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11% hike in the offing in Budget, India readies Rs 2K cr preventive health plan

MediBulletin Bureau
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11% hike in the offing in Budget, India readies Rs 2K cr preventive health plan

Last year health budget went up by Rs 10000 crore, this time the hike is expected to be Rs 5000 cr taking the total health allocation to over Rs 52000 cr

India may get a 11% hike in its health budget. Top sources in the health ministry say that there are indications that a Rs 5000 cr increase may be in the offing when the Union Budget is unveiled next month.

Last year India’s health Budget after a Rs 10000 cr increase was a little over Rs 470000 cr. This year it is likely to be about Rs 52000 crore say health ministry officials. The figure is still way short of the 2.5% GDP health spend that the National Health Policy 2017 envisaged and has been a long standing demand of health experts starting from the High Level Expert Group on Universal Health Coverage constituted by the erstwhile Planning Commission to various international reports.

“We have managed to get our budget increases by Rs 5000 crore,” a senior health official said.

Meanwhile, for the first time the health ministry has also finalised a Rs 2000 crore plan for preventive healthcare, primarily screening for non communicable diseases. In its meeting last month, the Empowered Programme Committee of the National Health Mission approved Rs 1200 crore for NHM for 2018-19 and Rs 1600 crore for 2019-20 for comprehensive primary healthcare

It is a part of the upgrade of 153000 health sub centres into health and wellness centres as announced in the budget speech last year. Of this Rs 1200 cr will be a central allocation and Rs 800 crore will come from states’ kitty. This will mean that health sub centres whose sole function till now has been to provide ante and post natal care like vaccinations etc will for the first time be truly equipped to do basic health checkups for diabetes, hypertension, cardiovascular diseases and a few types of cancers and will also have a small basket of medicines available to be given to patients free of cost.

The growing burden of non-communicable diseases such as diabetes, hypertension and cancer is the most stark feature of India’s changing disease burden and experts have for long called for a comprehensive preventive model to tackle it. The National Health Policy unveiled last year too stressed on prevention and this is the first step in that direction.

According to the blueprint drawn up by the Union health ministry, the new centres – to be called “health and wellness centres” would provide comprehensive maternal healthcare services to be

provided in those sites equipped to service as “delivery point”, comprehensive neonatal and infant health care services, comprehensive childhood and adolescent health care services, comprehensive contraceptive services, comprehensive reproductive health services, comprehensive management of communicable diseases, screening and comprehensive management of non-communicable diseases, basic ophthalmic care services, basic ENT care service, screening and basic management of mental health ailments, basic dental health care and basic geriatric health care services. The upgradation of each such centre would come at a cost of Rs 15-16 lakh and 500 centres across the country have already been approved. The target for the first year is 2500 centres

Bhutan bucks S Asia trend, headed for population reduction

MediBulletin Bureau
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Bhutan bucks S Asia trend, headed for population reduction

Bhutanese are not just happy, they are dwindling – albeit in a happy way. A new report on living standards in the Himalayan kingdom that introduced the concept of Gross National Happiness to the world shows that the country may be headed for population reduction.

Little girls attending school in Bhutan
Little girls attending school in Bhutan

The Bhutan Living Standards Survey Report 2017 shows that the total fertility rate (TFR) in the country is 1.9 – two points below the population replacement rate of 2.1. That rate, Bhutan had already achieved five years ago, as brought out by the 2012 version of the same report. TFR refers to the total number of children born or likely to be born to a woman in her life time if she were subject to the prevailing rate of age-specific fertility in the population.

WHO explains the 2.1 figure for population stabilisation as representative of the average number of children a woman would need to have to reproduce herself by bearing a daughter who survives to childbearing age. Data from India’s National Family Health Survey 4 (2015-16 data) shows that India’s current TFR is 2.2 (down from 2.7 in 2005-06). The TFR in individual states ranges from 2.7 in Uttar Pradesh to 1.7 in Goa.

The 2017 BLSS report says: “The TFR of Bhutan in 2017 was estimated at 1.9 children per women based on the number of births in the past 12 months prior to the survey period. This implies that, on average, a woman bears 1.9 children during her reproductive age (Table 4.18), which is lower than replacement level of 2.1. The TFR was almost equal in both urban and rural areas with about two children per women. Among the Dzongkhags, Tsirang had the highest TFR of almost four children per women, and the lowest was in Dagana with a TFR of less than 1.”

In an assessment of the TFR in southeast Asia, WHO says: “TFR in two decades (from 1985-1990 to 2005-2010) has declined in all SEAR countries except Timor-Leste where it has increased instead. Out of seven countries which had TFR during 1985-1990 higher than the world average, three (Maldives, Bhutan, Bangladesh) had over 50% decline by 2005-2010, two (Nepal and Myanmar) between 40 % and 50%, one (India) 35%, and the remaining one (Timor-Leste) minus 25% (meaning increase instead of decrease). The four countries which had TFR less than the world average in 1985-1990 continue to do so in 2005-2010 as well but at slower rate of decline (below the world average decline of 27%). Of these four, DPR Korea and Thailand have TFR below 2.1” The SEAR countries are Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor Leste.

100 crore Indians have no health cover: Govt data

Dr. Rajesh Dey
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100 crore Indians have no health cover: Govt data

India’s per capita public spending on health is very low

Six years after a committee appointed by the erstwhile Planning Commission submitted its seminal report on India’s road to Universal Health Coverage and one year after a scheme that was to provide health cover to 10 crore families, was sent to the Union cabinet, 100 crore Indians have no security whatsoever against possible bankruptcy due to catastrophic health expenditures.

December 12 is observed as Universal Health Coverage day.

A poor girl sits on a street in Udaipur
A poor girl sits on a street in Udaipur

According to the National Health Profile, a government report card compiled by the Central Bureau of Health Research and released in April this year, “Around 35 crore individuals were covered under any insurance in 2015-16. This amounts to 27% of the total population of India. 77% of them were covered by public insurance companies. Overall 80% of all persons covered with insurance fall under government sponsored schemes. Public Insurance companies had a higher share of coverage and premium for all types of health insurance policies, except family floater policies excluding individual policies. Compared to other countries that have either Universal Health Coverage or moving towards it, India’s per capita public spending on health is low.” India’s population is around 135 crore.

The public health spend has remained constant at 0.98% of GDP from 2009-10 to 2014-15

UHC as defined by the World Health Organisation includes  financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. On Monday health minister J P Nadda said that the government is “committed” to UHC. That commitment is hardly on display in the Union cabinet’s inordinate delay in taking up the proposal for a National Health Protection Scheme that provides for a Rs 1 lakh health cover for every member of 10 crore families (BPL plus families classified as “deprived” in the socio-economic caste census) aged below 60 years and Rs 1.30 lakh for those aged above 60 years. The proposal was sent to the cabinet last November.

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There are wide variations in the per capita health expenditure of states (health is a state subject), according to the CBHI report. It ranges from Rs 5666 in Sikkim to Rs 665 in West Bengal. India’s per capita health spend is about 15$ – lower than Nepal (16$), Indonesia (38$), Timor Leste (52$) Bhutan (65$) Sri Lanka (71$), Thailand (177$) and Maldives (913$). The public health spend has remained constant at 0.98% of GDP from 2009-10 to 2014-15 (period considered in the National Health Profile 2017). This is a far cry from the 2.5% GDP envisages first in the 12th five year plan that came to an end in March 2017 and subsequently in the National Health Policy unveiled earlier this year.

The road to UHC is further complicated by the fact that the average population served by a government allopathic doctor is 10,189. The reason for this is well documented. In its report on UHC, the High Level Expert Group (HLEG) formed by the Planning Commission noted: “ “From 8% in 1947, the private sector now accounts for 93% of all hospitals, 64% of all beds, 80% to 85% of all doctors, 80% of out-patients, and 57% of in-patients.”

Doctors’ assistants to hospital managers: artificial intelligence is the buzzword in India’s health industry

MediBulletin Bureau
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Doctors’ assistants to hospital managers: artificial intelligence is the buzzword in India’s health industry

New launches, partnerships and increasing use of AI to ensure better patient outcomes are  slowly changing the face of the industry 

Artificial Intelligence is the new buzzword in healthcare. If you are looking for proof, look no further than the bunch of AI-powered devices that have been launched in recent months for the health sector and the tie-ups that have happened with an eye on servicing the healthcare space using AI. 

From voice assistants for healthcare professionals to technology solutions that drive efficiency the whole gamut is covered and there is more coming. Bharosa AI recently launched Mira, a proprietary AI-powered voice assistant designed to assist both doctors and patients. Mira is not just a standalone product but a foundational technology that can power various applications on both the patient and doctor sides.

The voice application for patients enables them to receive verified health information through a simple phone call. Vandit Jain, Co-founder & CEO of Bharosa AI, said, “AI can ease the burden on doctors while giving patients reliable information. With India’s healthcare market projected to reach $610 billion in two years, the timing is right for a solution like Mira.”

Core Mobile, Inc., a Silicon Valley innovator in Native AI healthcare technology,  recently announced a strategic partnership with InfoVision. Together, the two companies aim to revolutionize healthcare operations by delivering cutting-edge technology solutions with Authority to Operate (ATO) that drive efficiency, reduce staff burnout and improve measurable outcomes.

Key Goals of the Partnership Include accelerating the adoption of AI-powered tools for scheduling, video monitoring with sentinel events,streamlining workflows and processes for hospitals, clinics, payers and clinical trials and leveraging predictive analytics and machine learning to drive smarter decision-making in real time with staff coordination.

Dentzz Dental, a company that works in dental care is utilizing AI-driven diagnostic tools and treatment planning systems to ensure better treatment outcomes. Dr. Shantanu Jaradi, Founder of Dentzz Dental, highlighted, “Dental tourism has historically been a prominent segment of medical tourism, with the affordability of dental treatments in India making it a popular choice for patients seeking both professional care and a combined touristic experience. AI has revolutionized the way we diagnose and treat dental conditions. Our AI-powered systems analyze thousands of data points to provide unparalleled insights, ensuring our patients receive the most effective and efficient care. This technological leap is also a cornerstone in elevating Dentzz as a leader in the AI and dental tourism space. Over the past year alone, we have recorded a 60% increase in international patients, largely due to our integration of advanced AI technologies.”

Not all that ‘good’ – HDL cholesterol is associated with a higher risk of Glaucoma

MediBulletin Bureau
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Not all that ‘good’ – HDL cholesterol is associated with a higher risk of Glaucoma

UK researchers also find that higher levels of LDL – normally known as bad cholesterol are associated with a lower risk of the eye problem

All is not well with the “good” cholesterol and the “bad” version is not altogether deplorable. That is the key takeaway from a study reported by Chinese and UK researchers who found that high density lioproteins (HDL) commonly known as “good” cholesterol are associated with a high risk of glaucoma.

Glaucoma is an eye disease that can cause loss of vision and even blindness because of damage to the optic nerve. Globally, it is one of the leading causes of blindness and the association with serum lipid levels has long been known. Low density lipoprotein (LDL) cholesterol commonly known as “bad” cholesterol, on the other hand was associated with a lower risk. “Elevated HDL-C is associated with an increased risk of glaucoma, while elevated LDL-C, TC, and TG levels are associated with a lower risk of glaucoma. This study enhances our understanding of the association between lipid profile and glaucoma and warrants further investigation of lipid-focused treatments in glaucoma management,” the researchers wrote in the British Journal of Ophthalmology. They found this association to be significant in subjects who were 55 years old or older. They followed 4,00,229 participants from the UK Biobank over a period of more than 14 years.

In light of the findings, the researchers called for good and bad cholesterol definitions to be altered in the context of diseases other than cardiovascular. Jeremy Sivak of Krembil Research Institute at Toronto Western Hospital, told Medpage: “The role of these types of blood lipids in glaucoma is likely to be very different, and might be related to the regulation of fluid flow and pressure in the eye. One important take-away from this study is that these ‘good’ and ‘bad’ labels might need to be reassessed in the context of other diseases.”

They followed 4,00,229 participants from the UK Biobank over a period of more than 14 years

In the journal article, they also called for more studies to further explore gender and age linked variations. “The associations between serum lipids and glaucoma differed based on sex. Given that most contradictory studies were cross-sectional, the causal relationship between blood lipids and glaucoma deserves further exploration, and it is recommended that age- and sex-specific effects be taken into account when assessing the relationship between lipids and glaucoma,” they wrote.

Vaccine derived cases on the rise, ECDC, WHO sound polio alarm for Europe

MediBulletin Bureau
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Vaccine derived cases on the rise, ECDC, WHO sound polio alarm for Europe

Europe was declared free of endemic polio in 2002 and has remained so for over 20 years now 

More than 22 years after Europe was declared free of endemic polio, experts from the European Centers for Disease Control and the World Health Organisation regional office have sounded a warning in Europe citing the rising number of vaccine derived cases of the disease in recent months.

The countries that they have specifically called out are Spain, Poland, Germany, United Kingdom and Finland. Europe was declared free of endemic polio in 2002 and has remained so for over 20 years now. “The unusually high number of poliovirus detections in recent months has reinforced the urgency of the wake-up call. From September through December 2024, vaccine-derived poliovirus type 2 (VDPV2) was detected in wastewater systems of 14 cities in five European countries: consecutively in Spain, Poland [6], Germany, the United Kingdom (UK), and Finland. The isolated VDPV2 viruses are linked to a lineage (NIE-ZAS-1) that was first detected in Nigeria in July 2020, and which has travelled in the intervening years to 21 other countries in Africa, causing outbreaks in 15 of them,”  Pamela Rendi-Wagner from ECDC and Hans Kluge from WHO Europe wrote in a piece in Eurosurveillance. They said that people with inadequate vaccination may be at a particularly high risk.

Polio is a viral infection that is usually contracted at childhood and can leave a person with a lifelong disability. It can spread from person to person at the time of infection or through contaminated food and water. At present polio is a disease stands eradicated in all countries of the world except Pakistan and Afghanistan. India had its last case in 2011 but continues to remain at a high alert at all times to prevent resurgence given the proximity of both countries. Special measures for example are on at the Kumbh Mela in Prayagraj to ensure polio surveillance is at a very high level.

Vaccine derived polio outbreaks though have continues to happen in all countries including in Europe. The most recent ones happened inTajikistan and Ukraine [9] in 2021, and Israel and the UK in 2022. In 2022 and 2023, VDPV2 outbreaks affected countries which had high overall vaccination coverage but localised pockets of under-immunised communities with tight social linkage, Wagner and Kluge wrote in their piece.

 

Claims worth Rs. 562.4 crore made under PMJAY by private hospitals rejected, govt tells Rajya Sabha

MediBulletin Bureau
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Claims worth Rs. 562.4 crore made under PMJAY by private hospitals rejected, govt tells Rajya Sabha

Governments tells Parliament 57 different technologies including rule-based triggers and machine learning algorithms used to detect fraud

 

Out of 6.66 crore claims made under the Pradhan Mantri Jan Arogya Yojana that were processed by the anti fraud unit, 2.7 lakh claims of private hospitals worth Rs. 562.4 crore were found to be non admissible, the government told Parliament Tuesday. The National Anti Fraud Unit (NAFU) rejected the claims on account of abuse, misuse or incorrect entries.

PMJAY is the tertiary care arm of Ayushman Bharat which is the flagship health programme of the NDA government. Under PMJAY, eligible families are entitled to an annual health cover of Rs 5 lakh. Families with members who are aged above 70 years are entitled to an additional Rs 5 lakh for every such member.

“NHA has issued guidelines to undertake several punitive actions to curb cases involving misuse or abuse under AB-PMJAY. These include the suspension or blacklisting or deempanelment of hospitals concerned from the AB-PMJAY network. Additionally, misuse/abuse claims are rejected, and penalties or legal actions are imposed on such hospitals. To enhance detection of misuse or abuse, near real-time monitoring and AI-based systems are used to check the hospital claims. Furthermore, hospitals undergo random audits and surprise inspections to ensure the authenticity of claims. State Health Agencies (SHAs) also conduct regular desk medical audits as well as field audits. As a result of the stringent measures, a total of 1,114 hospitals have been de-empanelled, and 549 hospitals have been suspended under AB-PMJAY,” minister of state Prataprao Jadhav told the Rajya Sabha while replying to a question from RJD MP A D Singh.

There have been several reports of fraudulent claims by hospitals under PMJAY in recent months and some reports also of surgeries or medical procedures being performed in insured patients without any medical rationale for doing so, just so that the claims can be made.

“NAFU deployed 57 different technologies including rule-based triggers and Machine Learning algorithms, fuzzy logic, image classification and de-duplication, etc. to identify misuse/abuse cases. Other technologies and interventions such as enhanced access controls to NHA IT system, near real time dashboards to highlight suspicious cases, regular monitoring and cleansing of databases and other data analytic techniques are also deployed to make AB-PMJAY more foolproof,” Jadhav added in his written reply. 

Single dose of intravenous iron in anemic pregnant women can reduce risk of low birth weight babies

MediBulletin Bureau
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Single dose of intravenous iron in anemic pregnant women can reduce risk of low birth weight babies

A study was conducted across multiple sites in India with 4,368 participants, making it one of the largest studies to date employing IV iron in pregnancy

A single dose of intravenous iron in pregnant women with mild anemia can reduce the incidence of low birth weight infants, a multicentre study in India has found. The latest survey estimates that over half the pregnant women in India are anemic.

The new study published in American Journal of Obstetrics and Gynaecology found that the single shot not only resulted in heavier babies but was also effective in tackling anemia in mothers. It concluded: “First-line treatment of moderate maternal iron deficiency anemia with single dose infusion of IV iron results in a reduced incidence of LBW infants (IV ferric carboxymaltose vs oral) and a higher incidence of attaining maternal NAS without use of additional iron or blood transfusion (IV ferric carboxymaltose and ferric derisomaltose vs oral). Clinical guidelines should address the potential benefit of single dose IV iron as the primary treatment of moderate iron deficiency anemia in pregnancy.” NAS refers to non anemic state and LBW refers to low birth weight.

Anemia during pregnancy is a common occurrence globally too, affecting an estimated 37 percent of pregnant individuals, according to the World Health Organization. Iron deficiency anemia is associated with increased rates of pregnancy-related problems, such as going into labor prematurely, hemorrhaging and, in some cases, even death. For the infant, maternal iron deficiency also can have long-term implications on their overall health and development.

The states with the highest prevalence are Ladakh (78.1%), Bihar (63.1%), Gujarat (62.6%), West Bengal (62.3%), and Odisha (61.8%)

The study was conducted across multiple sites in India and involved a total of 4,368 participants, making it one of the largest studies to date employing IV iron in pregnancy. India was selected because of the prevalence of anemia in the country, according to the study’s lead author, Richard Derman, MD, MPH, vice provost of global affairs and professor of obstetrics and gynecology at Thomas Jefferson University in Philadelphia.

“What’s unique about this study is that we did the iron intervention early in the second trimester. Many other studies comparing IV iron to oral iron are initiated in the third trimester,” says study co-author Rupsa C. Boelig, MD, MS, a maternal-fetal medicine subspecialist and associate professor at Thomas Jefferson University’s Sidney Kimmel Medical College. Boelig also serves as director of the University’s Department of Obstetrics and Gynecology Research Unit and associate director for the Maternal Fetal Medicine Fellowship.

“Iron requirements increase dramatically during pregnancy. An additional 1 gram of iron is required for the developing fetus, and for placental storage. Such requirements increased dramatically during the second and trimester, so it’s much more difficult to catch-up if you’re intervening in the third trimester,” notes Boelig. “Studies have shown that maternal iron deficiency anemia early in pregnancy is most strongly correlated with adverse outcomes, including short-term infant outcomes such as low birthweight and longer-term childhood outcomes, including autism and schizophrenia. So there is a need to intervene earlier and aggressively address anemia.

The study is significant for India because according to the National Family Health Survey 5, 52.2% of pregnant women in the country between the ages of 15 and 49 years are anemic. The states with the highest prevalence are Ladakh (78.1%), Bihar (63.1%), Gujarat (62.6%), West Bengal (62.3%), and Odisha (61.8%). 

This study was funded by the Children’s Investment Fund Foundation (CIFF).

 

Typhoid, paratyphoid vaccine in the works, Kolkata institute seeks private partners

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Typhoid, paratyphoid vaccine in the works, Kolkata institute seeks private partners

ICMR-National Institute for Research in Bacterial Infections has developed a technology that can help develop a vaccine from outer membrane structures of the Typhoid causing pathogen

The National Institute for Research in Bacterial Infections based in Kolkata which is one of the premier institutes under the Indian Council of Medical Research is working on vaccines for typhoid and paratyphoid. It has invited proposals from private sector companies for this.

The institute has developed a technology entitled “Enteric fever vaccine based on Outer membrane Vesicles from two different strains of Typhoidal Salmonelle species”. The bacteria that causes typhoid is known as Salmonella typhi. In a public notice inviting interest, the council has said that it is willing to collaborate with eligible organizations, companies, and manufacturers for undertaking validation, joint development and commercialization of a broad specificity vaccine that works in typhoid and paratyphoid.

Intellectual property rights would jointly belong to ICMR and the chosen private partner. Data would belong to ICMR 

“  ICMR-NIRBI Institute will provide expert guidance & technical support for the production of Typhoid  & Paratyphoid vaccine in all phases. Such technical oversight by ICMR-NIRBI Institute would accelerate the development of the Product and its commercialization. ICMR would provide technical support through its team of experienced scientists in study planning, product development, development of study protocol, results/data analysis, outcome assessment, safety & efficacy assessment, product improvement, etc., if deemed fit upon the mutual understanding between ICMR and collaborative company,” the notice inviting expressions of interest from private parties reads.

Typhoid is a water or food borne infection that is characterised by fever, loss of appetite, nausea, altered bowel movements etc. The topmost causes of the infection are poor sanitation and lack of clear drinking water. Paratyphoid which is caused by the Salmonella paratyphi bacteria also has similar symptoms.

For the vaccine, if developed, intellectual property rights would jointly belong to ICMR and the chosen private partner. Data would belong to ICMR provided the government organisation provides 100% funding. 

 

 

Special measures are in place in Kumbh for polio surveillance; WHO assisting the government

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Special measures are in place in Kumbh for polio surveillance; WHO assisting the government

Periodic sewage surveillance, planned environment surveillance are among the initiatives that are being undertaken during the religious extravaganza

 

As millions take a holy dip in the river to celebrate an occasion that only comes once every 144 years, health authorities are working overnight to ensure that diseases do not become the price India pays for religious fervour.

This also includes heightened surveillance for polio,  disease that India officially saw the last of in 2011 but remains at  risk of reintroduction thanks to the fact that two countries in the region – Pakistan and Afghanistan continue to see polio cases. The World Health Organisation is assisting the central and state governments in this endeavour. Sewage samples are being regularly collected to check for presence of the polio virus while environmental surveillance is going on at Gaughat and Ghaghar Nala in Prayagraj.

Ensuring the safety of millions of pilgrims requires planning, preparedness, and unwavering commitment

“Protecting public health at such a massive gathering is no small feat. Ensuring the safety of millions of pilgrims requires planning, preparedness, and unwavering commitment. Identified health conditions are reported to the IDSP-IHIP module daily from health facilities at the Maha Kumbh Mela, and WHO-NPSN teams are supporting the state in the surveillance of polio and other vaccine-preventable diseases. From supporting disease surveillance to vaccination and emergency response, WHO is committed to all efforts to safeguarding public health and preventing the spread of diseases,” says Dr Roderico H. Ofrin, WHO Representative to India.

Apart from the surveillance that is going on unobtrusively, there is provision at the mela site for 24/7 health services including a 100-bed hospital. There is also a labour room within the perimeter of the fair. Doctors, nurses and paramedical staff are posted on a rotational basis to ensure services continue at all hours.

 

Severe COVID19 can increase risk of heart attack, stroke for the next one year at least

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Severe COVID19 can increase risk of heart attack, stroke for the next one year at least

Chinese researchers have analysed risk of cardiovascular events in patients who had a severe  infection 

Severe COVID19 infection can increase the risk of plaques being formed inside the blood vessels, increasing in turn the risk of cardiovascular events such as heart attack and stroke. Chinese researchers retrospectively analysed data from 803 patients who underwent coronary angiography between 2018 and 2023 to reach this conclusion.

“SARS-CoV-2 infection was associated with a more rapid progression of lesion-based plaque volume and an increase in incidence of becoming high-risk plaque. Coronary plaques among patients who experienced COVID-19 were more prone to having an elevated risk of target lesion failure,” they reported in the journal Radiology.

The link between COVID19 infection and stroke was among the earliest associations around the viral infection that had been established. The current Chinese work expands it and puts it more in context by also defining the timelines during which the risk of cardiovascular events is the highest. It also gives a rationale for the increased incidence of cardiovascular events post COVID that many researchers have reported. For example, a study funded by the National Institutes of Health in the United States found that the infection increases the risk of heart attack, stroke, and death for up to three years among unvaccinated people.

The study referenced earlier studies that have found that viral and bacterial infections increase the chances of atherosclerosis. “Our findings suggest that SARS-CoV-2 infection may exacerbate cardiovascular risk by accelerating the advancement of susceptible plaque types and coronary inflammation, thus offering a potential mechanistic rationale for the link between prior SARS-CoV-2 infection and adverse clinical events. These mechanistic pathways may contribute to the spectrum of cardiovascular consequences after the recovery from COVID-19, which was explored in our study. However, a more comprehensive understanding of the biologic mechanisms is necessary for guiding the formulation of preventative and therapeutic approaches for cardiovascular manifestations among individuals with COVID-19,” the researchers wrote.

 

ICMR is working on a bird flu (H5N1) vaccine, wants to partner with the private sector 

MediBulletin Bureau
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ICMR is working on a bird flu (H5N1) vaccine, wants to partner with the private sector 

Recent Avian Influenza H5N1 outbreaks in India have happened in 2021, 2023 and 2024

The Indian Council of Medical Research is working on a vaccine that works against Avian Influenza H5N1, a highly pathogenic strain of bird flu. It has invited the private sector to partner with it in the development of the vaccine.

Recent Avian Influenza H5N1 outbreaks in India have happened in 2021, 2023 and 2024. The infection in humans, though rare, has a high fatality rate, with one of every two people infected with it standing a risk of dying.

Inviting proposals from private companies who may be interested in jointly developing the vaccine, ICMR said: “The ICMR-National Institute of Virology (ICMR-NIV), Pune, one of the constituent institutes of the Indian Council of Medical Research, is actively working on Highly Pathogenic Avian Influenza (HPAI) and low-pathogenic avian influenza viruses. Well Characterized strains of HPAI H5N1 are available at the laboratory. The ICMR-NIV team possesses expertise in outbreak investigations, avian influenza surveillance, virological and molecular characterization, vaccine candidate development through virus inactivation and molecular methods, and conducting preclinical trials using BALB/c mice. The institute also specializes in laboratory testing to evaluate antibody responses to vaccines during phases II, III, and IV clinical trials.” 

The PPP model of vaccine development has been explored very successfully in the past by ICMR when it partnered Bharat Biotech for Covaxin – an indigenously developed vaccine for COVID19. It was a part of India’s immunisation programme along with Covishield.

For the H5N1 vaccine ICMR institutes will provide expert guidance & technical support at all stages. The company will do product development, validation and manufacturing scale up but intellectual property rights, in case of commercialisation, will remain with ICMR. 

Ayushman Bharat has eased access to cancer care in India, finds Lancet study

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Ayushman Bharat has eased access to cancer care in India, finds Lancet study

Researchers from premier medical institutes write primary care linked screening programs at Health and Wellness Centres will help early detection

Pradhan Mantri Jan Arogya Yojana (PMJAY), the tertiary care arm of Ayushman Bharat (AB) which is the flagship health programme of the NDA government has eased access to cancer care, a new study published in The Lancet Regional Health has concluded.

The researchers compared treatment timelines in cancer patients before and after 2018, when AB was launched and also access to treatment for patients who were enrolled under the public health insurance scheme and those that were not. “As compared to patients who were diagnosed between 1995 and 2017, those diagnosed after 2018 had a 36% higher odds of timely initiation of treatment within 30 days. Upon stratifying by enrolment under PMJAY, we found that while the access for timely treatment initiation increased by 33% for those who were not enrolled, vs. 90% among those enrolled under PM-JAY. Overall, this shows significant improvement in timely initiation of cancer treatment as a result of introduction of PM-JAY,” wrote researchers from premier medical institutes including PGIMER Chandigarh, AIIMS New Delhi and Tata Memorial Centre, Mumbai.

PMJAY entitles eligible families to an annual health cover of Rs 5 lakh. Originally aimed to cover about 55 crore Indians, it was recently expanded to bring all Indians aged over 70 years under its ambit with and additional Rs 5 lakh cover for such individuals in eligible families. In families that are not eligible, the senior person alone would get the Rs 5 lakh cover.

PMJAY entitles eligible families to an annual health cover of Rs 5 lakh. It was recently expanded to bring all Indians aged over 70 years

Outlining the barriers to accessing timely care, the researchers also highlighted the need to have effective screening programmes to ensure the disease gets caught at an early stage. “The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS), now renamed as National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) has been in operation since November 2016, however population coverage has been extremely low. Only 1.1% population have received cervical cancer screening, and less than 1% have received breast or oral cancer screening till date. The coverage of screening needs to be expanded so that early detection is undertaken,” they wrote.

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