(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. You can subscribe here to get the newsletter in your inbox.)
2024 has dawned, and it’s a day past already, that is how quickly the wheel turns. Wishing you all a very happy, and healthy new year. Unlike other subjects, it’s a little difficult to make a laundry list of things we can expect, for pathogens are not really the predictable sort. There is no crystal ball to gaze into. But we can hope for better access to health care for all, affordable health services, robust insurance coverage, for a big fat budget for health, to resolve to do the things that keep non-communicable diseases at bay, to be prepared to handle future emergencies at the larger and individual level. And then, there are the unpredictable, but ever-persistent factors — climate change, environmental pollution — that are likely to take a huge toll on health and quality of life, if what we have seen this year are any indication.
For our part, at the health desk, we resolve to stay on the subjects that define the world in terms of health or the lack of it, track the trends that we need to watch out for, focus on the big picture, government policies, and status of health infrastructure, even as we look at the individuals and smaller innovations that are likely to have a far-reaching impact, we will try and cover new, emerging areas as well as look at neglected diseases and areas. We are also working on creating disease-specific pages on The Hindu’s website, making it a far more accessible database on specific health conditions.
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Providing a blueprint for the future, Sathya Sriram insists that both intent and action should result in making health our top priority in 2024, addressing the huge epidemic of non-communicable diseases (NCDs) in the country. While communicable diseases persist as a significant threat, NCDs such as cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases have emerged as the predominant public health concern. According to a World Health Organization (WHO) report titled ‘Invisible Numbers’, a staggering 66% of deaths in India in 2019 were attributed to NCDs. The report also suggests that 22% of individuals aged 30 or older in India would succumb to NCDs before their 70th birthday, surpassing the global probability of 18%. While the spectre of NCDs presents a challenge, the good news is it is never too late to invest in health. The fact is that NCD-led deaths are largely preventable, and the solution lies in the choices we make in our daily lives.
This health crisis not only affects individuals but also poses a substantial economic burden. The World Economic Forum estimates that India could incur a cost of $4.58 trillion between 2012 and 2030 due to NCDs and mental health conditions, she says, recommending simple techniques to move towards a healthy lifestyle, this new year. Do read the story for details.
Naturally, adopting a healthy lifestyle means watching what one eats. What is the government’s role in ensuring that their citizens have access to healthy foods, or the knowledge of exactly what they are consuming? Maitri Porecha looks at the demand to levy a health tax on foods high in sugar, salt, and fat, through a recent study. A health tax of between 20% to 30% in addition to GST can be considered to be imposed on sugar, sugar-sweetened beverages (SSBs) like colas and juices as well as foods high in sugar, salt and fat, public health researchers have recommended in a study published in the Journal of Health Policy and Planning. The study does not recommend taxing households on the purchase of their regular ration of sugar, but rather that bulk consumers of sugar such as confectionery and sweet manufacturers may be taxed.
Nellore Sravani reports that Union Minister Mansukh Mandaviya renewed his assurance that the Central Government was committed to making healthcare accessible and affordable to all is our goal. It would be heartening if the Centre continued to work towards achieving this goal, through this year. Mr. Mandaviya also said, on a separate occasion, that the government is expanding health infrastructure; to meet the requirements of medical professionals. ”It is our government’s responsibility and commitment to provide quality healthcare infrastructure and services to the people as only a healthy country can aspire to become a developed country,” Mr. Mandaviya pledged.
In the context of financing healthcare, experts point out the importance of securing adequate health insurance, and state-sponsored insurance schemes in order to avoid out-of-pocket expenditure and impoverisation as a result of paying healthcare costs. While R. Sujatha articulates the demand of paediatric surgeons to extend insurance coverage to congenital anomalies, N. Ravi Kumar analyses why 2024 will be a defining year for the larger insurance industry’s future course.
Meanwhile, here is data from the massive government-sponsored Ayushman Bharat health insurance scheme. Bindu Shajan Perappadan analyses the data to report that women account for approximately 49% of the total Ayushman cards created. The scheme provides health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation to 12 crore beneficiary families. As of December 20, 2023, approximately 28.45 Crore Ayushman Cards have been created since the inception of the scheme, out of which, approximately 9.38 crore Ayushman Cards have been created during the year 2023.
Stretching back to the past year, when the announcement that a non-invasive test for anaemia would replace the current protocol, here is a follow-up: ICMR initiates steps to provide easy-to-use non-invasive testing to tackle anaemia in India. Admitting lacunae in the achievement of the idea of the Anaemia Mukt Bharat (AMB) programme, the Indian Council of Medical Research (ICMR), Delhi, has now invited Expression of Interest (EoI) from the eligible organisations/companies/start-ups manufacturing ‘non-invasive hemoglobinometer’ useful in the effective screening of anaemia. Companies will have to respond by January 5.
Just like relooking the basic way in which we measure anaemia, the idea of reassessing basic parameters to suit an Indian population has been around for quite some time now. The call to reassign values more realistic for the Indian population, after scientific studies to validate these numbers for an Indian ethnic group has only gathered more grist over the years. In this article, Vandana Prasad and Dipa Sinha examine the pros and cons of shifting from WHO child growth standards to a nationally compiled one. The Indian Council of Medical Research has recently constituted a committee to revise the growth references for India. It has been reported that this committee has recommended a detailed rigorous study to be conducted across the country to examine child growth with the purpose of devising national growth charts, if necessary. Do read the article to see what strategy the authors recommend for India.
For some weeks now, across media, there has been some breathless coverage on COVID-19, and the latest strain that is driving the epidemic - JN.1 While the numbers, though reported diligently by the States and reporters, might seem overwhelming, and not quite meaningful to all, we have separated the wheat from the chaff, to compile tips from experts who tell us how to handle this wave, what best practices are to be followed. Do check the following links:
Dr. Soumya Swaminathan, former Chief Scientist, WHO, brought in some measure of sobriety to the anxiety surrounding JN.1. Spikes will occur, it’s best we arm ourselves to meet possible severe strains: Collect COVID data to take decisions, prepare systems, say experts.
Zubeda Hamid speaks to experts who clarify the current protocols for JN.1 COVID-19 infections. In The Hindu’s In Focus podcast, she chats with Dr. Soumya Swaminathan who explains how JN.1 has caused COVID-19 cases in the country to spike, whether or not booster shots are necessary and what our health system needs to do to be well prepared: What we know about the new COVID-19 variant JN.1
B. Madhu Gopal writes, speaking to experts, on how compliance with safety protocols in crowded places can help check COVID-19 spread.
Delhi health minister advises that the COVID positivity rate is around 1%, and there is no need to panic. While L. Srikrishna reports on Union Minister of State for Health and Family Welfare S.P. Singh Baghel’s statement: No need for panic about JN.1 virus spread.
Meanwhile, Serena Josephine M. quotes Tamil Nadu’s Director of Public Health: COVID-19 surge is likely, but there is no reason to panic.
Seven-day home isolation must for COVID-19 patients; doctors to visit houses of infected.
Over 220 crore COVID vaccine doses administered across India, but less than 23 crore booster doses: Health Ministry data.
COVID-19 wave is unlikely this time around, say experts.
If you want to see the numbers, and follow regional developments, do browse the following links:
January 1: Active COVID-19 cases in India rise to 4,394.
INSACOG says 196 cases detected in India.
December 31: India records 841 new COVID-19 cases.
December 28: India sees single-day rise of 702 COVID-19 cases.
December 27: India sees single-day rise of 529 COVID-19 cases.
Afshan Yasmeen reports that for precautionary vaccine doses, not more than 23% of adults are covered in Karnataka.
Active cases in Karnataka cross 500, 158 new COVID cases.
RT-PCR rates in Karnataka private centres to be fixed in two days.
Health Minister writes to the Bengaluru Police Commissioner and instructs him to ensure compliance with COVID-appropriate behaviour during New Year celebrations.
Siddharth Kumar Singh reports: Health department unaware of two JN.1 variant cases detected in November.
V. Geetanath on the silent wave of JN.1 COVID virus in Hyderabad and Secunderabad.
Low demand for precautionary dose amid surging COVID-19 cases in Telangana.
Maharashtra sets up COVID-19 task force again.
COVID-19 cases see 10-fold rise, but hospitalisation stays low.a
Symptomatic individuals, at risk and contacts in Tamil Nadu to be tested by RT-PCR only.
T.N. continues surveillance of latest COVID-19 variant, JN.1, says Minister.
We spoke of the impact of pollution on human health. In this context, it is impossible to ignore the recent ammonia leak that happened in Chennai. A night of terror ensued on the night of January 26, rousing people from their beds, choking for breath, their skin burning. Noxious ammonia fumes leaked from an industrial pipeline off Chennai’s coast in the Bay of Bengal, and 52 persons from the city’s industrialised area Ennore were hospitalised that night. The industrial disaster was contained in a few hours, but the incident exposed the possibility of things going south seriously in such cases. It also became an occasion for the residents of the area to articulate their grievance of living in an area so affected by the side effects of industrial pollution, leading to chronic health problems.
Residents of Periyakuppam fishing hamlet near Ennore were hospitalised following an incident of ammonia gas leakage at the factory in the wee hours on Wednesday. | Photo Credit: B. Jothi Ramalingam
For a comprehensive view of the incident, read this deep dive by Geetha Srimathi and Deepa H. Ramakrishnan: Ennore goes to battle again, after a night of terror.
A retired bureaucrat EAS Sarma called for those responsible for the industrial accident to be penalised. He said those responsible for criminal negligence that had resulted in these accidents to be subjected to prosecution under the Indian Penal Code. Mr. Sarma suggested that the extent of the health damage needed to be determined on scientific lines, quantified in monetary terms, and recovered from those responsible.
For the ammonia leak stories from earlier in the timeline, read on:
Ammonia leak from pipeline triggers scare at night; 52 admitted to hospital in Chennai.
Permission not given to Ennore fertiliser unit to resume operations yet: T.N. Pollution Control Board.
Residents of Ennore demand survey to assess effects of industrial pollution on their health.
An important discussion on medical negligence took place after the new Bill that replaced the IPC - the Bharatiya Nyaya (Second) Sanhita - was passed. While the Home Minister told the House that medical negligence would be decriminalised, the final law retained the penal provision that the IPC had for medical negligence. That set off a heated debate in medical circles, a debate that Sayanta Datta captures well, speaking to people on both sides of the bed. Also do readThe Hindu’s editorial on the amended legislation.
R. Prasad notes that part of the crisis in the tuberculosis arena also includes missing TB cases in the private sector. Despite the significant increase in the private sector TB notifications over the years, they fall far short of the targets set by the National Strategic Plan 2020-2025. The TB notification target set by NSP for the private sector in 2020 was 35%, 45% in 2021, and 56% in 2022.
Once again, Sridhar Sivasubbu and Vinod Scaria’s piece worms itself into our tailpiece section. Do spend a few minutes at this fascinating story on the utility of genetic information: You had your genome sequenced and found something – now what?
From the Health page
What a Hobson’s choice this! Gaza’s war-wounded forced to choose between risking death or losing limb
Suresh Menon writes on the age of social fitness: what makes us happy?
Remember that dreaded black fungus we heard of during the pandemic, a post-COVID complication? Here’s some good news for patients whose faces were disfigured by that affliction, reports R. Sujatha: IIT Madras develops 3D-printed face implants for black fungus patients.
Ever wondered what happens during psychoanalysis? This is your chance to find out. Alok Kulkarni explains the term and process, after Parliament breach accused underwent psychoanalysis.
Dr. Mani Sivasubramanian on floods and a ‘preventive measure’ that needs review.
Dr. Ennapadam S. Krishnamoorthy issues a call for disability inclusion that must be heeded.
For a comprehensive view of our regional content, see below:
Andhra Pradesh
Sumit Bhattacharjee writes Visakhapatnam’s first co-morbid death of 2023 sparks fears of a year-end COVID-19 resurgence.
Strict laws sought to prevent attacks on doctors in Andhra Pradesh.
V. Raghavendra reports that the Andhra Pradesh Government will launch the second phase of Jagananna Aarogya Suraksha on January 2.
Delhi
After 2 years, Delhi to notify amendments to Medical Termination of Pregnancy Act.
‘Fake’ drugs case: Saurabh Bharadwaj seeks action against 2 officials.
Chhattisgarh
Seven years after patient’s death in Chhattisgarh, police arrest four doctors for negligence.
Odisha
Satyasundar Barik reports: Naveen Patnaik government. to cover 90% of Odisha’s population under cashless care in private hospitals.
Haryana
Government doctors in Haryana go on strike for second time in a week; OPD services hit.
Haryana Government convinces doctors to put off strike.
Karnataka
FPAI launches national vaccine drive against cervical cancer.
Afshan Yasmeen reports that paediatric surgeons in Karnataka want every medical college to have a paediatric surgery unit.
With COVID spike, proposal to set up female foeticide task force remains on paper.
Kerala
Government plans to make all family health centres in Kerala antibiotic-smart this year.
‘Botched surgery’ in Kerala: chargesheet against two doctors, two nurses likely.
Medical genetics department to be opened at SAT Hospital in Thiruvananthapuram.
Puducherry
Hands-on training in emergency medicine for practitioners in Puducherry.
Amid New Year festivities, Puducherry health officials advise COVID-appropriate steps.
Tamil Nadu
Three PHCs in Tirupattur to get permanent buildings.
C. Palanivel Rajan writes: Saving inpatients, snake bite victim, getting food dropped from helicopter - these GH staff have seen them all.
Dog bite cases remain a concern in Tamil Nadu.
Tiruchi doctors perform Whipple surgery on woman for pancreatic cancer.
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