August 31, 2008

Doctors file PIL in HC against diabetes course

The state government's proposal to launch a six-month certificate course on diabetology in the distance education mode has run into rough weather, with a public interest writ petition filed in the Madras high court questioning its legal validity.

Though the court has not stayed the course, it said that admission to the course will be subject to the outcome of the petition, jointly filed by four practising doctors. The first bench, comprising chief justice A K Ganguly and justice F M Ibrahim Kalifulla, which heard the matter, has also ordered notices to the government.

The doctors, describing the proposed course as a "mockery of medical education ," wondered how the government could contemplate a medical course through distance education mode, that too with only two contact classes every month and without any attendance criteria for theory classes.

The government had planned to admit 750 candidates with MBBS qualification for the course.

Pointing out that neither the Central government nor the Medical Council of India had been approached by the state government for approval of the course, the doctors said the state government did not have jurisdiction or competence to offer such certificates. "No new courses, programme or training can be started or conducted except with prior permission of the Centre, in consultation with the MCI," the petitioners contended. The system of distance education is unknown to the Indian Medical Council Act, 1956, they added. Also, government medical colleges identified to offer the courses had no infrastructure or faculty to handle the additional load of students , the petitioners said.

The move will lead to dilution of standards and will affect patients in need, they added. When contacted, health department authorities told The Times of India that at the end of the programme, the candidates will have to clear an examination for being certified as diabetologists . "Unfortunately, the medical syllabus has very little on the epidemic in the undergraduate programme. A revision in medical course is a protocol-driven activity and it takes time. In the mean time, to meet the growing demand for diabetologists and to detect the disease early we thought we need to start creating awareness among the medical community . This course is the first step. And it needs no recognition from the MCI. Private universities in the state already offer the course," said health secretary V K Subburaj. The department decided to tighten things after the Chennai Urban Rural Epidemilogical Study by the Madras Diabetes Research Foundation estimated that at least 15.5% of the city's population was diabetic. The government's screening camps revealed that over two lakh people in the rural areas had high sugar levels, authorities said.

August 28, 2008

Apollo Hospitals working with TCS for patient ID number

Apollo Hospitals Enterprise Ltd is working on a project that would give each of its patients a Universal Hospital Identification Number (UHIN). The number is like a password that will give access to the entire medical records of the patient.

Anybody who walks into any Apollo outfit would be given this number.

“His medical data will be stored for life,” Dr Pratap Reddy, Chairman, AHEL, told a press conference here on Wednesday. Any doctor anywhere in the world will be able to access the patient’s medical history using that number, he said.

Dr Reddy said that Tata Consultancy Services is helping Apollo on this project. He said the project would be launched soon, “definitely not beyond December.”

He said that Apollo was also working on another project that would enable the use of the mobile phone to secure medical help — tele health. He did not elaborate. The press conference was held to announce the agreement for the 100th franchise for Apollo Clinic.

It was said at the meeting that today there are about 60 Apollo Clinics across the country and 40 more are coming up. Most of these clinics are run by franchisees, who pay a one time fee of Rs 25 lakh and an annual fee of 6 per cent of turnover to Apollo, for using the brand and knowledge resources of Apollo. It costs around Rs 2 crore to set up an Apollo Clinic.

Dr Reddy said that Apollo Hospitals was asking the franchisees to keep the clinics open 24 hours. He said that the aim was to have at least 1,000 Apollo Clinics across the country. Today, most of the 100 clinics are franchise-owned, but many of the clinics that would be set up in the future would be company-owned too.

Stake in Nigerian hospital

Apollo is working on proposals to take a stake in a 250-bed hospital company in Nigeria and set up another hospital of similar size in Ethiopia, the Managing Director, Ms Preetha Reddy, said.

She said that it looked like Apollo would invest around $12 million for a 30 per cent stake in the Nigerian hospital, but these numbers could change as negotiations are on.

The proposal for setting up a hospital in Ethiopia, in collaboration with a local partner, is at a preliminary stage, she said.

How hazardous are herbal remedies?

it's been reported that one-fifth of the ayurvedic medicines available online contain potentially dangerous metals. With many people now buying herbal remedies on the web, just how hazardous are they?

A mysterious, itchy rash appears on your skin. Where do you head for an explanation? In an age of instant gratification the answer is increasingly likely to be your computer keyboard, where you can find an instant (if unreliable) diagnosis and get a treatment delivered straight to your door. More millions people are now thought to buy medications on the web; but in doing so, say experts, many are risking their health rather than finding a means to improve it.

It was reported that researchers at Boston University school of medicine have found that one fifth of the Indian herbal medicines available online contain potentially toxic heavy metals, including lead, mercury and arsenic.

Dr Robert Saper and his team found 25 websites through an internet search engine and randomly selected and purchased 193 products made by 37 different manufacturers. They then subjected them to laboratory analysis.

Their results, published in the Journal of the American Medical Association, showed that medicines used in a branch of ayurveda called rasa shastra, used to treat serious illnesses, including paralysis, contained the highest levels of toxic metals, and that 20.7% of all products tested exceeded "one or more standards for acceptable daily metal intake".

This is not the first time that ayurvedic medicine has come under scrutiny. Previous investigations have uncovered high levels of heavy metals in the remedies used in this ancient medical system, an approach that has been popularised in the west in recent years by the backing of celebrity fans including Madonna and Naomi Campbell. Worldwide, around 80 cases of lead poisoning have been reported in association with ayurvedic approaches, with some preparations containing the stimulant ephedrine, a substance linked to high blood pressure - and even to potentially fatal heart attacks and strokes in susceptible people.

In some ways the risks have always been there. What has changed so dramatically is the ease with which consumers can now obtain these dangerously toxic concoctions for their bathroom cabinets from bogus online suppliers.

In 2006, a report by Envision, a web analysis company, suggested that there were about 2,500 websites selling medicines - prescription and alternative - to consumers worldwide. Since then that figure is thought to have risen. And many of those who purchase herbal medicines online do so without really knowing whether they are legitimate, effective or safe.

Like ayurveda, traditional Chinese medicine (or TCM), has become popular among those who want to try an alternative to Western medicine and prescription drugs. There are clinics and practitioners but there is also a burgeoning online business. Through TCM's 3,000-year old healing system, ailments are corrected using a combination of herbal remedies that include a bewildering list of ingredients - more than 6,000 medicinal substances are used, 300 of them regularly. Proponents justify the safety of TCM by pointing to the 8,000 clinical studies that have confirmed it presents little risk. But critics argue that many of these investigations are not conducted to sufficiently rigorous standards and that some of the herbs, which are used in hundreds of different combinations, are known to be poisonous.

Random tests by the UK's Committee on Safety of Medicines have identified banned substances such as the herb aristolochia, (which is linked to kidney failure), steroids, arsenic and mercury in many TCM preparations. In the wrong hands, these elements could be lethal, yet they are widely distributed in products available on the internet. According to the UK's Medicines and Healthcare Products Regulatory Agency (MHRA), a government authority that oversees the licensing and supply of medicines in Britain, products found to be on sale in recent years include a TCM slimming preparation that contained a highly toxic derivative of a banned substance called fenluramine, which is poisonous to the liver and a cause of heart irregularities in some people. Another product they found on the shelves was a Chinese treatment for constipation, called fufang luhui jiaonang, which contains 13% mercury - 117,000 times more than is legal in UK foodstuffs.

Weeding out unscrupulous websites and suppliers is not easy, although efforts are

being made to regulate UK suppliers of online medications. In February 2008, the Royal

Pharmaceutical Society of Great Britain (RPSGB) launched an "internet pharmacy logo" designed to protect the public. Only credible UK e-pharmacies can carry the RPSGB logo which Priya Sejpal, head of professional ethics for the RPSGB, says is one step towards eliminating the use of risky sites.

"Consumers just simply couldn't tell a good distributor from a bad one," says Sejpal. "A vast amount of products is available, but those sold from sites that offer to sell directly to the public or that offer unacceptable means of diagnosis do not meet our standards."

In a bid to crackdown on dangerous medication, the MHRA holds regular Internet Days of Action, the latest of which was in February. On these days, enforcement officers either visit the premises of UK websites to arrest those selling medications illegally, or contact the internet service providers of offending websites to ensure they are closed down. More than 40 websites are currently under investigation.

"We will not hesitate to take action against those who undermine public health," says Mick Deats, group manager of enforcement at the MHRA. But overseas suppliers are impossible to subject to any level of control.

Often it is difficult to determine whether a site is UK-based or not - even websites ending in or can be based abroad. A survey of internet medicine suppliers by the Trading Standards Institute found that many of those based in places as far-flung as Canada, India and Peru were distributing powerful medications with no advice about dosage or associated risks.

In 2006, two consultant opthalmologists from Sunderland Eye Infirmary, Sunderland, UK, reported the risks of self-prescription in the Lancet medical journal, highlighting the case of a patient who went blind after using an obscure Thai medication she had bought online.

Dr Philip Severn and Dr Scott Fraser explained how the woman had used information on the internet to self-diagnose chronic fatigue syndrome and then, on the recommendation of a neighbour, purchased a product from Thailand that contained steroids. She took the tablets for four years before arriving at Sunderland Eye infirmary, complaining of loss of vision.

Severn and Fraser discovered she had cataracts in both eyes and signs of glaucoma - both of which are indicative of long-term steroid use - which will require treatment for the rest of her life.

Buying online treatments for any medical condition "is a gamble", Fraser noted.

Herbal products aren't just being bought and used to treat medical ailments. Dr Martin Schmidt, a specialist registrar in psychiatry at St George's Hospital in London, recently

conducted a study into the rapid growth of what he calls the "worrying availability" of "herbal highs" - alternatives to recreational drugs - sold on the internet.

There is a commonly held belief, says Schmidt, that if something is labelled as

"natural" it is safe, "but that is a dangerous assumption," he says. His findings, reported

to the Royal College of Psychiatrists at their annual meeting, revealed that pills made from a cocktail of shamanic plants, synthetic stimulants and psychedelic cacti, were being sold as "legal highs" with unknown and potentially dangerous side effects.

"One product we found, called Original Herbal Ecstasy, contained nutmeg - which is hallucinogenic in sufficient quantities - hallucinogenic mushrooms and a lot of stimulants," he says. "Yet there is no way of telling how much of these substances is in there. Most packets contain no information about side effects or the potential of mixing these substances with things such as alcohol or other medications. They could cause a range of psychiatric disturbances from anxiety to panic attacks to psychosis."

In the course of his research, Schmidt stumbled across herbal preparations intended for a range of uses, which contained ingredients as dangerous as fly agaric mushrooms (commonly regarded as poisonous), the San Pedro cacti (containing the hallucinogen mescaline) and salvia, a Mexican herb that has been linked to problems with motor coordination and balance with short-term use and, after long-term consumption, to schizophrenia.

"There is considerable risk to the public from obtaining medicines through unregulated

websites," says Mick Deats of the MHRA. "There is no guarantee of safety, quality or effectiveness. It could be counterfeit or out of date. It may not contain the right amount of medicine. There is no ongoing treatment monitoring. At worst it may cause severe side effects. It's not worth it."

August 27, 2008

Apollo to tie-up with IGNOU to launch courses for doctors

Leading health service provider Apollo group today signed up its 100th Apollo clinic franchise.

The 100th clinic would be set up in Rajerhat, a township coming up in Kolkata, Chairman of Apollo Hospitals Dr Prathap C Reddy told reporters here.

The hospital also proposed to open another 100 Apollo clinics in the country in another two years,he said.

"To increase penetration and geographical reach of our clinics, we have adopted the franchise route for expansion. The idea is to supplement our knowledge and expertise in the healthcare domain with franchisee's understanding of the local market", he said.

He said Apollo Group would tie up with Indira Gandhi National Open University (IGNOU) to launch different courses in Chennai and Hyderabad for the doctors in order to improve their disciplines.

"Like in Delhi,we would be offering short term courses for the doctors in various disciplines with the help of IGNOU at Chennai and Hyderabad this year",

He said to start with the two-week course would be in Cardiology and Diabetes discipline, the area which has acute shortage of doctors.

"Other disciplines would also be introduced gradually".

On the other new initiatives, Reddy said Apollo hospital had tied up with Tata Consultancy Services (TCS) to launch the latest and comprehensive hospital management software.

"The sofware, to be launched by this year, would help the hospital to keep track of the patient record permanently".

August 20, 2008

General Atlantic to buy 20% in Wockhardt Hospitals

US-based private equity (PE) major General Atlantic is learnt to be final stages of talks with Wockhardt Hospitals to invest around $140-150 million. Although there are some differences over the valuation and structure of the investment, the PE may pick up around 20% stake in the Indian company, sources said.

The hospital chain has been in talks with several PE funds after its initial public offer (IPO) got derailed earlier this year. Talks with most PE funds had also fallen through over differences about the company's valuation, PE sources said.

When contacted, a Wockhardt Hospitals spokesperson said: "We don't comment on market speculations."

In January, Wockhardt Hospitals had planned to raised around Rs 688-762 crore by diluting 24% of the post-issue paid-up equity share capital of the company. To tide over the then prevailing low market sentiment, it had also reduced the IPO price from Rs 280-310 to Rs 225- 260 but the company fail to get enough subscribers to go ahead with the public issue.

According to General Atlantic's website, the company manages approximately $17 billion in capital under management and invest between $1 billion and $2 billion every year globally. The company's investment size ranges from $50 million to $500 million. If the deal goes through, it would be General Atlantic's first investment in the Indian hospitals. The American company had also picked up 8.5% stake in Delhi-based pharma company Jubilant Organosys for Rs 109 crore in 2005.

Wockhardt Hospitals has chalked out a Rs 900-crore expansion plan, which includes setting up of 11 new hospitals mostly in tier-II cities. The company also plans to increase the number of beds to 2000 by end of this fiscal from the current 1,400 beds spread across its 15 hospitals. It also plans to scale up the operations in several of its existing hospitals.

According to industry estimates, the booming healthcare industry is expected to see around $5 billion between 2008 and 2011. Last year, Apax Partners had invested $104 million in Apollo Hospitals for 13% stake.

August 17, 2008

Bitter pill from Beijing: Drug shortage in India

Abhinav Bindra's gold at the Beijing Olympics may have raised the country's hopes, but all's not gold for the Indian pharma companies. The industry could become an indirect casualty of the Beijing Olympics after the closure of China's polluting raw material producers.

A major source for Indian drug manufacturers, the shutdown could hit drug supplies to India in the coming months.

Essential medicines including antibiotics, drugs for TB, diabetes, even painkillers could soon be off the shelves across chemist stores in the country.

Drugs made of paracetamol, ibuprofen, sulphonamides, antibiotics like cephalosporin and erythromycin used to treat respiratory infections could be among the first to go.

India imports about 80 percent of its pharma raw materials from China and sells drugs worth $8 billion annually in the domestic market alone. While exports account for about $4 billion, chemist associations say from October, it will be down 75 per cent

"The Chinese government may allow the companies, but when local people protest, (they give in). If the raw materials stop coming, India will face a serious shortage of medicines,” says Secretary, All-India Organisation of Chemists and Druggists, Jagannath Shinde.

Domestic pharma manufacturers face a double whammy. While the shortage has already escalated local drug prices, regulations on price control have aggravated the problem

Director, Piramal Healthcare, Swati Piramal says, "Prices of typhoid medicines, antibiotics are 30-40 per cent higher because of our dependence on china. But we need to look for alternate supplies."

With most wholesale chemists holding an inventory of drug stocks that is expected to last till September, patients may not feel the pinch as of now. But in the coming months, it could be difficult to source medicines. It’s perhaps time to stock up on your blood pressure tablets.

August 16, 2008

Health cover portability faces last-minute hurdle

Last minute-glitches have held back a health insurance cover that would have enabled policyholders to retain the benefits even if they switched companies.

The new health cover is a common minimum standard cover, which will be renewable and portable across companies. This means no insurer can refuse renewing the policy on grounds of adverse claims, making it mandatory for insurers to pass on the benefits, such as cumulative bonus and discounts, even if a person changes his insurer.

While pre-existing diseases are only covered after four years of a policy, an insured will be eligible to these benefits from the first year of switching to a new company.

Insurance company executives said there is an in-principle agreement on the new product, though there are several grey areas, on which clarity is required.

The General Insurance Council, the self-regulatory body of non-life companies, met yesterday in Hyderabad, but could not reach an agreement. Insurers have now asked a team of health underwriters to prepare the final blueprint for the proposed product, which may take a couple of months.

Pricing is a major issue on which a decision has to be taken, said a source who was present at the meeting. A section of non-life insurers is insisting that portability should come at a price. So you may be able to move from company A to company B and retain all the features that you were entitled to earlier, including bonuses and continuity benefits, only if you are willing to shell out a little more money.

The head of another insurance company said insurers were unclear about the minimum sum insured under the portable and renewable product. The mechanism to cover pre-existing diseases in the new policy, after a change of the insurer, is another issue that has divided the industry.

At present, pre-existing diseases are covered after a health cover has been in operation for four years. So if a policyholder has a heart ailment at the time of purchasing the policy, no related claims then will be honoured in the first four years.

In case of perpetual claims or in policies where there is a high level of claims, a few insurance companies that were present at the meeting were unclear on how renewability and portability will work. The long-term impact of such a product on insurance companies will be analysed.

Similarly, companies have different underwriting guidelines in terms of client segments for various businesses. Some insurers have raised issues about how the proposed product will fit into their overall business. The other reason cited by insurance company executives is the mechanism for sharing of the consumer data.

August 14, 2008

First health insurance policy for HIV+ persons launched

In a first of its kind initiative that will bring respite to lakhs of people infected with HIV, an insurance company today rolled out a health policy, which will cover illness of such a patient due to his/her weak immune system.

Star Health and Allied Insurance Company, which launched its group medical insurance policy meant exclusively for HIV+ people, said the policy would cover hospitalisation expenses incurred on opportunistic illness acquired by an HIV+ person.

"The policy is unique not only in India but also in the world. It will cover hospitalisation expenses as a result of opportunistic diseases acquired by the HIV+ person," Star Health and Allied Insurance Company Vice-President, Government and New Initiatives, Uday Chandran told PTI.

He, however, said that the policy would not cover any treatment cost for HIV and would also not cover conditions, which existed before enrolling into the policy.

"The policy does not cover any treatment for HIV, like Anti Retro-viral Therapy (ART), but would only cover illness acquired by such person because their immune system becomes weak," he said.

Chandran was, however, quick to add that TB and gastroenteritis, the most common diseases affecting the HIV+ people would not be covered under the policy.

"We wanted the policy to remain as cost effective as possible for those persons. Had these two also been included, the premium would have gone up," Chandran said.

On asked if the policy would take care of expenses once a HIV+ person is declared full blown AIDS patient, he said that in such cases, lump-sum amount is paid to the policy holder as per the sum insured by him or her.

August 12, 2008

Now, insurers can`t refuse health cover renewal

In a move that will bring cheer to health insurance policyholders, non-life insurers are finalising the contours of a new product that will have a common minimum standard cover and will be renewable and portable across companies.

The move being pushed by the General Insurance Council, the self-regulatory body, will mean that insurers cannot refuse renewal of policies on grounds of adverse claims. Similarly, all benefits will continue to be available to an insured person even if he or she switches to a new company.

While pre-existing diseases are only covered after four years of a policy, an insured will be eligible to these benefits from the first year of switching to a new company. In addition, cumulative bonus and discounts will also be available after the change.

General Insurance Council Secretary General K N Bhandari said those buying a health cover at an early age will not be denied renewal on grounds of adverse claims. So, if someone buys the new cover at, say, 30, he will still get a cover at 50 years even if the he has developed heart problems and has filed for claims.

Insurers will approach the Insurance Regulatory and Development Authority for approval of the new product that will come with all these features later this month. Premium is, however, yet to be finalised, but will be affordable, Bhandari said.

“Insurance companies will not refuse renewing the health insurance policy except on specified grounds such as moral hazards. In case the insured has cheated the insurer or not disclosed the full facts regarding his health or in those cases where there is no correct exposure, we will refuse renewing the cover,” he added.

Health insurance policies contain the renewability clause that specifies the type of the contract and terms for renewal, which are of three types. The first type is optionally renewable, where the insurer has the option to renew the policy on its terms. This is the cheapest policy for the insured.

The second type is guaranteed renewability, the premium rating for which depends on the claims experience. The third type, which is the most expensive variant, cannot be cancelled and renewal is guaranteed, but the price can vary.

August 11, 2008

MCI cautions students against unrecognised Medical Colleges

The Medical Council of India (MCI) has warned people against enrolling their wards into any foreign institutions not approved by it.

An MCI advertisement published in newspapers on Saturday said that it had been observed that certain entities had issued misleading advertisements for luring innocent students for admission in MBBS from foreign universities.

The MCI said that it had not permitted any foreign university to establish a campus in India for imparting medical education. “No foreign university has been permitted by the MCI to start a medical course leading to degree equivalent to MBBS in India or establish such a campus in India and these degrees are not approved by the MCI,” it said.

As per Section 10A of the Indian Medical Council Act, 1956, no (foreign) medical college is allowed to start any medical course which would enable a student for the award of any recognised medical qualification except with the previous permission of the Centre.

Regulation 9 of the Screening Test Regulations says the eligibility certificate is valid only for candidates to join a medical institution outside India to obtain a primary medical qualification and for undergoing the screening test on return.

This eligibility certificate cannot be used for any student to actually join an institution in India (which is not granted permission or recognition by the MCI) on the pretext that the degrees are purportedly awarded by foreign universities.

The MCI has asked the people to check the status of any medical college or course on its website (

August 10, 2008

India to help WHO define counterfeit drugs

A World Health Organization (WHO) committee has initiated steps to take India on board while proposing a change in the definition of counterfeiting at the next World Health Assembly.

In the recently concluded inter-country consultations on combating counterfeit medicines here, members of the International Medical Products Anti-Counterfeiting Taskforce (IMPACT) have laid stress on the need for a consensus in finalising the matter.

The new definition says any “false representation in relation to identity, history or source” would be considered a case of counterfeiting.

The significance of the move stems from fears that the new definition could lead to India’s authorised exports of genuine drugs being termed counterfeit, if, by no fault of the exporters, the medicine is smuggled into a different foreign destination. Under the new definition, if medicines originally intended for one country end up in another country where they are not registered, they would be declared counterfeit.

The IMPACT proposal to enlarge the scope of “counterfeit definition” by including such “trade mark violations” was not considered by the WHA during its last meeting in May due to Indian objection.

India has opposed the new definition saying it goes beyond the issue of “quality, safety and efficacy”, and could be used as a tool to project India as a centre of substandard and counterfeit drug production.

India also called for further discussions among the WHO member countries to harmonise the definition of “counterfeit” to avoid genuine medicines being tagged as counterfeit — a term normally associated with illegally produced or supplied medicines that may or may not conform to quality specifications.

India had also stated that a generic or branded medicine not registered in a particular country, but available in that country (by whatever means) is not counterfeit but simply an unregistered product.

The domestic drug industry had also expressed apprehensions over the WHO negotiations meant to bring non-health issues that have no direct implications on the safety of a drug within the ambit of the definition of “counterfeit medicine”.

The industry had also pointed out that the IMPACT definition, if read with the EC Regulation, Article 2.1(c) of the European Union, could mean a serious threat to India’s exports of pharmaceutical products. The EC Regulation allows seizure of “counterfeit” products even during transit.

IMPACT has representatives from 22 organisations, including INTERPOL, the Organisation for Economic Co-operation and Development (OECD), the World Intellectual Property Organisation (WIPO) and the WTO.

At the World Health Assembly in May, a draft resolution on counterfeit medical products was proposed by Gambia, Ghana, Nigeria, Tunisia and the United Arab Emirates. The draft resolution, however, was not adopted because consensus could not be arrived at due to differing viewpoints. It has been referred to the Executive Board for further discussion.

Govt Plans Medical Tech Park In Chennai

In order to cut costs of healthcare equipment and research for new vaccines in Chennai, government of India has decided to set up a medical technology park in the city.

The proposed park, which is being constructed on 300 acres of land, will be equipped with medical device manufacturing units, healthcare infrastructure and vaccine technology facilities.

The park is scheduled to be completed by 2012.

Commenting on the launching of the park, Mr. Surinded Sing, drug controller general of India (DCGI) said, “The medical park will enable us to manufacture cost-effective medical equipment for the country. The vaccine park will research on developing new vaccines. However, details about financial benefits the government might give to companies are not known as the proposal is at a discussion level.”

The DCGI also stated that while the work for establishing the vaccine park has already commenced, the ministry of health and family welfare will shortly invite private players to set up facilities in the park.

The government plans to keep the park open to both national and international companies.

Sugar-free biscuits, chyawanprash come under health scanner

Sugar-free chyawanprash and biscuits have come under the scanner of health authorities, for containing artificial sweeteners not outlined in existing health-related rules.

The Centre has sounded a note of caution on the use of artificial sweeteners such as saccharine and sucralose in sugar-free chyawanprash and biscuits, besides asking the State drug licensing authorities to review medicines where artificial (and not permitted) sweeteners have been used.

Chyawanprash is an estimated Rs 300-crore market locally, and the more recent sugar-free segment has players such as Baidyanath (with its sugar-free chyawanprash granules), besides Dabur and Ranbaxy whose sugar-free formulations of the product target weight-watchers and consumers with diabetes or sugar-related problems.


Manufacturers will have to mention on their labels, the artificial sweeteners, permissible preservatives and colouring agents used in the product. They would also be responsible for the rationality, safety and quantity of various additives used in the formulation according to the Indian Pharmacopoeia and the Prevention of Food Adulteration Act, says the directive from the Union Health Ministry’s Department of Ayush (that handles alternate systems of medicine, including ayurveda, unani and siddha).

Consumers benefit by knowing the quantity of ingredients used in these products, and large players may already be including such details on their labels, said an ayurvedic products manufacturer.

Proprietary products

But, Dabur and Ranbaxy’s sugar-free formulations of chyawanprash may not quite come under the ambit of the Centre’s directive, as they are patent and proprietary products, said an industry expert.

Though Dabur’s sugar-free Chyawanprakash and Ranbaxy’s Chyawan Active include the benefits of chyawanprash, it is not the generic formulation of the product, he explained.

About 60 per cent of chyawanprash consists of sugar-syrup, makers of chyawanprash told Business Line. And companies use artificial sweeteners to make it a health and life-style product, they said. However, they add, manufacturers do not use aspartame (an ingredient in table sweeteners), because it is not heat stable and has safety issues in children and people with kidney problems, he added.

August 08, 2008

Indian doctors again clash with British government

Indian doctors are once again suing the British government, this time accusing it of violating the spirit of a four-month-old court order by seeking to deny thousands the opportunity to live and work in Britain.

The doctors, who won a landmark judgment in their favour April 8, say the British home ministry subsequently refused to withdraw an earlier rule that they say unfairly disadvantages doctors from India and other countries currently working in Britain.

The rule concerns the number of years a person needs to have lived in Britain before qualifying for Indefinite Leave to Remain (ILR) - the first stage to full citizenship.

The home ministry raised the minimum requirement from four to five years in April 2006, but refused to withdraw this change while issuing policy guidance in July this year - a move that a spokesman for the doctors termed as “unfair and unlawful”.

“Once again the Home Office has been requested to abide to the rule of law, and once again it seems inevitable that the law of the country needs to be enforced onto an obsessed Immigration Ministry which is going to waste the tax-payers' money to further defend such unfair and unlawful policies,” said Amit Kapadia, executive director of the HSMP Forum.

In April this year, the Forum won a high-profile case in favour of doctors who had been granted Highly Skilled Migrants Programme (HSMP) visas but suddenly found themselves unable to work in Britain because of changes made to the visa criteria.

Although the judgment concerned changes made in November 2006, the Forum says the government is violating the spirit of the ruling.

“The judgment delivered a complete package to bring relief to doctors. This action by the Home Office threatens the livelihood of a very large number of doctors,” Kapadia told IANS.

“Migrants and their families who applied for indefinite leave to remain after four years - as it was initially promised by the UK government to entice them to come to Britain to contribute to UK economy - are now issued with refusal letters and are being asked to leave the country,” the Forum said.

It said the difference of a year in qualifying for indefinite leave was causing migrants hardship and upsetting their plans.

Many migrants' children - faced with the prospect of having to pay high university fees that are charged international students - have abandoned studies, changed career plans or taken a year off studies.

Kapadia said the government has until mid-August to reply to a legal notice served by the Forum.

August 07, 2008

IRDA may ensure affordable health cover to all, even after 65 years

Senior citizens have good chances of getting a health cover even after they turn 65.

Insurance regulator IRDA is vetting a proposal to make health cover affordable to all senior citizens. A final view will be taken on providing guaranteed access to health insurance for this segment by the end of this year, said a top official of the regulatory body. The proposal is based on the recommendations of an expert panel on health insurance last year. The panel recommended allowing senior citizens to enter the health insurance system up to 65 years of age — or higher — at the discretion of the insurer.

If they do so, they should be given guaranteed renewal of their insurance without any upper age limit. As a transitional measure — since guaranteed access is being provided to senior citizens for the first time — there should be no upper age limit for entry or renewal for a period of three years from the date the IRDA issues the regulations”, the panel had said. It had made out a case for insurers to fix a “base” price of Rs 3,000 every year for a sum insured of Rs 1,00,000 (at 50 years).

“We are examining these recommendations of the panel we reckon that health insurance should be made affordable, given the mounting health care-costs,” said DVS Sastry, director general, IRDA at a seminar on effective cross selling of insurance and mutual fund products organised by Watson Wyatt and the Indian Institute of Banking and Finance here.

Several senior citizens have registered complaints with the regulator about insurance companies denying renewals.

Industry experts, however, reckon that people should enter health insurance schemes at an early age to enable insurance companies distribute their risks better. Currently, health insurance penetration is minuscule in India. The total premium from health insurance stood at Rs 4,970 crore in FY 08, marking a 55% growth over FY07. Currently, there are only two standalone health insurance companies — Star Health and Allied Insurance and Apollo DKV — offering pure health products.

The government is looking at raising the cap on foreign direct investment (FDI) in insurance from 26% to 49%. It is also considering a minimum capital requirement of Rs 50 crore for health insurance companies to make it attractive for new-entrants. Consumers are expected to get a better deal in terms of pricing when competition intensifies among these players.

August 06, 2008

Nine Kyrgyz doctors jailed for infecting kids with HIV

A court in Kyrgyzstan has jailed nine doctors for infecting children with HIV in several hospitals across the south of the country, a judicial source said, cited by the Aki news agency.

The doctors were sentenced to prison terms ranging from three to five years and ordered to pay 10,000 dollars in damages and interest to the children and their families, after being found guilty of negligence.

Prosecutors on Tuesday said 41 children and four mothers were contaminated in four different hospitals in a scandal that was first made public last summer.

Four doctors were sacked in July for allowing the virus, which causes AIDS, to spread. The health ministry said last August that the infections occurred "during injections and blood transfusions."

A similar scandal broke out last year in neighbouring Kazakhstan, where some 100 children were infected with the AIDS virus and 21 medical staff were sentenced to prison terms of up to eight years.

August 01, 2008

Study MBBS in Tamil from next year

From the next academic year, medical students will be given the option of choosing Tamil as the medium of instruction for their undergraduate programmes. The blueprint, jointly initiated by the vice-chancellors of four government universities, is pending approval from chief minister M Karunanidhi.

In the first phase, the option will be offered at three government medical colleges — Stanley Medical College, Chennai, Tanjore Medical College, Tanjore and Madurai Medical College, Madurai. The translation of the syllabus will be completed in the next three months by a team of doctors and specialists.

"But we made a decision not to change the medical terms. For instance, terms like cardiomyopathy will not be translated into Tamil. This way, the job of the translator becomes easy and the students also learn the English terms they can't shy away from," said Tamil Nadu Dr MGR Medical University vice chancellor Dr Meer Mustafa Hussain.

Nevertheless, the University will only do the translations for the syllabus. The several hundred reference books and manuals will be in English. "It's difficult to translate all the books that students refer. It probably can be done in a phased manner," said one of the doctors involved in the translations.

The Directorate of Medical Education is yet to decide if it should provide the allotment to these courses by claiming for additional seats or with the existing seats. The directorate is sure that there will not be a different team of professors teaching. "The faculty should only talk in Tamil. Most of them do it anyway when a student from the Tamil medium requests them to do so," the official said.

Though the proposal has excited students and teachers of Tamil-medium schools, many professors have termed the proposal absurd. "When countries like China have started teaching in English just to keep pace with globalisation we are pushing our students behind if we don't make them learn English. I studied in Tamil medium myself but I could cope with English in my MBBS. And I think there is nothing wrong if a professor of medicine teaches a bit of English," said a head of department.

But some other professors feel that students can do better if they learn in the language they are comfortable with. "In a class of 100, a professor is not going to wait and see if everyone has understood the lesson. In most cases, Tamil-medium students are too shy even to get up and ask doubts. You can start them on English tuitions and keep medical lessons waiting. We have a very tight academic schedule. Teaching in Tamil is anyway only an option given to the students," another senior professor from the Tanjore Medical College said.

IGNOU to launch new medical courses

Indira Gandhi National Open University on Thursday joined hands with Christian Medical Association of India to launch a set of medical courses through its distance learning model.

The university will offer short and long term training courses in health related areas like medical, allied health among others.

The IGNOU signed a Memorandum of Understanding with CMAI for setting up of "CMAI-IGNOU Chair for Health Sciences" in this regard.

"The new arrangement will help in imparting professional training in health sciences to students from different parts of the country," said V N Rajasekharan Pillai, Vice Chancellor IGNOU.

He noted that with its large network and reach IGNOU can cater to a huge section of the population with such popular courses.

Degrees for successful candidates in these courses will be awarded by IGNOU.

CMAI president Joyce Ponnaiya said the new health care courses will be "need based" and emphasis will be on developing and imparting professional and quality health care training.

The two institutes will collaborate together in producing and distributing self instructional course materials, apart from imparting training through various available media.



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