the Indian Doctors for Peace and Development (IDPD), Dr Tejbir Singh – Prof. of Community Medicine Govt. Medical College and Hospital, Amritsar pointed out that health was recognised as human right way back in 1966 in the International Covenant on Economic, Social and Cultural Rights. And in the year 2002 -  Human Rights Council created the mandate of the Special Rapporteur on the right of everyone to the highest attainable standard of physical and mental health. It declared that Human rights should be exercised without discrimination of any kind based on race, colour, sex, language, religion, political, or other opinion, national or social origin, property, birth or other status such as disability, age, marital and family status, sexual orientation and gender identity, health status, place of residence, economic and social situation. 

 

Despite all the above happenings, the Constitution of India does not expressly guarantee a fundamental right to health. The references to the state’s responsibility to health of the people are mentioned in the directive principles in Part IV of the Indian Constitution. These provide a basis for the right to health.  Article 39 (E) directs the State to secure health of workers.  Article 42 directs the State to just and humane conditions of work and maternity relief.  Article 47 casts a duty on the state to raise the nutrition levels and standard of living of people and to improve public health.  Article 21 guarantees the right to life. 

 

As mentioned above Primary Health Care is based on  Equitable distribution, Community Participation , Intersectoral Coordination  and Appropriate Technology 

  

These are to be done through Education about prevailing health problems & the methods of prevention & control , Promotion of food supply & Nutrition , Safe water and Basic Sanitation , MCH care including Family Planning , Immunization against major infections, Prevention and control of Endemic disease, Appropriate treatment of common illnesses  and Provision of essential drugs mentioned Dr Tejbir Singh in his presentation.  

 

 

There has been a paradigm shift in the approach from the first National Health Policy - 1983  which emphasized on promotive, preventive curative and rehabilitative services. The National Health Policy - 2002   shifted its emphasis towards the provision of health care through private sector and opening up secondary and tertiary level health care for private investment.  The spirit and principles of Primary health care was compromised by shirking the responsibility for health by the public sector.   This resulted in a setback to the equitable distribution of health for the people. This is a period following World Trade Organisation which was founded on 1st January 1995.   

 

The National Rural Health Mission was launched in 2005. It was later extended to urban areas also as National Urban Health Mission in 2011. Consequently the two were merged as National Health Mission in year 2013  however, implementation of national health mission remained fragmentary and half-hearted. 

 

The National Health Policy (NHP)  2017 however made a leap forward to corporate centric and insurance based healthcare system. It also highlighted on strategic purchase of non govt. secondary and tertiary care services.  Insurance system was further strengthened and as a result public funds are diverted to the private insurance and health care sector.

 

As a result 75% of healthcare expenditure comes from the pockets of households – 80% for OPD care and 60% for Indoor care.  Every year 6.3 crore population of India is pushed towards poverty due to out of pocket expenditure. This catastrophic healthcare cost is an important cause of impoverishment which further adds to poor health.

 

India has roughly 20 health workers per 10,000 population, with 39.6% doctors, 30.5% nurses and midwives, and 1.2% dentists. Of all doctors, 77.2% are allopathic and 22.8% are ayurvedic, homeopathic or unani.  Total doctor-population ratio 1:1445. It is to be noted that Govt doctor-population ratio is 1:11,926 in contrast to the desired 1:1,000. This is a major cause of in equality in healthcare to the marginalized sections who are dependent solely on state healthcare system.  

    

 

WHO recommends minimum of 5% of the GDP as expenditure on Health. The  Planning Commission of India had said that the state spending on health will be 2.5% of GDP by end of 12th five year plan and 3% by 2022. Interestingly under the present BJP government the 2015 NHP draft mentioned this to be  2.5% GDP by 2020. The revised NHP 2017 pushed it further to 2025. In 2015-16 there was 5.7% decrease in the health budget which was increased by 5% in the budget 2016-17. In 2017-18 the budget was further increased but it was still less than the budget for the year 2011-12 (1.1% of GDP).

 

Now we find that investment in health insurance has increased. The Ayushman Bharat is an insurance based system. NHM budget was decreased by 10%. The  ICDS budget has been decreased. Nutriton budget decreased by Rs.1000 crores from 3700 to 2700 crores rupees in this year’s budget.

 

Even after more than 70 years of independence, health in India is a dream for the was majority and luxury for the rich. 

 

Unfortunately even after the dreadful experience of the Pandemic there is hardly any discussion on health in the society. The debate on healthcare is largely limited to the professional discussions that too of a few concerned. Health education in the society is very poor which becomes a cause for late detection of several diseases. Political parties have a feeling that discussion on health may not fetch them votes. So they are callous towards this. Civil society has to come forward to build a public movement demanding health as a fundamental right so as to make the state answerable.  

 

1.       https://tbfacts.org/tb-statistics-india/

2.       https://www.indiaspend.com/high-blood-pressure-killed-1-6-mn-indians-in-2016-but-most-are-unaware-of-its-dangers-94201/

3.       https://www.indiaspend.com/1-in-2-indian-diabetics-unaware-of-their-condition-study/

4.       https://www.indiaspend.com/50-rise-in-diabetes-deaths-across-india-over-11-years-32711

 

https://www.nationalheraldindia.com/opinion/public-health-must-be-a-fundamental-right-in-india

 

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/mass+movement+in+india+for+public+health+as+fundamental+right+is+needed-newsid-n323596628

 

 

https://news.anypursuit.org/article36831-MASS-MOVEMENT-IN-INDIA-FOR-PUBLIC-HEALTH-AS-FUNDAMENTAL-RIGHT-IS-NEEDED

16 Sep,2021

Doctors in service of humanity are much above parochial ideas

Date: 16.09.2021

Doctors in service of humanity are much above parochial ideas

Dr Arun Mitra

 

The advertisement from Tirumala Tirupati Devasthanams: Tirupati medical department published on 09.09.2021 seeking specialist doctors belonging to Hindu Religion only is a matter of serious concern. This has belittled the medical profession which professes its commitment to render service to the mankind irrespective of caste, creed, religion, gender, socio-economic status or political affiliations.

 

Another news item released from Bhopal on 5th September 2021 is about the decision of Madhya Pradesh government to include lectures on RSS founder K B Hedgewar and Bhartiya Jan Sangh Leader Deen Dyal Upadhyaya, Swami Vivekanand and Dr B R Ambedkar in the first year foundation MBBS course so as to promote patriotism among the students.

 

This is in contrast to earlier situation when medical students were encouraged by the teachers to read about great personalities in the medical science like Louis Pasteur, Rene Laennec and Alexander Fleming who had played a significant role in the development of modern medicine. Laennec’s invention of stethoscope made it easy to reach the diagnosis of several diseases particularly those related to lungs and the heart. Through his observation Alexander Fleming discovered Penicillin which revolutionised the management of infections in the body. Louis Pasteur and Edward Jenner were pioneer in developing vaccines. These are few names but there are thousands who worked hard to advance the medical care. To know about them is motivational for the upcoming doctors to contribute effectively in the field of medicine.  

 

Motto has been ‘Medicine is a passion not profession’. That was also the time when to discuss about ethics was common. These produced doctors with the ideals to serve the poor and the sick without any priority for financial considerations. This inculcated patriotism and desire to serve the nation. 

 

Code of Medical Ethics was developed by the Medical Council of India (MCI). Clause 6.1 of the Code prohibits the doctors to solicit patients through advertisement. As per the declaration by the doctor at the time of registration according to clause 8.8 of this Code he/she has to pledge to ‘serve the humanity and use the medical knowledge with utmost respect for human life and will not permit considerations of religion, nationality, race, party politics or social standing to intervene between the duty and patient’. This is in continuation with the clause 1.1.2 of this ethics which states ‘The prime object of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration. Who-so-ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A physician should be an upright man, instructed in the art of healings. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life’.  

 

Times have however changed. Commercialism has overtaken science. Ethics are by and large only for the record sake. Financial issues apart, there is a serious effort to divide the doctors for jobs on communal lines even though a doctor is ethically bound to serve the patient from any religion without discrimination.     

 

Dividing the medical personnel on communal lines is not new. This was seen during the period of Hitler when some doctors were forced to collaborate with Nazis and participate in mass murders of Jews. They would extract the gold plated teeth of the prisoners just because wife of a Nazi officer liked that. 

 

Advertisement by Tirumala Tirupati Devasthanams: Tirupati medical department should have been taken note of and opposed by the medical bodies particularly the Indian Medical Association (IMA). But unfortunately no voice has been raised on this score. 

 

The National Medical Commission decides the syllabus of the MBBS course. It sets topics for each subject. Lectures on the political leaders to be given officially is not as per the norms. According to Madhya Pradesh Education Minister Vishwas Sarang such lectures about the RSS and BJP leaders have been introduced by the state for the purpose of character-building. Names of Swami Vivekanand and Dr B R Ambedkar in the series have been very subtly added to avoid any controversy. How will these promote ethics in medical practice is beyond comprehension. This is clear intent to thrust upon RSS ideology on medical students. 

 

Patriotism of RSS is equivalent to narrow nationalism and creation of a Hindutva based monolithic, homogenous society marginalising the minorities. This is against the idea of India which was conceptualised by the freedom fighters and revolutionaries who had thought of a country with multi religious multi-cultural, multi-linguistic society with people living together with equal rights. Any conscious person would understand the motive of all this. Such absurd and dangerous steps must be opposed by the medical bodies to prevent medical education becoming the playground of hate politics. 

 

 

08 Sep,2021

DESPITE SEVERAL HEALTH PROBLEMS FARMERS SPIRIT UNDAUNTING

Date: 08.09.2021

 

DESPITE SEVERAL HEALTH PROBLEMS

FARMERS SPIRIT UNDAUNTING

 

During several visits to the Singhu and Tikri borders where farmers are protesting for the repeal of farm laws since 26th November 2020, every time it is more enthusing than the previous visit to watch the commitment and spirit among them. Staying in the tractor trolleys or makeshift hutments away from the families is not an easy task.  In such situations anyone is prone to health problems, more so the elderly, women and children. Stress of staying away from their kith and kin is quite disturbing. At home, one has so many things to discuss among the family members, relations and friends. There are always many positive and negative events that happen in life which a family sorts out together. But staying here far away from their family members for too long, the day to day physical meeting with each other discussing the family issues is missing. It affects the elderly even more who now miss the happiness and charm of playing with grandchildren. Here they have to live with the unknown people and interact with them. Each family has its own issues and problems which are confidential and cannot be talked of with the unknown people. Somebody taken ill in the family, some happy occasions in the family, some wedding, some birthday or some other events, happiness and sadness always keep occurring in the human life. But togetherness of a family and concern for each other keeps us going. 

 

Food and nutrition are so important a factor in life. To be healthy to work we need quality food. There is always a choice of food with every person. But here in a gathering like this that choice is completely missing. One has to eat whatever is provided at the community kitchen or langar. To make good food the vegetables need to be thoroughly cleaned and properly peeled off, prevented from flies, utensils need to be properly washed time and again. Drinking water glasses need to be cleaned hygienically. In the set up camps like this it is not possible at all.  One cannot ensure hygienic supply of food or even the clean plates to eat food. The surroundings where the food is cooked cannot be maintained in a hygienic manner for so long a period. Even though they spray insecticides regularly but in such large gatherings where there are no facilities provided by the government, rather the government is hostile, chances of getting ill due to unclean food items always persists. 

 

There is always a danger to fall prey to vector borne diseases like malaria and dengue. Staying with unknown people one is more prone to catch infectious diseases like Flu, Tuberculosis and other respiratory illnesses. 

 

Another issue is the absence of proper clean toilets which is so essential in such situations. They have made some makeshift toilets but then there is a need for regular water supply and clean up staff trained for the job. This is even more important for the female folk who are there in large number.

 

Emergencies are difficult to treat in such situations. There have been some patients who suddenly landed up into cardiac, neurological or gastrointestinal emergencies. Such patients need to be managed effectively and on emergency basis. For such patients family support has great emotional value. Chances of losing life by the patients in such conditions is more than the normal circumstances. At home one can also go in for regular check up from the doctors. This can many a times prevent serious illness.

 

Therefore the people sitting there are seen to be suffering from both communicable and non-communicable diseases. As the number of people above age of 60 is substantial, it is imminent that they have developed old age problems like the joint pains and back ache. Skin diseases are rampant. Diseases like Diabetes and Hypertension need constant care which can-not be provided in make shift camps.

 

Every visit is a challenge for the doctors and staff accompanying the medical team. The medical teams by the Indian Doctors for Peace and Development (IDPD) have been holding medical Camps of various specialties including Eye, ENT, Cardiac, Orthopaedics, Physiotherapy and Dental. The farmers have been fitted with Hearing Aids as well as Spectacles as per the requirement.

 

The commitment and will of the farmers however enthuses the health staff. It is the un-daunting spirit among the farmers despite several health issues that they are continuing their protest with vow to stay till victory. They are ready to sacrifice to any extent because they are convinced that the acts passed by the government will starve them otherwise also. Even under such arduous conditions they maintain regular discipline in their life, waking up on time in the morning, some of them do some exercise. Youth plays the games like volleyball to stay fit. Elderly take a stroll around the place of their stay. To bring cheer to their life they sing songs and celebrate all the festivals of different beliefs together. It is the togetherness that fills them with un-daunting spirit of sacrifice to the last for the cause despite several physical and mental health problems.

 

 

 

31 Aug,2021

800 MILLION PEOPLE IN FREE RATION QUEUES - A POINTER TO SERIOUS NUTRITIONAL CRISIS

Date: 31.08.2021

800 MILLION PEOPLE IN FREE RATION QUEUES - A POINTER TO SERIOUS NUTRITIONAL CRISIS 



Central Government’s scheme to give 5 Kilogram of grain and One Kilogram of Daal to 80 crore people  is an acceptance of abject poverty in our country. This is at a time when the country is aspiring to be 5 trillion economy. It is a pointer to persisting nutritional crisis and failure of the government to pay heed towards the nutritional demands of the people.   

 

This scheme under the Prime Minster Garib Kalyan Yojna (PMGKY) is not a new idea. The basis lies in the National Food Security Act. According to this act it is the duty of the government to just not fill the stomach of the people but also to ensure proper nutrition. The government notified the National Food Security Act (NSA), 2013 on 10th September, 2013 ‘with the objective to provide for food and nutritional security in human life cycle approach, by ensuring access to adequate quantity of quality food at affordable prices to people to live a life with dignity’.(2)  

 

Food security, as defined by the United Nations' Committee on World Food Security, means that all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their food preferences and dietary needs for an active and healthy life. 

  

The NSA also has a special focus on the nutritional support to women and children. Besides meal to pregnant women and lactating mothers during pregnancy and six months after the child birth, such women will also be entitled to receive maternity benefit of not less than Rs. 6,000. Children up to 14 years of age will be entitled to nutritious meals as per the prescribed nutritional standards. In case of non-supply of entitled food grains or meals, the beneficiaries will receive food security allowance. (1) Ration given under PMGKY is less than what is required for sustenance what to talk of healthy nutrition.

 

Nutrition does not mean just filling the stomach. It means a balanced supply of proteins, carbohydrates, fats, minerals, vitamins and other essential items and micro nutrients  required for physical and mental growth. We get these from vegetables, eggs, meat, milk and fruits. Lack of any of these items leads to deficiency diseases. Moreover we do not eat raw food. We have to cook food for which we need fuel, oil and several other items. Supply of only Daal and Grain does not serve the purpose of nutrition. It is astonishing that the union government which is talking of nutrition for all citizens, cut down expenditure on nutrition for children and women by 27% from Rs. 3700/- Crore to Rs.2700/- crore in its last budget. Therefore India has fallen much low in the hunger index; even below the other neighbouring south Asian countries. Our rank in hunger index is 94 out of 107 countries, Pakistan ranks at 88, Bangladesh 75, Nepal at 73 and Sri Lanka at 64.   

 


Five Kg. grain and one Kg. daal costs around ?225/-.  That means it is supporting a person by just ? 225/- over his/her income. From where this money will come when people are already losing jobs and means for livelihood. 

 

A committee of experts appointed by the world renowned medical journal Lancet had proposed a diet chart wherein it had specified the amount of different types of food including grains, pulses, meat, milk, fruits, vegetables etc. needed by a person. as per the present market rates the average approximate cost of this healthy nutritious diet comes to be around Rs.130/- per person per day. For a family of 5 members this comes out to be Rs.650/- per day or Rs.19500/- per month. This is impossible to be met with in present day economic situation where millions have lost their jobs and means of livelihood. With the national-level minimum wage at around INR 176/- (US$2.80) per day, which works out to INR 5280/- per month as against the workers’ demand of Rs.18000/- per month, to fulfil basic nutritional needs is beyond imagination.

 

Making people dependent on free rations at the mercy of the government is no good. This affects their self-esteem. What is needed is to ensure sufficient income to the people to increase their purchasing capacity. But with new acts coming up in the name of labour reforms, we are moving towards a society where workers will be denied their right for collective bargaining. The marginal and medium farmers, who are the producers of food, too are facing the problem of nutritional deficiency because of lack of sufficient income. They feel that with new acts on agriculture their situation is likely to get worse; that is why they are protesting in large numbers. The government has already admitted in the Parliament that average income of a farmer’s family of five members is Rs. 8000 per month.

 

To improve nutrition of the people it is urgently required to increase income of the people, provide them with facilities for proper housing, environment, clean drinking water, sewerage facilities and quality education.

 

1.        https://dfpd.gov.in/nfsa.htm 

2.        https://wocatpedia.net/wiki/Definition_and_Dimensions_of_Food_Security  

 

 

16 Aug,2021

Violence prevention a public health concern

Date: 18.08.2021

 

Violence prevention a public health concern

 

Dr Arun Mitra

 

The incident of shouting highly communalized slogans and chanting genocide of Muslims and also that they be thrown out of India by a mob of Hindutva goons with police watching as mute spectator is not a new thing. The difference however is that this incident has happened at Jantar Mantar in proximity to the Parliament. Till date neither the Prime Minister nor the Home Minister have uttered a single word to condemn it. Even in his Independence day speech the Prime Minister took no notice of this. Their silence is intriguing. Encouraged with government’s covert support, an incident of similar type occurred in Kanpur just after three days. In this case the accused got bail in the Police station itself. Earlier too we have seen crowds forcing people to chant Jai Shri Ram. Many innocents have faced mob lynching something hitherto unknown in our country. All this is not spontaneous but apparently a part of the pre-planned strategy of the Hindutva brigade to vitiate the atmosphere and generate communal riots so that the situation is then utilized to further their agenda at a time when elections in some parts of the country are a few months away. As a result of such incidents social cohesion becomes weak and health is a major casualty. 

   

Not many have been left alive to tell the tale of partition of the country when the communal frenzy led to the death of more than 20 lakh people including Hindus, Muslims and Sikhs. In such events the mobs are made to believe that the people from other community and ethnic groups are a threat to them. These mobs do not spare even liberals belonging their own community so as to silence any sane voice among them. 

  

Rwanda is an example of modern times where in just 100 days in 1994, about 8 lakh people were slaughtered by ethnic Hutu extremists who targeted members of the minority Tutsi community, as well as their political opponents, irrespective of their ethnic origin. Neighbours killed neighbours and some husbands even killed their Tutsi wives, saying they would be killed if they refused. 

 

That perpetrators of violence have no mercy is apparent from the scenes of 9 year old daughter of the person being beaten at Kanpur who kept on begging mercy, but that had little effect on the goons. The child is now under extreme stress and has been refusing to eat food.

  

In any violent situation health bears the major burnt. Health effects are in the form of physical injury, death, nutritional deficiencies, mental stress etc. Women, children and the elderly are the worst victims. A study carried out by the IPPNW Kenya affiliate – One Bullet Story, of a teenager from D R Congo who was shot in the face and treated in Nairobi by an IPPNW doctor, was shown to United Nations delegates at an international meeting on small arms as well as many other venues. Cost of treatment in this case was $ 6000. This amount is sufficient to meet the expenditure of One year of primary education for 100 children/ 8 years of secondary education for 10 children/ Full immunizations for 250 children/ 1 1/2 years education for a medical student.

 

 

Thus Violence Prevention is a Public Health Issue.  “Violence can lead to premature death or cause non-fatal injuries. People who survive violent crime endure physical pain and suffering and may also experience mental distress and reduced quality of life. Repeated exposure to crime and violence may be linked to an increase in negative health outcomes” 1.

 

Children exposed to violence may experience behavioral problems, depression, anxiety, and post-traumatic stress disorder. They may also show increased signs of aggression starting in upper-elementary school.

 

The effects of exposure to violence in childhood may be seen in adulthood and can result in greater risk for substance use, risky sexual behavior, and unsafe driving behavior. Individuals exposed to violence at any age are more likely to engage in and experience intimate partner violence. Women exposed to intimate partner violence have an increased risk of physical health issues such as injuries, and mental health disorders such as disordered eating, depression and suicidal ideation 2. 

 

During any communal/ ethnic riot of serious nature the people are displaced and forced to live in the make shift camps. The condition in these places is generally awful. There is shortage of clean drinking water, proper sanitation, and food. A long stay of the people in such places can lead to nutritional deficiencies. The private family life is disturbed. Children loose their schooling. There is always an increased risk of sexual violence against women.

  

The perpetrators of communal frenzy have agenda with them. Many a times there are personal prejudices or business rivalries. Other times they intentionally want to split the society for their political gains. These have long standing implications on the society.

 

For a public health professional and activist it is an important duty to prevent such violence and save the social cohesion. It is important for them to speak out forcefully against any kind of violence. Engage the youth in positive activity. Try to prevent any violent reaction by the community/ group who are at the receiving end as this gives an alibi to the perpetrators to justify their communal propaganda and violence. Liberals should not take the events lying down, they must speak vociferously. It is important to select the people who are not rabidly communal but have been swayed away momentarily. They can be engaged in a positive dialogue.  It is only through a conscious humanitarian and secular outlook that nefarious designs of the violence promoters can be countered. The experience of Indian Doctors for Peace and Development (IDPD) in this regard through people to people dialogue, media writings and engagement with authorities has been quite encouraging and yielded tangible results. Some times taking stand in front of mobs can prevent untoward happenings.

 

Reference:

1 & 2 : https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/crime-and-violence 

 

 

 

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/prevention+of+communal+violence+is+a+duty+of+public+health+activists-newsid-n308532330

 

https://news.anypursuit.org/article36397-PREVENTION-OF-COMMUNAL-VIOLENCE-IS-A-DUTY-OF-PUBLIC-HEALTH-ACTIVISTS

07 Aug,2021

Changing paradigm of healthcare during 74 years of independent India

Date: 07.08.2021

 

Changing paradigm of healthcare during 74 years of independent India

 

Dr Arun Mitra

 

On 15 august 2021 when we celebrate 75th day of independence from the colonial rule, it is important to review what we have achieved in these 74 years. Even though health forms an important issue to be discussed but not much has been talked about health in the debates. This time as we have passed through serious COVID pandemic crisis, there is concern in the minds of the people about healthcare situation in the country.

 

In the pre-independence period Indian society was largely dependent on the traditional medicines, faith healing and belief system.  Modern health planning in India started after the Joseph Bhore committee recommended in 1946 that “the health programme should be developed on a foundation of preventive health work’ and that ‘if the nation’s health has to be built, such activities should proceed side by side those concerned with treatment of patients’.  It was based on the principles that no individual should be denied to secure adequate medical care because of inability to pay; medical services should be free to all without any distinction and doctor should be a social physician. The committee also observed that health and development are inter-dependent and improvement in other sectors like water supply, sanitation, nutrition, employment lead to improvement in health status.  

 

This report goes in consonance with the Public Health definition by CEA Winslow and Rudolf Virchow who had conceptualised healthcare as social medicine and that every doctor is a social physician. 

 

In the first few decades of post-independence period the direction of the healthcare was influenced by these principles During that period much of the health care was developed in state sector with an emphasis that modern scientific healthcare should reach the remotest rural areas.  

 

It is during this period that India started manufacturing cheap generic drugs for local and global market. With the vision of Prime Minister Jawahar Lal Nehru Indian Drugs and Pharmaceutical Ltd. (IDPL) was established in 1961. He had said “the drug industry must be in the public sector….. I think an industry of the nature of the drug industry should not be in the private sector anyhow. There are far too much exploitation of the public in this industry”. IDPL played a major role in the strategic National Health Programmes. Recognising its role, the World Health Organisation commended that “IDPL had achieved in 10 years what others have in 50. IDPL products have been examined for quality very carefully by the developed countries and many of them want to buy from here”.

 

 

 

 

 

But after the shift in economic policies and neo liberal model of development the whole scenario changed. From the holistic perspective there occurred a policy shift towards health, that treats health as ‘techno-dependent and amenable to commodification’. The shift was seen in the approach of WHO also. Thus in our country we find that the public sector is now responsible for the preventive services while the private sector is profiteering from the advanced tertiary care.

 

The Alma-Ata Declaration of 1978, a mile stone document for public health, to which India too is a signatory raised the hope for a comprehensive healthcare system. But it was not to happen. It is around this time only that shift started in whole policies and the Alma Ata declaration virtually remained on paper.  

 

The effect on Medical Education too is evident. At the time of independence, there were 20 colleges out which only one was in private sector. Most of new additions were in the state sector till late 1980s. Between the periods 1990 to 2017 number of colleges opened in private sector was 238 while only 115 were opened in state sector. At present out of 554 medical colleges as per the National Medical Commission 285 are in government sector and 269 are in the non-government sector. This led to denial of students from lower socio economic strata to get into the private medical colleges because of exorbitant charges.  

 

We have seen huge growth of corporate hospitals in health sector. The advanced care has become out of reach of low and even middle income group. Health is being projected only as a curative thing with little talk to improve health determinants like improved sanitation, clean drinking water supply, housing, job security and increase in capacity to spend on nutrition.  

 

No wonder the government recognises the fact that every year 6.3 crore people are pushed below poverty line because of out of pocket expenditure on health. But the remedy being offered is rather further pushing the people into debt. The whole healthcare concept is insurance based which fail to provide comprehensive healthcare. Senior citizens are the worst affected. Even the Ayushman Bharat covers only 50 crore while the rest 88 crores are left out. It is applicable for indoor care only, whereas 70% of the out of pocket expenditure on health is on OPD care. Moreover there are several conditions attached to get registered with this scheme. Eligible people also find it very hard to make the card. Other state run insurance schemes offer a limited benefit. For a person to get insured with private or public sector company, she/he has to shelve huge amount. The ESI started in 1952, CGHS in 1954 and ECHS in 2003 provide comprehensive healthcare to the employees to an extent. There is a move to dilute the ESI. The government is planning to handover district hospitals to the private sector to open medical colleges. In these hospitals 50% patients will get free treatment while the rest will have to pay. The free patients will have to get authorization from a designated authority, thus creating several hurdles for them.  

 

To encourage education among the children from deprived families, the National Program of Nutritional Support to Primary Education (NP-NSPE) was launched as a centrally sponsored scheme on 15th August 1995 in 2408 blocks in the country for enhancement of enrolment, retention, improvement of attendance and quality of education and improving of nutritional levels among children.  To care for the children of working people Aaganwadi was started in 1975. ASHA worker scheme was started in 2005. They worked as frontline workers during the pandemic. But till date they have neither been regularised nor been given the status of worker.     

 

The concept of universal comprehensive health care was first of all realized by the Soviet Union who in the Soviet constitution 1936 guaranteed that the Citizens of the USSR have the right to health protection. The NHS was launched in the UK on 5 July 1948, by the then Health Secretary, Aneurin Bevan. This gave huge benefit of free healthcare to the population. The Cuban government adopted the concept of social medicine into practice. Its effect is well recognised globally. Cuba has a doctor patients ratio of 1:150. In comparison India has 1:1456. Even the developed USA has 1:333.  Despite long standing embargo against them by the US government Cuba has achieved commendable health indicators better than many developed countries.  

 

The government of Cuba spends approximately Rs.25000/- per person each year on healthcare, while India spends around Rs.1418/- on the health per capita with a corresponding expenditure of Rs.2.65 lakh in the UK. (https://www.tribuneindia.com/news/nation/india-spending-rs-1-418-per-capita-per-year-on-health-govt-in-rs-223236). India is one of the 15 countries with ignominious distinction of public spending of less than or about 1% of the GDP on health; other similarly placed countries spend twice the amount while developed ones spend 10 times more – says K Sujatha Rao in her book Do We Care. Cuba spends up to 15%. It is no surprise therefore, that the secretary general of the United Nations, Ban Ki-moon, during a visit to Cuba hailed its healthcare service as, “a model for many countries”.    

 

 

 

Quality healthcare is a dream for an average Indian. The inability to pay is pushing our population to buy loans for health or sell the assets. To make the things further worse obscurantist ideas like astrology, Gau Mutra and Tantriks are being highlighted under the present regime. 

 

There is need for reversal of these policies to make healthcare a social responsibility with state taking effective intervention at all levels to ensure healthcare for all. It is the duty of the public health and social activists to educate people on the issues of their rights to health in proper perspective. Health should be declared as a fundamental rights. “The focus on our health policies should be grounded in the ideology of human welfare and to achieve the tree basic goals of health systems – equity, efficiency and quality” – K Sujatha Rao. 

 

In September 2019, a High-Level Group on the health sector constituted under the 15th Finance Commission had recommended that the right to health be declared a fundamental right. This if implemented, will strengthen people’s access to healthcare. 

 

On this independence day let the country take effective measures for health. Promise to take positive steps so that governments promote, finance and provide comprehensive Primary Health Care. Enhance public spending on health to 5 per cent of GDP immediately.  Put an end to privatisation of public health services and ensure effective regulation of the private medical sector.

 

Assure safe drinking water supply through piped water; sanitation in all households and localities, and enforce complete safeguards against air, water and soil pollution by industries, mines and other developmental projects. Eliminate Malnutrition by implementing National Food Security Act 2013. Promote people’s spending power by ensuring sufficient wages so as to meet their nutritional needs. There is need to implement a Rational Drug Policy. Ensure improved availability, accessibility and affordability of drugs including vaccines and sera in the public health system; through quality conscious pooled procurement systems and promotion of manufacture of essential medicines. Strengthen Public Sector Units to make cheap bulk drugs. Medical education should be in the state sector only.

 

https://www.nationalheraldindia.com/opinion/an-idea-for-pm-modis-speech-on-75th-independence-day-deliver-efficacious-equitable-healthcare-to-all

 

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/healthcare+must+get+top+priority+as+india+celebrates+75th+independence+day-newsid-n305803630

30 Jul,2021

IS SOUTH ASIA INCHING TOWARDS POWDER KEG

Date: 30.07.2021

 

IS SOUTH ASIA INCHING TOWARDS POWDER KEG

  

Use of atomic weapons on Hiroshima and Nagasaki on 6th and 9th August 1945 respectively led to a situation where the common man was struck in dismay; even the military strategists of Japan could not imagine that such a powerful and devastating weapon had already been developed by the Americans and now being used on their population. The event is remembered around the globe by paying homage to the victims and pledging to work for complete nuclear disarmament so that no person on earth has to ever face such heinous crime.  

 

Continuous warning by the International Physicians for the Prevention of Nuclear War (IPPNW) about the health and humanitarian consequences of the nuclear fallout has withheld the use of these weapons till date after 1945. Several treaties have been undertaken between the nations, but the biggest achievement of the peace movement is the passage of Treaty Prohibiting Nuclear Weapons (TPNW) by the UNO four years ago as a result of persistent efforts of the International Campaign to Abolish Nuclear Weapons (ICAN). The treaty has delegitimised the use of nuclear weapons in any form. It has now been signed and ratified by the countries in the required number for the treaty to enter into force.   

  

It is however a matter of concern that nuclear weapons possessing countries have not honoured the global voice of the people. They still believe in the doctrine of nuclear deterrence, not realising that the very presence of these weapons poses a threat of their being used.  

 

Unfortunately south Asia with all its problems of poverty and hunger too has fallen into the trap of nuclear arms race. The economy of India and Pakistan has been in crisis which has worsened during the pandemic. According to PEW Research Centre, in India, the number of people earning less than $2 has doubled from 59 million to 134 million during Pandemic; and as per study by the Center for Sustainable Employment at Azim Premji University 230 million people earn less than Rs.375/-  per day. Pakistan is already in the grey list of Financial Action Task Force (FATF). The economic condition of Afghanistan is pitiable. Loss of jobs and means for livelihood are pushing people into malnutrition. 

 

Economic hardships lead to social unrest. In such situations narrow nationalist slogans are used and blame of economic hardships is put on some social-religious groups which are to their disliking. We have seen how Nazis swayed the people in their favour.

 

We are witnessing similar fundamentalism in South Asia today. Taliban aspiring to capture power in Afghanistan pose a serious threat to the region.  Pakistan is going to be most affected. Pakistani society is a mix of modern thought, the people who want to live in peace, practice their religion but are opposed to fundamentalist slogans. They want to live in consonance with others. There are some forces in Pakistan that ally with Taliban and intend to bring similar setup in Pakistan. As a result of such forces Pakistan has become breeding ground for terrorism. The government of Pakistan is in a very precarious situation as they are faced with challenge to develop modern, economically developed Pakistan on one hand and to fight the radical forces on the other. Women in Pakistan who have achieved a lot in the past and who have shed obscurantist ideas will be the worst sufferers if Wahabi type of Islam is imposed. 

 

India which developed as a secular nation is now being threatened by the fundamentalists. They are out to put blame of all the ills on minorities and so increase communal conflicts. There have been incidents of violence against minorities perpetuated by these Hindutva brigade and supported by the government in BJP ruled states. This is evident from several incidents of mob lynching on the pretext of eating beef and other frivolous issues. The incident of violence against minority community in “North East” Delhi in the end of February 2020 where instead of putting cases against the perpetrators of violence the victims of violence have been arrested and are being prosecuted. Happenings in the name of Love Jehad, highlight bias against the vulnerable sections, the minorities, the so called lower castes – Dalits, women and those fighting for their rights. The present rulers want to impose majoritarianism. They have been the protagonists of ‘Akhand Bharat’ that means a ‘Greater India’ which includes Pakistan Afghanistan Indonesia, Bangladesh, Myanmar and Philippines etc.

 

Situation in Bangladesh is also quite fluid after the influx of large number of Rohingiyas from Myanmar who were forced to flee from their own country after government sponsored repression. We have witnessed lately the movement by the fundamentalists in Bangladesh. Nepal is in political instability. Sri Lanka has not sorted out the issues of Tamils. China, with its military designs and nuclear arms is another important factor to force India to amass arms.

 

Failure to meet the expectations of the people these forces from time to time raise bogey of external interventions. Such situations are a precursor to the danger of an armed conflict in the region. Under the present circumstances any armed conflict could be of grave nature. Both India and Pakistan have no intention to even reduce the expenditure on the nuclear weapons what to talk of their abolition. Skirmishes between India and Pakistan are a day to day occurrence affecting the population across the borders. Putting blame on each other both the countries are amassing arms. India is second largest importer of arms (1)    and is now pursuing to  become an arms exporter particularly to Indian Ocean Region Countries to balance China (2). 

 

 

There was a time when despite all these problems and even after India & Pakistan had gone nuclear, there was a strong narrative for nuclear disarmament. Now that narrative is missing from the governments’ side. From the side of the people’s movements too this issue has taken a backseat. Unfortunately this is at a time when number of the armed conflicts is increasing every other day.    

 

The COVID Pandemic has thoroughly exposed how much ill prepared we are to tackle serious health emergencies. Nuclear fallout would be much more catastrophic with effects on next generations. Medical fraternity has already warned that medical science has no remedy to offer in the event of nuclear fallout. As per a publication by the ICAN  in the event of nuclear exchange between India and Pakistan, in New Delhi every doctor would be responsible for treating about 102 people simultaneously and every doctor in Islamabad would be responsible for treating about 363 people simultaneously.

 

We could produce vaccines to combat the Pandemic, on the contrary there is no such remedy to nuclear fallout.  However good thing is that nuclear catastrophe can be prevented by abolishing the weapons which are our own creation.

 

Peace movement has to work very hard. A broad strong peace movement has to be built to counter such forces otherwise uncertainty will continue to prevail for which we will have no answer to the next generations.  

 

Reference:

 

  1. https://sipri.org/sites/default/files/2021-03/fs_2103_at_2020.pdf
  2. https://thediplomat.com/2021/02/indias-defense-export-strategy-balancing-china-in-the-indian-ocean-region/

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/south+asian+nations+have+to+meet+challenges+of+covid+and+health+care-newsid-n303218342

 

https://news.anypursuit.org/article36266-SOUTH-ASIAN-NATIONS-HAVE-TO-MEET-CHALLENGES-OF-COVID-AND-HEALTH-CARE

19 Jul,2021

Misuse of draconian laws - a public health crisis

Date: 19.07.2021

 

Misuse of draconian laws - a public health crisis

 

Chief Justice of India has very validly pointed out the misuse of Section 124(A) of IPC which deals with the offence of sedition. Laws like the NSA, UAPA and sedition laws are a reflection of colonial era. He pointed it from legal perspective as these laws are utter violation of human rights. Any such such law which curtails the right to freedom of speech and right to critically analyse the events and the government’s performance amounts to negation of basic human rights as enshrined in our constitution. There have been several allegations of these laws having been misused and people being framed falsely. These allegations are corroborated by reports that out 326 sedition cases filed during 2014 to 2019 only 6 have been convicted (Mukesh Ranjan – The Tribune 19.07.2021). 

 

In these conditions health bears the maximum brunt in terms of both physical and mental wellbeing but hardly gets any space in the public discussion. It is only after Father Stan Swamy’s death in custody that the issue is getting highlighted. This has been widely acknowledged globally. In the Indian context it poses even a more serious question because here it is the vulnerable sections of the society who are at the receiving end. Presently it is the minorities, rights activists, those working for the uplift of tribals, adivasis, the dalits and women, who are being framed under such laws. Now even the farmers protesting for their demands are being framed under such laws.

 

The Indian penal code has sufficient provisions to charge a person for any crime even when it concerns the integrity & sovereignty of the nation. Difference being that under these special laws there is provision of keeping the person in lockup for a long time without any trial and without the right to get reprieve from judiciary for a stipulated period. Such incidents have several health issues not only for the individual framed as accused but for his family, community and society as a whole. 

 

Arrest of a person particularly if he/she is the bread earner, which they mostly are, pushes the family into sudden economic crisis which affects their basic needs for food, nutrition, health and education. Many a time the children and the elderly also have to go hungry as the family has to spent huge amount on litigations which further pauperizes them. Children in the growing age suffer from malnutrition which impacts their all life to come. Women in our families sacrifice their food for the family in general and for children in particular, they thus land up into nutritional deficiency disorders. Needless to mention the person in the lockup is denied a healthy diet in the prison.

 

Until acquittal the whole family faces social stigma for the crime which is not proven. The family members find it difficult to get job of their liking; even to find a rental accommodation is a hard task. Children face humiliation in the school. This affects their psychological makeup. Many of them are likely to develop Post Traumatic Stress Disorder (PTSD). A child who should have grown with love and compassion now grows up with contempt and hatred.  

  

Many cases imposed on the members of a community or a group are meant to send fear signal among them to keep shut or face the consequences of being framed in false cases. As a result, even though willing, the community or the society tends to stay aloof for the fear of reprisal by the state or the antagonistic groups. The paranoia which develops has serious consequences. Affected people can develop violent reaction. The hapless accused in many cases develop suicidal tendencies out of frustration of having been falsely implicated. 

 

The perpetrators of misuse of such laws, politicians, mafia, bureaucrats, police or vested interests in a particular situation develop narcissist behaviour and the feeling of being able to force upon their will. Guarantee to go scot free after being protected by the state apparatus gives the gangs alibi to bully any one. This adds to their criminal behaviour. Many of them had never been into crime earlier but now circumstances embolden them.

 

It is therefore important that only a transparent legal system be adopted to check any sort of crime giving due place to the accused. The sedition law, RSA, UAPA and TADA should be immediately revoked. We have enough history to learn from the crimes committed by the Nazis against those who differed from them.

 

The World Medical Association and the International Physicians for the Prevention of Nuclear War had condemned arrest of members of central council of the Turkish Medical Association when they issued a declaration titled “War is a popular health issue” in opposition to the Afrin operation. The government had charged them with “making a terrorist organisation’s propaganda” and “inciting the people to hatred and enmity” on account of the peace declaration. In India we have the example of Dr Kafeel who was arrested for raising the issue of shortages in the hospital in Gorakhpur which had led to death of children. Medical personnel who are custodians of health of the people have to raise voice vociferously against such laws so as to protect and promote people’s health.

 

Dr Arun Mitra- ENT Surgeon, Sr. Vice President Indian Doctors for Peace and Development (IDPD) M: 9417000360

 

Dr S K Prabhaker – Neuro-Psychiatrist, M: 9876155343

 

https://www.nationalheraldindia.com/opinion/misuse-of-laws-such-as-ipcs-sedition-section-is-detrimental-to-the-very-social-fabric-of-targeted-communities

 

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/indiscriminate+arrests+by+authorities+lead+to+serious+health+problem+of+families-newsid-n300049316

13 Jul,2021

Insurance based system has failed to meet our health needs

Date: 13.07.2021

Insurance based system has failed to meet our health needs   

Dr Arun Mitra

The COVID – 19 Pandemic has exposed the weaknesses in our healthcare system. Complications of the disease apart, unprecedented number of people lost their lives due to lack of basic needs like Oxygen, ventilators, medicines and hospital beds. Over and above exorbitant cost of treatment has become real constraint in the treatment of cases requiring hospitalization. A patient requiring ventilator had to pay around Rs.20,000 per day as ICU charge in the private hospitals which had become the people’s choice in the absence of updated government facilities in most of places. After adding the cost of medicines and other items, the patient had to shelve nearly Rs.40000/- per day. This is an amount beyond the capacity of our people who are already in deep economic crisis as a result of lockdowns, loss of jobs and livelihood. According to Pew Research Centre the number of people earning less than $2 has doubled from 5.9 crore to 13.4 crore during Pandemic and as per study by the Center for Sustainable Employment at Aziz Premji University 23 Crore people earn less than Rs.375/-  per day.   

People in the elder age group have been the worst hit by the COVID-19. By the time of attaining this age many people are retired and become dependent on their children even for day to day living. Despite the fact that senior citizens have contributed through their life to the nation’s building, healthcare for them remains a big challenge. The National Health Policy 2017 laid emphasis on the need for palliative and rehabilitative care for all geriatric illnesses, but in practice hardly any steps have been taken. 

To meet health needs the government’s focus is on insurance based healthcare instead of health as state’s direct responsibility. The Ayushman Bharat has serious limitations. It provides healthcare coverage to only 40% of the population, that too for indoor care only. This means 60% of the population is left out of this insurance scheme. It is also a well-known fact that 70% of the out of pocket expenditure on health is on outpatient care.  This affects more to the geriatric group because a person in this age group is faced with the diseases of chronic nature, for which he/she has to pay frequent visits to the outpatient clinics. Moreover there are several conditions to get benefit of the Ayushman Bharat scheme. Those who own a two/three/four wheeler or a motorised fishing boat; Those who own mechanised farming equipment; Those who have Kisan card with a credit limit of Rs. 50000/-; Those who work in government-managed non-agricultural enterprises; Those earning a monthly income above Rs.10000/-; Those owning refrigerators and landlines; Those with decent, solidly built houses; Those owning 5 acres of more of agriculture land. (https://www.bajajfinserv.in/insights/ayushman-bharat-yojana-are-you-eligible-for-the-pmjay-scheme) are not entitled to get benefit under Ayushman Bharat.

Several other healthcare schemes include  Rashtriya Swasthiya Bima Yojna (RSBY) for Below Poverty Line (BPL) families, Aam Admi Bima Yojana for rural landless household, Janashree Bima Yojana (JBY) for below poverty line and marginally above poverty line, Universal Health Insurance Scheme (UHIS) for health care to poor families.  These schemes provide very minimal healthcare facilities for hospitalization only.   

Employees’ State Insurance Scheme (ESIS), Central Government Health Scheme” (CGHS) and Ex-Servicemen Contributory Health Scheme (ECHS) are better in this respect and provide both OPD and indoor care without any limits. Under the ESI scheme total beneficiaries number around 3.2 Crore employees or about 13 crore of their family members. The other two schemes provide benefit to about 50 lakh employees. During the COVID peak most of the ESI hospitals were converted to COVID hospitals. As a result the employees were not able to get treatment for other illnesses for which they had to go to the private hospitals and pay from their own pocket.

In the absence of any suitable healthcare schemes by the government, big chunk of our population which is in unorganised sector, is left with choice to opt for health insurance coverage either by the public sector or the private sector insurance companies. However to pay premium for insurance is becoming a nightmare. That is why even the middle income group people are now at receiving end.  

Paradox is that whereas a person is more likely to be taken ill in the elderly age and looses regular income, the insurance companies increase the premium exorbitantly with age of the insured. The rate of premium of these companies has increased tremendously in the previous 5 years. For example under the Mediclaim policy of public sector unit, the New India Assurance Company Limited, premium for those in the age group of 66-70 for a sum assured Rs.100000/- increased from Rs. 5600/- in the year 2016 to Rs. 19866/- in 2021, an increase of 354%; and for sum assured 2 lakh from Rs.10630/- to Rs. 28218/- an increase of 265% in the last 5 years. For a sum assured of Rs.5 Lakh it increased from Rs.24230/- to Rs.42120/- that is a rise of 173% during this period.           

 

For the Senior citizens, who have either no income of their own or have very meager income and are dependent on their children, it is impossible to pay such high insurance premium. Pandemic has exposed this myth of insurance based health care system. No company will cover if the expenses increase beyond the sum assured. Patients requiring ventilators had to spend much more than this amount during uncertainties of the outcome. So they had to either borrow or sell their assets.

The companies have stopped dealing with the cases directly and have appointed TPAs. This has been done only to put blocks on getting reimbursement from the companies by raising frivolous objections. 

Therefore only a comprehensive universal health care system can meet the needs of our people. The government should strengthen the primary healthcare. They should open its advanced tertiary care centers where facilities for palliative and rehabilitative care are available. Insurance companies should be made to compulsorily cover OPD care cost as well for the insured. The irony is that tariff of the government owned companies is more than the private sector companies in some cases.

https://www.nationalheraldindia.com/opinion/govt-must-take-direct-responsibility-of-citizens-healthcare-not-leave-it-to-insurance-based-system

 

https://m.dailyhunt.in/news/india/english/india+press+agency-epaper-indpres/insurance+based+system+has+failed+to+meet+india+s+health+needs-newsid-n298380218

 

05 Jul,2021

A critique of Prime Minister’s address to the Medical fraternity on the Doctors Day

 

Date: 05.07.2021

 

A critique of Prime Minister’s address to the Medical fraternity on the Doctors Day

 

Medicine is a passion not a profession. Preventing disease and treating the patients gives immense pleasure to a doctor. A person dedicated to the cause is beyond the need for praises. However recognition of medical professional’s work from the mouth of the head of the government is a different matter. The Prime Minister very well utilized the art of using words to praise the doctors on the day dedicated to the memory of Dr B C Roy, a physician, educationist, philanthropist, freedom fighter and statesman who served as the Chief Minister of West Bengal in the Congress government. 

 

After showering praises on the doctors for their role during the pandemic the Prime Minister should have addressed the issue of  violence against the doctors which continues unabated despite their role in serving the society during pandemic. He failed to give any concrete assurance. He did not utter that a bill to the effect is pending with the government since December 2019. No steps have been taken to expedite it despite several incidents of violence against the doctors.

 

He started by blaming the governments before 2014 for not being serious towards healthcare system. Fact of the matter is that immediately after the freedom from the British colonial rule India had been squeezed of all resources. India's GDP, in absolute numbers in 1947 was mere Rs.2.7 lakh crore. It rose to Rs.57 lakh crore in 2014(https://www.firstpost.com/business/data-business/from-1947-to-2014-how-the-indian-economy-has-changed-since-independence-1983853.html). Our life expectancy stood at as low as 37 years in 1947 which improved gradually with improvement in healthcare as well as nutrition and it rose to 68 years by 2014.

 

In the immediate post-independence period our healthcare was developed in the state sector so that it could reach the common man as much as possible. As a result Primary Health Centres were established and rural dispensaries were made in the far flung areas. Not only that India became a hub for producing cheap medicines under the public sector companies in particular. These were supplied not only to developing countries but also the developed countries at cheap rates. We also strengthened our own vaccine making sector. It is in 1952 that the ESIC was established to give comprehensive healthcare to the employees. Hardly any scheme matches this. Even the Aysuhman Bharat provides health care for the indoor patients only. In addition there are several conditions to be registered under the scheme. There was effort to break myths in the healthcare and develop it on scientific basis. True, there were several short comings  in the planning but to say that nothing was done in those years before 2014 will be injustice and denying the fact.

 

Coming to the COVID he went on to say that India did better than many western countries in the field of COVID management. He forgets that India’s situation in COVID management has been worse than our neighbouring countries in south Asia even though they have much poor economy. During the second surge there was unprecedented increase in the number of COVID cases in our country. As on 17th May we recorded 2.60 lakh cases or 19 cases per lakh population, Pakistan 3232 cases or 1.4 cases, Bangladesh recorded 698 cases or 0.42 cases, Nepal recorded 9198 cases which is 31 cases, Sri Lanka recorded 2456 cases that is 11 cases per lakh of population.  This data from www.worldometers.info indicates a comparison in the proportion of population being taken ill of COVID. As on 17 May 2021 India had nearly 13 time more cases than Pakistan, 44 times more than Bangladesh, 0.60 times of Nepal and 1.6 times of Sri Lanka.  

  

People have not yet forgotten the nightmare they had gone through because of lack of oxygen, lack of a hospital beds, shortage of ventilators and other equipment to save life. He has also forgotten that 23 crore more people have gone below poverty line during this period. Many have been pushed to hunger because of the absence of any aid from the central government. The developed countries, with whom he is comparing our country, paid lakhs of dollars to their people to meet the economic crisis. On the contrary Indian government did not even heed to the economists’ advice of paying Rs.7500 to the poor families. The poor have got only 5 kilogram grain and 1 kg Daal Which costs only Rs.225.

 

Boasting on the increase in the health budget the prime minister said that in this year’s budget the expenditure on health has been increased by more than 2 times. This is completely untrue. The factual increase on the health budget is from Rs.65000 crore to 72000 crore. This is a marginal increase of 10 %, which is barely  enough to meet the inflation in one year. Most worrying factor in this year’s budget was reduction in the spending on Nutrition from 3700 to 2700 crore rupees. This is at a time when India is at 102nd position in hunger index out of 117 countries, worse even than our neighbouring South Asian countries. In fact the public health expenditure on health has been hovering around 1% of the GDP for the last several years and has not increased since 2014 either.

 

However there has been increase in the corporate sector’s investment on health. With this we have improved in advanced health care but vast section has been excluded.  It is only recently that his government took decisions to even privatise the district level hospitals.

 

Prime Minister’s boasting about vaccination drive in India is far from reality. Whereas on 21 June 80 lakhs people were vaccinated, the number is coming down since then. Number of people vaccinated on 27 June was 17 lakh, on the doctors day it was 42 lakh falling to 14.77 lakh on 4th July. As on today 6.4 crore have been fully vaccinated. With this pace of vaccination it may not be before April 2022 that we will be able to vaccinate our population.

 

We have recently seen how the data on the number of diseased and deceased has been fudged. This is anti-science because the database gives us knowledge on the strategies to be evolved to manage pandemics in future. It is also well known that most of the decisions being taken during the pandemic had been on the political level rather than the scientific level involving the Public health experts and the epidemiologists. Only an inclusive decision making involving experts can yield results. Our Prime Minister should understand the difference between addressing the medical fraternity and election rally.

 

Published at :  https://www.nationalheraldindia.com/opinion/pm-modis-boasts-about-success-of-covid-vaccination-drive-far-removed-from-reality

 

18 Jun,2021

Historic Biden – Putin summit could pave the way for complete nuclear disarmament

 

Date: 18.06.2021

 

Historic Biden – Putin summit could pave the way for complete nuclear disarmament

 

Contrary to the assessments by several experts based on the recent rhetoric between President of the United States of America Joseph R. Biden and President of the Russian Federation Vladimir Putin, the joint statement issued at the end of Geneva summit on 16th June is quite encouraging. The two leaders have realized the importance of mutual dialogue. They have spelled clearly “note the United States and Russia have demonstrated that, even in periods of tension, they are able to make progress on our shared goals of ensuring predictability in the strategic sphere, reducing the risk of armed conflicts and the threat of nuclear war”.

 

They have further affirmed their commitment to nuclear arms control by extending the New START Treaty. The wording “Today, we reaffirm the principle that a nuclear war cannot be won and must never be fought” is what of peace organisations around the globe have been cautioning. “Consistent with these goals, the United States and Russia will embark together on an integrated bilateral Strategic Stability Dialogue in the near future that will be deliberate and robust. Through this Dialogue, we seek to lay the groundwork for future arms control and risk reduction measures” is quite valuable statement in the present circumstances.

 

If carefully taken forward, this summit can yield several positive outcomes. First, all the nuclear weapons possessing countries should take a lead from this statement that nuclear weapons are the weapons of mass destruction. This has been amply proved by the damage done in Hiroshima and Nagasaki. The medical experts have warned that the medical science has no remedy to offer in the case of a nuclear war. The International Physicians for the Prevention of Nuclear War (IPPNW) has come out with an evidence based study that even a nuclear exchange between India and Pakistan with 100 Hiroshima sized nuclear weapons each will put over two billion people at risk of starvation and death. A nuclear exchange between Russia and the USA would mean end of modern civilization built through thousands years of human labour.

 

The second important point is the talk of arms control as an important issue today. It gives a boost to the peace organisations who have been advocating effective arms  control treaties. Several parts of the world particularly the Middle East is in the midst of serious armed conflicts leading to deaths, injury and displacement of hundreds and thousands of citizens.

 

The third important outcome of the summit is the realization of persistent dialogue to resolve the issues. This is a signal to several countries involved in the armed conflict to come to peace. It is particularly important for developing countries like India and Pakistan to shun rhetoric and give importance to mutual dialogue.

 

But we have to move with caution and skepticism. The military Industrial complex is very powerful and would not so easily surrender its super profits. More over the two countries are party to the ongoing conflicts and skirmishes in many parts of the world. They have made lots of money by creating such situations and selling arms. They have even attacked militarily on other countries in the name of establishing democracy.

 

However their joint statement can generate virtually dead debate on the importance of nuclear disarmament. The medical consequences of nuclear war have been high on agenda of the IPPNW and the International Campaign to Abolish Nuclear Weapons (ICAN). It became a nodal point to generate opinion among the nations in the UNO which led to passage of Treaty Prohibiting Nuclear Weapons (TPNW) in July 2017 for which the ICAN was awarded Noel Peace Prize. Let us hope that taking the outcome of the this summit forward we can convince all the nuclear weapons possessing countries to join the TPNW.

 

 

Dr Arun Mitra

Co-President IPPNW

Mobile: 9417000360

 

18 Jun,2021

Why doctors must protest !

 

Date: 18.06.2021

 

Why doctors must protest !

 

Dr Arun Mitra

 

A doctor was called to the police station for inquiry into a complaint lodged by him against someone who had misbehaved with him. The police officer asked the doctor that why he did not retaliate when the said person was misbehaving. The doctor politely replied that as a doctor he is not trained to shout at anyone but to be modest, polite, caring, listening and serving to best of his ability. This is true for most of the medical professionals who have been bound with the books in their teenage and then on entry into the medical college further burdened with the huge syllabus which they must remember to be a doctor. To meet the expectations of the society he is trained to be modest, caring and polite towards the persons who visit him for advice. During the training he forgets that once he comes into practice of medicine there is much difference between what he has been taught and what he has to do as a practitioner particularly in respect to the social behaviour. Generally speaking the medical students are not educated on how to win over the confidence of the patient and how to communicate with them in the event of a crisis. Therefore for a young doctor many a times it becomes difficult to tell the attendants about the pattern of the disease. In case of death of the patient it is further a hard task for the young doctor to inform. Therefore it is very important that the young medicos are trained in the art of communication. It has become all the more important because degeneration in the society can be seen in every sphere and with the lowering of moral values, sometimes the attendants of the deceased overreact and even become violent towards the doctor. Young doctors have to face the wrath more often because they are the immediate contact with the attendants.

 

Violent behaviour of the attendants often is an immediate reaction because they had not apprehended a serious happening to their patient. Therefore they can easily blame the doctors for negligence. It is not that incidents of negligence do not occur, but it is not a routine as the doctor has to meet up to her/his reputation in the society and continue with getting goodwill of the patients. At times there are elements who suddenly crop up when such incidents occur and instigate the attendants to be in their good books and even worse they try to extract money from the doctor. Such incidents have lately increased in all parts of the country leading to extreme violence against the doctors at some places.

 

The doctors have now started protesting and demanding from the government to make laws against such people who indulge into violence against them, their staff or cause damage to property. Some states have come up with such laws but they have not been implemented in letter and spirit. Therefore the doctors are now demanding a central legislation to the fact which should be a guiding force for all the states to adopt and for this the Indian Medical Association (IMA) had given a call for National Protest Day on 18th June.

 

Violence is not the only issue that the doctors are protesting against. The doctors have been under much physical and mental stress during the ongoing pandemic. Giving long duties in the PPEs has been a horrendous task. This has brought a definite behavioural problem in them which has affected their family life as well. The family members of such doctors on COVID duties are equally under stress and fear. There has been demand that such health workers should not be put on more than four hours duty in one day in the COVID wards. In many parts of the country however the doctors have not been given their due. Just showering flowers on them from the aeroplanes cannot build up their morale. The doctors protested when they were not being provided the basic equipment to protect themselves from the virus. They also protested for higher wages when on such duties. Nearly 3000 doctors in Madhya Pradesh have threatened to submit mass resignations in case their demands are not fulfilled. This has conveyed their feelings to the government and the society that they are ready to work but must be given due care in return.

 

But protests by the doctors have generated anger in the ruling government. Dr Kafeel Khan of Gorakhpur was arrested for raising the issue of oxygen shortage tragedy that led to the deaths of more than a hundred children. Similarly Dr Sudhakar Rao a doctor with a government hospital in Andhra Pradesh, who was suspended for questioning the shortage of PPE kits, was admitted to a mental health facility, a day after he was allegedly manhandled by the police and arrested for creating nuisance in Visakhapatnam.

 

Doctors were outraged when the Union Health Minister started promoting Coronil manufactured by Ramdev who had claimed it to be a remedy against the COVID but had no evidence for it. Modern science is dynamic and believes in evidence based practice. Therefore it is amenable to changes with time in the process of development of science. Ramdev said that people died despite the doctors and despite the oxygen and due to vaccines. This has been highly contested by none other than the IMA. They even demanded FIR against Ramdev for his utterings which could damage the management of COVID as it could give strength to the unscientific ideas among the people’s mind who could be influenced and become  hesitant to adopt scientific medical treatment for the management of the disease. Unfortunately neither the Health Minister nor the Prime Minister took any notice of this demand of the doctors. This anti science attitude of the higher ups in the government has further irked many medical personnel. No wonder the Prime Minister as long back as in 2014 had claimed that the ancient India had the technical knowhow to transplant an elephant's head on a human body. This was contested by many medical scientists. But it was an indication that how the message has to be percolated down to the people in the coming period. No wonder as an obedient servant Dr Nageshwar Rao - Vice Chancellor of Andhra University in Indian Science Congress in January 2019 said that ancient India had the technology of stem cells in. That is how we see the propagation of use of cow urine cow dung or religious rituals to fight back the COVID and spread of anti-science ideas.

 

 

17 Jun,2021

Vaccine policy will encourage super profits and add to health inequity

Date: 17.06.2021

 

Vaccine policy will encourage super profits and add to health inequity

 

Dr Arun Mitra

 

As per the reports the Sputnik vaccine on its arrival will be first given to Apollo Hospital. Whether it will be inoculated free of cost or will be paid has not been made clear by the government. It is understandable that the production of vaccine against COVID-19 was not an easy task. But the hard work by the scientists around the globe made it happen. Normally it takes five years plus to prepare a vaccine but because of urgency during the pandemic it had to be made in less than one year.  Most of the countries had promised vaccines by the end of 2020. Manufactures like Pfizer, Moderna, Astra Zeneca etc. even booked them by October 2020. The affluent countries booked large percentage of these as it involved money. Besides  Covishield of Astra Zeneca from the Serum Institute of India, Pune India aspired to make indigenous vaccine named Covaxin. The Prime Minister was so jubilant about it that he even announced in the July 2020 that Indian vaccine would be ready by 15th August 2020. He probably wanted to take super credit by announcing this on the Independence Day from the Red Fort. The ICMR director Dr Bhargav issued directives to speed up the trials. It was only after he was put to corner by the scientific community that he retreated and announced the vaccine could be ready by December 2020 or January 2021. This was realistic estimate since vaccine production requires several trials. It has however been allowed for emergency use. The WHO has not approved of the Covxin till date. As a result many international travellers particularly the students going to USA/Canada have to face many problems. Convinced that India has controlled the COVID-19, the government allowed export of millions of vaccines in the name of Vaccine Maitri, ignoring the warning by the scientists and the medical community of a second wave which could be much more harsh than the first one. This has created difficulties in vaccination for domestic use. Presently our vaccine stock is insufficient, that is why now India is importing them. 

 

So far in all the National Immunization Programmes including the small pox, pulse polio the vaccination has been given free of charge to the citizens. The pulse polio has been one of the most elaborate programme where the doses were administered door to door. There has been some resistance by a section to the vaccination programmes including that of Small Pox. But this was overcome by extensive health education and motivation. Ironically this time the resistance is being intentionally generated by persons like Ramdev and protagonists of use of cow urine, cow dung. These people are in regular visits to the corridors of the power in Delhi.

 

As announced by the Prime Minister from 21st June onwards 25% of the vaccines will be given to private sector who will be permitted to charge Rs.780/- for Covishield, Rs.1410/- for Covaxin and Rs.1145/- for Sputnik. It is interesting to note that the CEO of the Serum Institute of India Adhar Punawala had said in May 2021 about the price of Rs.150/- per dose to the government “it is not that we are not making profits but we are not making super profits”. As a philanthropic gesture on behalf of @seruminstindia he Tweeted on 28th April 2021 ‘I hereby reduced the price to the states from Rs.400/- to Rs.300/- per dose, effective immediately, this will save thousands of crores of state funds going forward. This will enable more vaccination and save countless lives’. In the light of this it is difficult to comprehend why the rates have been fixed so high. As an afterthought the Biotech has come out with the statement that the price of Rs.150/- per does is not sustainable. It is astonishing that the price of such products is decided by the companies even during the pandemic. The government should have come out clearly on the production cost of the vaccine and fixed a minimum margin of profit. Several organisations have been pleading with the government to channelize the pricing of the drugs based on cost accountancy. A report by the Committee on High Trade Margins in the Sale of Drugs submitted in December 2015 had given similar recommendations.   

 

The government should have planned to give Sputnik Vaccine through its own infrastructure instead of Apollo Hospital. This is a signal towards the happenings in future. The 25% share to the private sector will enable the upper middle and high income groups to vaccinate themselves. This will leave large chunk of the society spending their time standing in the queues waiting for their turn. Science tells us that if you leave large section unvaccinated the pandemic will not come under control. It is high time the government rejuvenates state owned vaccines and drugs producing companies so that profit does not become the prime motive during this crisis. The present vaccination policies will encourage super profiteering by the companies and add to the already existing health inequity to serious dimensions.

10 Jun,2021

INCREASE IN SPENDING ON NUCLEAR WEAPONS DURING PANDEMIC AMOUNTS TO MASS GENOCIDE

Date: 10.06.2021

 

INCREASE IN SPENDING ON NUCLEAR WEAPONS DURING PANDEMIC

AMOUNTS TO MASS GENOCIDE

 

Dr Arun Mitra

 

A recent report published by the International Campaign to Abolish Nuclear Weapons (ICAN) titled Complicit: 2020 GLOBAL NUCLEAR WEAPONS SPENDING has brought forwards startling facts on the total insensitivity of the governments and the nuclear weapons industry during the Pandemic which has already cost 37.5 lakh lives. In addition the health problems, including the mental ones, of those who fell ill but recovered are unaccountable. It is reported now that the mental health issues have increased by five times during this period. India witnessed death of 3.54 lakhs. As many as 30,071 children were orphaned, lost a parent or abandoned mostly due to the COVID-19 pandemic as per data submitted by different states till June 5, the National Commission for Protection of Child Rights (NCPCR) informed the Supreme Court. Of the total, 26,176 children have lost a parent, 3,621 have been orphaned and 274 have been abandoned according to the NCPCR.

 

Barring a few, the economic activity was affected in all sectors during this period. The daily wage earners were the worst affected. Whereas in some countries the government took care of the people or the business, in India the low income groups have been a harried lot in the absence of any substantial support from the government. Nearly 54 crore workers which means 40% of the country’s population had to face hunger like situation.    

  

This was an opportunity when the global community could have joined hands and decided to put in all energy and finances in controlling and minimizing the damage  by the Pandemic. But it was not to happen despite repeated appeals by the scientists and medical personnel. The ICAN report has highlighted that the nuclear weapons industry continued to flourish unabated. The US has been the worst spender on the nuclear weapons during 2020. It spent 270000 crore rupees or 51.72 lakh rupees per minute on nuclear weapons. China spent 72970 crore rupees or 13.97 lakh rupees per minute. Coming to South Asia Pakistan spent 7297 crore rupees or 1.4 lakh rupees per minute. India spent 17500 crore rupees or 3.3 lakh rupees per minute. This amount is half the money allocated towards vaccination programme which is 35000 crore rupees.    

  

The report says that ‘During the worst pandemic in a century, nine countries chose to increase their spending on nuclear weapons by about $1,400,000,000. During a year when health care workers got applause instead of raises. A year in which it was essential to have minimum wage workers risk their lives to keep economies afloat, but not essential to pay them a living wage. A year in which millions of lives were lost and the status quo that sustained systems of power for decades started to get upturned. A year in which the first treaty making nuclear weapons illegal finally became international law. During this year, nine countries still decided nuclear weapons spending was a priority. The fault doesn't lie with the leaders of these nine countries alone. Behind them is a massive enterprise of vested interests, eager to get a piece of the $72.6 billion taxpayer-funded pie. The twenty-one companies profiting from nuclear weapons spent $117 million making sure that lobbyists kept the systems they build as the solution to policy makers’ problems. And they spent at least $5-10 million funding think tanks who write and research about nuclear weapons’.  The Military Industrial Complex in connivance with the governments is out to make profits from spending on nuclear weapons.

  

Ironically such information is intentionally not percolated down to the people fearing some section of the society is bound to react and demand from the governments to show more concern towards life of the people than nuclear weapons. The International Physicians for the Prevention of Nuclear War (IPPNW) has been constantly raising the issue of humanitarian consequences of nuclear war. Even if the war does not occur such huge expenses on the nuclear arms race if diverted towards welfare could solve the problems of health and education for a large section of the people particularly in the developing nations. It is disgusting that none of the governments in the nine nuclear weapons possessing countries took lead to denounce the spending on nuclear weapons under the present circumstances. Instead we are watching unashamed war in Middle East which could have very serious consequences as the big powers are overtly or covertly involved in it.   

  

The whole responsibility comes on the shoulders of the peace movement to raise this issue, educate the public and organize them to put their foot down to demand end to nuclear arms race for the sake of mankind otherwise the upcoming waves of the pandemic with new variants of the Corona virus will continue to play havoc in which the poor countries and poor in the poor countries will have to pay the ultimate price. It is therefore important to form broad alliances of peace movements, students & youth bodies, women organisations, trade unions and farmers organisations to raise their voice asking for health and education instead of nuclear weapons. It is important to lobby with every elected official, company representative and researcher to get out of the destructive nuclear weapons spending cycle and back the Treaty Prohibiting Nuclear Weapons (TPNW) to get rid of them once and for all.  

 

03 Jun,2021

PATENT RIGHTS ON MEDICINES AND VACCINES MUST BE WAIVED OFF

Date: 03.06.2021

 

PATENT RIGHTS ON MEDICINES AND VACCINES MUST BE WAIVED OFF

 

Dr Arun Mitra

 

As the world is passing through serious crisis of COVID Pandemic, at present Vaccination seems to be the only answer to put a break to it. The process has to be carried out simultaneously at the global level if we have to achieve an early end to Pandemic. This is important because in this highly interconnected world movement of people from one to other country cannot be stopped for very long. Whereas the developed countries have been able to vaccinate substantial number of their population, most of the developing countries are finding it hard to procure the vaccines in required numbers. The affluent countries booked the vaccines much early. Under the circumstances several developing countries including India are unable to get the vaccines now from the companies in other countries.

 

It is also important to note that maximum number of people should be vaccinated in a short span of time. If the gap of time is too large, then the people vaccinated in the early stages may loose the immunity due to vaccination by the time next lot of people is vaccinated. This would defeat the purpose to obtain herd immunity which is expected to be reached if 60% - 70% population is immunised.

 

The high cost and unavailability of medicines is another serious issue of concern. It is highly distressing to see people running from pillar to post in search of Oxygen and essential medicines such as steroids which are the lifesaving in COVID.

 

In this connection 74th World Health Assembly (WHA) on 24th May 2021 called for a concrete action plan and coordinated strategies to control the Pandemic. The WHA statement said that “where countries have struggled to implement effective COVID-19 control, political leadership has often undermined the critical role of skilled frontline professionals. The greatest success has been achieved between the government, professionals, trade unions, and communities working together with a high level of mutual trust. Where this has occurred there has been an important increased control of the virus allowing countries to resume freedoms and functional economies”.

 

The WHA in the statement called on World Health Organization (WHO) and its member states to take action to:

 

 

  • Ensure that treatments and vaccines are available to everyone everywhere. This requires establishing multidisciplinary engagement with local up to cross-borders social protection systems to reach all people.

 

  • Transform COVAX into a COVID-19 Solidarity Pooling Platform, enabling knowledge sharing as well as boosting production capacity under a public health-driven alliance of vaccine manufacturers, dedicated to research, development, manufacturing, and supply of high-quality, efficient, safe and sustainable vaccines and treatments.

 

  • Increase preparedness including health literacy while decreasing vulnerability to future pandemics through reducing health and social inequalities that have undermined the current interventions in controlling this pandemic.

 

  • Establish a clear partnership between the politicians and the health, social, and trade unions’ professionals to build public trust and engagement.

 

The statement which has been signed by International Physicians for the Prevention of Nuclear War, World Federation of Public Health Associations, International Federation on Ageing, International Hospital Federation, World Organization of Family Doctors, World Federation of Occupational Therapists, International League of Dermatological Societies called on member states to build their strategies on the human rights-based approach to guarantee equal access to the highest attainable standard of health, to build concrete, healthy, socially equitable, and environmentally sustainable solutions for the short and long term.

 

It is important that the developing countries get to produce medicines and vaccines on their own at affordable costs. There was a time when India was hub of cheap medicines supply not only to developing countries but also countries in Europe. But after the introduction of TRIPS under the World Trade Organisation (WTO) rules the situation changed entirely. Members of the WTO, countries are bound to agree on 18 specific points in the agreement. The Trade-Related Aspects of Intellectual Property Rights (TRIPS) is the most important one in context of the pharmaceutical sector and access to medicines.

 

(https://www.who.int/medicines/areas/policy/wto_trips/en/)

 

 

 

Under the TRIPS Agreement WTO Members are bound to provide  protection for a minimum term of 20 years from the filing date of a patent application for any invention including for a pharmaceutical product or process. Prior to the TRIPS Agreement, patent duration was significantly shorter in many countries. For example, both developed and developing countries provided for patent terms ranging from 15 to 17 years, whilst in certain developing countries, patents were granted for shorter terms of 5 to 7 years. The TRIPS Agreement also requires countries to provide patent protection for both processes and products, in all fields of technology. Before TRIPS, many countries provided only process — but not product patents. Product patents provide for absolute protection of the product, whereas process patents provide protection in respect of the technology and the process or method of manufacture. These clauses created constraints for the pharmaceutical companies to produce generic medicines thus leading to high cost of medicines. 

 

However, TRIPS also contains provisions that allow a degree of flexibility and sufficient room for countries to accommodate their own patent and intellectual property systems and developmental needs. This means countries have a certain amount of freedom in modifying their regulations and, various options exist for them in formulating their national legislation to ensure a proper balance between the goal of providing incentives for future inventions of new drugs and the goal of affordable access to existing medicines. This however requires political will in the leadership of the time.

 

Dr Vandana Shiva, a crusader for equity in trade practices and abolition of patent laws in medicine and agriculture warned that it is not just the medicines or the vaccines, the Multinational Corporations (MNCs) have patented each and every product. It is astonishing to note that even the bacteria and viruses including the Corona Virus have been patented. Such patenting denies the right of a person, a community or country over its own produce. She has contended the claim of the MNCs that they are doing research and so have the right to earn profit. Most of the research done worldwide is by the Public institutions and through public funding, she says.

 

Bill Gates who till date had the image of a philanthropist stands exposed as  a thoroughly insensitive businessman who wants to make huge profit in this hour of global health crises by denying the transfer of vaccine technology to the developing countries.

 

 

This has to be changed through public movements and the governments have to be forced not to work under the diktats of corporations or persons like Bill Gates. The patent rights on vaccines and medicines have to be waived off to save and promote health of the people globally particularly during this crisis of Pandemic. It is high time Indian government rejuvenates the public institutions which produced medicines and vaccines and who have commendable track record of serving the nation during health calamities in the past.

 

 

 

25 May,2021

A CRY THAT WAS NOT

Date: 25.05.2021

A CRY THAT WAS NOT

The catastrophic damage caused by the COVID Pandemic has put every person on physical and mental strain. Several families have lost their members. Losing kith and kin leads to biggest stress on one’s mind. No person unless totally emotionless can avoid crying with sorrow and pain of others. The process began from suddenly announced lockdown one year back without consulting anyone or considering the damage to the jobs and livelihood it would cause. The number of people in reverse  migration was beyond imagination. People walked on foot, bicycles, rickshaws, autos or any other means they could get. They were herded in the vehicles on exorbitant charges like the animals are carried by the butchers. It is not easy to forget the video of a two years baby whose mother had died on the railway station and the baby was covering her with sheet. The scene was not less heart-rending than the photo of a Syrian child dead at sea shore or the picture of a vulture waiting for the child to die so that it could eat the dead baby during civil war in Somalia. None in the government at the centre was moved by such events albeit the Prime Minster termed the sufferings of the working people as ‘Tapasya’. It is an addition to the vocabulary that sufferings caused due to some other person’s acts are Tapasya.

 

The 2nd wave has turned out to be much worse. Number of positive cases per day has been more than four times of the last year. Number of dead too is in similar proportion. We are in worst situation in South Asia. People are running in search of Oxygen to save their nears and dears. They are searching for beds. The number of equipment does not match the requirements. In this one year when we had known the course of the disease we failed to prepare. Dead bodies floating in Ganga river was some thing hitherto unknown in a democratic country which wants to be Vishva Guru. Our per capita income fell below Bangladesh which has nearly three times more population density than us and has much less number of industries.

 

Some people faulted, but 139 crores are meeting the fate and are struggling hard to save lives and to earn living during the lock downs re-imposed.   The crisis has been since the beginning of April. But all this left the prime mover unmoved. He was going around the election bound states addressing rallies with pride. It is difficult to imagine how many times he might have rehearsed before pretending to cry for the dead probably after receiving repeated reports of his losing popularity.  People of the country are not fools. They give a damn to such gimmicks. That is why so many sections of media reflected people’s views terming the so called act of crying as Crocodile tears.

 

Crisis have to be faced boldly with logic and scientific bent of mind. India has the history where freedom fighters sacrificed their whole property and lands. They sacrificed their lives. But never compromised with the imperialist tyrants. Such people never shed tears, they stand firm. When one is at a governing position he/she has to be a strength for others; so has to show boldness. Pretending to cry is an act of cover up of failures and cowardice.

 

Instead of pretending to cry it would have been better to talk to health care workers, the doctors, nurses, ASHA & Aanganwadi workers and others and listened to their grievances and sorted out their issues of concern. Would have paid special attention of the staff working in the COVID wards. Assuaged  stress and strain they and their families are passing through. But alas the ministry even did not have data of health workers who had died of COVID. The PM could have won over farmers’ heart by deferring the implementation of the farm laws till the government reaches an agreement with them. He could have held dialogue with workers over their grievances to the new codes. This is a good time to defer central vista project and divert money to Pandemic for buying vaccines.

 

Mother gets upset when the child is in pain but boldly tries to solve the problem with love and affection. In the poem Cry of the Children, Mrs Browning has brought forward the agony children were passing through in the early industrialization period in England.   These children never pretended and so did the poetess. “The Cry of the Children" is a poem by English writer Elizabeth Barrett Browning. It examines children's manual labor forced upon them by their exploiters. It was published in August 1843 in Blackwood's. The PM could have talked of children’s agony as we know hundreds of children die of mal nutrition in our country, and in present times they are loosing their parents being orphaned by dreaded decease Covid 19.

 

That is why it was not a cry, just another means to try to befool others.    

 

 

18 May,2021

India at worst in COVID crisis in South Asia

Date: 18.05.2021

 

India at worst in COVID crisis in South Asia

   

Dr Arun Mitra

 

Number of COVID cases and deaths due to it is a cause of grave concern. Presently India stands number two in the total number of COVID cases in the world after USA. True that we have a large population and so the number is high, but even a proportionate number comparison with other countries in south Asia is worrisome. We come from same ethnic background, have similar culture, food habits, nutritional status and have same level of inequities in income as well as disparities in the access to the healthcare system.    

   

As on 17th May 2021 out of a population of 139 crore India has recorded 2.5 crore cases and 2.78 lakhs deaths. Pakistan with a population of 22.5 crore has recorded 8.80 lakh cases and deaths 19752. Bangladesh has a population of 16.6 crore and has 7.8 lakh cases and the number of deaths due to COVID is 12181. Like wise Nepal with population is 2.9 crores has 4.6 lakh cases and death 5215. Sri Lanka population is 2.14 crore has 1.45 lakh cases and deaths 981.    

 

As per the above figures India recoded 1812 cases and 20 deaths for each one lakh population. In comparison number of cases in Pakistan 393 cases and 9 deaths, Bangladesh 470 cases and 7 deaths. Nepal has 1569 cases and 17 deaths per lakh of the population. Sri Lanka has 675 cases and 5 deaths per lakh of the population.   

 

During the second surge there is unprecedented increase in the number of COVID cases in our country. As on 17th May we recorded 2.60 lakh cases or 19 cases per lakh population, Pakistan 3232 cases or 1.4 cases, Bangladesh recorded 698 cases or 0.42 cases, Nepal recorded 9198 cases which is 31 cases, Sri Lanka recorded 2456 cases that is 11 cases per lakh of population.    

   

This data from www.worldometers.info indicates a comparison in the proportion of population being taken ill of COVID. As on 17 May 2021 India had nearly 13 time more cases than Pakistan, 44 times more than Bangladesh, 0.60 times of Nepal and 1.6 times of Sri Lanka.  

   

If this data is to be believed then we have to very seriously introspect into the causes of such a catastrophic situation. Countries which we have been calling to be far behind us in economy have fared better in COVID management till date.

 

It is acknowledged globally that India has high level of expertise in medical science and has several hospitals with advanced care facilities compared to anyone in the world. As a result people have been coming to our country for medical treatment (medical tourism) from across the world including the developed countries for the last over 20 years.

 

We also have good number of pharmaceutical companies, and have been supplying medicines and vaccines to other countries including Europe. We have already fought several national calamities successfully and even launched the biggest immunization programme of Pulse Polio in the world since 1994. We also successfully managed Plague in 1994 in Surat. With some ifs and buts we also fulfilled health needs of our people during national disasters like Earthquakes, Tsunami, Cyclones, Floods, Landslides and Drought in the last few decades. This has been possible through the health planning in the post-independence period. Our health personnel took active part in developing national health missions like Revised T B Control Programme, National Leprosy Control Programme etc. This means we have sufficient scientific knowledge.

 

 

Then where did we fault ?  

 

The above said successes were met with through a coordinated effort between the polity, medical personnel, and concerned citizens groups. But the present day disaster is of catastrophic nature which occurred because of skewed priorities and lack of scientific temper.

 

Science has never been the centre of focus during the on-going Pandemic. Political interests took over science in managing Pandemic. Ironically, a public health issue was never discussed with public health experts or epidemiologists. All decision making was done in a totally centralized non transparent manner by the Prime Minister himself without any consultation with medical personnel, economists, civil society, elected representatives or even his colleagues in the cabinet.

 

The government completely ignored the advice of the experts in December 2019 and then in January & February 2020 when they were busy in welcoming the US President and later allegedly in engineering communal violence in North East Delhi. It was only in March 2020 that the Prime Minister suddenly woke up to impose a lock down without consulting any expert. That caused immense damage to the economy of the country and livelihood of the people. Instead of talking with seriousness, he raised gimmicks like banging Thaalies and clapping etc. Unscientific ways such as use of Cow urine and cow dung to control the disease or perform Yagya to push corona virus away were propagated through his bandwagons; unfortunately some of the doctors and scientists too were part of it. The Health Minister who is a trained person in modern scientific medicine and at a very prestigious position in the WHO propagated non proven drug like the Coronil of Baba Ramdev. He even advised people to eat Cocolate, something reminiscent of the French princess advising people to eat cakes if they do not get bread.  

 

 As a consequence despite the briefings by the scientists about the upcoming 2nd wave the government was totally unprepared for the second wave because of preoccupation in elections and Kumbh Mela.

 

In any heath emergency database is important to plan for the present and also the future. But the data of the number of people taken ill and deceased was purposefully fudged. This led to complacency in the society. Government’s acts added to such complacency in the minds of people. The Prime Minister was full of self-praise in the months of January and February even at the international forums.

   

There was no definite strategy about immunisation programme. That is why the vaccination schedule is being changed every now and then.  The Public sector units in pharmaceuticals and vaccine production have been closed even though they have a praiseworthy track record of participation in national health programmes. We failed to procure sufficient number of vaccines for our people on time.

 

Not a word of empathy for those taken seriously ill or deceased from the mouth of Prime Minister who is always vocal even on trivial matters. The government is not ready to divert funds allocated for Central Vista project to Pandemic. Any one questioning the approach of the government is being threatened with prosecution. This is against all norms of democratic values of our great nation.

 

Health services in the last few years have been corporatized. That is why even the middle classes have been feeling the pinch of corporatized healthcare. Only public health services with more emphasis on the preventive aspect and allocation of sufficient budget for primary, secondary and tertiary prevention is the way out for future. 

 

 

29 Apr,2021

LESSONS FROM PANDEMIC- BUILD HOSPITALS, NOT BOMBS

Date: 29.04.2021

LESSONS FROM PANDEMIC- BUILD HOSPITALS, NOT BOMBS

Even though the world is into the deep crisis of COVID pandemic, the situation in low and medium economic group of countries with limited resources is precarious.  For the first time there is a realization that we need huge resources and meticulous planning for universal healthcare system where each section of the society in all the countries around the globe gets required facilities and we do not suffer inequity in healthcare. High cost of care is affecting the availability of oxygen and medicines to the economically moderate and poor sections. Black marketing is making it worse. There is a situation like health anarchy in the country with people running from door to door for want of required medical assistance including Oxygen and medicines. Over and above the Chief Minister of Uttar Pradesh has warned of strict action even NSA against those who create panic of oxygen. Insensitivity can be gauged easily when the Chief Minister of Haryana says that we should not talk of the dead because they will not come back. Now there are reports that less than 20% of the declared number of oxygen plants under the PM cares fund were installed in last one year.  

These are serious matters which need statesmanship and vision, not gimmickry or chest thumping and cheap politics. There is need for serious introspection as to the nature of spending we have to do. Concerned with this,  organisations of doctors of South Asia affiliated to International Physicians for the Prevention of Nuclear War (IPPNW) recently came out with a clear cut opinion that the countries of South Asia specially should immediately drastically bring down the expenditure on the arms race, completely shun the nuclear weapons, declare the region as nuclear weapons free zone and divert money from arms race towards health. They declared that it is proven beyond doubt that medical science has no remedy to offer in the event of nuclear fallout. It has been estimated through scientific studies that even a limited nuclear exchange with 100 Hiroshima size nuclear weapons between India and Pakistan will put over two billion people at the risk of starvation and death globally.  

The International Campaign to Abolish Nuclear Weapons (ICAN) in a recent study has come out with data on health capacity in Delhi and Islamabad. Predicted capacity after nuclear attack in Islamabad is 730 doctors and 373 nurses and midwives. In such situation 264870 people are likely to be injured. That means every doctor in Islamabad would be responsible of treating 363 people simultaneously.  Likewise with the health capacity available in Delhi in the eventuality of a nuclear attack every doctor would be responsible for treating 102 people simultaneously. 

Going by the history of nuclear catastrophe in Hiroshima on 6th August 1945 as reported by Dr Marcel Junod from Red Cross, very few health workers were willing to go to the radiation affected areas. We have developed PPEs for protection of the health workers from the SARS COV-2 but it would be impossible to develop such equipment for protection from the nuclear radiations.  

Crisis is grave and real as both India and Pakistan have estimated number of 150 nuclear weapons each. They are the only two nuclear weapons possessing countries who have been on hot and cold wars since long. Even the armies of the two countries have faced each other in high alert. There is no indication of thaw in the tension between them in near future. It is high time the nuclear weapons possessing countries realize gravity of the situation. Doctors and other peace loving sections of the society have to come forward to impress upon the governments of India and Pakistan to reach agreement for the region to be nuclear weapons free zone. The Treaty Prohibiting Nuclear Weapons (TPNW) passed by the UNO, which delegitimizes the nuclear weapons is an opportunity. Only Bangladesh has ratified the treaty while Nepal has signed but not ratified it. The non nuclear weapons possessing countries of the region can play significant role in calling upon both India and Pakistan to become nuclear free. 

 

20 Apr,2021

Lack of seriousness on COVID

Date: 20.04.21

Lack of seriousness on COVID

Dr Arun Mitra

The Prime Minister has woken very late in appealing to the pilgrims at Kumbh to go back and that Kumbh should be symbolic now. The damage has already been done. Even if those at Kumbh at present start to vacate the place, it may take several days before the area is completely free. These people have come from all over the country and now returning home they will carry the virus to the rural areas as well which have been having low incidence of the disease till date. The scientists had already warned about the surge of COVID in March and it would be naïve to believe that the Prime Minister was not briefed on this and the danger ahead if such huge gathering takes place in Haridwar. Not only that the site lacked required facilities to test and to treat. The rallies in West Bengal totally without following COVID norms has been seen by everyone. When the head of the government defies his own edict how can one expect COVID appropriate behaviour from the ordinary masses who always view the leaders as role models and try to follow them.  

 

 

 

In fact there has been lack of concern and scientific approach towards the COVID crises. It has been more of gimmickry, political oriented and self-chest thumping. The whole thing started from the total unpreparedness and callous attitude of the government when the spread of COVID was known globally and the WHO had issued warnings. Months of December 2019 then January, February and March 2020 were wasted as the government was busy in other affairs. It has now become clear that the lockdown imposed on 24th March 2020 was without consultation with the health professionals, economists, the cabinet or the executive. This has been revealed by the BBC which got the information through several RTIs. The government has not denied BBC’s report. This means that it was totally authoritarian and unscientific decision on the part of the Prime Minister without considering any benefit that the lockdown would give or the harm it would do to the jobs, livelihood, food security and life as a whole of the working people. No wonder it led to unemployment of more than 12 crore people and economic set back to the vast majority. Sadly during this last one year the Prime Minister has not uttered a single word of empathy for those who suffered while walking to their native places during the lockdown.  However during that period, according to Oxfam, the average increase in Ambani’s wealth in just over four days represented more than the combined annual wages of all of Reliance Industries’ 195,000 employees. (1)  

 

 

 

The scientific experience has shown that lockdown does not help in eliminating the disease. It only gives you time to prepare. This is evident from the fact that at the time of lockdown there were only few hundred cases, while we found persistent increase in number of cases thereafter. 

 

 

 

It was sickening to hear the Prime Minister saying in his speech on 25th March that we had won Mahabharata in 18 days and will defeat COVID in 21 days. Such unscientific  utterings led to complacency in the society thinking that soon we will be free of disease. This type of gimmicks were repeated from time to time by his band wagon. Lot many myths were spread about treatment of COVID. People were advised to drink cow urine as a cure and the use of Panchgaya which is a mixture of cow dung, cow urine, milk, curd, jaggery, ghee, banana, tender coconut and water were propagated to be effective. These absurdities were spoken by several well-meaning leaders including the west Bengal chief of BJP.  Soon there was introduction of Coronil by Baba Ramdev a so called medicine developed without any evidence. Worst scenario is that it was promoted by none other than Dr Harshvardhan, Union Health Minister who is an ENT Surgeon trained in modern scientific medicine.    

 

   

 

When the vaccines became a global issue, the Prime Minister thought of taking lead and become world’s first to develop vaccines. He asked scientific community to develop vaccine before 15th August 2020. This forced director ICMR to issue strict directives on this. He however retreated after being criticized by the scientific community. Alas the Prime Minister’s dream to announce the vaccine from Red Fort was not fulfilled.  Then he decided to send vaccines to other countries without realizing our own needs. 

 

   

 

Some very dangerous events occurred. The Tabhighis who had gathered in a Masjid in Delhi in a few hundreds were labelled as Corona Bomb and communal hatred was spread against Muslims. They got relief ultimately from the court. But the situation had already been communalised. In contrast we are witnessing lakhs of people at Kumbh who are super spreaders of the disease.

 

 

 

The government kept on boasting about the check on COVID successfully in India as a major gain of the BJP government in general and PM personally in particular. Now we are seeing the surge and shortage of basic things to manage the pandemic, the beds, oxygen, vaccines etc. It was very sorry indeed when the Minister failed to produce any data on number of doctors who died fighting COVID, and for whom the PM had asked our air force to shower flowers. 

 

 

 

The time is not lost. Much can be done to assuage the sufferings of the poor. While the upper classes will enjoy the present  short lockdowns by eating delicious foods at their home the poor are again seen rushing back home out of real panic based on their experience one year back. They would prefer to die of COVID than starvation. So are the farmers sitting at Delhi borders. Instead of asking them to vacate the place the government should address to their issues.     

 

 

 

Health education is a leading factor to prevent, control and treat diseases. State and the people both are responsible for this. Whereas the common man is not expected to hold knowledge on this, the government has sufficient infrastructure and departments who are supposed to design the health education programme and propagate down to the common citizens. For any health education programme to be successful honesty of action is important in the concerned machinery right from ministry  to the executive. Such programmes have to be evidence based and promoted by the professionals. The people must have trust on the educators. It is therefore important that health personnel take lead and guide the polity who should follow their advice as people have more trust on the health professionals when it is an issue of health. The role of several politicians has been more of gimmickry and political interests rather than health concerns even during this serious COVID Pandemic.     

07 Apr,2021

Culture of violence is unending, inhuman and a potential threat of escalation

Date: 07.04.2021

Culture of violence is unending, inhuman and a potential threat of escalation

Dr Arun Mitra

Global community is rightly outraged at the killings of over 500 peacefully protesting people by the Military Junta in Myanmar. Not long ago the Rohingyas were forced to flee by the violent mobs. People are again running away from their homeland and are trying to take shelter in India and Bangladesh. That this is happening in a country inhabited by the Buddhists is totally beyond comprehension, because Buddhists confess, preach and are supposed to practice non-violence. We are more concerned about Myanmar because they are our neighbour and migration of population to our country and other south Asian countries poses several problems. Migrants are forced to live in subhuman conditions in the refugee camps. There is always reaction of the local people against the influx of foreigners. Such reaction is exploited by some conservative groups for their vested political and economic interests.  

It is not just in Myanmar but all of our region, the South Asia, we are witnessing culture of violence growing. Violence is being committed in the name of religion, caste, ethnicity, gender etc. Situation gets worse when state is overtly or covertly supportive of such acts. Lies are spread against particular communities, castes, ethnic groups who are demonized. Their killings are either condoned or justified in the name of some cooked up historical events.   

We have witnessed unashamed violence and denial of rights to women in Afghanistan on the pretext self-proclaimed values of religious scriptures. In Pakistan the Blasphemy law has been used to punish those whom the perpetrators of violence think to be enemies of Islam.  In some parts honour killing is rampant and so is violence against minorities. Such forces are so powerful  that they dictate terms to the government even if it wants to take some positive measures. We have seen extreme violence in Sri Lanka in the name of ethnicity. Tension still persists. Nepal too has been a centre of violence for other reasons. In Bangladesh also we are witnessing fundamentalists taking to streets.  

 

India which developed as a secular democratic country is moving in that direction. Laws like CAA and Love Jihad are passed to prevent mixing of people and create a monolithic society. There have been several incidents of engineered riots and violent mobs killing people of minority communities. The minorities are  disgraced and blamed for all the ills of society including spread of COVID as we witnessed when propaganda was unleashed against Tablighis for spreading COVID. Christian Nuns were recently detrained after being blamed for religious conversions by some unscrupulous groups. Any one differing with them is termed as anti-national and violence against them is justified openly even by the Ministers in the central government. Worst was a case of Police Inspector Subodh Kumar Singh who was murdered by gangs but the killers instead of being punished were eulogised and rewarded. Such groups indulge in violent acts against their own community people and intimidate them to keep shut. Such violent acts have not remained limited to the people from minorities but even other marginalized sections of society. There has been surge in violence against Dalits in the last few years.

Pushing people into hunger and deprivation as we saw when lakhs of workers had to walk for hundreds of Kilo meters on foot to reach home after sudden lockdown one year back which left them without food, job, means of livelihood or place of stay is another form of violence. Ironically not a word has been uttered in their sympathy by the Prime Minister or any of the higher up in the government even after one year. This behaviour is expected only from political salesmen and not statesmen. There is worldwide experience in history that people with  mediocre intelligence and narcissist grandiose personality who are propped up by the corporates stoop too low to keep themselves in power.

In such situations democratic ethos of the people are crushed. We are seeing this in the form of anti-farmer laws, changes in labour laws and even education policy in our country during the times of COVID crisis when we need to build a more humane society.  

Such situations have been seen globally. In Rawanda violence between Tutsi and Hutu tribes killed lakhs of innocent people in the name of ethnicity. There are reports that in some cases even the married couples killed their spouse after being swayed away by such slogans. This is also true of the Nazi government who banned marriages between Christians and Jews. Love Jihad campaign is of similar variety.     

However this may not remain limited and the perpetrators of such acts too have to bear the brunt of violent acts by those being suppressed and denied rights. Violence against the BJP leaders in Punjab and Haryana is an example. Such situations push the society into anarchy.

Violence may also not remain limited to some area or country. The internal strife may be used to indulge in external aggression. In such situations there is always a danger of large scale war which further kills many more besides affecting economic development and further marginalizing the already deprived. Such deprivation may again be a cause of violence. So the violence becomes an unending phenomenon and a serious humanitarian crisis. With the nuclear weapons any further escalation could be catastrophic. It has to be stopped, earlier the better !  

In the ‘Notes on Cultures of Violence, Cultures of Caring   and Peace, and the Fulfillment of Basic Human Needs’ Ervin Staub - University of Massachusetts at Amherst has outlined what is required for individuals, groups, and nations to not act violently, but instead to care about and promote others’ welfare? What are the cultural, social, and psychological requirements for a peaceful world that nourishes the human spirit and helps individuals develop their personal and human potentials? Influences that generate violence, have to be put to end. Cultural and societal conditions that frustrate basic psychological needs make violence more likely, whereas conditions that help fulfill these needs in constructive ways contribute to the development of peaceful relations and fully human lives.   

 

 

04 Apr,2021

Coping up with Quarantine

Date: 04.04.2021

 

Coping up with Quarantine

 

Dr Arun Mitra 

With a linear fall of Corona infection cases not only in our country but around the globe a complacency had developed about the preventive measures. Life cannot come to a standstill but when the situation is not conducive some changes in the lifestyle need to be made. As there is a surge in the cases of COVID the whole discussion about prevention of the disease has started again. With new variant strains coming in we find some people getting infected for the second time. With the coming of vaccine there is a renewed hope among the population, even though there is controversy over the efficacy and the time period for which immunity will be provided by the vaccine. The experts give us hope that vaccine may not give complete protection but if someone is taken ill after the vaccination then the severity of diseases is minimized and life is saved. This has given some confidence among the population after an initial hesitancy in getting vaccinated. 

 

Much has been said about the preventive measures like keeping physical distance, washing and sanitizing hands, using masks and staying away from the crowded places etc. but not much attention has been paid to the stress which the patient and the family pass through. Even though percentage of death rate is less than 2%, the tension and stress in the family suddenly escalates. Since even the doctors cannot predict the course of disease, uncertainty adds to the problem. We however know that the elderly and those with co-morbid conditions are more vulnerable to become serious.  The uncertainty of the course of the disease is a cause for mental stress the patient as well as the family pass through. Therefore it is important that this issue is discussed more and the fears are allayed. 

 

The family has to be explained that the number of people getting serious is very little. Therefore if the person is not having any co-morbid condition and is not in highly vulnerable age group the chances of his coming out of the disease are very bright. This gives lot of confidence to the whole family and the patient. Even those in the vulnerable age group and with co morbid conditions are to be given confidence and hope that if they take care they would remain alright.  

 

When the reports come positive the patient is advised to go into quarantine for 17 days. This adds to the already stressful mental state of affairs of the person. Beside the illness the person gets worried of the long duration to stay alone.  

 

 

 

This is a crucial period but a meticulous scientific planning soon reduces the stress and one learns to manage these 17 days. One should not count 17 days, but one day at a time. After the report comes there is some time during which one should collect the essential items and other things like mobile phone, laptop, pen, note book and books of interest etc. These will help in planning the period and keep you connected with the outside world.  

 

During the quarantine it is important to keep regular oxygen check before and after a six minute walk minimum of four times a day. This gives us clue of the lung functions at that particular moment. 

 

It is advisable to sleep with belly below and back up. This helps in clearing lungs. Sleeping on one side also helps. The patient should undertake breathing exercises in the morning hours. This helps in giving strength to the lungs. 

 

In the day time one should spend sufficient time in reading news papers, books of interest and also checking your emails and chatting with your friends. Video conferencing helps in connecting better and reduces loneliness. One should try to live in a room with balcony and spend some time in watching the people moving around. If there is attached kitchen with the room one should try to cook if the health permits. This helps in fulfilling your taste needs as well as nourishment. Light exercise is important to keep the joints free in mobility.    

 

It helps to watch entertainment programmes on the television.   

 

As the condition improves and fever has gone down then one can do some exercise.  

 

It is important for the others to stay away from the patient’s room when the food is given from outside but the patient should maintain good hydration by taking sufficient amount of liquids and healthy diet as advised by the doctor. 

 

Best is to design your own day as you are the best person who knows your interests and daily requirements. By keeping oneself busy, soon one will find the hidden  skills coming out which give pleasure because you were not able to carry out those earlier because of several reasons. It is always good to share daily experience with someone whom you trust.

 

Remember you are not in jail but in quarantine in your own home. Read about those who have lived in isolation in solitary cells in jails for several years but never lost hope. Large number of freedom fighters in cellular jail in Andeman Nicobar islands  spent their prime youth in tough times but kept themselves strong. Nelson Mandela spent 18 years in one cell in loneliness but never felt alone instead continued to fight to victory. 

 

 

 

 

27 Oct,2020

Ratification of Treaty Prohibiting Nuclear Weapons an enormous win for planetary health

Date: 27.10.2020  

 

Ratification of Treaty Prohibiting Nuclear Weapons  

an enormous win for planetary health 

It will pave way for stronger movement  

for nuclear weapons abolition 

Dr Arun Mitra 

  

It is unfortunate that an event that concerns the very existence of life on earth is hardly under debate and is poorly reported. With Honduras submitting its document of ratification to the UNO on 24th October, the Treaty Prohibiting Nuclear Weapons (TPNW) have now been ratified by 50 countries. This fulfils the criteria for its entry into force. The treaty is now set to be operational within 90 days from ratification, that is on 20th January 2021 the treaty will become international law binding on the states that have already ratified it and those which subsequently ratify the treaty. This is a great step forward to eliminate nuclear weapons and save the mankind from extinction. This is all the more important as several parts of the world  are now under low level conflicts and some parts of the world witnessing full scale war with the blatant intervention of big powers. Any escalation could trigger the use of nuclear weapons.  

  

We have witnessed atomic bombing of Hiroshima and Nagasaki in Japan on 6th and 9th August 1945. The two incidents led to the death of over 200000 people and destituted many more. Blast was so powerful that large buildings also crumbled. Temperature generated by the bombs was so high that even the concrete buildings around the epicentre could not withstand that and melted  what to talk of the people and other life systems in that area. There was total chaos in the two cities with no one to take care. This was reported by none other than Dr Marcel Junod from the International Red Cross who was the first foreigner to visit Hiroshima in September 1945.  Radiations all around made the situation much worse and the effect has been passed to the next generation in form of malformed babies and cancers. 

All this has been testified several times by the Hibakusha, the survivors of atomic bombing.   

There are nearly 2000 nuclear weapons on high alert. Studies have shown that even if one per cent of the existing nearly 14000 nuclear weapons are used, there will be global nuclear icing leading to crop failure, nuclear famine and will put over two billion people at risk . Any nuclear exchange between the two major nuclear powers could be an end of  human civilisation built through thousands of years of human labour.    

  

Situation now is so complex that even if the states decide not to use nuclear weapons, their being used under natural catastrophe, use by the terrorist groups or the cyber criminals cannot be ruled out.    

  

The TPNW is an opportunity which the global society must utilise. The nuclear weapons possessing countries are already spending huge amounts in further updating and strengthening their nuclear arsenal. The US has shown no intention to carry forward the START-2 which is to expire on 5th February 2021. Moreover that is a bilateral treaty. The TPNW is a global treaty passed by the UNO on 7th July 2017with 122 votes in favour and only one against  and one abstention.  

 

The  whole process has not been easy. The peace forces around the globe have been advocating for a comprehensive treaty which would lead to nuclear weapons abolition. The International Physicians for the Prevention of Nuclear War (IPPNW) was awarded Nobel peace prize in 1985 for highlighting the Humanitarian Consequences of nuclear war. It took initiative to unite all the peace movements under the banner of the International Campaign to Abolish Nuclear Weapons (ICAN). Adoption of treaty by the UNO was largely a result of massive campaigning, lobbying and advocacy by the ICAN who were able to convince the governments of different countries to join the treaty. For this the ICAN was bestowed with Nobel Peace Prize  in 2017. Passage of treaty despite immense pressure by the nuclear weapon countries on the smaller states is a moral defeat for the big nuclear powers. 

 

The disastrous effects of the nuclear weapons have no cure. The World Health Organization (WHO) and the Red Cross have now confirmed that emergency services would not be able to respond in such a catastrophic health emergencies. Prevention is the only answer. TPNW is an opportunity.   

 

We have treaties that prohibit the use of Landmines, Cluster Munitions, Chemical Weapons and the Biological Weapons. These treaties have been holding good and helped save the mankind. The nuclear weapons are much more deadly. Therefore it is imperative that the TPNW must be respected and joined by all the countries of the world. The nine nuclear weapon countries out of which five are in Asia bear special responsibility in this situation.  

  

 

Dr Arun Mitra 

MBBS; MS (Consultant ENT Surgeon) 

Co-President  

International Physicians for the Prevention of Nuclear War (IPPNW) 

139-E, Kitchlu Nagar 

Ludhiana – 141001 

M: 9417000360 

 

12 Oct,2020

Government’s Insensitivity towards drug price control sceptical

Date: 12.10.2020

 

Government’s Insensitivity towards drug price control sceptical

 

Dr Arun Mitra    

Statement by the Minister of Chemicals & fertilizers DV Sadananda Gowda  in the Parliament that the Union government has no plans to make the Uniform Code of Pharmaceutical Marketing Practices (UCPMP) mandatory is very disappointing. He said this in reply to a question by K. Muraleedharan, Congress MP from Kerala in the Lok Sabha. His reply caused utter disgust as the matter concerns the health of the people. 

 

The Pharma companies spend huge amount of money for promotion of their products. Much of this is spent in organizing medical conferences in the name of continued medical education programmes. This involves travel expenditure to the doctors, lavish stay in five star hotels and sometimes even foreign trips for the whole family.  This ultimately adds to the cost of drugs. Sensing this and on the demand of several civil society organisations the government formed a UCPMP. This was prepared by the Department of Pharmaceuticals, Government of India. But it was said to be voluntary for some time. A letter of the ministry of chemicals and fertilizers, department of pharmaceuticals dated 12 December 2014 had mentioned that this will be voluntary for a period of six months with effect from 1st January 2015 and will be reviewed thereafter.      

       

The voluntary implementation of the code however did not yield desired results. H.N. Ananth Kumar, the then Union Minister for Chemicals and Fertilizers, had said in the Rajya Sabha in June 2016 that the voluntary code introduced in 2015 had not yielded desired results and that the government would make it mandatory. Pharmaceutical companies did not take any tangible steps to implement the code. Clauses 6 and 7 of the code prohibit the Pharma companies from giving freebies to the medical professionals.  But despite several representations from the public health activists and civil society groups the practice has not stopped. The Indian medical council (professional conduct, etiquette and ethics) regulation also warns the doctors against such practices to receive financial benefits in any form including for attending education programs. Taking cognizance of the matter even the central board of direct taxes (CBDT) in its Circular No. 5/2012 [F. NO. 225/142/2012-ITA.II], Dated 1-8-2012 had said that any such expenditure by the Pharma company will not be considered for tax deductions.          

       

As per the guidelines in the UCPMP the companies have to adopt stipulated procedures laid down by the competent authority for involving doctors in their research projects. Several  research works are not carried out in accordance with the laid down procedures. There are instances when the companies paid money to the doctors for the work which they had actually not done. It is a common practice that the companies approach doctors to do surveys highlighting efficacy of a particular drug produced/marketed by their company. These companies then use doctor’s reference including her/his photograph in their promotional literature. The UCPMP prohibits such work.   

   

The U turn on making UCPMP mandatory raises suspicion of lack of will on the part of the government to keep its commitment and smells of some unfair deals between the government and the Pharma companies. When a delegation of the Alliance of Doctor for Ethical Healthcare had submitted its opinion to the drugs price regulating body, the National Pharmaceutical Pricing Authority (NPPA) in February 2020, they were told that the NPPA has no jurisdiction to check the companies. This has to be done through changes in the law at the ministerial level.     

   

The high cost of drugs seriously affects the healthcare of our population. As nearly 67% of out of pocket health expenditure in our country is on drugs, this pushes 6.3 crore population below poverty line every year, a fact admitted by the National Health Policy document 2017.  But the government has not taken any tangible steps to control the trade margin which many a times has been found to be 700 – 800%.       

      

A committee was formed on high trade margins in the sale of drugs to go into the whole issue on 16 September 2015. This committee submitted its report on 9 December 2015. But it is now almost 5 years that the government has been sleeping over it. Even though this committee also did not spell on how the cost price of the drugs should be calculated but it took serious note of the excess trade margins. They pointed out that in some cases the trade margin is as high as 5000%. The government’s sleeping over the report for a such a long period raises scepticism over its intentions.       

      

The pricing of the drugs should be calculated on the basis of the cost involved in its production. The market based pricing calculating the average of the highest selling drugs is totally a flawed approach.    

   

It is high time the government makes the UCPMP mandatory and comes out with an effective control on drug prices. 

 

22 Sep,2020

LEST WE FORGET!

Date: 22.09.2020 

 

LEST WE FORGET!     

   Dr Arun Mitra 

Co-President IPPNW 

Mobile: 9417000360 

Twitter: @DrArunMitra51  

   

The harrowing experiences shared by the Hibakusha, the survivors of the atomic bombing at Hiroshima and Nagasaki, make everyone shiver and think how can human being stoop so low as to develop bombs to kill their fellow beings in such large number in such a brutal manner? The testimonies by them about the devastation caused in the two cities and the socio economic problems, in addition to the health issues, faced by them are nothing but a nightmarish experience to listen. The information by Dr. Marcel Junod, a Swiss doctor who was the first foreigner to visit Hiroshima in September 1945 gives us a glimpse of the destruction. It has been estimated that these bombs killed a total of 213,000 people immediately. The radiation effects have continued till date on the generations that have grown since. The deadly bombs destroyed 42 of 45 hospitals, killed 272 of 300 doctors and 1684 nurses out of 1780 perished. People were burnt to death, buildings collapsed like cards and there were radiations all around.   

       

The memories of the bad events of past are a rejoinder to never let such mistakes be repeated. Therefore some days have been marked to warn and remind the people from time to time.   The 26th September, declared by the UN as the International Day for Total Elimination of Nuclear Weapons is not only to remind us of the worst ever destruction in human history, but also to pledge to avert any such happening in future. 

  

The United Nations was founded On 24TH October in 1945 after the Second World War by 51 countries committed to maintaining international peace and security, developing friendly relations among nations and promoting social progress, better living standards and human rights. (1)   Global nuclear disarmament is one of its major goals. The UN General Assembly (UNGA) established the Atomic Energy Commission to make specific proposals for the control of nuclear energy and the elimination of atomic weapons and all other major weapons adaptable to mass destruction. It continued several diplomatic efforts in that direction.  This  also strengthened peace movement globally.  

 

As a result of peace movement there have been treaties in the effort for reduction of nuclear weapons.  The Strategic Arms Reduction Treaty (START -1) is one such very important treaty between George Bush and Mikhail Gorbachev. The treaty was signed on 31 July 1991 and entered into force on 5 December 1994. The treaty barred its signatories from deploying more than 6,000 nuclear warheads atop a total of 1,600 inter-continental ballistic missiles (ICBMs) and bombers. START negotiated the largest and most complex arms control treaty in history, and its final implementation in late 2001 resulted in the removal of about 80 percent of all strategic nuclear weapons then in existence. (2)  

New START treaty was signed in Prague by United States President Barack Obama and Russian President Dmitry Medvedev. Following ratification by the U.S. Senate and the Federal Assembly of Russia, it went into force on 26 January 2011 (3). But there have been difficulties in it. As a statement of Deputy Foreign Minister Russia Sergei Ryabkov published in the media on 22nd September  ‘that the conditions setup the US administration are impediment in extending the New START Treaty’. It is an unfortunate development. (4).  

  

As per the information from different sources there are somewhere between 14000 to 17000 nuclear weapons on earth. All the nuclear weapons possessing countries have separate budget allocations to upgrade their nuclear stockpiles. Presently nine countries USA, Russia, UK, France, China, Pakistan, India, Israel and North Korea possess nuclear weapons. There are many others who have potential to develop their nuclear arsenal. Nearly half of the world’s population lives in counties which either have such weapons or are members of nuclear alliances (5).    

    

The nuclear weapons possessing countries take the alibi of nuclear weapons as the weapons of deterrence. But they forget that the very presence of these weapons poses a potential threat of their being used at any time. Moreover the expenditure on their upkeep is at the cost of the public health needs globally.  Despite that both India and Pakistan posses nuclear weapons, the two countries went to war at Kargil in 1999.    

    

There have been several achievements to the credit of the global peace movement. There are five Nuclear Weapons Free Zones in the world. The Latin America negotiated the Treaty for the Prohibition of Nuclear Weapons in Latin America In 1967 known as the Treaty of Tlatelolco, and established the first nuclear weapons-free zone (6).  

  

The South Pacific became the second nuclear-weapon-free zone, the Treaty of Rarotonga in 1985. South Africa voluntarily renounced its nuclear weapons programme in 1991.  Belarus, Kazakhstan and Ukraine voluntarily renounced nuclear weapons in their possession following the dissolution of the Soviet Union.  In 1995 Southeast Asia became the third nuclear-weapon-free zone, the Bangkok Treaty.  In 1996 Africa became the fourth nuclear-weapon-free zone the Pelindaba Treaty.  Central Asia became the fifth nuclear-weapon-free zone - Treaty on a Nuclear-Weapon-Free Zone in Central Asia.     

    

The efforts of International Campaign to Abolish Nuclear Weapons (ICAN), a brain child of International Physicians for the Prevention of Nuclear War (IPPNW) bore fruits after long and hard campaign. On 7 July 2017, the Treaty on the Prohibition of Nuclear Weapons (TPNW) was adopted. It is the first multilateral legally binding instrument for nuclear disarmament to have been negotiated in 20 years. The treaty has already been signed by 85 countries and ratified  by 46 countries; only four short of its entry into force.     

    

True that all global effort is now directed towards tackling COVID. We will succeed in that soon. But Nuclear weapons are our own creation. Barring the Military Industrial Complex, they serve no one’s interest! Time is now to dismantle these weapons. A study by the IPPNW that even a limited nuclear exchange between Pakistan and India would put over two billion people at risk is a warning. The only true guarantee against the use of nuclear weapons is their total elimination. The Treaty Prohibiting Nuclear Weapons is an opportunity.  

 

References:  

  1.  https://www.un.org/un70/en/content/history/index.html#:~:text=The%20United%20Nations%20is%20an,living%20standards%20and%20human%20rights
  2. https://www.jatinverma.org/start-treaty  
  3. https://en.wikipedia.org/wiki/New_START     
  4. Indian Express 22nd September 2020; Page-10  
  5. https://www.un.org/en/observances/nuclear-weapons-elimination-day   
  6. https://www.un.org/en/observances/nuclear-weapons-elimination-day   

 

 

14 Sep,2020

Doctors too have the right to dissent

 

Date: 14.09.2020

Doctors too have the right to dissent

Dissent and different views are always strength of democracy and essential for development of any society. Unfortunately there is increasing intolerance to Dissent by those at the helms of affairs. This is not limited to one part of the world or any set of people. Even those who save the life of others are not being spared. Nobel Laureate Dr Denis Mukwege, who has worked for decades with great courage and compassion to address the needs of survivors of sexual violence has been getting threats to his life. He has been opposing the use of sexual violence as a weapon of war, in the strife ridden Democratic Republic of Congo (DRC) and around the world. In 2012 he faced a deadly assault in which he narrowly escaped but his guard was killed. Undeterred he never gave up and is continuing to raise his voice vociferously.  He has operated upon hundreds of such patients and given them a new lease of life both physically and mentally. For his work he was awarded Nobel Peace Prize in 2018 along with Nadia Murad.  Threats to his life have increased recently. Several Health activists and Nobel Laureates including the International Physicians for the Prevention of Nuclear War (IPPNW) Nobel Peace Prize awardee 1985 and then as a partner of International Campaign to Abolish Nuclear Weapons (ICAN) in 2017 have in strong words condemned such cowardly acts and have extended all support to Dr Mukwege.  

There are reports of onslaught on doctors in Turkey. Doctors who called war a “man-made public health problem” received jail sentences, in the government-led assault on the Turkish Medical Association last year. 

In India in the state of Punjab many health personal faced threat and were attacked during the terrorist violence in the decade from 1980 - 1990. Some of these health activists preached against the violence while there were others who were attacked for extortion.  They suffered at the hands of both, the government and the terrorists.

But recently such threats form the state have increased in our country.   Dr Kafeel Khan, who worked in Gorakhpur and treated the cases of encephalitis, was charged by the authorities for raising voice against lack of oxygen supply and other basic equipment which led to death of several children. Even though he was exonerated by the local enquiries twice, he was not taken back to the job. Not only that, he was booked under National Security Act (NSA) for addressing a rally at Aligarh on the charges of inciting, communal hatred and violence. In a strong worded judgment the Allahabad high court, while relieving him of all charges, has warned those who had booked him under the NSA for complete dereliction of duty and constitutional oath. Dr Kafeel has appealed to the government to take him back to the job as now he has been discharged by the high court. But the government has not responded so far. 

Likewise Dr Anwar who helped hundreds of patients from all communities irrespective of socio economic status and financial considerations during the engineered communal violence in Delhi in the end February has been named in the list of those who in the eyes of government abetted communal violence.  

Dr Sudhakar Rao from Andhra Pradesh was suspended from the job when he raised the issue of lack of regular supply of PPEs during the COVID.  After some time when he again raised the issues he was stripped off and dragged by the police. It was later said that he is mentally unstable. To drag a mentally unstable person like this is even a bigger crime because such patients have to be dealt with more empathy and sympathy than others.  

It is a matter of anguish that the health workers have been looked upon with suspicion at some places as spreaders of COVID infection. A doctor couple in Delhi had complained that the people living in the society where they have their house were against them just because they are on the COVID duty and they feared that this couple will infect them too.  Some nurses were not allowed to enter their place of stay fearing that other persons in the locality will cath infection. The health workers engaged in difficult tasks need appreciation and encouragement. But such incidents and in human behavior discourages them. This can have long lasting effect on their behavior which may affect the psychological build up of their children. 

There have also been incidents when the doctors had been attacked by the mobs and injured seriously just because they thought that their ward has not been treated well. 

Whatever may happen, it is the moral, ethical and professional duty of the doctors to continue to work for the betterment of society. The Red Cross, the Doctors Without Borders are the organizations which show the way. In the Sikh history in India Bhai Ghanhaiya is a well known figure who gave water to wounded soldiers from both sides of the army despite objections by some of his mates. But Guru Gobind Singh ji appreciated his humanly task.  

Let the government and the society realise that doctors too have the right to dissent and express their opinion which must be given due respect and consideration and not treated with violence by the people or the state.

 

10 Sep,2020

The National Digital Health Mission will be another mechanism for surveillance by the state through personal data collection on health

Date: 10.09.2020

 

The National Digital Health Mission will be another mechanism for surveillance by the state through personal data collection on health

Will in no way help in improving health of our people

 

Dr Arun Mitra

 

Healthcare has always been a concern in our country, but lately the people are more sensitised towards it. This is because of the spread of COVID which is taking toll on the lives of many people from all socio economic strata. In addition the repeated lockdowns have affected the day to day life and economy. Crores of people have lost their jobs/livelihood. As a result they are unable to meet their healthcare requirements. People have started questioning the healthcare system in our country. It appears that it is in this background the Prime Minister announced National Digital Health Mission in his independence day address to the nation on 15th August 2020.

 

The mission will singularly focus on collection of  data of all the citizens on their health status. On the face of it appears very attractive and useful. The government’s contention is that through this data collection they will be able to frame policies for the healthcare in the time to come. 

 

That the draft of the National Digital Health Mission (NDHM) was kept in public domain for opinion from the people for only seven days shows government’s reluctance to discuss the issue of such immense importance. It is only after lot of inputs from the health activists that this period was extended by just seven days.

 

As per the draft health care providers will collect data which will then be shared with the state health authority and the central health authority. As per the medical ethics a patients' health status is a confidential issue and no doctor should share it with anyone unless permitted by the patient himself/herself. By sharing the data with three parties this basic ethical issues has been completely ignored and flouted. In this world of cybercrime where even the prime minister's twitter account was hacked for some time, how can you guarantee that the data will not be leaked.

 

This is blatant interference with the fundamental right to privacy. India has been debating the Draft Personal Data Protection Bill for the past two years. Under the bill, data relating to health, finance, genetics etc. is considered ‘sensitive personal data’ as its disclosure can cause serious harm to individuals and institutions. Extensive due diligence is required by all stakeholders to ensure that a right balance is created between the public healthcare needs and the legal rights of the citizens, specifically the right of privacy and data protection.

 

 

The health care provider will give consent for his/her enrollment in this mission to collect the data. Similarly the consent of the principal, the person/individual, will be necessary to collect data about his/her health status and share it with the state of the central health authorities. There is also provision that the health care provider or the principal will have the right to opt out of this mission. But according to the draft the person’s record isn't erased after they have opted out but it is simply locked. Moreover it cannot be erased for a certain period of time. The government of India doesn't have a good track record with cyber security, and the strategy doesn’t allay one’s concerns.

 

It is said that the data will be totally confidential with no scope of leakage or sharing with anyone. The job of compiling/managing the data will be given to private setups thus completely negating the security issue. Thus a person's privacy will be completely undermined under this mission. There is no provision of sufficient safeguards against commercial exploitation of Sensitive Personal Data that may be caused by private entities that will be linked to public entities under this system. These include insurers, pharmaceutical companies, and device manufacturers.

 

There is also provision to collect highly sensitive personal data like financial information such as bank account or credit card or debit card or other payment instrument details; physical, physiological and mental health data; sex life; sexual orientation; medical records and history; biometric data; genetic data; transgender status; intersex status; caste or tribe; and religious or political belief or affiliation. All these have nothing to do with the health of the people but can have negative impact. 

 

The fear that such a data could be used by the state on some pretext or the other is not unfounded. We have the example of Aadhaar Card which is now compulsory to be linked in almost any activity and the state has complete knowledge and control of the activities of the people in our country. Gradually the digital health card will be made compulsory to join the Ayushman Bharat/RSBY/CGHS/ECHS/ESI or any other government sponsored scheme or the insurance by the companies.

 

Health is a state subject but through this there will be complete infringement on the rights of the state.

 

The contention of the government that this will help us improve the health policies is a joke. The government already knows the problems of health care in our country but it needs political will to sort out those problems. Several health activists/civil society groups and experts have already given their view point on how to improve healthcare system. 

 

This type of exercise may be useful in a health care system which is comprehensive and universal. But in the system like ours, where health care delivery is so much diverse, right from the faith healers, alternative medicine to the system of modern scientific medicine. The medical practitioners vary from small scale sector to corporate sector. For the small scale sector it is extremely difficult to maintain such records in details. Small scale sector which lacks the infrastructure will have to employ new people for the job which will ultimately fall upon the patients to pay the cost. Already our patients are highly burdened with the cost of the health care. The National Health Policy document clearly admits that 6.3 crore people are pushed below poverty line due to out of pocket expenditure on health. With very meager spending by the state sector on public health, the patients are left to remain at the mercy of private sector which accounts for nearly 80% of the health care in our country. 

 

This bill which in no way will help in improving the health needs of our people, rather  will be another means to give power for surveillance of the people should be shelved.

 

28 Aug,2020

Finance Minister should not evade responsibility by calling COVID-19 an act of God

Finance Minister should not evade responsibility by calling COVID-19 an act of God

COVID has several factors which need to be analysed scientifically

 

By calling the COVID 19  an act of God, the finance minister Smt Nirmala Sitharaman has not  only tried to evade responsibility but also sent misleading information to the people and perpetuated myths already prevalent in the society. She said this in the meeting of the GST council on 27th August. Several states have demanded that the GST due to them should be given which the central government is evading.

 

Every disease has a scientific basis, so has the COVID-19. It is spread by a virus, but unfortunately it is a taken the shape of pandemic. The pandemics are not new.  We've seen Bubonic plague several times in the history and we had most deadly pandemic of  the Spanish Flu in 1918 in which over 5 crore people died the world over and we lost about 1.5 crore people in our country, which is about 5 % of India’s population at that time. That was a different time; medicine had not developed so much by then. The information technology was primitive compared to present level. Moreover we were ruled by the colonial power. So we could expect the colonial rulers to be apathetic to the problems of our people. That in fact lead to death of so many.  This also occurred during the Bengal famine in 1940s when 30 lakh people are reported to have died as a result of starvation because the food meant for the famine affected areas was diverted to the soldiers of the British army in Myanmar. Therefore the finance minister must understand that disease has to be viewed on the basis of science.

 

Scientists are on the job of finding out reasons for the spread of Novel Corona virus in so much intensity. Doctors have already given suggestions about the prevention of the disease by simple measures like hand washing, sanitizing, physical distancing and use of masks. There is all out effort around the globe to find vaccine to prevent the disease and also to find anti-viral drugs to treat the sick. When the Finance Minister terms it an act of God, it means we are helpless and that we cannot do anything to the God’s creation.

 

Several diseases have come up because of climate change which has led to mutations in the micro-organisms. There is need to find out whether there is any such relationship between the climate change which has occurred due to human activity in the past few years to the COVID.  We have already seen several catastrophes due to climate change. Recent enactment of the new Environmental Impact Assessment Act (EIA) which ignores and dilutes many important environmental clauses for the clearance of projects is likely result into many such happenings in future, which we may again attribute to God’s act to escape the responsibility. 

 

There are also rumbling around the world that this virus was generated with the purpose of Biological warfare, even though this is not proven till date? It is only when we believe that there is a reason for a disease that we look forward to its prevention and treatment. But if we label it as an act of God, then it is sheer helplessness because no one can do anything against the wish of God. In this situation should we stop doing research on the virus; should we ask the WHO do not do anything on COVID; should we ask to ICMR not to do any work on this; should we ask the doctors to not treat the patients but only pray to God?

 

This is not the time to talk such things and spread myths. Our country was already late in responding to the COVID. To hide its failure the Prime Minister said on 25th March that we will win over the COVID in 21 days because Mahabharta was won in 18 days. Not stopping at that, he made Indian public to clap, beat Thalies, sound Shankha, light candles in the belief that COVID will be taken care of by such acts. During all this there was chest thumping by the government at that time that India has very low number of cases even though the epidemiologists had warned of peak ahead. Now when the number is rising fast, there are no briefings by the government on COVID. It was said by many in the ruling that the cow urine or cow dung is the treatment. Let us be honest to ourselves. Very senior ministers in the government including the Home Minister are under treatment in big hospitals under modern scientific medical system. They should have spoken against such myths at that time. Ironically even the Health Minister, who is a doctor himself did not counter such myths. It is time to strengthen scientific temper.     

 

27 Aug,2020

IGNORING OTHER DISEASES DURING PANDEMIC COULD BE COUNTERPRODUCTIVE

Date: 27.08.2020

 

IGNORING OTHER DISEASES DURING PANDEMIC

COULD BE COUNTERPRODUCTIVE

 

Dr Arun Mitra

 

The Pandemics bring with them misery in the form of morbidities and mortalities. Bubonic plagues are an example. The Great Plague of 1665 was one of the worst during which 100,000 residents of London died just in a span of seven months (1). The Spanish flu in 1918 was even worse. During this period the pandemic is believed to have killed up to 14 -17 million people in our country, the most among all countries which is about 5-6% of total population(2).

    

In addition pandemics are associated with economic hardships because in such situations the economic activity is affected adversely. On one side the people who fall ill are forced to absent themselves from work. Measures by the governments taken supposedly to control the spread of the disease add to the problem. Poor sections of the society are affected more. We have witnessed this during the lockdown imposed in our county in the end of March, which was done without thorough consultations with the epidemiologists and those working in public health & community medicine and without taking effective measures to prevent hardships to the working people who suddenly lost their  of jobs and livelihood. The International Labour Organisation (ILO) has pointed out "In India, with a share of almost 90 per cent of people working in the informal economy, about 400 million workers in the informal economy are at risk of falling deeper into poverty during the crisis …..forcing many of them to return to rural areas(3)."

 

  

It is true that corona infection has involved crores of people around the world and in our own country currently there are over seven lakh active cases. Over 65,000 new Covid-19 cases are being reported every  24 hours pushing the number of COVID patients to more than 32 lakhs. Till now more than  58,000 people have succumbed to the virus.  It is therefore a serious issue and we must concentrate on prevention of infection and save lives of people taken ill.   

  

But what is of equal concern is that we cannot ignore other pre-existing diseases as India is the hub of many communicable and non-communicable diseases. The number of morbidity and mortality due to these is nowhere less. But in the last five months many of these diseases have been completely ignored.   

Some of the important disease that India is hub to are Tuberculosis (TB), Hepatitis,  Diarrhoea, Diabetes, Coronary Heart Disease, Cancer and Kidney diseases etc.   

  

India has the largest number of TB cases in the world. As per the latest report released by the World Health Organisation (WHO) India accounted for 27 per cent of the total, followed by China with 9 per cent, Indonesia at 8 per cent, Pakistan (6 per cent) and Bangladesh (4 per cent) (4). According to the India TB report 2020 India notifies 24.04 Lakh TB Cases. This is 14 per cent increase over the previous year. The country recorded 79,144 Deaths in 2019. This figure is much lower than the WHO estimate of 4.4 lakh fatalities. However in the absence of any substantive change in the TB control in the last one year, the figures given by the Ministry of Health and Family Welfare need to be reconfirmed particularly in view of that in 2018, 4.4 lakh people died from TB that is 1205 patients daily. The corresponding number was 4.1 lakh in 2017 (4 a).

  

Diarrhoea and Pneumonia are other deadly diseases in our country. In 2016, almost 261,000 Indian children died before their fifth birthday due to diarrhoea or pneumonia, both preventable diseases. This is the highest toll taken anywhere in the world by the two diseases--a fifth of their global burden--according to the 2018 Pneumonia & diarrhoea Progress Report, released on November 12, 2018, which was World Pneumonia Day (5).

  

With 1.5 lakh deaths annually and almost 60 million Indians affected, Viral Hepatitis continues to be a serious public health concern.  It is estimated that 4 crore people are suffering from Hepatitis B and 0.6-1.2 crore people are suffering from Hepatitis C in India (6).

 

According to the National Institute of Cancer Prevention and Research (NICPR), an estimated 2.25 million people in India live with cancer and more than 1,157,294 new cancer patients are registered every year (7).  

  

There has been an alarming increase over the past two decades in the prevalence of Coronary Heart Diseases (CHD) and Cardiovascular mortality in India and other south Asian countries. Current estimates from epidemiologic studies from various parts of the country indicate a prevalence of CHD to be between 7% and 13% in urban3–5 and 2% and 7% in rural 6,7 populations. Epidemiologic studies have shown that there are at present over 30 million cases of CHD in this country (8).

 

During this period of COVID-19, the patients of above mentioned and several other diseases have been suffering as hospitals are occupied with COVID care. As a result, many of those suffering from chronic diseases have lost their lives. There is urgent need to evolve a comprehensive healthcare system where it is ensured that a balance is maintained between the care of pandemic and the pre-existing diseases. Some special hospitals have to be built to deal with epidemics while the already existing medical care facilities should continue to provide healthcare to the people suffering from other diseases, failing which there will ensue another crisis of diseases which could have been managed otherwise.   Let the COVID-19 be a lesson to move forward. The governments have to take healthcare seriously which has been hitherto ignored. It has been generally observed that we tend to forget once the situation has changed. It should not happen now.  

 

References:

  1. https://www.nationalarchives.gov.uk/education/resources/great-plague/)   
  2. https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India
  3. (https://economictimes.indiatimes.com/news/economy/indicators/about-400-million-workers-in-india-may-sink-into-poverty-un-report/articleshow/75041922.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst ) 

 

  1. (https://economictimes.indiatimes.com/news/politics-and-nation/india-continues-to-record-maximum-number-of-tuberculosis-tb-cases-/articleshow/71638359.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst )  

 

4a. https://thewire.in/health/india-tb-cases-drop

 

 

  1. https://www.business-standard.com/article/health/diarrhoea-pneumonia-kill-one-child-every-two-minutes-in-india-118111500106_1.html#:~:text=From%202000%20to%202018%2C%20diarrhoea,%2D%2Dfrom%20485%2C094%20to%20158%2C176. 

 

 

  1. https://www.theweek.in/wire-updates/national/2019/07/18/des60-dl-ilbs-2ndld%20hepatitis.html  

 

  1. https://www.google.com/search?q=National+Institute+of+Cancer+Prevention+and+Research+(NICPR)%2C+an+estimated+2.25+million+people+in+India+live+with+cancer&oq=National+Institute+of+Cancer+Prevention+and+Research+(NICPR)%2C+an+estimated+2.25+million+people+in+India+live+with+cancer&aqs=chrome..69i57.852j0j15&sourceid=chrome&ie=UTF-8

 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860846/

20 Aug,2020

South Asian countries should increase cooperation to combat COVID-19

Date: 20.08.2020

 

South Asian countries should increase cooperation to combat COVID-19

 

Dr Arun Mitra

 

Increase in the number of the cases of COVID-19 in India is a worrying factor even though it is on the expected lines as predicted by several epidemiologists. While Delhi has shown some downward trend, other states have now been showing rising numbers. Bihar, Uttar Pradesh, Punjab, Haryana, Himachal and some areas in North East are having increasing number of cases. This has added to the overall number of cases country wide. Vaccine is long awaited. But the vaccines have to pass through several trials before they are put to use on human population in large number. Since the infection of Corona is not age specific, the vaccine has to be given to each and every person. This in itself is a huge task which involves production, distribution and then inoculation in such large numbers. It is not yet certain up to what duration the vaccine will provide immunity to the individual.


The consolation so far is that mortality rate in our country is not as high as in the USA or Europe. This however is true for all the South Asian countries. With similar ethnic background and similar socio economic situation, it is time that the South Asian countries should collaborate with each other and review the strategy to check the spread of disease. Reviewing the data of cases in the South Asian countries it has been found that out of all Sri Lanka has done better in controlling the spread of COVID-19. As on 15th August Sri Lanka with a population of 2.2 cores has only 2890 cases and 11 deaths. Nepal with population of nearly 3 crores has 26660 cases and 104 deaths. Bangladesh which has population of nearly 16 crores has 276549 number of cases  and 3657 deaths. Pakistan has a population of nearly 21 crores and has 288717 number of cases and 6168 deaths. India which is the largest country in South Asia with a population of 138 crores has 2618877 cases and 50464 deaths.

 

According to the above data Sri Lanka has 0.01% population which is positive for COVID-19 and out of these 0.38% died. Nepal has 0.08% of population sick with COVID-19 and a mortality of 0.39% out of these sick people. Bangladesh has 0.17% people developed COVID-19 infection out of 1.32% could not survive. Pakistan has 0.17% sick population and mortality of 2.25% out of these. India has 0.11% population infected with COVID and a mortality of 1.92% out of these.

 

It is not time to browbeat anyone’s loss or highlight any ones victory. It is a human issue. So we have to work on multipronged strategy. One, that we have to check the spread of disease and have to devise strategy for early detection of cases, test all the suspected cases and the positive cases have to be advised for care as per the grading of the disease. Those who understand and have facilities for home quarantine should be encouraged for that. For others we have to develop large number of places where the cases can be observed in the institutions. Those needing oxygen only can be then shifted to oxygen beds while those who require ventilator can be taken for further treatment. All this requires lots of money. So it is time for serious global cooperation. For the South Asian countries it is even more important to coordinate and cooperate, know about the strategies adopted by each country to combat the COVID.

 

Several South Asian doctors with social orientation affiliated to International Physicians for the Prevention of Nuclear War (IPPNW) have suggested following steps to be taken in this regard. 

 

  • The South Asian countries as members of the SAARC should increase their cooperation in fighting such pandemics as well as other health related issues in region.    
  • We should develop a continuous system of sharing of knowledge on the health issues in different countries of South Asia and also try to learn from health care delivery system in each country.     
  • South Asian countries should increase the public health spending to a minimum of 5% of the GDP.    
  • We should also devise means to make people of the region to travel to other countries for healthcare needs without any visa problems.    
  • Countries of the region should hold continuous mutual dialogue to sort out problems between them.    
  • We should have a joint platform to sort out the food security issues in the region.
  • We should reduce spending on the arms and instead spend on the health care issues.     

 

SAARC is an appropriate forum which should be made active at this juncture. This is not the time for rhetoric but it is time to take steps to strengthen coordination and cooperation. South Asia is already in turmoil due to severe socio economic disparities, low Human Development Index and at a poor grading in the Hunger Index. Let COVID be a lesson for our polity and people to learn to live in peace and harmony.

 

 

03 Aug,2020

Remembering the victims on 75th Anniversary of Atomic Bombing of Hiroshima and Nagasaki

Remembering the victims on 75th Anniversary of Atomic Bombing of Hiroshima and Nagasaki

The Time for Nuclear Weapons Abolition has come now

 

 

(This article is a homage to the victims of atomic bombing at Hiroshima and Nagasaki and is dedicated to the forces of peace and disarmament)

 

Dr Arun Mitra

 

While visiting the Peace Memorial in Hiroshima, one wonders how with the knowledge of destructive power of weapons could man build and then use the nuclear arms on human population. To watch the pictures of the destruction while going around the memorial and to read the account of the loss that took place as a result of atomic bombing is a nightmarish experience. The tiny atomic bombs (as per the standards of the present day nuclear weapons) killed around 140,000 people in Hiroshima and nearly 70,000 in Nagasaki and roughly half of the deaths in each city occurred on the first day. Out of 300 doctors 272 died, 1684 of 1780 died and 42 of 45 hospitals were destroyed. There was complete lack of medical care. High dose of radiations added to the chaos. Listening to the testimonies of the Hibakusha, the survivors of Atomic Bombing, one cannot control the emotions while they are narrating the incidents. It is difficult to imagine how it must have been to watch nears and dears melt away in a matter of seconds as a result of intense heat produced by the nuclear detonation. Today Hiroshima is like any other modern city. However the building which was the epicentre of the explosion has been preserved in the same form as it was after the explosion on 6th August 1945 so that generations to come remember the devastation caused and imagine how insane man could be at certain times.

 

With the surrender of Germany 9th May 1945 the war had virtually come to an end on. Surrender of Japan was imminent in a few weeks. It was expected that long lasting peace would prevail after the Potsdam Agreement between the three heads of the state Joseph Stalin, Harry Truman & Winston Churchill (replaced by Clement Attlee) in July 1945. But it was within a few days of this conference that Hiroshima was bombarded with atomic weapon followed by Nagasaki after three days. While lakhs were crying in despair in the two cities, the American administration rejoiced over this barbarous act. Use of atomic weapons on human population by the US was a show of strength and muscle power which unfortunately instead of halting, unleashed the nuclear arms race. 

 

The number of nuclear weapons has been increasing and it is assumed that there are nearly 17000 nuclear weapons on earth today. The number of countries which possess these weapons also increased from one to nine. These include USA, Russia, Britain, France, China, North Korea, India, Pakistan and Israel.

 

The nuclear weapons are a real threat to not only the human population but the whole flora and fauna on earth. The very presence of these weapons is fraught with the danger of their use. It is well known that India and Pakistan have threatened each other with use of nuclear weapons 13 times and this rhetoric is not stopping. We are witnessing every day violent actions by highly motivated individuals and groups around the world who are ready to kill the innocent without any remorse. Even if the states decide not to use the nuclear weapons, there is a grave danger that these could fall in the hands of non-state actors who with their utterly insane outlook would not hesitate to use them. 

 

The destructive power of nuclear weapons is well documented now.  Ira Helfand, Co President of IPPNW in a study on Climate Consequences of Regional Nuclear War has pointed out that even a limited nuclear war between India and Pakistan using Hiroshima sized nuclear weapons could put over two billion people at risk. Up to 20 million people would be killed outright as the great cities of the subcontinent were destroyed and it would blanket much of South Asia with radioactive fallout. But the global consequences are even more alarming. Peer-reviewed studies by climate experts show clearly that this limited nuclear conflict would even affect weather patterns throughout the world. Soot and debris injected into the atmosphere from the explosions and resulting fires would block sunlight from reaching the earth, producing an average surface cooling of -1.25ºC that would last for several years.  Even 10 years out, there would be a persistent average surface cooling of -0.5ºC.  This would lead to crop failure and affect the size of available food stocks. If the soot injected into the atmosphere in a nuclear war caused significant ozone depletion that could cause a further major decline in actual food production. The combination of failed harvests and a collapsed distribution system would prevent essential foods from reaching the areas which require these. This scenario will affect the poor countries more and the poor people in these countries even worse.

  

It is being slowly realized that complete abolition of nuclear weapons is the ultimate and in fact the only solution to overcome the potential consequences of nuclear weapons for humanity. Without the complete elimination of nuclear weapons, the element of risk that nuclear weapons will be, will continue to exist. Our former Prime Minister Rajiv Gandhi had proposed an action Plan for nuclear disarmament. He had pointed out that the use of nuclear weapons could result in the death of 4 billion people, or the end of life on Earth as we know it. On 21 January 1988, in his speech at the opening session of the Six-Nation Five-Continent Peace Initiative in Stockholm, he had stated: “What we need to end is the option of unleashing global devastation or holding the survival of humanity to ransom. We must protect humanity as much from the known dangers of extinction as from those that are still unknown.”

 

Adoption of Treaty Prohibiting Nuclear Weapons (TPNW) by the UNO is a big step forward and a real hope. The treaty has been already signed by the 82 countries and ratified by 40 countries. There is need for 10 more ratifications for its entry into force. The treaty delegitimizes and prohibits the possession, testing, use, trade of the nuclear weapons in any form. This is indeed a big achievement. The nuclear weapons possessing countries have met a moral defeat in the highest international forum by not joining the treaty. It is time all the nuclear weapons possessing countries realize their duty to join the treaty and abolish these weapons of mas destruction.

 

In her highly emotive lecture at the Nobel Peace Prize giving ceremony to the International Campaign for the Abolition of Nuclear Weapons (ICAN) in Oslo on 10th December 2017, Hibakusha Setsuko Thurlow  had said "To every President and Prime minister of every nation of the world, I beseech you: Join this treaty; forever eradicate the threat of nuclear annihilation”.

 

Dr Arun Mitra

MBBS, MS (ENT Surgeon)

Co-President International Physicians for the Prevention of Nuclear War (IPPNW)

139-E, Kitchlu Nagar, Ludhiana – 141001

Mobile: 94170 00360

 

23 Jul,2020

Health Minister’s Silence is Intriguing Proactive intervention by the Health Ministry could have mitigated the damage by COVID-19

Date: 23.07.2020

 

Health Minister’s Silence is Intriguing

Proactive intervention by the Health Ministry could have mitigated the damage by COVID-19

 

Dr Arun Mitra

 

It is the prerogative of the Health Minister to speak on the issues that concern health of the people in our country. This is even more relevant when the Health Minister is a doctor specialized in Otorhinolaryngology and is also Chairman of the Executive Board of the WHO, which is specialised agency of the United Nations responsible for international public health and is currently at the forefront of global efforts towards containing the novel coronavirus pandemic. COVID-19 is the period when people expect scientific information on issues related to prevention and management of the disease from a doctor’s mouth as they think it to be more appropriate and it gives confidence to them. The virus enters our body from the nose and the mouth, and the Health Minister is an ENT Surgeon.

 

When the disease was first reported from Wuhan in China there was apprehension that this would spread around the world and carried to other places by the travellers. Many doctors, particularly those who are working in the field of Epidemiology and Social and Preventable Medicine had warned about this.  The Health Ministry should have become pro-active in December 2019 when it became a worldwide knowledge that COVID could spread globally. First case was reported in India on 30th January. On the same date WHO had warned about COVID to be a serious Public Health Emergency. The Health Ministry knew very well that the disease is contagious and is being spread by those who are coming from outside. Check-up of those entering India should have been done extensively from that time onwards. But it did not happen. Whether the ministry did not realize the gravity of the situation or was under some other compulsions to ignore, this is not clear till date. When the US President Donald Trump came to India, four thousand personnel accompanied him. Health Ministry should have insisted on their COVID tests. When the organized engineered violence was going in North East Delhi in the end of February causing death of more than 50 and serious injury to hundreds of people, a visit to the area by the Health Minister to assess the health situation and oversee the make shift camps and ensure proper health care to them could have assuaged the feelings to an extent, more so with impending danger of COVID. Full one month of February was lost without warning and directions from Health Ministry.  Even in the month of March the advisory issued by the Health Ministry on 13th March did not point to a grave emergency. 

 

Before the Prime Minister announced sudden lockdown on 24th March, the Health Ministry should have made a detailed assessment of its impact on health, nutrition and necessary preparations to upgrade health system to deal with this Pandemic. This should have included suggestion to the government to take appraisal of the impact on economy, job situation, livelihood, nutrition of the people particularly of those going to their native places and the issues of stay of people and correlating it to physical distancing etc. while taking any steps to deal with the situation. Ministry should have then advised to the Prime Minister accordingly. But this did not happen and as a result, the sudden lock down created immense problems of health and nutrition for the marginalised sections of society.

 

When the Prime Minister appealed to the people to bang thaalies, clap and  sound shankhs, light candles and diyas which created complacency and understanding among masses as if  these could dispel the threat of corona, the Health Ministry should have said that this is unscientific and will not get rid of Corona. Even  when the Prime Minister said that we will be able to win over Corona infection in 21 days, the Health Minster should have not kept mum and warned the people to remain prepared to fight with the disease for several months..

 

The Health Minster was hardly to be seen on briefings on Corona. Initially these were addressed by the bureaucrats and ICMR, but soon the ICMR officials vanished from such briefings for the reasons unknown. The Health Ministry should have ensured that such briefings are always addressed by medical scientists alongside the government officials.

 

The Ministry should have vehemently opposed absurd ideas like cow urine and cow dung to be cure for Corona infection and warned people of the country to beware of myths. 

 

When ICMR said that the community spread has not occurred, while several epidemiologists issued statements to the contrary, the Health Ministry should have assessed the situation clearly and then come out with a concrete statement.

 

ICMR Director’s statement that the vaccine against COVID will be ready by 15th August, created sharp reaction from many scientists who warned against any fixation of dates on that and the use of unpalatable language in the letter. This put