Health Matters | Treating diseases — going back to go forward 

This week in health: life after death, ethics of medical research and a hopeful new TB regime.

Updated - August 02, 2023 10:17 am IST

Published - August 01, 2023 02:07 pm IST

Image for representational purpose only.

Image for representational purpose only. | Photo Credit: Reuters

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It’s rare that we have, in these parts, a real medical whodunit, an unravelling of a medical mystery, nearly 200 years post facto too. While post-mortems are common, it is undeniably rare that one digs deep and long, and employs every tool in the trade to smoke out the mystery behind what happened all that long ago. That is what makes this article all that interesting: Who killed Beethoven? Nearly two centuries after Beethoven the musical genius of the Western world, who suffered from what seemed like multiple ailments, passed on, scientists finally discovered his cause of death. Hepatologist Abby Cyriac Philips breaks down for us the paleopathological process of investigation that used locks of hair and skull fragments reportedly to study the cause of death. Incidentally, close to World Hepatitis Day, it became obvious that the culprit was Hepatitis B, egged on of course by the quarts of wine generously consumed in those days. 

Paleopathology, or studies on the preserved remains of ancient human populations, have been revelatory. Besides offering valuable insights into a past life, they also provide for researchers an ability to see into the past, in order to see into the future. From diagnosis of tuberculosis, leprosy, and venereal and non-venereal diseases in fossils, mummified remains over the years, for instance, have provided an understanding of how the pathogens have behaved, the paths of mutation, to a possible better understanding of the vector and its host. Turns out old bones can help us gaze into the crystal ball of the past, after all.

(While we are on the subject of Hepatitis, do check out my quiz on the site.)

From the past to the present, even the future maybe. India takes its first step towards opening the door to Controlled Human Infection Studies, says Bindu Shajan Perappadan.  For long, it has been believed that CHIS has a bunch of ethical issues, as it involves intentionally exposing healthy human volunteers to pathogens in a controlled environment. However, the Indian Council of Medical Research’s (ICMR) Bioethics Unit is set to change this. Of course, it has been employed outside of India to study multiple pathogens and possible solutions. It is more often used to study ‘less-deadly diseases’ such as influenza, dengue, typhoid, cholera and malaria, unlike in traditional clinical studies. At this point of time, the ICMR has only invited comments on its consensus policy paper on CHIS for a month. Do read this explainer by R. Prasad on what the CHIS means to India, to understand the ethical concerns, its advantages and what could possibly go wrong. Also read The Hindu’s editorial on CHIS, calling it a welcome move, but insisting that robust institutional mechanisms be put in place. 

Further, on detection, Vinod Scaria and Sridhar Sivasubbu record how cell-free DNA promises to transform how we find diseases. Thanks to a cfDNA-based technique, clinicians can now screen mothers from a few millilitres of blood, obtained after nine or ten weeks of pregnancy, to ensure the developing foetus is devoid of some chromosomal abnormalities.

Staying on the topic of diseases, and continuing to note the rising trend of dengue cases, globally, here is another article on how changing climate climatic conditions in Europe, such as increased heat waves, floods, and prolonged hot summers, have created favourable environments for dengue-causing mosquito species. Bani Jolly et al explain that the recent surge in dengue cases worldwide ,including India, means immediate attention of the government and action from them. 

A worrying feature of the public health spectrum is the rapid increase in the prevalence of some non-communicable diseases, along with the persistence of some communicable diseases, Moumita Koley and Ismael Rafols point out in a timely article. In this context, they wonder if India’s research spending is adequate at all, and whether these funds effectively address the country’s health needs and prioritise the right disease areas.

There is some confidence that enhanced attention to Tuberculosis will benefit the vast number of people infected, and affected by TB. The modified BPal regime under trial by the Chennai-based National Institute for Tuberculosis — using only three drugs — bedaquiline, pretomanid and linezolid — with the treatment lasting only for 25 weeks, in contrast to eight-nine tablets each day for 18 months in the conventional treatment for DR-TB, is a definite sign of hope.

Noting here, the kerfuffle last week, over the sudden suspension of the director of the International Institution for Population Sciences, K.S. James, citing irregularities in recruitment. The IIPS works under the Union Ministry of Health and Family Welfare and conducts important studies like the National Family Health Survey, Assessment of National Rural Health Mission, and the Global Adult Tobacco Survey. While the Union Government stood by its statement that they were assessing charges of faulty recruitment in the Institute, the rest of the academic world has wondered loudly if the results of some of the studies IIPS produced come in the way of the government’s claims and ‘achievements’. Meanwhile, the Parliamentary Panel has rapped the government because there is ‘no accurate account of population with disabilities’, records Abhinay Lakshman. This comes at a time when the government is already in the line of fire for dropping the disability question from the NFHS.  

More hope is on the horizon, with increasing cadaver donations and transplants across the country. After the decline in cadaveric donations during the pandemic and the cessation of organ transplants too, there is now a trend where the numbers are going up again. There is again, the hope of a new lease of life for many patients with organ failure in Telangana and in Tamil Nadu, say Siddharth Kumar Singh, and Serena Josephine M. 

Our interesting tailpiece for the week: In America, there is cheer now, after the controversial judgement overturning Roe Vs. Wade and denying abortions to women and their agency over sexual reproduction in many States within the federation. The first over-the-counter birth control pill, for which there is no need for a prescription, has naturally evoked cheers in the United States. Here’s a primer on what the Opill is and how it acts to prevent conception, by Saumya Kalia.

From the Health pages

Here are some quick links for you to check out this week: 

In five years, pharma pricing authority received 5,772 complaints of alleged overcharging: Minister of Chemicals and Fertilizers.

Delhi, West Bengal top the list of rabies deaths in the country.

Childhood obesity leads to a lifetime of poor health, says Katherine Trejo Tello.

This podcast by Ileena Dutta on work-life balance and mental health.

Biocon Foundation announces Oral Potentially Malignant Disorders Atlas project.

Deaths due to heatwave across the country; Kerala highest with 120.

More health news from all over the country. Welcome to our offerings from the different regions:


Patient attacks Ganga Ram neurosurgeon; doctors renew call for Central Act, says Samridhi Tewari.


A NIMHANS study aims at addressing depression and anxiety in patients with non-communicable diseases, records Afshan Yasmeen.

Nearly 550 road traffic accident victims got emergency treatment under State’s ‘Accident Victims scheme’ in last one year.

A Bengaluru-based eye hospital to soon start human clinical trials of indigenous gene therapy for ocular diseases.

An acute shortage of testing kits for HIV in Karnataka hits patients hard.

Study finds higher level of air pollutants in western parts and major roads of Bengaluru.


In Kerala, a health travelogue to create awareness on TB among Muthuvan tribes.

Menstrual cup distribution for schoolgirls in Kerala’s Nedumangad begins.

Kerala HC calls for verifying educational qualifications of all government doctors.

Tamil Nadu

NATHEALTH discusses areas to collaborate with in Tamil Nadu.

Tele-mental health service records over 21,000 calls in eight month.

Japan’s OMRON Healthcare begins construction of manufacturing unit in Chennai.

As always, do put us on your radar, as we bring more health content your way. Get more of The Hindu’s health coverage here.

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