Categories
Healthcare Technology

TataMD Check launched for Covid19 testing

Tata Medical and Diagnostics Ltd (TataMD), the healthcare venture from Tata Group has launched the Tata MD check, which is probably India’s first and probably the largest COVID19 diagnostic kit. This kit has been built in association with CSIR- IGIB and is built on top of a CRISPR Cas 9 for COVID19 testing. The algorithm, incidentally, is called Feluda. Very interesting to note that it might be in reference to the detective character created by Satyajit Ray.

It took about 100 days for Tata MD,for its licencing and commercial launch. And also, it has been approved by the Indian Council of Medical Research (ICMR) and the DGCI and will be available through our diagnostic centres in India. It’s a paper based test with the image based visual readout. The reaction time is about 45 minutes, and the total testing time is about 75 minutes only because it’s from an mRNA extracted sample. There is high scalability. About 1 million of these test kits will be produced in a month from the Tata diagnostic and Research Centre outside of Chennai in Tamil Nadu.

Also, there is an AI based reporting tool that will help authorities keep track of traceability of samples and the results will be accessible from anywhere. And it. This test will allow from and massive rapid adoption potential to the far away regions of the country. It will be interesting to see how this pans out considering the seem to be close to good testing we seem to be close to a good vaccine and we seem to be good, close to a good protocol. Let’s see how things go from here.

Categories
Public Health

Closing the Oxygen Gap in Covid19

Oxygen is essential. It is a key treatment for a wide range of diseases that affect all parts of the population—but it’s often overlooked in health system planning for a number of reasons. It is both a medicine and a device, has complex delivery infrastructure, requires proper training for health workers and sustainable maintenance plans for oxygen equipment, and should be supported by sufficient budget.

While medical oxygen remains an essential commodity for improving a variety of health outcomes, the COVID-19 pandemic has spotlighted its importance as the first line treatment for COVID-19 patients struggling to breathe.  However, many countries, including India, face a gap in access to medical oxygen, leaving many health facilities in these communities unequipped to meet the level of patient demand.  

The COVID-19 pandemic has spotlighted the role of medical oxygen as a lifesaving therapy for patients struggling to breathe. It also pushed to the surface the long-existing issue of oxygen access gap, as it created an overwhelming demand for oxygen technologies and supplies across many health facilities in LMICs.

Closing this gap will require an integrated set of solutions and investment in strengthening the oxygen delivery systems, including resilient oxygen markets—from demand planning to financing to supply and distribution systems. PATH the Chicago based Not for Profit organisation has been working in India for many years. In the past they have worked on areas like providing contraception to remote areas of the country by tying up with India Posts, you can read that story here- Link.

Now they have launched the “Markets Matter: Closing the Oxygen Gap” initiative, this campaign puts a spotlight on the role that efficient markets play in scaling up #OxygenAccess. Now is the time to add your voice and help close the oxygen gap!

We have a chance to move some of the solutions forward now to ensure a rapid response to the pandemic, as well as build a sustained platform for the future. Now is the time to use our voices to elevate these important messages about the need to prioritize oxygen access amidst the COVID-19 pandemic – and beyond.  

You can get involved as well, please download the campaign material from this link and share it within your network. Looking forward to all your support.

Categories
Public Health

In pursuit of a Vaccine for Covid-19

Covid-19 pandemic has brought vaccines under limelight once again. Research laboratories and pharma/biotech companies are working overtime to develop a vaccine against coronavirus at the earliest. As of July 31st, 2020, more than 100 efforts to develop a vaccine for Covid-19 are underway in different parts of the world, and at least four of these are in phase III trials – three in China and one in the UK. As per some unverified reports, some phase III trials are underway in Russia also, but not much is known about these trials at the moment.

We have two promising candidate vaccines here in India also – one at Bharat Biotech in collaboration with ICMR and the other at Zydus Cadila. The Drugs Controller General of India (DCGI) has allowed both of them to start human clinical trials. Besides the early stage trials of these two indigenous candidate vaccines, Serum Institute of India received the regulatory approval on July 31st, 2020 to conduct a large multicentric phase III trial for the AstraZeneca/Oxford vaccine in India.

Every small or big news coming out of the laboratories is getting dissected endlessly – not always in the most logical manner and often with more political rather than scientific context. For example, there have been claims by eminent people in India, US and other countries that a vaccine for Covid-19 could be available by or before the last quarter of 2020. In fact, just this week Russian news agencies announced that two candidate vaccines there are in the last phase of development and that Russia will launch a vaccine by August 12th itself.

I have discussed this in a detailed point of view here.

We need to be careful while setting any timelines for Covid-19 vaccine. Going by the history of vaccine development, this seems a rather aggressive timeline. Till date, Mumps vaccine is the fastest developed vaccine, which took four years in development – from the time of initial sample collection in 1963 to its licensing for mass consumption in 1967. Despite all the scientific advancements since then, Mumps vaccine remains the only vaccine ever to be developed in less than five years. So, to have a vaccine for Covid-19 thoroughly tested, approved and readied within under one year may actually be a wee bit too ambitious a goal.

By Dr Lalit Singh , Managing Director – McGraw Hill Education, India

Categories
Mental Health Wellness

Three health benefits of Yoga

Yoga has been India’s gift to the area of preventive health for centuries. Though the practice of Yoga has seen its ups and downs, in popularity, there is no denying the benefits that it brings to us. So on this International Day for Yoga, let me look at three key areas that Yoga helps us.

Strengthening the back

One of the biggest challenges of this lockdown in the quarantine due to Covid19 is a sedentary lifestyle. This has impacted our backs, especially lower backs. As the back and spine carry the entire load of the body it becomes important to keep the back straight and strong. Yoga practices can help. The one asana or practice that I can recommend from practice is the Bhujang Asana or commonly known as Cobra Pose. Highly recommended for those in sedentary jobs and that practically the whole country these days. This is a useful link, that one can use to learn more about the practice.

Strengthening the lungs

One of the biggest impacts of Covid 19 is on the upper respiratory system. As there is no cure for the virus, and no vaccine in sight, the best defense is strengthening the immune system. One of the ways to strengthen the lungs is by the practice of Anulom Vilom Pranayam. The practice as it helps the lungs to grow the size of the lungs and strengthen the upper respiratory system. This is a very important practice and this link is a good example of how to practice Anulom Vilom effectively.

Calming the mind

The other big casualty during Covid 19 is our mental health. Before the lockdown, it was estimated that by 2020 almost 20% of Indian citizens would require mental counseling. My estimate is that number would be close to 50% today. Financial uncertainty and almost no social contact has led to a situation in which many people are feeling the anxiety and slippi9ng into depression. The recent suicide by actor Sushant Singh Rajput has again brought the spotlight on how we as Indians are exposed to mental illnesses. The yoga practice of meditation really helps in fighting depression and strengthening our mental health. A practice daily of 5-10 minutes has had a huge impact on the mind and productivity. Here is a link that can help you get started on this practice.

I hope these links and practices are useful to you. I have been practicing Yoga for the last 4 years and this has really helped me make most out of my day and time. Here is wishing a very International Day for Yoga.

Categories
Public Health

Post Covid19 will healthcare become a poll issue in India?

Recently, Dr Devi Shetty, the founder of Narayana Hrudayalaya, authored an article in the Times of India Sunday Edition where he said that healthcare will become a poll issue in the future. Given the historically low percentage of budget allocated to public health in India, can Covid19 realistically push the government to prioritise this area?

An analysis[1] of select 2014 election manifestos indicates that we may be woefully behind on the path to a more comprehensive health plan for citizens.

  • India spends about 1.2% of its GDP on health services and in 2018 this number went up to 1.4%. However, this is still significantly lower than the time and efforts allocated to areas like physical infrastructure development and jobs.
  • Women Led parties had more space dedicated to healthcare in their election manifestos (AIADMK – 6% and TMC – 5%). AAP follows closely with 4%, whereas national parties BJP and Indian National Congress (INC) dedicated around 2.3% and 2.1%, respectively. Interestingly, the AIADMK appears to have been implemented given that Tamilnadu leads on several health parameters, the TMC in West Bengal needs a stronger implementation policy to suitably action on its promise.
  • Most parties tend to pay little attention to preventive health. There is almost no mention of areas like nutrition in election manifestos and while the BJP manifesto does talk about Swachh Bharat, there is no mention of ways to tie that back to measuring health outcomes. The INC manifesto talks about malnutrition and mentions Anaemia and HIV but does not spell out anything concrete in terms of action plans to prevent or tackle the disease.
  • All election manifestos considered for analysis missed addressing non-communicable diseases and the measures to tackle them. Given the high incidence of non-communicable diseases such as diabetes and hypertension in India, this is a glaring miss.
  • Most of the focus on health in manifestos is on building hospitals – more beds and more clinics and so on. But there is no focus on the quality of care provided at these centres or the variety of ailments they can treat. One cannot provide hospitalisation and expect improvement in the state of health without tackling the underlying social and sanitation causes for the ailments.
  • Strangely, while the focus remains on building new facilities, there is no mention of improving existing primary health centres and community health centres that have suffered from decades of neglect. Even in Ayushman Bharat these have not been addressed. While the insurance part of Ayushman Bharat is doing well, the wellness program can be significantly improved.
  • There is no mention of disease surveillance in any manifesto. This is surprising considering most developing countries in the world have some semblance of proactive disease surveillance to curb the spread of disease and manage its citizens’ health.

In summary, even if all that has been promised in the election manifesto is delivered, it would not even make a dent in the state of health in the country.

Why is this so?

Historically India missed the boat in prioritising healthcare reforms recommended by the Bhore committee in 1946 (See box in the next page), particularly the delivery of health at the grass root levels through primary health centres (PHCs).

Further, religious beliefs that tie poor health to karma and a generally fatalistic outlook have ensured hospitals and external care providers are seen as the last resort for patients. Preventive healthcare was largely provided at home. In line with this, the government has not undertaken research connecting the health of its citizens to their productivity. For instance, a study in the UK found that those who smoked were twice as likely to take time off work. Another study found that workers with obesity (BMI over 30) annually took an average of three sick days more than those with normal weight (BMI less than 25), and those with severe obesity (BMI over 35) took six days more. In India, a large population and limited availability of jobs means employment remains a bigger issue than health for the government.

The relatively affordable cost of healthcare so far has also meant citizens have remained negligent about lifestyle diseases. Until recently health insurance wasn’t understood and perhaps without the tax exemption many citizens may not opt for it.

Until the time healthcare is viewed as a discretionary spend, political parties may see no value in contesting elections on the plank of better healthcare for citizens. Citizens themselves need to demand for better health from its government for parties to take the issue seriously. A possible reason why some of the Southern states have overall better health indicators is the relatively high proportion of senior citizen population that resides alone, without support from younger people who tend to live outside the state/ country. This changing demographic of voters may have prompted political parties in the region to place greater emphasis on public health and deliver results.

In addition states like Karnataka and Kerala have prospered from the investments from the princely states. Tamilnadu alone benefitted by keeping public health distinct from Health Services, this is one of the few states that implemented this recommendation from the Bhore Committee recommendations.  

The article is based on the research report “Healthcare and Democracy: Can healthcare become a poll issue in India”.


[1] About the analysis –

  • The following part manifestos were considered for the analysis – Bhartiya Janata Party (BJP), Indian National Congress (INC), All India Anna Dravida Munnetra Kazhagam (AIADMK), Trinamool Congress (TMC) and Aam Aadmi Party (AAP). The rationale was to consider national level parties and those led by women, as it is widely acknowledged that women tend to prioritise health. (We wanted to include the Bahujan Samaj Party (BSP) but we couldn’t find the manifesto in the public domain). AAP was considered in the analysis as it was a recently formed political party that emerged from a citizen movement demanding a corruption free India. All manifestos from 2014 were considered for the analysis.
  • The following parties have not been considered as their manifestos were unclear on the healthcare aspect – JDS Karnataka, Shiv Sena, Shiromani Akai Dal, and Biju Janata Dal. The communist parties are also missing from our analysis. We are planning a follow up report on the analysis of the 2019 manifestos and we plan to include more parties there.