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This week in health: care protocols for babies in India, the true purpose of a medical college and a looming TB drug shortage.

Updated - August 30, 2023 03:17 pm IST

Published - August 29, 2023 12:12 pm IST

The National Medical Commission (NMC) has issued and withdrawn guidelines for medical education and the prescription of generic drugs within a short period. Illustration: Satheesh Vellinezhi

The National Medical Commission (NMC) has issued and withdrawn guidelines for medical education and the prescription of generic drugs within a short period. Illustration: Satheesh Vellinezhi

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Flip-flops can be embarrassing, definitely unsettling, particularly if they pervade officialdom. In recent times, the National Medical Commission (NMC) has issued and withdrawn guidelines for medical education and prescription of generic drugs, within a short period. The withdrawals have invariably followed outrage among health practitioners and students, not to mention State governments. Once announced, the stated policies and guidelines have been reconsidered, bowing into vociferous demands. While the government has the prerogative of drawing up rules and regulations, in a democracy it is expected to be a consultative process. It definitely seems as if adequate consultation in preparation for a rule amendment has either not been present, or inclusive with the NMC. The latest of course was the absolute kerfuffle caused by the fiat that mandated doctors prescribe only generic drugs, it was by no means original, but what annoyed doctors was that there was a heavy punishment if one were to prescribe branded drugs, versus generics. That, along with the argument of expecting a basic minimum quality assurance in the standards of drugs produced in the country, currently not available, cemented their defence. For a detailed picture of what the NMC guideline if implemented would do, do read this piece by Abdul Ghafur, an infectious diseases specialist. Invariably, and expectedly, the Health Ministry withdrew the fiat, reports Bindu Shajan Perappadan

Naturally, there was joy when the mandate was rescinded, as reported by Siddharth Kumar Singh. There was no doubt that the rule was ill-considered and not adequately thought out, particularly with the Union Ministry itself turning attention to ensuring quality in the drug-making process, and taking efforts to enforce good manufacturing processes in the vast array at the small and medium enterprises that are participants in the Pharma industry.

That is not the only disappointment with the working of the NMC this week, in India. The NMC’s ‘soft stand’ on stipends for Post Graduate medical students was also criticised for its inadequacy, reports C. Maya.

On August 24, NMC wrote to all private medical colleges to comply with Regulation 13.3 of the Post Graduate Medical Education Regulations (PGMER) 200. As per this regulation: “the postgraduate students of the institutions which are located in various States/Union Territories shall be paid remuneration on a par with the remuneration being paid to the postgraduate students of State government medical institutions/Central government medical Institutions in the State/Union Territory in which the institution is located.” The students’ grouse was that the council had yet again chosen to soft-pedal the issue of stipend by merely warning private medical colleges that strict action would be taken, that too “if any complaints (regarding non-compliance with the PGMER) were received in future”.

One more for the record: The fresh guidelines of the National Medical Commission (NMC) leave out pulmonology department (speciality) as a requirement for the establishment and commencement of new medical colleges. All medical colleges established from the academic session 2024-25 onwards are required to feature 21 departments within their MBBS programmes, and pulmonology is an obvious miss. Given the world’s recent experience with the COVID-19 pandemic and the life-saving role that pulmonologists played in it, it comes as a puzzle that the NMC would remove pulmonology from the list. The members of the Madurai Respiratory Society wrote to Union Health and Family Welfare Minister Mansuk Mandaviya and sought his intervention to reconsider and reinstate this critical department in the mandatory curriculum, reports L. Srikrishna.

Meanwhile, Mathew George goes back to the drawing board to define the true purpose of a medical college. A medical college, he reasons, is an institution that has dual purposes. First and foremost is its educational role: as primarily an institution for the education and training of students to become medical professionals through teaching and apprenticeship (internship). Its secondary purpose is to offer medical care.

Moving on, the world was reminded of the ghastly murders of seven babies (and attempted murders of 6 other babies) by British nurse Lucy Letby after she was handed down a life imprisonment conviction, the maximum under British law. At this point, here’s a look into what the care protocol for babies in hospitals in India. 

Here’s a podcast you might like to listen in on: It deals with the rising rate of childhood obesity in India as Zubeda Hamid talks to Dr. Vijay Vishwanathan, senior diabetologist and researcher on childhood obesity. They discuss the long-term health complications childhood obesity can lead to, and what can be done by parents, schools and societies to tackle this.

But how do we measure what we eat? Learn more about calories and kilojoules - the energy content of food, and how accurate the labels that packages bear are in this article here, by Lauren Ball, Emily Buch, Katelyn Barnes. The fad about consuming supplements is not about to die down, even if several studies continue to bust claims from time to time. Researchers from Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal, and Yenepoya Research Center, Mangaluru, unveiled some insights into the potential impact of the widely used herbicide clethodim on male reproductive health. These findings necessitate further investigation and thoughtful reconsideration of the use of such herbicides to ensure the well-being of both humans and our environment, researchers concluded.

The National Institute of Nutrition recently said in an animal study, they proved that cinnamon and its active components prevent prostate cancer, and that further research would be carried out to examine the potential of using this compound on humans as well.

A couple of stories published this week in The Hindu, stay on the Tuberculosis subject, advancing it further with periodic updates. Here, R. Prasad examines how while India faces a TB drug shortage, there is no such shortage in Tamil Nadu. India has been facing an acute shortage of tuberculosis drugs, including medicines used for treating drug-resistant TB such as Linezolid, Clofazimine, and Cycloserine, for about a year now. The Tamil Nadu Medical Services Corporation procures drugs for the State, averting the shortage that other States seem to be facing.

He also notes the critical gaps in detecting TB cases among children despite significant progress and a greater understanding of the challenges faced in addressing TB in children in this story: Missed childhood TB cases impede achieving 2025 goal. 

From time to time we are reminded that COVID-19 is not really in the past but that it has cast its shadow upon us for times to come. Here, Dr. Rajeev Jayadeva examines his favourite subject again - the long-term outcomes following a COVID-19 infection. While you are at it, also do read Simon Clarke’s piece on whether the mask should come back on, after the new variant BA.2.86 (nicknamed pirola) spurred concern because of the high number of mutations in its spike protein. He does add that scientists are still searching for credible data.

This week, there’s more than one tailpiece, as we bring you unique stories on health care and wide-ranging perspectives. 

Jake Eberts, a volunteer in a controlled human infection trial in the U.S. discusses what it means to be under the lens, as India considers introducing CHIS, in this story: Battling a deliberately-acquired infection to help find a cure.

Satyasundar Barik came up with this cracker of a story of how Odisha villagers seek police permission to hire witch doctors for treating people with psychological disorder.

From the Health page

If you have some extra moments, while you are here, do pause by on the following stories: 

India, Asian Development Bank to set up climate change and health hub in Delhi.

This is great news! Actor Puneeth’s eye donation inspired nearly 1.28 lakh to pledge eyes in last two years; 3,989 eyes collected since.

Follow up, part 3 of the Vital Signs podcast series by Sonikka Loganathan and Vignesh Radhakrishnan: Does NEET’s curriculum serve only as entry filter or does it offer more?

And this is where you come to for more content from our regional bureaus, this past week.


70 schoolboys in Delhi’s Sagarpur fall ill after midday meal.


Water contamination deaths in Karnataka: CM Siddaramaiah seeks report within 15 days.

Government to probe allegations of issuing pre-dated work order for PET-CT equipment project at Kidwai.

NIMHANS to set up brain and mind museum to increase awareness of neuroscience in Bengaluru.

Karnataka sets up enquiry commission to probe alleged COVID-19 irregularities during BJP regime.


Anti-microbial resistance shows an upward trend in Kerala by A.S. Jayanth.

Thalassemia patients get a short shrift in ‘Samashwasam’ scheme of Kerala government.

Referral system could help ease rush to Kozhikode Medical College Hospital.

Type 1 diabetes: college students to get extra time during exams.

Tamil Nadu

Delay in surgical correction: SHRC recommends Tamil Nadu to pay ₹5 lakh compensation to woman.

Government announces incentive marks for COVID-19 duty, section of doctors raise questions.

Intellectual Property India gives patent for non-invasive ‘nadi parisothanai’ device.

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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