I'm not sure if we have a thread of this nature but I certainly believe we need one. India has a gigantic population and its healthcare industry has to rapidly expand to improve the standard of living.

Personally I'm doubting private healthcare as the way to go. I think these services should be in the hands of an able government. But as an able government is far from reality privitization may just be the only option.

Here's a nice article I came across to start this thread:



Healthcare goes five-star...
Radhieka Pandeya / New Delhi December 2, 2006
Naresh Trehan

...not because private hospitals are elitist but because of the quality of their services. No wonder big money is flowing in.

Wearing a plain brown sari and a gemless gold ring, Vandana sits patiently in the swank, white-and-green lounge of a private hospital in Delhi. Her only other piece of jewellery is a gold bangle worn over four red glass bangles.

A black knapsack rests at her feet. “My husband has a kidney problem,” she says slowly. “He is being treated at AIIMS (All India Institute of Medical Sciences) but the doctors there asked us to get his dialysis done at a private hospital.”

Vandana and her husband have travelled 116 km from Muzaffarnagar and are happy with the service and attention they are receiving at the private hospital — Max Balaji, recommended to them by AIIMS and a family member who was operated on there.

Vandana and her husband are part of a movement the private healthcare sector is witnessing in India. Though the trend started with Apollo Hospitals in Chennai many years ago, it is picking up at mindboggling speed.

Healthcare is the new buzzword for corporates and individual businessmen alike, with many corporates setting up private hospitals under their banner. Private healthcare has grown into a formidable industry with an estimated worth of Rs 80,000 crore (CII estimate).

The result: hospitals that don’t resemble hospitals, machines that were once unheard of in India and services that can match any five-star hotel. Yes, the Indian healthcare industry is getting an extreme makeover and is touching the lives of people not just in India but all over the world.

According to a CII study, with demand exceeding supply, the industry is expected to continue its upward run at a rate of 13 per cent annuallyfor the next six years.

The last five years have witnessed the evolution of very large corporate hospitals that don’t stop at just a single unit. So you have Max Healthcare setting up six hospitals in Delhi alone, Wockhardt setting up 10 across the country, Apollo Hospitals going international and Fortis Healthcare running 12 hospitals in north India, with more in the pipeline. Indian healthcare owes its facelift to changing consumer expectations.

Vishal Bali, CEO, Wockhardt says, “Indian consumers are being exposed to global healthcare standards and expect similar services here.” Consider this: today, a middle-level manager with a family of four spends between Rs 8,000-12,000 a year on healthcare, compared to Rs 2,000 in the late 1980s.

Corporate hospitals have not only raised the bar for healthcare in India but have also eased the pressure off government hospitals dealing with tertiary care. Waiting time for patients has dipped since those requiring immediate attention are promptly referred to a private hospital.

Praveen Chawla, COO, Fortis Hospital says, “The private sector is able to provide a much higher quality of healthcare.” Visit any corporate hospital today and the first thing you notice is the presence of people from low- to high-income groups under one roof, demanding and receiving the same services. As Dr Naresh Trehan, MD, Escorts Heart Institute and Research Centre says, “Healthcare is a business with a soul. So it is very important that corporates run it in a humane manner, laying their foundation on ethics and ethos associated with the healthcare industry.”

Famously referred to as five-star hospitals, private hospitals are now attempting to break away from this image and are reaching out to people from all walks of life through health insurance cover, competitive rates and even free treatment for some.

Mukesh Shivdasani, executive director, Max Healthcare and chief executive, NCR 1 explains, “Private hospitals are not as expensive as is perceived. Also, there are organisations that help the economically challenged in meeting hospital expenses.”

The growing demand for private healthcare and the awareness towards the sector has also encouraged insurance companies to push their health insurance policies, covering everything from doctor’s fees, room charges, diagnostic charges and medicine to pre- and post-hospitalisation expenditure.

Kartik Jain, marketing head for ICICI Lombard, believes that with the cost of healthcare going up and lifestyle diseases also witnessing a rise, there is a sudden need and demand for health insurance. Today, even corporates are sustaining employees by including health insurance as a benefit.

However, the number of people picking up a health insurance policy is insufficient. Health cover premiums account for less than one per cent of life insurance premiums. In fact, the health cover premium collections for 2004-05 were around Rs 1,800 crore.

One of the biggest benefits of corporatisation is the building of brand India as a medical tourism destination or, as Shivdasani puts it, a global healthcare destination. SAARC countries like Bangladesh, Afghanistan, Sri Lanka, Malaysia and Indonesia account for the most patients, with the US and UK following suit.

While patients from SAARC countries come in search of better healthcare options at competitive rates, for the US and UK it is primarily a matter of getting world-class healthcare at less than half the cost. However, the one factor that is pulling people into India is the quality of service in the healthcare industry.

“Hospitals are bending over backwards to make sure international patients feel comfortable,” says Chawla, “with services like airport pick-up and drop, a city tour, critical care and constant communication with the patient’s hotel.”

Take 56-year-old California resident Billy Schroeder, who was denied health insurance in the US due to high prostate-specific antigen and suspected cancer. The tests that confirmed he had prostate cancer cost him $7,000. Schroeder decided to head East for his treatment and came to Fortis

Hospital, Delhi. His complete surgery here cost him $10,000. “I think hospitals here are as good as, if not better than, any hospital in the US. The heartening thing is that the staff spends time with you and makes sure you are comfortable and satisfied.” A month after coming to India, Schroeder is now ready to head home...cured.

Beyond curing patients, corporate hospitals are transforming the lives of another set of people — doctors. The worth of doctors is now being realised not by the corporates alone but even by the doctors themselves.

Dr. Upendra Kaul, director and HoD, cardiology at Fortis Hospital, recalls, “I used to work at a government hospital and the experience was very different. In a private corporate set-up like this you don’t face bureaucratic hassles.”

The corporate set-ups have also given doctors access to resources like never before. Dr Ajaya Nand Jha, director of neuro-surgery at Max Super Speciality Hospital, has two high-end computers and one laptop in his office.

“I need these to keep records, track patients, communicate with other doctors and to keep myself updated with the latest happenings in the medical world,” he says. “In this competitive world, you need to keep running to stay in the same spot.”

The biggest benefit though has been in terms of salary and lifestyle change. Dr Arvind Taneja, director-paedriatrics at Max Hospital, admits being involved with a lot of administrative work at Max.

“I have been a consultant at many private and government hospitals but this has by far been my most advanced centre to date. We are working with technology that is enabling us to provide much more than just basic healthcare.”

An interesting trend among corporate hospitals is that of setting up super-speciality or multi-speciality hospitals vis-à-vis general hospitals. Speciality centres bring one medical department together under one roof.

So, you have a super speciality hospital focusing on neuroscience, orthopedics, obstetrics and gynecology, cardiac care and oncology. Speciality hospitals come into play once your illness has been diagnosed.

Thus, if you suffer from a neurological problem, instead of visiting a general hospital where you might be shunted from one department to another, you would ideally visit a hospital that specialises in neurological sciences and has all the necessary equipment and expertise in the field. Today these hospitals are also constantly investing large sums of money in the latest technology and machinery.

But like every other positive trend, the corporatisation of hospitals has its pitfalls. A major concern among doctors and patients alike is the filtration of expertise as you go down the ladder in doctor rankings.

Hospitals are selling their treatment services by hiring the best names from the medical field. But healthcare is not a one-man show. Whether the expertise is trickling down to the doctor’s juniors remains to be seen. The movement is still in its nascent stage and sustenance of service and standards over the next few years will be the decisive test.

Healthcare experts also feel the need for medical standardisation, accreditation and certification in the medical sector by the government, to maintain standards.

“We need standardisation to come into play in the country,” says Dr Dharminder Nagar, CEO, Paras Hospital. Agrees Trehan, “We are providing a service and must do so with decency and sensitivity towards the community. India needs more regulation in healthcare.”

Vishal Bali believes India needs to create drivers of affordability of healthcare for the average Indian. That, however, has not received sufficient attention in a rapidly growing economy.

In fact, the general belief is that private consultants are encouraged to ask for superfluous tests and even avoidable procedures so that the hospitals can recover the cost of the investments made in testing and other equipment.

Still, the availability of an alternative to government hospitals, and of quality care at reasonable cost, is changing the lives of tens of thousands. Vandana and her husband agree. “If you want good health, you have to pay for it, no matter what,” she says, as she steps into the hospital garden with her husband to sit in the sun.

THE WAY TO HEALING

Statistics


The Indian healthcare industry is now estimated to be a $17 billion (Rs 80,000 crore) industry
The total spend on the healthcare sector currently accounts for 6.1 per cent of the GDP, of which the government spend is 1.1 per cent
The annual growth rate of the industry is 13 per cent and is expected to continue at this rate for the next six years
Most healthcare users pay from their own pocket and prefer to use private services as compared to government services
India has only 43 doctors for every 10,000 people as compared to the 2,340 doctors per 10,000 people in the US
Hospitals in India run at an occupancy rate of 80-90 per cent
Major corporations like the Tatas, Apollo Group, Fortis, Max, Wockhardt, Piramal, Duncan, Ispat and Escorts have made significant investments in setting up state-of -the-art private hospitals in cities like Mumbai, New Delhi, Chennai and Hyderabad
India receives 1.5 lakh medical tourists every year. A CII-McKinsey report has projected that medical tourism could contribute Rs 5,000-10,000 crore as additional revenue for the tertiary care hospitals by 2012. This will account for 3-5 per cent of the total healthcare delivery market


Medical technology and services

Apollo Hospitals

# Introduced the revolutionary 64-Slice CT scanner that allows a full body scan in seven seconds
# Invested in the 3 Tesla MRI scanner that can show real time changes in body tissue and disease progression
# Pioneered in setting up the first modern secondary care, rural hospital, using telemedicine
# Has partnered with various organisations like ISRO, CDAC and the Government of Japan to increase the outreach of telemedicine
# Has entered into an agreement with John Hopkins Medicine International for collaboration in numerous clinical departments
# Entered into an agreement with Reliance Infocomm where Reliance WebWorlds will offer access to the Apollo Telemedicine Networking Foundation
# Set up new super speciality centres — Apollo Centre for Obesity Diabetes and Endocrinal Diseases, Apollo Pediatric Cardiology and Cardiac Surgery Unit and Apollo Centre for Advanced Pediatrics
# Plans underway to set up hospitals in Mauritius, Fiji, Ethiopia and Abu Dhabi


Max Hospitals
# Owns and operates six hospitals in Delhi and NCR. Plans to operate a total of nine hospitals in this region with an investment of Rs 700 crore
# Launched the Six Sigma Methodology for improving administrative processes to improve quality
# Acquired the Brain Suite, an intra operative MRI system. This is the first such installation in the Asia Pacific, and the third in the world
# Runs the Max TeleMed service, with special focus on Manipur, and plans to extend services to rural areas in the country

Fortis Hospitals
# Runs 11 hospitals across north India. Planning two more hospitals in the NCR with a total investment of Rs 550 crore
# Acquired the Escorts Group last year and holds 90 per cent intrest in it
# Planning a medical college in Gurgaon called Fortis Institute of Medical and Bio Sciences
# The Escorts Heart Institute and Research Centre has a tie-up with Air Deccan for its air ambulance service called Air Rescue One.
# Has an ongoing telemedicine network across north India.

Wockhardt Hospitals
# Are South Asia’s first Journal of Clinical Investigation accredited super speciality hospitals
# Have associations with Harvard Medical International, which gives them access to the best hospitals in the US for knowledge and research. Leader in medical tourism in India

MORE TO COME
# Escorts’ Dr Naresh Trehan’s Rs 1,200 crore project, Medicity, a centre for integrated medical sciences and holistic therapies in Gurgaon
# Apollo Tyres’ Artemis Hospital in Gurgaon
# Reliance Anil Dhirubhai Ambani Group’s multi-speciality hospital in Mumbai

VOICES

"The private sector has been actively involved in healthcare. What we are witnessing now is corporatisation" — Harpal Singh, chairman, Fortis Healthcare

"The access to high-end technology has become easier now and hospitals cannot afford to ignore this technology" — Vishal Bali, CEO, Wockhardt Hospitals

"Corporates should bring with them the highest degree of accountability. Privatisation of healthcare delivery by the right corporates is good for the country and the patients" — Analjit Singh, chairman, Max India

I'm not sure if we have a thread of this nature but I certainly believe we need one. India has a gigantic population and its healthcare industry has to rapidly expand to improve the standard of living.

Personally I'm doubting private healthcare as the way to go. I think these services should be in the hands of an able government. But as an able government is far from reality privitization may just be the only option.

Here's a nice article I came across to start this thread:
It's good to have choices. I have worked in both government and private health care sectors in India. I like the Indian model better than the US (strictly private) or Canadian (strictly government) model. In India, if you can afford it and you want priority care, you can go to a private hospital. If not, you can go to a government hospital. So, I don't see anything wrong with the above article, as long as they don't do the unethical things that the HMOs do in the US.

^^ But I don't think the Indian government is capable enough to enforce the hospital ethics and regulations required. What will probably happen is that the corporates will only care for their profit and there would be little or no regulation of the practices. Also, these private hospitals are further going to create a gap between the rich and the poor. Those who can afford proper care in private hospitals and those who cannot.

^^ But I don't think the Indian government is capable enough to enforce the hospital ethics and regulations required. What will probably happen is that the corporates will only care for their profit and there would be little or no regulation of the practices. Also, these private hospitals are further going to create a gap between the rich and the poor. Those who can afford proper care in private hospitals and those who cannot.

Absolutely right.

Health care economics and ethics is complicated. We must start to see how health care should be delivered. For instance is health care aright or a privilege?

My personal view is that it is a social right.

But how should health care system be formed in India?
In Europe and Japan there is a mixture of state and private health care,where the state is the major contributor for delivering health care.

As the state structure looks now i am skeptical if the state can deliver good quality health care.

So what about the poor and those who don't have enough capital to spend on private health care?

my answer: let the Gov pay , no matter what the cost is.

I think we have a huge shortage of doctors. Many more Medical Colleges need to be set up and people need to be trained as doctors. Same with nurisng. All other allied fields also need to be boosted. Health Infrastructure should also be created in suburban and rural areas. Not only will this improve the health scenario in the nation, it will contribute to economic growth.
Plus there has to be political momentum on this issue and implementation of laws and plans.

Private five star hospitals are fine. But how many people can afford them? Some of the private hospitals are basically money making machines.

What really is bothersome is that for decades we have had the sociialists-leftists in power and yet social areas are some of the most neglected! Goes to show the incompetent and sloganeering nature of our socialist-leftist elite - all slogans no impelmentation.

Only 128 doctors per lakh population in India

http://www.hindu.com/thehindu/holnus/001200612020312.htm

The doctor-population ratio in the country does not paint a very flattering picture of the status of medicare, with only 128 doctors available for every one lakh people.

The ratio works out to a dismal 1:781, Minister of State for Health and Family Welfare Panabaka Lakshmi said in a written reply in Rajya Sabha on Friday.

As per the statistics of the Medical Council of India, the allopathic doctor-population ratio at present works out to an even worse 1:1722.

There are more than six lakh practitioners of Indian Systems of Medicine and Homeopathy in the country, Lakshmi said.

There are 262 medical colleges with an annual intake of around 29,500 students, she said in response to a question on the steps being taken to improve the ratio.

"As existing in other professions, even in the medical sector, some doctors resort to migration abroad for improvement in one's prospects for professional, academic and financial considerations, which is a common feature in a number of countries," she said replying to a question on whether migration of doctors to foreign countries was one of the reasons.

Wockhardt Hospital, Bangalore
photo copyright Abhinav Agarwal

http://img112.imageshack.us/img112/6849/wockhardthospitalabhinatt9.jpg

http://img281.imageshack.us/img281/5993/wockhardthospabhinavagalx5.jpg

I think it's more important for the Indian health care system to focus more on the needs of its own population than to go to full lengths to attract medical tourists. There is no point in having a huge medical tourism industry when your own hospitals can't cater to the average population.

In terms of doctor shortage, with a huge population that will be a continuous problem. But in addition to training more doctors, they have to in some way keep the trained doctors in India. So many of them use Indian training and just emigrate from India. And the only way to keep these doctors in India is to have better hospitals and a proper system.

The medical tourism is being led by private hospitals, and I suppose they can do whatever they want, as long as they are not breaking rules.

Providing primary healthcare to millions of children in such a huge country is a Herculean task, and despite the government's best efforts, it has always remained inadequate. Massive private involvement is the way to go.

The medical tourism is being led by private hospitals, and I suppose they can do whatever they want, as long as they are not breaking rules.

Providing primary healthcare to millions of children in such a huge country is a Herculean task, and despite the government's best efforts, it has always remained inadequate. Massive private involvement is the way to go.

First of all, I think all the private hospitals vouching for international patients have to have their hospitals certified by healthy care agencies like HCA in US. Simply because big insurance companies who send their patients to India cannot go for Hospitals that do not match HCA (Hospital Corporation of America) standards. Sending patients to any other health care facility is an open invitation to costly law suits.

Secondly, this mushrooming of private hospitals provides excellent opportunity to expand medical education. If you notice, ALL medical colleges are located in a hospital. Government should liberalize the education and allow private hospitals to setup educational facilities and appoint a regulator on the line of TRAI in Telecom.

But with Mr. Arjun Reservation Singh in HRD, it is highly unlikely that will happen anytime soon.

An interesting article...

Fixing India's healthcare system

S Sivakumar

India has made remarkable strides in increasing the life expectancy of its citizens. During the beginning of the 1930s, the average life expectancy of an Indian adult was only 32 years.

As of 2000,the average life expectancy stands at 64 years. Advances in medical science and improvements in sanitation have reduced the spread of infectious diseases, better medical facilities, preventive measures using vaccines against diseases such as polio, measles and awareness have contributed to the rise in life expectancy.

This article analyses the state of healthcare in India, indicates some of the deep-rooted structural problems, and highlights possible solutions to address the problem.

J K Arrow, the Nobel Prize winning economist laid the foundation of health economics. His major contributions to the field are medical economics of social choice, social investment criteria, market failure in healthcare, behavioural aspects of healthcare under uncertainty and optimal insurance.

The principles are relevant for India's healthcare research and policymaking. The growth in per capita income, increasing urbanisation, availability of modern biomedical technology, education and overall awareness indicate that demand for healthcare is bound to increase in the country.

There is a two-way causality between health and economic development. Countries, which are economically well developed, tend to invest more on healthcare.

Greater investment in healthcare also leads to longer life expectancy, less morbidity and increasing work productivity that results in economic progress.

Over the last two decades, life expectancy at birth in India has increased by approximately double the increase in life expectancy in middle income and high-income countries.

However, the average Indian life expectancy is 15 years less than that of a citizen of a high-income country. Notice the low levels of public expenditures on health in India compared to middle income and high-income countries.

The ratio of India's purchasing power parity-adjusted per capita income to that of middle-income countries is 52 per cent and that of high-income countries is 10.6 per cent. The ratio of India's purchasing power parity-adjusted health expenditure per capita is 35 per cent of middle-income countries and 3.6 per cent of rich countries.

Even allowing for some wasteful expenditure in developed countries, we are certainly under investing in health. Notice the low levels of public expenditures on health in India compared to middle income and high-income countries.

The number of physicians per 1000 people has remained unchanged in India over the last twenty years. Another unique feature in the country is the usage of public health services by the bottom 20 per cent of the population (classified by income), which is only marginally higher than the top 20 per cent of the population.

Hence, there is urgent need to rejuvenate the public healthcare system to ensure that the poor get access to essential medical services.

Though the budget resources are scarce, there is certainly a need to double the public expenditure on health, given the long-term benefits. The emphasis should be on prevention and making essential public health services available to the poor.

About 88 per cent of the pregnant women are anaemic. India is unfortunately leading the world in this risk factor. The surprising issue is that this is not related to income distribution.

Other aspects such as low birth weight babies and child malnutrition are close to the poverty line numbers. While deadly diseases such as Tuberculosis and HIV are receiving public attention, the long-term consequences of in utero problems have been neglected.

Rober Fogel, the Nobel prize winning economist emphasises that "It may well be that a very large increase in expenditures on ante-natal care and paediatric care in infancy and early childhood is the most effective way to improve health over the entire life cycle, by delaying the onset of chronic diseases, alleviating their severity if they occur, and increasing longevity."

In a study published in The Lancet 1996, which evaluated 517 men and women born between 1934 to 1954 in a mission hospital in Mysore, 9 per cent of the men and 11 per cent of the women had coronary heart disease.

Low birth weight, short birth length and small head circumference at birth were associated with the prevalence of this disease.

The highest prevalence of the disease (20 per cent) was in people who weighed 5.5 lbs (2.5 kg) or less at birth and whose mothers weighed less than 100 lbs (45 kg) during pregnancy. In India, coronary heart disease is pitted to become the most common cause of death within 15 years.

Some of the key problems are low public spending on health, lack of emphasis on prevention, enforcing standards of medical care rendered by hospitals and private health practitioners, insurance to provide financial protection from catastrophic events, more research, awareness and communication and greater public involvement in understanding health issues. It is of paramount importance to increase public spending on health.

Given that even the poor are not using public health services, it is time to revamp it to offer basic essential services of good quality to all and charge in a graded fashion for specialised services.

A significant portion of the spending must be targeted toward prevention by subsidising and making available nutritional supplements for pregnant women.

Substantial efforts must be directed toward acquisition of 'womb to tomb' data on health and ill health. Such research efforts can yield insights into the risk factors that lead to chronic diseases.

The importance of ante-natal healthcare must be disseminated widely in India. The Indian Council of Medical Research has already done some work in this area.

More needs to be done. One of the creative ways is to harness college students to spend at least 100 hours as part of their curriculum to create awareness of health in rural and remote areas.

Presently doctors conduct camps in rural areas for testing, administering antibiotics etc. By creating awareness, you can lower the cost of dealing with chronic conditions later on in life and enhance the quality of life.

The private sector can create incentives for students who undertake such activities by explicitly including such community service as a factor in their recruitment decisions.

The private sector must also fulfil its social responsibility by committing some resources to non-governmental organisations and holding them accountable for results.

India does not have a functional western model to follow in healthcare. The non-price rationing by queuing in Canada/ Britain and the price-based rationing in the US are not functioning effectively. India has its own system with private healthcare practitioners, who are largely unregulated, playing a significant role in meeting the healthcare needs of people.

More disclosure on the part of the private clinics and hospitals must be made mandatory so that the public can assess the quality of medical care and get some understanding of the track record of practitioners and hospitals.

Research has shown substantial medical expenditure occurs during the last two years of a person's life. A broad based hospitalisation catastrophic insurance must be offered to protect individuals in their old age.
The benefits clearly defined and properly enforced can minimise fraud and delays in these programmes. Last but not the least, more collaboration is needed between doctors and economists to jointly pursue research and make health economics a robust discipline for specialisation. A healthy India is certainly a precondition for a wealthy India.

Apollo Hospital New Delhi - Designed by Hafeez Contractor

http://www.indiabuildnet.com/arch/ahc-18.jpg

http://www.indiabuildnet.com/arch/ahc-12.jpg

http://www.indiabuildnet.com/arch/ahc-16.jpg

http://www.indiabuildnet.com/arch/ahc-17.jpg

Elbit, Ambuja Realty to build hospital chain in India

Israel-based Elbit Medical Imaging Ltd. said it signed a joint venture with India's Ambuja Realty Group to develop and operate a chain of multi-specialty tertiary hospitals in India.

The company said the first hospital in the chain will be a 1000-bed centre in Kolkata and the capital investment in the project will be about 10 billion rupees (about $230 million) over a period of several years.

http://today.reuters.com/news/articleinvesting.aspx?view=CN&storyID=2006-12-11T140212Z_01_WNAS5211_RTRIDST_0_ELBIT-JOINTVENTURE-AMBUJAREALTY-URGENT.XML&rpc=66&type=qcna

Corporate hospital sector witnesses healthy growth (http://www.business-standard.com/compindustry/storypage.php?tab=r&autono=268323&subLeft=1&leftnm=1)

The corporate hospital sector of the country is all set to take away a significant share of the tertiary healthcare service business from individual private healthcare providers by 2010.

All major players, doing brisk business, have lined up plans for green field projects and acquisitions capable of at least doubling their capacities within two years.

Existing corporate like Apollo, Fortis, Wockhardt and Max have all announced plans for setting up new healthcare facilities. Corporate groups like Apollo Tyres and Paras are among the new entrants in the healthcare business.

The move is triggered by the growth in the GDP, emergence of health insurance and expected growth in the medical tourism.

Says Vishal Bali, CEO, Wockhardt Hospitals “The corporate healthcare segment is to replicate the success of Indian IT sector. Healthcare space is getting more and more organised. Ten years from now, 30 - 40% of tertiary healthcare delivery could come from corporate sector.”

Wockhardt which had a bed strength of 650 two years ago, currently has 10 hospitals with 1500 beds across five states. Two 250 bedded hospitals are coming up in Calcutta and Delhi. The company intends to reach out to second tier cities too in future.

Meanwhile, Max Healthcare Institute Limited, a major player in the National Capital Region of Delhi saw its revenue from all six hospitals grow 195 per cent during 2005-06.

The company, that will complete its first phase of expansion with the completion of its 100 bedded hospital in Gurgaon next year is planning to go beyond NCR as its next growth phase.

The consolidated turnover of Apollo Hospitals Group, leading healthcare chain of the country also showed a steady growth during the last few years. Apollo also added 255 beds to its combined bed strength during H1 2006.

Paras Healthcare, the new entrant into the hospital business, plans to invest about Rs 650 crore in next two years to set up five specialty hospitals in NCR region. The first project of the group, a 250 bedded speciality hospital focusing on neuro-surgery, trauma, orthopedics, and mother & child, is already completed.

“The second phase of our expansion involves the setting up of three green field hospitals and two acquisitions in NCR within two years. Our green field projects will have a bed size of 250 each and the acquisitions will be of small facilities with 60 - 70 bed strength”, Dr Dharmender Nagar, Managing Director, Paras Hospitals said.

The report of the National Commission on Macroeconomics and Health had estimated the size of private healthcare sector in India to be worth Rs 69,000 crore and projected that size to double to Rs 156,000 crore by 2012,besides an additional Rs 39,000 crore if health insurance picks up. With the current pace, the corporate segment in the private medical service sector is likely to absorb a good share of this business.

Hmmm!
It's really interesting that forumers have started to discuss about this topic. Let me get some points clear.
1. Are we talking here about buildings which provide physical health care?
2. Are we seeing 'Health' here as an industry?
3. Are we talking about 'Health' as a basic/fundamental right?
It's incredibly complex if we talk about 'Health' as basic concept or as defined holistically. To talk about 'medical tourism' in India, without looking in to the shabby public health service available to millions of poor is an unethical, hypocrtic and extremely complacent way of seeing improvement of health care in India. What we have seen is vertical development in tertiary health care technology catering to medical illnesses, rather than 'True health'.
There is an issue of industry here, of course.
We also need to see it's relation with primary education and population explosion.
However, few signs of optimism can be smelt. I am just putting them randomly:
1. Prime minister's NRHM (National Rural Health Mission).[http://mohfw.nic.in/nrhm.html]
2. Establishment of several public health institutes collborating with
International institutes like John Hopkin's Bloomberg school of public health
We can also try and replicate good public health service seen in some states, like Kerala (through different public health indicators).
Finally on my recent trip to a small village in Assam, I witnessed a community hospital (also the FRU for the region, FRU being First Referral Unit) doing extremely well ( as told to me by a staff). It even has been rated the best in Asia in it's category on several performance measures. I, of course could not verify it personally. I took two photographs of the same. Here, one of them:
http://img183.imageshack.us/img183/3387/assam4137kq8.jpg (http://imageshack.us)

Have you guys explored the NEIGRIMS?
Find out more in [http://neigrihms.gov.in/]
One image of the institute:
http://img145.imageshack.us/img145/3356/neigrimsgn6.jpg (http://imageshack.us)
This is courtsey: http://www.flickr.com/photos/33901600@N00/

Any comments?
:ohno:

Another thing, if somebody talks about model of health care in India, I would very much prefer a two-tiered system. It would draw the best example and best practices of private institutes (e.g. Kaiser Permanente) (http://www.kaiserpermanente.org/) and improved goverment aided equitable public health infrastructure. How these two will marry is a different problem to solve again.
THIS MUST BE A FANTASY ON MY PART

Hmmm!
It's really interesting that forumers have started to discuss about this topic. Let me get some points clear.
1. Are we talking here about buildings which provide physical health care?
2. Are we seeing 'Health' here as an industry?
3. Are we talking about 'Health' as a basic/fundamental right?
It's incredibly complex if we talk about 'Health' as basic concept or as defined holistically. To talk about 'medical tourism' in India, without looking in to the shabby public health service available to millions of poor is an unethical, hypocrtic and extremely complacent way of seeing improvement of health care in India.

Any comments?
:ohno:

Well the thread has just started. What course it takes depends on what forumers discuss.

I don't see anything wrong with highlighting Medical Tourism. It's part of the health "industry". Similarly someone wants to highlight achievements and failures of the public health "services" it is fine.
A new thread always takes some time to evolve.

Indian Soul has good points in his post, and from I understand, medical tourism is but once facet of this whole thread.

Ideally, I would like to discuss our domestic healthcare infrastructure more, and with the government supposedly more open to private role in that, we will get to see many more private sector hospitals coming up in all parts of the country which will also cater to public healthcare.

While I understand many of these hospitals will mostly cater to the more well off, but like you said, hopefully we will get to see an excellent system of government aided and guided public health infra lead by the private sector.

Thanks Kronik. If only I am allowed to be sceptical, please go through this serious stuff...:?

(From http://phm-india.org/issues/nrhm/ruralhealthpolitics.html)

The Politics of Rural Health in India
- Debabar Banerji, Professor Emeritus, Centre of Social Medicine and Community Health, JNU




The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long suffering rural population to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, either because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, both in terms of the efforts to earlier somewhat sincere efforts to develop endogenous mechanisms to offer access to health services as well as from the devastative impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, techno-centric vertical programmes on the people of India. The also ignore some of the basic postulates of public health practice in a country like India. That did not substantiate the bases of some of their substantive contentions with scientific data obtained from health systems research reveals that they are not serious about their promise to rural population. This is yet another instance of what Romesh Thaper had called `Baba Log playing Government Government'.

Political Dimensions of the National Rural Health Mission
In the formation of the National Rural Health Mission (NRHM) (1) we hear echoes of what Rudolf Virchow (2) had said in that fateful year of 1848 - that health is politics and politics is health, as if people matter. Despite making numerous solemn promises to improve the situation since India gained Independence, the state of the rural health services to this day is extremely unsatisfactory. This is rooted in the politics of heath and health services of the past. However, to garner the rural votes, during the 2004 elections, some political parties expressed `deep concern' over these shortcomings and made yet one more promise to rectify the conditions. After the elections, they brought together some other parties to form of the United Progressive Alliance (UPA), which was able to form the government at the Centre. Improvement of the rural health services was included as a part of the Common Minimum Programme (CMP) agreed to by the UPA.



The obviously limited political commitment to improving rural health services has confined the NRHM mostly to some superficial issues that have come in the way of development of the rural health services. For instance, while the UPA has regretted that India has the unenviable distinction of being among the lower five countries of the world in terms of the percentage of the GDP allotted to the health services (0.9%) (1), it has not analysed the politics of the of the process of the steady decline of the percentage over the years. The same considerations have led to their ignoring the fact that while the public sector heath expenditure accounts for some 70-90 per cent of the total health service expenditure in rich European countries, it hovers around 20 per cent in India. The CMP contains promise to increase the expenditure to `2-3% of the GDP' in the five years of the rule by the PHA. The budgetary allocations for the first two years do not appear very promising (3). Furthermore, because of its very apparently limited purpose, the NRHM has got to be ahistorical in its approach. It has to adopt a simplistic approach to a highly complex problem. It provides little scientific evidence, based on health systems research, to substantiate its recommendations. Even a cursory look at the history of public health in the country will expose many serious flaws in the formulation of the NRHM. These considerations will be taken up in some detail after a brief review of the trends in health service developments in the past and the politics which has shaped them.

Early Phases of Growth and Development of Health Services
The politics of health and health services was qualitatively very different and much more powerful during the freedom movement. This was summed up by the National Health (Sokhey) Sub-Committee of the National Planning Committee of the Indian National Congress (4) in 1940. What it has called `the cornerstone of the scheme of their recommendations' was a Community Health Worker for every 1000 of village population. This worker is trained in practical community and personal hygiene, first aid and simple medical treatment with stress on social aspects and implications of medical and public health work. It also recommended that, `Practitioners of ayurveda and unani systems were to be drawn into the state health systems, after giving them further scientific training when necessary.'

The report of the Bhore Committee (5), submitted in 1946, is to this day regarded as an authoritative document, not only because of its distinguished authorship but because many of its proposals and recommendations continue to be valid even today. It was guided by such lofty principles as `nobody should be denied access to health services for his inability to pay' and that the focus should be on rural areas, with emphasis on preventive measures and training of what it called `social physicians'.

After Independence, the political soil was not adequate to nurture the seeds of hope that took shape during the freedom struggle. However, during the early years the new rulers were impelled to carry over some of the democratic processes in making decisions concerning health. Taken as a whole, these decisions gave a perspective to public health principles and practices in the country, which was markedly different from the ones preached in the conventional schools of public health in Western countries or elsewhere (6). Despite considerable difficulties and shortcomings, India could develop an endogenous, alternative body of knowledge that was more suited to the social, cultural, economic and epidemiological conditions prevailing in the country. This led to the emergence of an alternative approach to education, training, practice and research in public health (7). Mention of highlights of some of the major decisions are being made to elaborate on the outcome of the pro-poor ambience which lasted during the early years of Independence.



Following the acceptance of the report of the Bhore Committee by rulers of the newly independent country, a start was made in 1952 to set up Primary Health Centres (8) to provide integrated promotive, preventive, curative and rehabilitative services to entire rural populations, as an integral component of a wider Community Development Programme (9) - it sought to be an integrated health services approach as a component of intersectoral action, as was envisaged much later in the Alma Ata Declaration on Primary Health Care (10).



Departments of social and preventive medicine in medical colleges were upgraded to give social orientation to medical education (11), (12)),(13). Apart from the already existing highly rated institutions like the All India Institute of Hygiene and Public Health (14) and the Malaria Institute of India (15), institutes such as the National Institute of Communicable Diseases (16), National Institute of Health Administration and Education (NIHAE) (17) and the National Tuberculosis Institute (NTI) (18) were established in the 1960s, to provide support to education, training and research to the budding health service system of the country.



During 1961-64, interdisciplinary research work done at NTI received worldwide attention (19). Perhaps the most remarkable feature of its work was to give primacy to people (20). Imparting sociological dimensions to epidemiological issues (21), developing people oriented technologies and formulation and use of operational research approach in public health (22),(23), can be cited as instances of some other features of the National Tuberculosis Programme (NTP) developed at NTI . NTP was designed to sink or sail with the general health services (20).



The convulsive political changes that took place in the 1970s impelled the Central Government to implement the vision of the Sokhey Committee of having one Community Health Worker for every 1000 people to entrust "People's health on people's hands"(24). At least on paper, India had developed a network of health services, which compared favourably with any country in the world with similar socio-economic situation. There was a Community Health Volunteer/Volunteer and a Trained Birth Attendant for every 1000 population, a sub-centre with a male and a female multipurpose health worker for 5000 people, a primary health centre for every 30,000 people and a community health centre for 100,000 persons, with referral and supervisory and supportive echelons which went right up to the national level. As providing health services to the population was considered a responsibility of the government, these services were offered free of charge.

India had thus came quite close to the Alma Ata Declaration on Primary Health Care made by all the countries of the world in 1978 (10). The Declaration included: commitment of governments to consider health as a fundamental right; giving primacy to expressed health needs of people; community self-reliance and community involvement; intersectoral action in health; integration of health services; coverage of the entire population; choice of appropriate technology; effective use of traditional systems of medicine; and use of only essential drugs.

Phases of All Round Decline in Organisation and Management
Not unexpectedly, there were huge gaps between the policy commitments and their implementation. Significantly, as late as in 1982, the government party, which had been ruling the country during the past 35 years, made a major move in the politics of health by coming up very sharply against the heath work done in the country during that period. In the document on its National Health Policy of 1982 (25), it had described the health services at that time `has been largely engendered by the almost wholesale adoption of the health manpower development policies and establishment of curative centres based on western models, which are inappropriate and irrelevant to the real needs of the people and the socio-economic conditions obtaining in the country. The hospital-based disease and cure oriented approach towards the establishment of medical services has provided benefits to the upper crusts of the society, especially those living in the urban areas.' It took another 20 years for the government of India to confess in the 2002 edition of its National Health Policy (26) that the promise made in the 1982 were `too ambitious' (!!) and that it needed toning down. The NRHM (1) is the latest phase in the making promises to the long suffering deprived sections of the people of the country.



However, the reasonably correct public health commitments made at the initial phases could have been used as a springboard for more effective implementation of the philosophy of Primary Health Care in India. This did not happen. Significant shifts in the power relations between the rich and the poor, both within the country and internationally, came in the way. Even the limited hopes aroused during the early years after Independence were belied.



The seeds of a retreat from the promising start were sown as early as in 1967 (27). A virtual mass hysteria was worked up by the ruling elite and their mentors from foreign countries about the perils of population explosion. A common refrain those days was to exclaim that `the fruits of development are being eaten away by the exponential growth of population'. It was obviously inconvenient for the proponents of population control to ask the simple question: who had been eating away the so-called fruits of development during the earlier two decades? It was inevitable under the highly polarised power relations that the only way to control population growth among deprived sections was to use force. To get this hatchet work done, the politicians preferred the bureaucrats, who still carried the colonial tradition of imposing the will of their masters on the people. They also lacked adequate technical competence which could embarrass their masters by asking inconvenient questions. Another `qualification' of bureaucrats is that they are ahistorical - they have short memories, as they frequently hop from one ministry to another. The politicians of all hues, bureaucrats and foreign agencies formed a formidable nexus - a powerful syndicate



The Union ministry of health was crudely `partitioned' into departments of health and family planning. Family planning was accorded overriding priority by the government (27). People became the `targets' of their own government (28),(29). Most of the political parties within or outside the legislatures, the intellectuals and social activists were mute spectators, if not active promoters, of this gross violation of human rights of the masses of people for three decades (30). However, as described in detail elsewhere (30), despite almost astronomical allocation of funds to family planning, as compared to other health programmes, the population of the country shot up from 351 millions in 1951 to over a billion in 2001 - `greater the allocation, the greater is the decennial rise in population growth!' In addition, preoccupation with family planning led to gross neglect of the health services, which were so painstakingly built over the first two decades after Independence.



Then, there were the far-reaching consequences of the responses of the rich countries to the declaration of self-reliance by the poor people of the world at Alma Ata in 1978 (31). Their response was swift and sharp. Knowingly or otherwise, they betrayed profound lack of understanding of the basic philosophy of the Alma Ata Declaration of entrusting "People's health in people's hands", by contending that most of the developing countries were too poor to undertake what they called `comprehensive primary health care' (32). Instead, in 1979, these descendents of the European Enlightenment virtually fabricated, without producing any scientific evidence, an alternative approach of limiting action to dealing with a few diseases at a time which they claimed to be cost-effective and which can be managed by such countries - and it received a proud place in the New England Journal of Medicineas a `profound' piece of research (32),(33),(34) (35).



This alternative was called the approach of Selective Primary Health Care (SPHC), which is the very antithesis of the concept of primary health care (PHC) (36),(37),(38) Under the substantially changed political equations between and within countries, the political leaderships of poor countries were `persuaded' by rich countries to give up some of the key elements of PHC in their health services in favour of SPHC.



The rich countries mobilised organisations such as the WHO, UNICEF and the World Bank to promote their agenda of SPHC (35),(39). This led to opening up of a virtual barrage of what the international agencies called International Initiatives (39),(40),(41). These `vertical' or `categorical' programmes were ill-conceived, prefabricated, technocentric programmes, which were imposed on the poor countries of the world. Worse still, despite massive investment running into billions of US dollars in these vertical programmes on a global scale, they have fallen far short of the forecasts made at the time of their launching (42).



Government of India, in its National Health Policy 2002 document (26) makes a forthright `confession' of the degree to which its health service system suffered for agreeing to the donor driven vertical programmes (including immunization, Tuberculosis and AIDS). It now says: `Over the last decade or so, the Government has relied upon a `vertical' implementational (sic) structure for the major disease control programmes. Through this, the system has been able to make a substantial dent in reducing the burden of specific diseases. However, such an organisational structure, which requires independent manpower for each disease programme, is extremely expensive and difficult to sustain. Over a long time range, `vertical' structures may only be affordable for those diseases which offer a reasonable possibility of elimination or eradication in a foreseeable time frame"...



It goes on to state :"It is a widespread perception that over the last decade and a half, the rural health staff has become a vertical structure exclusively for the implementation of the family welfare activities. As a result where there is no separate vertical structure, there is no identifiable service delivery system at all. The Policy will address this distortion in the public health system".



These had been an awe-inspiring demonstration of power of the rich to impose their will on the poor. As late as in 2001, WHO's much publicised Commission on Macroeconomic of Health (43:68), which, incidentally, included the eminent Indian economist-politician, Manmohan Singh, had strongly advocated adoption of vertical programmes.



In addition to the imposition of the International Initiatives, the International Monitory Fund had imposed conditionalities in return for extending loans to bail out the government of India from the financial morass of the early 1990s. Their Structural Adjustment Programme (SAP) enabled the IMF entry into most vital elements of the governance of the country in the form of influencing budgetary allocations in the country. Dutifully submitting to their dictates, the then Union finance minister Manmohan Singh inflicted a 20 per cent cut in the health budget of 1992-93, without taking into account the inflation (44),(45). The impact of the SAP on the state health budgets was even more devastating. The decimation of the state funded health service system enormously expanded the space for private initiative. Indeed, the government extended assistance to the private sector in the form of various types of duty exemptions and incentives. The governments were also made to undertake a most unimaginative regime of `cost recovery' from the pitiably meagre allocations made for the government funded health services (44),(45),(46). The breakdown of the public health system rapidly expanded the `market' for the private sector.



The government's moves towards globalization further extentuated this trend of commodification of the medical services. There has been a mushrooming growth of numerous unregulated profiteering private hospitals, nursing homes, diagnostic centres and other ancillaries of the medical industry. With unabashed political support, unregulated institutions for education of physicians and other health personnel such as dentists, nurses, homeopaths and vaids rapidly expanded in the private sector as they became a lucrative field for making profits at the expense of the suffering of the people..



All these trends point to what Ivan Illich (47) had long ago mentioned as medicalisation of life. Producing dependence - almost addiction - to medicine and generation of iatrogenesis of various kinds, were mentioned by him as maladies of the market driven `modern' medicine. Systemisation of medicine, when healers become a cog of the wider `system' and its even more awesome manifestation in the form of a still bigger conglomerates -conglamoratisation - have been the more advanced manifestation of this malignant trend in the `developed' countries (48). The vast proportion of suffering people of the world, who have lost their endogenously developed coping capacity and who are unable to pay the exorbitant rates charged by the private sector institutions, were left in the lurch - it is a case of Marie Antoinette Syndrome - no free lunch for the poor! Illich's prescription (47) for this dilemma is demystification of medicine and increasing coping capacity of the people to deal with their health problems, as also visualized by Gandhi (49), John Grant (50), the Sokhey Committee (4) and Borremans (51).



Conventional public health organisations have virtually ceased to perform the function of preventive work. Even the work of epidemic control has sharply deteriorated. Information system to identify outbreaks of epidemics and emergency action to control them, as was done even in the colonial days, has long ceased to exist. Even the few of the outbreaks that get reported in news media elicit tepid response from the authorities, including pivotal investigative agencies. People, including those who pretend to take their side, meekly submit to outbreaks of several `epidemics of epidemics'.



The imposition of the TRIPS regime by the World Trade Organization has led to steep escalation of prices of drugs.

Present State of the Health Services
The foregoing analyses of different phases and facets of the health services of the country make it possible to get an idea of the state of the health services. It will be sufficient here to refer only to a few of major studies.



An Independent Commission on Health in India (52) (ICHI), set up by the Voluntary Health Association of India, which submitted its report to Prime Minister Vajpayee in 1997, had pointed out that the health services `are in an advanced stage of decay'. Equally expectedly, this evoked little action from the head of the government or from the concerned minister. Documents from the Planning Commission also paint an equally gloomy picture (53),(54). A study of a national sample of community health centres (CHC) (55) by the Programme Evaluation Organisation (PEO) of the Planning Commission has revealed that virtually none of them is working at its optimal level. The 1992 and 1998 Rounds of the Family Health Survey (56), (57) revealed that India is among the countries having the highest rates of maternal mortality. The survey conducted by the National Council of Applied Economic Research (58) revealed that, among the poor, expenditure incurred to meet the medical needs is the second most important cause of rural indebtedness.



A newspaper report (the Pioneer, New Dehli, April 23, 2005) quotes the Programme Iplementation Division of the government of India as saying that with the exception of the (small) States of Nagaland and Harayana, there has been `zero per cent' growth in the setting up of Primary Health Centres; the target was 193. The performance in terms of setting up Community Health Centres (CHC) is equally pathetic. As against the countrywide target of 103, merely 11 CHCs were set up during April 2004 and January 2005. The Mission Document (1) too draws a bleak picture - hospitalized Indians, on an average, spend 58% of their total annual income; over 40% of hospitalised Indians borrow heavily or sell their assets to cover expenses; over 25% of hospitalised Indians fall below poverty line because of hospital expenses.

Evidence Base of the of the Approach of the Mission
The approach adopted by the Mission provides a telling evidence of the lack of competence of the political and bureaucratic leadership of the Ministry of Health and Family Welfare (MOHFW) and its advisors to develop thinking to rectify what the ICHI had rightly termed in 1997 as an `advanced stage of decay of the health services system, particularly the rural health service system of the country'. As mentioned earlier, the Mission has adopted a simplistic approach to a highly complex problem. Instead of considering the health services as a complex, interacting system, they have selected a few catchy slogans such as `Accredited Social Health Activists' (ASHA), Panchayat Health Committees, Rogi Kalyan Samities, health planning starting at the village and district levels, setting up rural health missions at the district, state and national levels, and so on. It brings to mind what the late Romesh Thaper had mentioned in the context of the Emergency of 1975-77, as `Baba Log playing government government'.



There are three fundamental infirmities in the Mission Document which seriously erode its credibility for dealing with the daunting task of improving the health situation in rural populations, particularly in the backward regions:

The MOHFW seems to be doggedly refusing to learn from the past experiences. The most conspicuous among them was the experience of the large scale employment one Community Health Volunteer (CHV) for every 1000 people, along with setting up of a trained dai in every village, by the Janata Party government, which came to power in the wake of withdrawal of the Emergency. The CHV Scheme, which at one stage had more than 450,000 workers, could not be sustained because of the nature of the power structure in villages. If anything, the class-caste equation has deteriorated much further following the `mandalisation' of the population. The MOHFW did not learn any lesson from this experience while formulating the centrepiece of the recommendations of the Mission - that of having ASHAs in every village of the country. One of the advisors involved in formulating the NRHM (1) got so much carried away by their `re-invention of the wheel' that he visualized `These women should emerge as the missionaries dedicated to advancing health in India. Money, medicines and medical facilities will be meaningless without these missionaries'. If he had analysed the causes of failure of the CHV Scheme, he would have realised that he was unwittingly writing the obituary of the NRHM! One explanation for such a major flaw of thinking in the formulation of the NRHM could be that the bureaucrats of the MOHFW and their political masters had never been very serious about the plight of the deprived sections of the population. Otherwise, how can one explain the `advanced stage of decay' of the health services six decades after Independence?



The MOHFW and its advisors must have suffered from massive blind spots about well established principles of public health practice when they developed their vision of the rural health services. For instance, developing facilities for education and training of Managerial Physicians, who have the epidemiological, managerial, social and political competence to provide leadership in the administration of the health services in the country, ought to have found a key place in the in the Mission Document. It was perhaps necessary for the MOHFW officials to develop the blind spots, because, otherwise it would not have been possible to justify giving dominant positions to unqualified, ministry hopping bureaucrats in the MOHFW, or, for that matter, having physicians with no public health qualification or even experience to occupy key positions in the health administration - sorts of square pegs in round holes. Other key issues such as the cadre structure at the State and Central levels, epidemiological approach to solving community health problems, social orientation of education and training of different categories of health workers, and line and staff alignments in the drawing up the organizational structure, have been kept out of the range of vision of the Mission. Political leaders have also looked the other way, as these blind spots conveniently fall within the purview of their politics of health and health services



The central task for the NRHM was to produce data which would enable the MOHFW to devise the mechanism(s) to make most effective use of the resources -- in terms of the funds, technology, organization management, etc -- within the constraints of given social, cultural, economic, epidemiological and other such conditions: that is, it was required to find ways of optimizing use of resources under given conditions However, NRHM has produced little supportive data for carrying out its elaborate Plan of Action, which encompass a number of key components -- technical support mechanisms, including conceptualization of a Programme Management Support Centre and Health Trust of India, role of the Central and State government machinery, Panchyati Raj Institutions, NGOs and paying attention to special problems to the North-Eastern State and Mainstreaming AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy). Thus, it ought to have been a classical problem of systems analysis and operational research (22),(24). The NRHM has failed to substantiate their contentions with appropriate research data derived from health systems reaserch, using such methods: there is no scientific evidence base to justify the proposals made by them will lead to optimization of the use the resources. This is a grave infirmity in the Mission Document. In the absence of supportive scientific evidence, it almost amounts to practice of public health quackery. Furthermore, the system conceived by them excludes such vital elements as health human resource development, cadre structure at the Central and State levels and organisations for conducting health systems research at various levels. The timid mention of `Action research' goes to show their lack of understanding of the research needs As issues such as nutrition, access to adequate amounts of protected water and proper environmental sanitation has critical bearing on the health status of the rural populations, these also ought to have formed key variables in the analysis of the rural health system. Confining analysis to a truncated portion of the rural health system and that too in the absence of a minimal evidence base, cuts at the very root of the approach of the Mission. It will turn out to be a fatal lapse.

The NRHM, should, however, be commended for attempting to make a `bottom-up' approach to development. It has also gone beyond the somewhat halting steps spelled out in the National Health Policy of 2002 by categorically stating that the `National Disease Control Programmes for Malaria, T.B.(sic), Kala Azar, Filaria, Blindness and Iodine Deficiency , and Integrated Disease Surveillance Programme shall be integrated under the Mission for improved programme delivery'. The massive Programme under Family Welfare also falls in this category. Not unexpectedly, however, the actual delivery of the services under the National Disease Control Programmes retain their `essential verticality', as envisaged in the original documents of these vertical programmes. These find mention in the Annexures1-5 of the draft guidelines given in the Indian Public Health Standards (IPHS) for Community Health Centres (CHC) (62), prepared by the NRHM. Had it not been so, echoes of the integrated National Programmes could have been heard all along the line, down to the work specifications of the ASHA.



It is worth noting that the Task Group-III of the NRHM, which was assigned the task of preparing document on IPHS (59), after discussions with the RHM authorities, stated that `the paper was scaled down to discuss the requirements for the minimal functional grading of the CHCs with scope for further upgradation'. Essentially, the `minimal functional grading' was the same as those worked out when the CHC scheme was launched long ago. Furthermore, while the Mission had identified 18 States of the country, `which have weak public health indicators and/or weak infrastructure', namely, Arunachal Pradesh, Assam, Bihar, Chhatisgarh, Himachal Pradesh, Jharkhand, Jammu and Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orrisa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh, this may well turn out to be a Quixotic assignment for the Mission personnel when it is realised (as was demonstrated in PEO Report on CHC and the recent report on Programme Implementation, 2004-5) that very few of the CHCs in the remaining `non-weak' States of the country come anywhere near fulfilling the `minimal grades' set by the IPHS of the task Group-III. Under such conditions, visions of such formidable tasks as `provision of 24-hour service at least in 50% of the PHCs', `ensuring conformation to IPHS at CHCs', `public-private partnership', `reorientating health/medical education to support rural health issues' and `pooling of medical care expenses', come very dangerously close to mere wishful thinking.



View list of references

Hi,
Here are some pictures of the National Drug Dependence Treatment Centre at Kamla Nehru Nagar, CGO Complex, Ghaziabad. It's a part of the AIIMS, New Delhi. It is the national centre for treatment and research on addictive disorders. It does not get publicity like Apollo, Fortis as there is no industry issue here. But it's a part of the health care infrastructure of the country. It featured in Lancet at some point. Enjoy! The photos were taken in 2004- a bit old, no doubt.
http://img124.imageshack.us/img124/7379/oldpictures2064rr7.jpg (http://imageshack.us)

The panoramic view from front

http://img72.imageshack.us/img72/7517/oldpictures2042de4.jpg (http://imageshack.us)

Another view, not a panoramic one, taken from roof of the adjacent hostel

http://img120.imageshack.us/img120/4539/oldpictures2054rb3.jpg (http://imageshack.us)

First floor

http://img187.imageshack.us/img187/3047/oldpictures2052el7.jpg (http://imageshack.us)

Attic and corridor in first floor

Space Hospitals lines up Rs 25 cr for expansion (http://business-standard.com/compindustry/storypage.php?tab=r&autono=268919&subLeft=1&leftnm=1)

Chennai-based telemedicine service provider, Space Hospitals Ltd, is expanding its services by setting up 500 satellite medical centres, 800 telemedicine centres, and 40 more hospitals in the next one year across India.

By the end March 2007, the company plans to establish 126 telemedicine centres, 38 satellite medical centres and 10 regional associate hospitals.

In the first phase, spread over the next six months, Space Hospitals will invest around Rs 25 crore. "Our target is to establish around 10,000 centres in the next five years," said A Sivakumaran, CFO, Space Hospitals.

The company will also launch 10 mobile telemedicine units in the next one year, with two units in each of the four states -- Tamil Nadu, Andhra Pradesh, Maharashtra, Kerala and two more in New Delhi. Around Rs 10 lakh will be invested in these mobile units.

“We are also going to extend our services to the Asian countries, Middle East and Africa. We are still in the preliminary stage of discussions and will be able to formulate concrete plans after considering a few issues like connectivity tariffs. However, we intend to hit the international market in another six months," said Sivakumaran.

Space Hospitals is in talks with institutions like BRS Hospital, SKS Hospital, Meenakshi Mission Hospital, Kovai Medical Centre and Medindia for further associate hospital tie-ups.

For the setting up of satellite medical centres, it is considering tie-ups with M V K Nursing Home in Tanjore, Sangeetha Hospital in Coimbatore and Saravana Hospital in Madurai.

Space Hospitals expects around 15 percent of doctor-patient consultation in India to switch over to telemedicine services in the next five years.

Hi,
Here are some pictures of the National Drug Dependence Treatment Centre at Kamla Nehru Nagar, CGO Complex, Ghaziabad. It's a part of the AIIMS, New Delhi. It is the national centre for treatment and research on addictive disorders. It does not get publicity like Apollo, Fortis as there is no industry issue here. But it's a part of the health care infrastructure of the country. It featured in Lancet at some point. Enjoy! The photos were taken in 2004- a bit old, no doubt.


Thanks for posting them!

:)

Max Devaki Devi Hospital, New Delhi

http://img297.imageshack.us/img297/6462/max20devkidelhishk1.jpg

Dinanath Mangeshkar Hospital, Pune

http://img297.imageshack.us/img297/6715/deenanathmangeshkarhospbw0.jpg

Bombay Hospital, Indore, Madhya Pradesh

http://img259.imageshack.us/img259/1763/511596844cicwhaph7ek.jpg

http://www.flickr.com/photo_zoom.gne?id=231036994&context=photostream&size=l

Did not feel like copying and pasting for copyright consciousness

India to Increase Its Allocation for Healthcare Sector

New Delhi: India will endeavour to increase allocation for the health sector from a dismal 0.9 percent of gross domestic product (GDP) to two percent, Minister of State for Industry Ashwini Kumar said Monday.

Speaking in a Global Healthcare Conference organised by the industry lobby Federation of Indian Chambers of Commerce and Industry (FICCI), Kumar said the government had in the past shown a very insignificant level of commitment to healthcare and that was reflected in a mere 0.9 percent of the GDP being devoted to public health.

It would be the endeavour of the United Progressive Alliance (UPA) government to increase the figure to at least 'two to three percent of the GDP in the years ahead', the minister added.

He said that industry too must invest in social sectors like health and education to make growth and economic development meaningful to people.

http://www.medindia.net/news/view_news_main.asp?x=17552

Owaisi Hospital and Research Centre, Hyderabad
photo copyright nizams

http://img243.imageshack.us/img243/6051/owaisihospitalhyderabadcg3.th.jpg (http://img243.imageshack.us/my.php?image=owaisihospitalhyderabadcg3.jpg)

Wockhardt Hospital, Bangalore
photo copyright chefseehund

http://img178.imageshack.us/img178/6779/wockhardthospitalchefsewp6.th.jpg (http://img178.imageshack.us/my.php?image=wockhardthospitalchefsewp6.jpg)

KIMS, Trivandrum
photo copyright sudheeshnairs

http://img178.imageshack.us/img178/5942/kimssuddheesjjp0.th.jpg (http://img178.imageshack.us/my.php?image=kimssuddheesjjp0.jpg)

Rotary plans paediatric Orissa child eye clinic (http://business-standard.com/compindustry/storypage.php?tab=r&autono=271900&subLeft=1&leftnm=1)

Orissa will soon have a state-of-art Paediatric Eye Hospital, first of its kind in eastern India.

The sophisticated hospital, to be built by the Cuttack based JPM Rotary Eye Hospital and Research Institute at a cost of approximately Rs 2.2 crore, will not only cater to thousands of children afflicted with eye related diseases in Orissa but also other parts of eastern India.

The proposed Hospital is expected to come up by the end of March, 2008 and will directly benefit children having cataract, refractive errors, and glaucoma and visually handicapped, children with squint and possible Vitamin A deficiency and Measles blindness.

The project also promises to bring hope for the visually handicapped by providing those Low Vision Services and organise integrated education.

Sight Savers International, an international NGO, will contribute about Rs 40 lakhs for the hospital while the balanced amount will be raised from Rotarian and non-Rotarian donors and some corporate houses.

Run by the Rotary Club, Cuttack, the present JPM Rotary Eye Hospital and Research Institute has been in existence since 1992. It has 120 beds of different categories and has examined more than 10 lakh patient in the OPD, which has an average attendance of more than 200 patients.

The hospital is also a Post Graduate Ophthalmology Teaching Institute in private sector, which is recognised by the union health ministry.

"The paediatric hospital, to be located within the existing JPM Rotary Eye hospital premises at Bidanasi, Cuttack, will ensure that no child in the state remain blind due to paucity of funds. Besides giving free consultation and surgery, the hospital will create awareness among the people especially in the rural and tribal areas on preventive aspect of childhood blindness", said the president of the institute, Rotarian Pawan Agarwal.

He pointed out in eastern India states cases of visual disorder among children and child blindness are very high as the problem has not been addressed adequately and systematically due to lack of paediatric eyecare facility.

The JPM Rotary Eye Hospital and Research Institute charges a reasonable fee to the paying patients for their treatment while providing totally free services to about 70 per cent patients through outreach camps in rural areas.

Just wanted to post this story here because our rural breathren need more such services as provided by these fine people.

Reliance Life to set up hospitals, make drugs (http://business-standard.com/compindustry/storypage.php?tab=r&autono=273375&subLeft=1&leftnm=1)

Reliance Life Sciences is planning to invest at least Rs 1,000 crore to set up hospitals in the country’s metros and dispensaries in small towns. This is in addition to a similar amount the company has already committed for drug manufacture.

The company is reported to be in talks with various parties across the country for acquiring hospitals. Reliance Life Sciences is also planning to invest approximately Rs 1,000 crore for setting up four state-of-the-art facilities to manufacture generic drugs, discover molecules for new drugs and take contracts for manufacturing drugs for other pharmaceutical companies.

Last year, Reliance Industries Chairman Mukesh Ambani said the group’s future prospects lay in healthcare and life sciences. A source close to the company said healthcare would become the group’s primary focus in about two years. Part of this business would be owning and running hospitals.

The group currently owns and runs HN Hospital in Mumbai. The foray into drug manufacturing will start with the setting up of four FDA-compliant facilities near Mumbai and Pune.

Work on the first facility will begin in March. “Mechanical completion of this will take three months, following which validation will take one month. Commercial production should start by August or September this year,” said a source.

As its profits mainly lie in royalties, Reliance Life is expected to actively pursue research for discovering new drugs.

“Contract manufacturing should (also) be a lucrative business. As the company will have large FDA-compliant facilities, all major pharmaceutical companies are expected to enter into contracts with Reliance,” said another source. The source added that nearly 50-60 per cent of the medicines sold in the country were spurious and the company would be looking at correcting that imbalance with drugs.

Hope this legislation passes!

http://www.baroda.com/glimpses.html#Medical

Emergency Medical Services: To try and provide emergency medical services in accident cases and serious illnesses, Gujarat proposes to set up an Emergency Medical Services Authority and establish councils in major cities and districts. The necessary legislation will be introduced during the budget session of the Gujarat Assembly that begins on February 22. The city and district councils will register base hospitals and maintain ambulances to provide life-saving medical care to people in the 'golden hour', that is, within the first and very crucial hour of an accident. The proposed body will ensure emergency medical services to all persons (free of cost to Below Poverty Line patients), provide technical assistance to the city and district councils and NGOs, give financial assistance to these councils and accredite trauma centres.

Fortis, Apollo, L&T to set up hospitals in J&K (http://business-standard.com/compindustry/storypage.php?tab=r&autono=276290&subLeft=1&leftnm=1)

Three leading groups in the private health sector, Fortis, Apollo and L&T, have offered to set up hospitals under the public-private partnership model in Jammu and Kashmir.

“We have received nearly 17 proposals for setting up hospitals and three big proposals from the country’s leading private players in the health sector. After studying proposals, the best of them will be selected by the government,” said K B Jandial, secretary, health and medical education.

Before giving its nod to the private hospitals, the health department has decided to work out a mechanism under which the mandatory 25 per cent free treatment to poor patients is strictly adhered to by the private hospitals.

The state government has suggested that private players set up hospitals at places other than the two capital cities of Jammu and Srinagar. But a majority of them have shown interest in setting them up in the two cities.

The state government has offered land at concessional rates to the private players willing to establish hospitals and an agreement is likely to be in place after the finalisation of the proposal.

About 50 per cent of the proposals have been received from outside the state and there is one from Saudi Arabia.

Following complaints regarding the denial of benefits to poor patients, the state’s ministry of health has decided to constitute a committee to monitor the process and look into their complaints.

This proposal to private players has been offered by Jammu and Kashmir following the heavy rush of patients to government hospitals and minimise the burden on government doctors and hospitals in Jammu and Srinagar, besides other districts in the state.

There should be a thread on "Indian Pharmaceutical Sector". We are not big NOW compare to those Pharmaceutical MNCs. But there are lot of postive news on the Indian Pharmaceutical sector. I just saw a pleasent:) news on New Scientist just now.

Since this is a healthcare thread, i won't post the article. but since healthcare is closely related to pharmaceutical, here is the link (http://www.newscientist.com/article.ns?id=mg19325935.900&feedId=online-news_rss20).

India's healthcare spending to cross Rs 2,00,000 cr by 2012 (http://www.hinduonnet.com/thehindu/holnus/002200703060311.htm)


India will spend a huge Rs 2,00,000 crore on healthcare in the next five years as the country, on an economic upsurge, is witnessing changes in its demographic profile accompanied with lifestyle diseases and increasing medical expenses.

"Changing demographics and disease profiles and rising treatment cost will cause the spending on healthcare delivery to over Rs 2,00,000 crore by 2012," a CII-Mckinsey study on 'Health in India' has said.

The healthcare sector contribution to GDP and employment is significant and it is one of the largest service sectors of the economy. Given the appropriate regulatory support and clearer roles for public and private healthcare delivery, the sector can play an even greater role, the report said.

"Revenues from the healthcare sector account for 5.2 per cent of the GDP and it employs over 4 million people. By 2012, revenues can reach 6.5 to 7.2 per cent of GDP and direct and indirect employment can double," it said.

The report suggests that to meet the rising demand, India will need to invest in infrastructure and create cost-effective facilities, "Investment would be needed for building a healthy base of hospitals and medical personnel."

An investment of Rs 1,00,000 crore to Rs 1,40,000 crore would be needed to create the desired capacity, it said.

Close to 80 per cent of the required investment should come from the private sector. The Government's spending on healthcare is around 0.9 per cent of the total GDP, which limits the extent and effectiveness of the coverage it can provide.

Private healthcare will continue to be the largest component in 2012 and is likely to double to Rs 1,56,000 crore. It could rise by an additional Rs 39,000 crore if health insurance cover is extended to the rich and middle class.

The public spending could double if the Government reaches its target spending level of 2 per cent of GDP, up from the current 0.9 per cent, according to the report.

Coupled with the expected increase in the pharmaceutical sector, the total healthcare market in the country could increase to Rs 2,32,000-Rs 3,20,000 crore (6.2-8.5 per cent of GDP) in the next five years.

Outpatient care accounts for 61 per cent of private healthcare spending, of which maximum is on acute infections like fever, diarrhoea and gastrointestinal disease. Inpatient spend is concentrated on groups like cancer, heart disease, accidents, acute infections and injuries that account for 85 per cent of private spending.

Of the expected Rs 1,56,000 crore private healthcare spending in 2012, inpatient spending will account for 47 per cent. The growth will be driven by rise in diseases, especially cancer and cardiovascular disease. Outpatient spend will decrease in terms of share but increase in absolute terms to Rs 74,000 crore, the report added.

KIMS, Trivandrum
photo copyright sudheeshnairs

http://img178.imageshack.us/img178/5942/kimssuddheesjjp0.th.jpg (http://img178.imageshack.us/my.php?image=kimssuddheesjjp0.jpg)

Australian accreditation for KIMS Hospital

Friday March 16 2007 10:01 IST

T’PURAM: With the Kerala Institute of Medical Sciences (KIMS) receiving accreditation of the Australian Council on Healthcare Standards International(ACHSI), it became the first hospital in the country to have a national as well as an international accreditation.

KIMS, which is celebrating its fifth anniversary this year, had received the National Accreditation Board for Hospitals and Healthcare Providers (NABH) Certification from Indian President earlier this year.

“This is a recognition for the quality of our healthcare service,” said KIMS chairman and managing director Dr M I Sahadulla who will receive the accreditation certificate from ACHSI chief executive Brian Johnston at a function to be held in the hospital on Saturday. Union Minister for Overseas Indian Affairs Vayalar Ravi will inaugurate the function to be attended by Health Minister P K Sreemathi.

http://www.newindpress.com/NewsItems.asp?ID=IEO20070315234003&Page=O&Title=Thiruvananthapuram&Topic=0&

National Institute of Pharmaceutical Education Bill okayed (http://www.financialexpress.com/latest_full_story.php?content_id=158010)

The Lok Sabha approved a bill to empower the Central Government to set up new national institutes of pharmaceutical education and research or its centres in different parts of the country.

The National Institute of Pharmaceutical Education and Research (Amendment) Bill, piloted by Chemicals Minister Ram Vilas Paswan, was passed by a voice vote without any discussion amid opposition's din over the killing of farmers in Nandigram in West Bengal.

NIPER is the first national level institute in pharmaceutical sciences which caters to education and research in this field.

Fortis plans sports science institute, 10 hospitals by 2010 (http://business-standard.com/compindustry/storypage.php?tab=r&autono=278108&subLeft=1&leftnm=1)

Fortis Healthcare plans to set up a Sports Science Institute and build at least 10 more hospitals here ahead of 2010 Commonwealth Games.

“The Sports Science Institute would train and treat injured athletes and would be the first of its kind in the country,” a source close to the development said.

The company plans to bring in doctors from abroad for the proposed institute. Fortis is on the look out for a place to build the institute.

“The company had selected a few places for the institute, but because of the Municipal Corporation of Delhi’s drive, it has lost six months and those places have been declared illegal,” the source said.

The company is prepared to invest Rs 50 crore but this could go up to Rs 70 crore because of skyrocketing real estate prices in the national capital. Fortis CEO & MD Shivinder Mohan Singh declined to confirm the development.

Singh said he is barred from Sebi to make any futuristic statements because the company has filed for Draft Red Herring Prospectus (for a public issue) with the market regulator.

With less than three years left for the Commonwealth Games and Fortis’ experience shows that it takes at least six years to set up a fully operational greenfield project. So the company proposes to takeover an existing building and transform it into an institute.

The Delhi-headquartered Fortis began its operations in 2001, with a hospital in Mohali near Chandigarh. Today it has 12 healthcare facilities spread in Delhi, Punjab and Haryana. So far, Fortis’ footprint has been confined to North India. To shed its North India image, Fortis would be starting operations in Navi Mumbai in two months.

By 2010, from 12 operations now, the healthcare provider wants to take its number to 35-40 facilities across India. To acquire a pan-India image, the private healthcare provider is focusing on three strategies - to set up greenfield projects, acquire an existing facility or management contract. So to achieve 40 facilities by 2010,

Fortis would follow the greenfield and acquisition strategy in metros and Tier 1 cities and take management contract route in Tier 2 cities, the source noted. The company is also keen to make its debut in health insurance and waiting for the government to relax rules.

Hindujas, Dubai World plan $1bn health biz (http://business-standard.com/common/storypage_c_online.php?leftnm=11&bKeyFlag=IN&autono=21777)

While the Hindujas will spend Rs 1,200 crore in Dubai to set up a world-class waterfront project spread over two million sq ft, Dubai World will partner Hindujas in their attempt to set up a chain of hospitals across India. The initial investment in the healthcare project is Rs 4,400 crore ($1 billion) that is to be equally contributed by the partners.

On the healthcare plans, Hinduja said that the 51:49 JV with Limitless LLC (another Dubai World subsidiary) will initially set up hospitals in cities like Delhi, Hyderabad, Mumbai and Bangalore. The Hinduja hospital chain is to have its presence in all major cities of the country. "We have already purchased the required land in six locations", Hinduja said.

The healthcare investments of the group will come through it's listed entity in India i.e, Hinduja TMT. The initial investment will aim at having facilities with a cumulative capacity of 2,000 beds in two-three years, he added.

AIIMS clones a non-starter (http://business-standard.com/economy/storypage.php?tab=r&autono=279818&subLeft=1&leftnm=3)

Three years and four Budget assurances later, the government’s prestigious project to set up six super-speciality hospitals modelled on the All India Institute of Medical Sciences (AIIMS) in New Delhi is yet to start.

Work on the project, which was to fill the gap in tertiary healthcare infrastructure and medical education in under-served states, was to have started in the 10th Plan, which concluded on March 31.

The project, however, has not crossed the preliminary step of finalisation of a consultant to prepare a blueprint.

The health ministry’s first attempt in 2006 failed and a second attempt was initiated in February. As many as 29 companies, most of them consortiums of Indian and foreign partners, have reportedly bid, including the public sector Hospital Services Consultancy Corporation (India) Ltd.

The project – called the Pradhan Mantri Swasthya Suraksha Yojana – was to establish apex healthcare institutes at Bhopal, Bhubhaneswar, Jodhpur, Patna, Raipur and Rishikesh.

The project received Planning Commission’s approval for a Rs 1,000-crore outlay and was cleared by the Cabinet in 2006.

The initial bid was for all six institutes and attracted 16 domestic and overseas players. Every applicant except one failed to secure the minimum qualifying marks at the technical stage. The lone successful applicant quoted too high a price, sources said.

For the fresh bids, the ministry invited separate applications for each institute and segregated the housing component of the project which would be given to an EPC developer on a turnkey basis.

The deadline for submitting applications ended on March 19, and the ministry has started shortlisting the applicants.

Choosing the consultant is expected to take at least three or four months. Assuming no further delays, the blueprint is unlikely to be ready before mid-2008. The hospitals were expected to be functional by that time.

The major difference between the two bids is that while the former looked at one technical collaborator for all projects, the current one is looking at several technical partners to look at individual projects.

The project was first announced by Jaswant Singh, the then finance minister in the previous National Democratic Alliance (NDA) government, as part of the interim budget for 2004-05.

MCH administration goes hi-tech

C. Maya

Computerised hospital management system becomes fully operational

# Quick retrieval of information on patients possible
# System implemented by the Centre for the Development of Advanced Computing

Thiruvananthapuram: Patient management, medical records maintenance and day-to-day administration have become easier affairs at the Medical College Hospital here, as the hospital management system implemented by the Centre for the Development of Advanced Computing (CDAC) has become fully operational.

The system had been on the run for the past one-and-a-half years and was formally inaugurated last month.

First in State

The Thiruvananthapuram MCH is the first one in the State to be fully computerised, and now that the benefits of an automated hospital management system has begun to sink in among the staff, there have been demands that such systems be replicated in other Government hospitals too.

This is also the first time that CDAC has attempted the computerisation of a Government hospital as mammoth as the MCH here.

The software used here is also the most advanced and sophisticated currently available. The campus-wide network, with fibre optic backbone, links the outpatient clinics of 21 clinical departments, 35 inpatient wards, five operation theatres, nine ICUs, 10 laboratories, nine OP counters, registration and enquiry counters in the hospital.

The system has 250 nodes with 80 computers and as many printers and UPSs, 14 fibre-optic network switches, to be managed by two servers.

"The accent was on developing a user-friendly software, with features that will directly benefit the public. All patient-care activities such as outpatient and inpatient registrations, payward reservations, generation of lab results and discharge summary have been automated. There were some inhibitions among the hospital staff initially, despite the training and motivational sessions, but they have now realised how the system helps them to organise their work better," says G. Alexander, Deputy Director (Hospital Informatics), who led the project.Quick retrieval of consolidated information on patients is now possible for doctors and nurses, making patient care easier.

Accessing information

One of the major problems faced by patients and visitors to the MCH was the difficulty in accessing information, be it the availability of OP clinics or locating a patient who has been admitted as inpatient. Now, a visitor need give only the name of the patient or his/her native place at the enquiry counter and the patient can be easily located using the search facility. This information can be accessed from any terminal.

Nine computerised counters and 12 token display systems are available at the OP division, which caters to an average of 1,000 patients every day. Printed OP tickets are issued to patients, with token numbers so that the crowd can be managed better. For admissions, entering the OP number will automatically sent the details to the ward.

Lab tests can be ordered from the wards by the nursing staff and the results can be accessed from the wards itself, unlike before, when it was the patient's duty to collect the lab reports. Any patient information can now easily be retrieved and this has helped in the generation of a valuable database that will enable doctors to identify disease patterns.

Registries have been set up for accidents and incidents, major accidents with mass casualties, for quick access to information. Information about epidemics or infectious diseases is sent automatically to the Prevention of Epidemics and Infectious Diseases Cell, so that one can easily generate statistics for the information of authorities.

The system has also made ward management and staff scheduling easier for the nursing staff. Duty posting of nurses and deployment of general staff on a day can be easily managed now.Earlier, a good part of the duty time of nurses used to be spent on generating daily ward census reports, diet reports and staff movement registers. These reports are now generated at the click of a button, reducing the burden of paper work.Nursing Superintendents can now glance through the computer chart and re-deploy staff to wards as per requirement. Payward reservations and availability of rooms have all been automated.

The SAT hospital and the Regional Institute of Ophthalmology are yet to be brought into the network.In the second phase, the store, pharmacy, medical records division and the blood bank will be brought into the system, by adding another 70 nodes.Touch-screen kiosks, scrolling display and e-notes taker (a hand-held device) for doctors have been planned.

http://www.hindu.com/2007/04/04/stories/2007040415901100.htm

The Trivandrum MCH is the state's premier hospital, as well as being its oldest medical college and largest hospital. It is being upgraded to AIIMS status under a Rs 120 Crore joint Centre-State project. This involves the construction of several new blocks, including a high-rise super specialty centre, as well as the acquisition of state-of-the-art equipment.

The Centre for Development of Advanced Computer in Trivandrum is a leader in e-governance and cyber forensics besides traditional fields like high-performance computing.

Boost to public-private truck in healthcare (http://business-standard.com/economy/storypage.php?tab=r&autono=280783&subLeft=1&leftnm=3)

The Gujarat government’s Malaria Control Society hires private agencies to disseminate information about the disease. In Jaipur, Sawai Man Singh Hospital run by the state government has allowed a private agency to run its drug store round the clock.

The Orissa government has allowed an NGO to run two of its primary health centres. It has also hired Sulabh International for upkeep of the toilets in GB Hospital.

The Government of India has signed deals with private doctors and NGOs to run the TB programme in 14 sites across the country.

The Planning Commission is now looking at prospects of mainstreaming some of these models of partnerships between the government, the private and the non-profit sector for providing healthcare in the Eleventh Five Year Plan period. The proposals have been made by a working group set up by the Commission.

The sick primary health centres in the countryside which have no doctors or pharmacists would be targeted first for the partnership treatment if the recommendations are incorporated in the Plan.

The report of the working group on public-private partnership in healthcare suggests that the government health clinics that need to be contracted out are those which have a large number of vacancies for a long period, high absenteeism, and consistent low performance on all reproductive and child health (RCH) indicators.

“Some states are more prepared for contracting out services compared to others. Fear of losing jobs and perceived shrinking role of the government in the health sector are the main reasons for resistance. Advocacy efforts are required in those states where resistance levels are high for contracting out services,’’ it says.

The report says that the contracting out of existing services and infrastructure can happen in four ways.

First, the government can hand over the clinic, equipment, budget and personnel to an agency. Second, it may hand over just the clinic and equipment and money but allow the agency to choose its people. Third, the government may hand over the clinic and machines but allow the agency to follow its own system. Finally it may give the agency total freedom in having its own staff and system.

The report is silent on user charges.

The report looks at 17 different kinds of partnerships to take healthcare to more and more people in the rural areas and to the poor sections of the society.

These include, contracting out clinics to private sector, hiring private doctors and other personnel on contract, tieups with corporates, NGOs and cooperatives, handing vouchers to beneficiaries and so on.

The report admits at the outset the limited reach of the public sector healthcare system. It says that private sector provides 78 per cent of the treatment in rural areas and 81 per cent in the urban areas. The use of public healthcare is lowest in the states of Bihar and Uttar Pradesh.

The report says the deals with private providers could be for a single service or on a long-term basis. The partnerships could be struck in providing services, providing information and awareness, infrastructure and capacity building.

In service partnerships, there could be large-scale hiring of private doctors and nurses on contract — a trend already started by the National Rural health Mission.

It would also include social marketing of products like contraceptives and oral rehydration solutions through NGOs or private players, and using private or NGO vans to provide medical healthcare. Private vehicles, buildings, as well as private trainers are recommended by the working group.

AIIMS breakthrough...

http://timesofindia.indiatimes.com/AIIMS_docs_slice_one_cornea_to_give_vision_to_three_patients/articleshow/1907471.cms

: A 50-day-old Pakistani boy, Ryan, suffering from multiple cardiac defects, breathed a new life in India. His family is happy after he was successfully operated upon by the surgeons at Chennai hospital.

“There is no heart defect left. As long term also, this child can have a normal heart and grow up like a normal child,” said Chief Pediatric Surgeon at Madras Institute of Orthopaedics and Traumatology (MIOT), Robert Coelho.

Little Ryan's father says he's most grateful the visas came quickly. “We never thought we would be going to India keeping in mind that we were Pakistanis. But I am thankful to the Indian government for granting us visa in no time,” said Ryan's father, Tariq.

He also has a little girl called Noor Fatima to thank—her successful visit to India for a heart surgery in Bangalore put the spotlight on the numbers of Pakistani children who could benefit from Indian medical facilities and spurred the government into announcing a special visa quota for them.

http://www.ibnlive.com/news/pak-infant-undergoes-surgery-in-chennai/38457-3.html

Pak infant undergoes surgery in Chennai

Thats great! And another step to further strengthen India-Pak relations :)


AIIMS breakthrough...

http://timesofindia.indiatimes.com/AIIMS_docs_slice_one_cornea_to_give_vision_to_three_patients/articleshow/1907471.cms

From TOI
http://img404.imageshack.us/img404/2949/pc0012000oi7.jpg

Dispur nod to hospital facelift
OUR CORRESPONDENT
Silchar
April 30: After a two-year wait, the principal healthcare centre in south Assam is poised for a facelift. Dispur has cleared the much-vaunted Rs 100-crore proposal for the uplift of the 38-year-old Silchar Medical College and Hospital.

Announcing this at a news conference at the local circuit house yesterday, Assam health and family welfare minister Himanta Biswa Sarma said the modernisation scheme would involve expenditure under two heads — infrastructure and equipment.

The minister said the state government has already released Rs 18 crore to the hospital authorities to purchase state-of-the-art healthcare equipment, including an MRI machine.

The hospital has also been instructed to take up pending construction work with a portion of the released funds.

The minister gave the authorities a month-and-a-half to draft the blueprint.

“I will come here after 45 days to pick up the draft, including financial estimates for the purchase of equipment. If I find that the college authorities have been lax in preparing the ambitious scheme, I will not hesitate to transfer the grant to the medical college and hospital in Dibrugarh,” the minister observed.

Sarma said his department would release the funds in phases by the end of March next year.

He said chief minister Tarun Gogoi was likely to visit the college in November to give the go-ahead to the implementation of the scheme, which would take at least three years to complete.

Earlier, Sarma laid the foundation stone for a 30,000-square feet building for basic sciences, under the jurisdiction of the medical college, at Ghoongur, about six km to the south of Silchar town. The venture will cost the state Rs 2.91 crore.

To improve amenities in medical colleges, the cost of daily food for patients has been hiked from Rs 10 to Rs 25, and the allotment of yearly funds for purchase of medicines increased from Rs 5 crore to Rs 20 crore from this fiscal, Sarma said.

FROM-http://www.telegraphindia.com/1070501/asp/northeast/story_7718178.asp

It will be interesting to see whether this materialises or not

I thought we should have this thread under infrastructure and economy. Public health and human development are exremely important to a country's overall development. I start by a part of report depicting a sorry state in this regard despite India becoming strong economically recently. :ohno:
Other potential areas for discussion could be things like major reforms in policies in this area, say judciary/criminal-justice system, e-governance etc. Hope this becomes interesting.

http://hdr.undp.org/hdr2006/statistics/countries/country_fact_sheets/cty_fs_IND.html

Each year since 1990 the Human Development Report has published the human development index (HDI) that looks beyond GDP to a broader definition of well-being. The HDI provides a composite measure of three dimensions of human development: living a long and healthy life (measured by life expectancy), being educated (measured by adult literacy and enrolment at the primary, secondary and tertiary level) and having a decent standard of living (measured by purchasing power parity, PPP, income). The index is not in any sense a comprehensive measure of human development. It does not, for example, include important indicators such as inequality and difficult to measure indicators like respect for human rights and political freedoms. What it does provide is a broadened prism for viewing human progress and the complex relationship between income and well-being.

The HDI for India is 0.611, which gives India a rank of126th out of 177 countries with data.

http://hdr.undp.org/hdr2006/images/factsheet/hdi-trends/ind_2.gif

Another interesting but very basic diagram showing relations among GDP(economy), health and education.
http://habitat.igc.org/wealth-of-networks/figure-9-1.gif
http://habitat.igc.org/wealth-of-networks/figure-9-1.gif

Infant deaths in Kerala unfortunate. It is the best state in India in terms of key development indices including infant mortality rate. Hopefully lessons will be learned.

http://www.business-standard.com/common/storypage.php?autono=283564&leftnm=4&subLeft=0&chkFlg=
Sreelatha Menon / New Delhi May 6, 2007
Kerala, lauded for being a model state in education and many development indicators, has a healthcare system that seems to be chronically ill.

Here is something good, bad and ugly.

The good thing is that Kerala’s health minister has been held answerable by a court for the deaths of 39 newborn babies in a government hospital due to hospital induced infections. In fact, the minister and seven key health officials have been charged with culpable homicide by the additional chief judicial magistrate of Thiruvananthapuram.

The bad news is the death itself of 39 babies out of the 101 births in Sri Avittam Thirunal Hospital in the state capital in the space of three months.

The ugly part is that Kerala, lauded for being a model state in education and many development indicators, has a healthcare system that seems to be chronically ill.

Last year, it was a spate of deaths due to mosquito bite. The state said it was chikungunya and the Centre said it was not.

Hence, people kept dying without anyone making up his mind what ailed the hundreds who died untended.

The poor public healthcare apparatus was exposed like never before. Now the institutional deliveries that the state can take pride in, turn out to be as bad as the absence of any such facilities, which plagues the rest of the country where 70 per cent of children are born in their homes.

In Kerala, according to the latest National Family Health Survey (NFHS), 99.7 per cent of babies are born in hospitals. So is that good and bad, if government hospitals offer no guarantee of infection-free neo-natal facilities?

Yet the good part cannot be underplayed. For, the deaths themselves are not shocking if one were to go by the standards of hygiene prevailing in hospitals in the rest of the country. Add to that the indifference of health authorities when these things are pointed out.

So, it is probably a positive sign that the superintendent of Sri Avittam Thirunal Hospital has been held accountable and transferred, and a court has charged the health minister, the school teacher turned politician K P Srimathy Teacher, under Sections 304 and 34 of the IPC and the Opposition as well as the media are baying for the blood of the LDF government.

An estimated 1.2 million babies die in India each year in the first month after birth, making up two-thirds of the nation’s infant mortality of 67 per thousand live births. The Government of India has set itself a target of lowering it to 30 per thousand by 2010.

Kerala has the lowest infant mortality rate of 15 per thousand births as against the all-India average of 60. But again, that is hardly good news. For, while infant mortality has been declining even in states like Orissa, in Kerala, with 91 per cent homes having electricity, 97 per cent having toilets and everything seeming otherwise rosy, the infant mortality as well as the number of underweight babies have been on the rise as per the third NFHS.

So, what is wrong with the state which provides 90 per cent of nurses for the rest of the country and a substantial number to the rest of the world?

The earlier Kerala identifies its warts and treats them, the better for its children who are otherwise the most endangered species in the rest of the country.

Hopefully enough to stimulate debate and discussion. Posting a video link, which I am sure people have seen (on a positive note)!
http://video.google.com/videoplay?docid=5446091014702365336&q=India

The source of problem lies in UNIVERSALIZING ELEMENTARY EDUCATION IN INDIA

"One half of India is certainly not shining, let alone poised for "a glorious tomorrow", as it continues to stay educationally challenged, with a large number of its school-age children still remaining out of school in seven educationally disadvantaged States of Andhra Pradesh, Assam, Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, and West Bengal."

The survey includes Tamil Nadu, "one of India's star performers in elementary education" to support Arguments and analyses presented in the books.

http://www.hindu.com/br/2007/05/08/stories/2007050800881500.htm

I agree with you Leo r. Primary education is absolutely essential and the backbone of a strong nation. However, I wonder what the forumers think about how rapid industrialisation (SEZ, corporate giants capturing retail market etc. etc.) will affect these things. Theoretically we should have a pro-agriculture/farmer policy to preserve the interest of the farmers and our rural economy (subsidised material coming from abroad is another issue).
Do we hope that industrialisation will in fact correct these someway (may be a circular argument)? I am not an economist, just thoughts coming to my mind. I feel the basics (social security, access to primary health, education...) should be set right for a country to develop holistically including ability to see desirable effects from democracy.
:speech:

No point protecting Indian farm industry when the simple problem there is over-employment - 60% of the workforce in agri - they need to be attracted to industry and cities, instead of over-working ever shrinking plots of land, which one tractor could do in their place.

Is it then a question of realising and accepting what lies ahead for the farmers in future in India? I saw a programme in channel 4 (UK), where a farmer from Gurgaon was complaining that local industries there would not employ them and that as a result of 'mall-ification', they have become unemployed. Interesting?

Those farmers were probably under-qualified for the industry being set up - an education system problem - but in the case of basic industry, they face another problem - unions and socialist parties that protect employed labourers from losing their jobs to better more needy workers.

NOW YOU CAN FIND DETAILED REPORT ABOUT YOUR PRIMARY SCHOOL BACK IN INDIA

Just checked out the District Information System for Education (DISE), created by National Institute of Educational Planning and Administration, New Delhi (NIEPA). I was amazed by the amount of information there. I could actually read a report about my primary school back in India. This may not be sphisticated like the OFSTED report in the UK, but surely this is a significant development.

http://www.schoolreportcards.in/

The National University of Educational Planning and Administration has created a comprehensive database on elementary education in India under one of its most prestigious projects, known as, District Information System for Education (DISE). The project covers both Primary and Upper Primary schools of all the districts of the country. What is more remarkable about DISE is that it has completely eliminated the time-lag in availability of educational statistics which has come down drastically from 7-8 years to less than a year at the national and only a few months at the district and state levels. DISE is supported by the Ministry of Human Resource Development and UNICEF.
The National University has successfully developed School Report Cards of more than 1.12 million Primary and Upper Primary schools. In addition to quantitative information, the Report Cards also provide qualitative information and a descriptive report about individual schools.

Also check:
http://www.dpepmis.org/
:banana:

Those farmers were probably under-qualified for the industry being set up - an education system problem - but in the case of basic industry, they face another problem - unions and socialist parties that protect employed labourers from losing their jobs to better more needy workers.



the sooner we accept the reality, the better we'll cope with the situation. as i see it, there is no other way except delaborising the agri industry in massive proportions over the next coupld of decades. but again there is no political will. this is where a China type scenario works well. all that matters is the national interest. anyway, let's not go there.

I suppose this is also a side-effect of democracy in India, where politicians need to please every group of people shouting right or wrong. The result is that there are zebra crossings in expressways!
:bash:

Millennium Development Goal (MDG) and India :ohno:

http://southasia.oneworld.net/article/view/140590/1/
Decline of infant mortality rate not fast enough in India
Tuesday, October 10,2006 LUCKNOW: At the current rate of decline in the under-5 Infant Mortality Rate (IMR), India is not likely to achieve the Millennium Development Goal (MDG) of bringing down the IMR to 40 per 1,000 live births for the year 2015, according to a UNICEF report.

The MDG for India for the year 2015 is 41 per 1,000 live births which cannot be attained at the current pace of decline, the report said.

Though the IMR had been declining for the past years, it stood at 60 per 1,000 live births currently, it said adding the Maternal Mortality Ratio (MMR)is currently 407 per one lakh live births in the country.

The highest number of child and maternal deaths occur in Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan and Orissa, the report said.

The Norway-India partnership initiative (NIPI), which was based on India's ambitious new health initiative- National Rural Health Mission (NRHM) -would, be focussing on these five states, it said.

These five states together contribute almost 60 percent of infant deaths and pose an enormous challenge in implementation because of the socio-economic status, large inequalities, weak health system and poor programme management capacity, the report said.

India's success in achieving MDG depends on the effectiveness of the child health programmes in these five states, it went on to add.

The report said NIPI for MDG would provide technical cooperation at a cost of around $ 80 million for five years from 2006-2010.

According to the report, the input would complement the national efforts and stimulate acceleration of the NHRM implementation for MDG by providing flexible support to enable implementation and innovation to resolve bottlenecks.

The initiative would test and introduce new ways of scaling up quality services by community health workers known as Accredited Social Health Activist (ASHA) at the village level in the five focus states, it said.

It is proposed to develop a Child Health Resource Network (CHRN) with nodes in the five focus states linked to a national centre, the report said.

The CHRN will conduct rapid and in-depth studies in select areas considered crucial to the effective scale-up of the child health strategies, it said.

The report has expressed serious concern over the unsatisfactory pace of Integrated Management of New-born and Childhood Illness (IMNCI) scaling up owing to a lack of understanding and a severe shortage of trainers.

It also said the time had come to introduce IMNCI in the curriculum of undergraduate medical (MBBS) students.

A significant feature of NIPI was to rope in the private sector for delivering MDG-related services, the report added.
Source: southasianmedia.net

Another interesting but realistic observation
http://southasia.oneworld.net/article/view/148461/1/

A comment on two Years of the Indian National Rural Health Mission
Dr Sanjit Nayak

23 April 2007
Health being a state subject, states have used their own discretion to interpret and implement the National Rural Health Mission (NRHM). While this has resulted in some activities being implemented the broader goal of the NHRM to empower local communities has been lost. This has lead to the dilution of the agenda of placing people's health in people's hands.

The current government approach is to mandate community participation by issuing government orders to its functionaries at the district level. In rural areas, village and district action plans based on community need assessment have remained a non starter and in urban areas the poor remain marginalized from this process.

The NRHM talks about health sector reforms but the specific objectives of the reforms appear unrealistic and unlikely to result in the improvement of the health status of the individual or the community. In effect the Mission remains more target oriented with a disproportionate emphasis on inputs rather than focused on output or performance.

The concept of Accredited Social Health Activist (ASHA), which forms the core through which the NRHM will be operationalised, cannot be described as being an innovation but rather is old wine in a new bottle. In earlier versions of the health programme similar human resource mechanisms have been proposed - for example the community health worker, link worker, multi- purpose worker amongst other things. In India, the polices, plans and schemes have often been comprehensive but the implementation has remained poor and as a result the desired result as envisaged by policies and programmes has never been actualised.

The ASHA as has been mentioned earlier forms the core implementation mechanism for NRHM, who will undertake the bulk of the activities at the community level. Inspite of playing this critical role, women who are selected are seen to be volunteers and the programme itself does not define any type of financial compensation for the work they will undertake. Recent findings show that it is proving to be extremely difficult to motivate individuals to undertake the work where no remuneration is forthcoming.

As part of the ASHA scheme an incentive system has been proposed under the supervision of Sarpanch and Auxiliary Nurse Midwife. This has lead to non-integration (architectural correction) of all the other health programmes at the community level. Furthermore, there is an extremely high expectation from ASHA whose envisaged work profile does little justice as a part time worker. The ASHA work under severe constraints with regard to infrastructure as a result ASHAs often have to resort to referring their patients to private service providers.

In addition, ASHA has replaced the male health worker. ASHA's work profile is different and primarily to support the ANM. The numbers of male MPWs is already reduced and it is likely that their role will soon be written out of health programmes. It is important to point out that MPWs have a key role to play in other programmes e.g. prevention of communicable diseases and undertaking surveillance, none of which can be undertaken by ASHA.

As part of the reform process of the health sector, which remains an important component of NRHM, the strengthening of public-private partnership has been mooted. However, many health activists feel this is the governments' way of shirking responsibility to provide health services in particular primary health care as has been envisaged in the Constitution. The government is now trying to even privatize primary health care and does not want to invest in improving the public health sector.

Upgrading infrastructure, especially PHC to FRU/ UPHC in un- served and underserved areas with doctors unwilling to provide service will further privatise primary health care. Contracts to private practitioners will be the only solution to man these PHC.

Indian Public Health Standards (IPHS) to provide quality health care in the public health system by ensuring minimum requirements of infrastructure, accountability of doctors, the need for standard treatment protocols and social audit through rogi kalyan samiti (RKS) has been a non- starter. This has been the scenario previously as such policy directions have not translated into action.

The guidelines for IPHS do not address the real issue which requires an analysis of failure of previous schemes. An attempt was made by the National Commission of Health and Macro-economics but its recommendations are gathering dust.

NRHM aim is to reduce infant mortality and maternal mortality by improving access through the ASHA and the Janani Suraksha Yojana (JSY) scheme by strengthening Community Health Centres. The emphasis is on technology alone. It has failed to address the correlates to nutrition and thus to poverty.

The belief that reducing total fertility will reduce infant mortality ignores the links between the socio-economic status of the community especially that of women and health of an infant. It is important to note that access to care is also linked to discrimination as well. Additionally unskilled human resource and poor infrastructure in un-served and under-served areas compound the problem.

Targets to reduce infant mortality rate (IMR) and maternal mortality ratio (MMR) by only increasing health sector expenditure needs to address issues of equitable distribution and resource allocation. Conceptual problems do exits in NRHM. Much of NRHM today depends on public- private partnership and not on strengthening the public health system. By outsourcing and contracting we have subscribed to privatisation of the health care delivery system. It is also difficult to comprehend how ASHA can bring about inter- sectoral coordination.

In conclusion the link between poverty and ill-health are cursorily mentioned and are ignored in the actual implementation plan laid out as part of the NRHM. Based on the above analysis it might be fair to say that attainment of the goals envisaged by NRHM by 2012 remains wishful thinking.

The author is a public health specialist with the Population Foundation of India New Delhi. The views expressed are that of his owns as an activist and not that of the foundation

However, the 2007 estimate according to some show the IMR to be
34.61
:)

source: https://www.cia.gov/cia/publications/factbook/rankorder/2091rank.html

Since there is no quick fix solutions to convert illiterate/unskilled workers to employable category in Industry, the process of development running to few generations, the Govt's I mentioned earlier should not waste any more time in ensuring 100 % enrolement in school. The next stage is to give birth to healthy children who don't have learning disability. TN Govt. gives Rs 1000/m to pregnant poor women along with nutrition supplement and iron tablets and insist primary health centres to aim for 100 % instituitional delivery and have babies of minimum 2.5 kg weight. Such proactive schemes practiced consistantly can result in a healthy society in few decades. The Govts have very nice policy measures, but implementations in many states are very very untidy. Kerala has the best systems and TN follows closely behind and all other states can learn from them. Some North Eastern states also have performed reasonably well.

A revolutionary idea to cut down on period required to improve the HDI is to " Maintain a sperm bank from healthy, well educated donars" and promoting the idea of artificial insemination or use surrogate mothers. People have accepted that idea in Agriculture and Animal Husbandary and over a period will have many takers. Though I called it revolutionary, fact is different if we read 'Mahabharatha' where lead characters come through similar route.

we need this to spread throughout the country quickly
http://specials.rediff.com/news/2007/may/28slide1.htm


US style trauma centres in India
May 24, 2007
Thanks to the sustained effort of an Indian-American surgeon who has been pushing for this project for over four years, Mumbai will soon be the beneficiary of emergency medical services and trauma centres based on the US template.

This was decided at a meeting of senior Maharashtra state government officials, Mumbai city officials and the US consul general at the Hinduja Hospital in Mumbai recently. The meeting was convened by Dr Navin Shah, one of the founders and former president of the American Association of Physicians of Indian Origin -- arguably the largest and most influential international medical organisation in the United States.

Shah, a Maryland-based urologist, is the medical education director at the Metropolitan Urologic Institute and also a former president of The American College of International Physicians.

Among other things, this project envisages one dedicated emergency number -- like the 911 number in the US -- and a command centre for hospitals manned around the clock, backed by fully-equipped ambulances.

Consequently, patients will be immediately treated at the accident site, during transport in the ambulance and at the receiving hospitals with specially designed trauma centres, manned 24/7 by emergency physicians and surgeons.

At the meeting that was attended by Azeez Khan, the Principal Health Secretary, Government of Maharashtra, Dr S Damle, Mumbai Municipal Health Commissioner, Dr Paresh Navalkar of Ambulance Services, US Consul General Michael Owen, and several CEOs of private hospitals led by Pramod Lele of Hinduja Hospitals, it was unanimously resolved to initiate Phase 1 of the EMS and TC project by June 1 of this year and to request the Maharashtra government and the Mumbai Municipal Corporation to provide 10 fully-equipped ambulances each within the next six months.

Owen promised that the US Consulate would provide one ambulance on behalf of the US government. The project will involve four medical college hospitals, 10 major private hospitals in Mumbai, and over a dozen government and municipal hospitals that will be supplemented by facilities that specialise in burns, rehabilitation and pediatrics.

A board of directors and an executive committee was also elected, with a prominent thoracic surgeon Dr G B Daver, formerly Dean of J J Hospital and currently the medical director of Hinduja Hospital, elected chairman of the executive committee. The executive committee has the mandate of coordinating with all participating hospitals, and devising a plan to initiate the project from June. Shah and Dr S Balasubramanium, the president of AAPI -- which has given its blessings to the project -- and a trauma surgeon at the University of California, Los Angeles medical centre, were to serve as the US representatives on the executive committee.

This is great news for Mumbai. Such services might be already operational in other cities. I know Pune has a 911- style emergency medical service.

The medical emergency number in Pune is 105 and it is known as the Pune Heart Brigade. It has various ambulances as well as a helicopter which are used for emergency services of Puneites. More than 8 Pune hospitals come under the Pune Heart Brigade. This should start in all major cities atleast and it surely will be needed.

This is great news for Mumbai. Such services might be already operational in other cities. I know Pune has a 911- style emergency medical service.

The medical emergency number in Pune is 105 and it is known as the Pune Heart Brigade. It has various ambulances as well as a helicopter which are used for emergency services of Puneites. More than 8 Pune hospitals come under the Pune Heart Brigade. This should start in all major cities atleast and it surely will be needed.

curious.. is it different than the 100-101-102(i might have the wrong numbers but there used to be/still are different numbers for police, ambulance, and fire) emergency numbers that used to exist in bombay and other parts of the country?

^^
I think the emergency numbers in all cities in india are basically for government services, like the police or govt hospital of the city.

"105" was started privately and came to be known as the Pune Heart Brigade. A couple of years ago 6 hospitals were attached to this number. They even have set up a call centre recently. So if u call 105, then the hospital nearest to you will send the ambulance and treat you instead of the govt hospital which might be at the other end of the city if u call the govt emergency number which might be 102 or 103 or whatever. Im not sure how many more hospitals have joined the Pune heart brigade by now. But this private 911 like service has proved to be more successfull than the govt numbers due to their connection to hospitals in all parts of the city as well as the recent helicopter service. Not sure if any other city has such a service yet, but it surely will work anywhere in india.

Accident and trauma services in India needs massive revamp, requiring focus on issues such as policy, resources, training and at last, but not the least- Attitude.
My impression while working (and some contact with CATS) in Delhi in 1995-96 was not that satisfactory, but things might have changed to some degree now.
Then there is the JPN Apex Trauma Centre waiting to be commissioned in New Delhi for some time. There is a helipad on the site.

http://www.aiims.edu/aiims/departments/spcenter/TraumaCentre/traumaintro.htm

http://pib.nic.in/archieve/lreleng/lyr2001/rdec2001/03122001/r0312200114.html (Old stuff)

^^
I think the emergency numbers in all cities in india are basically for government services, like the police or govt hospital of the city.

"105" was started privately and came to be known as the Pune Heart Brigade. A couple of years ago 6 hospitals were attached to this number. They even have set up a call centre recently. So if u call 105, then the hospital nearest to you will send the ambulance and treat you instead of the govt hospital which might be at the other end of the city if u call the govt emergency number which might be 102 or 103 or whatever. Im not sure how many more hospitals have joined the Pune heart brigade by now. But this private 911 like service has proved to be more successfull than the govt numbers due to their connection to hospitals in all parts of the city as well as the recent helicopter service. Not sure if any other city has such a service yet, but it surely will work anywhere in india.
oh.. thats pretty cool. it is good that private sector is stepping in to fill in needs that the government is unable to provide.

Royal College Of Physicians Exams Now In India

The clinical examination for the prestigious Membership of Royal College of Physicians (MRCP) can now be held in India.

Three colleges under the RCP banner - the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Physicians of London - Friday signed a memorandum of understanding with Sri Ramachandra University (SRU) here to offer the examinations.

'Any physician from anywhere in the world can take his/her clinical tests for MRCP here,' said Georgi Abraham, coordinator for the India programme. So long physicians had to fly to Britain or to any of the nine other countries where the examinations are held.

'We have been trying to get this specialist examination held in India since 1997 and it has taken us ten years to convince the MRCP board that we have the facilities to hold it,' Abraham who is also professor of medicine at the Sri Ramachandra Medical College told IANS.

The SRU medical college has 25 specialist skill stations and has made available seven of these for the MRCP examination.

The first examination was held this week over three days with about 45 examinees attending. The candidates included one from Britain, one from Australia and another one from Pakistan.

Neil Dewhurst, the Medical Director and Chairman of the MRCP Examinations Board, expressed hope that many more young doctors from South Asian countries would attempt to qualify the clinical exams now.

The exam will be held twice a year and the MRCP authorities expect at least 90 to 100 physicians taking the test this year.

The membership to the RCP is recognised worldwide and allows physicians to practise almost in every country. At least 25,000 doctors take the exam every year.

There are plans to offer the specialist examination for membership to the Royal College of Surgeons, in India, Abraham added.

http://newspostindia.com/report-2060

Royal College Of Physicians Exams Now In India



http://newspostindia.com/report-2060

It may be good news for Royal Colleges and SRU, but it is almost impossible to get job for Indian doctors after passing MRCP/S after all these visa rules and EEU doctors coming to UK. The reason for opening these centres now is not at all clear.
:ancient:

From today's Economics Times
http://economictimes.indiatimes.com/articleshowcnews/msid-2101371,curpg-1.cms

'Growth not enough to reduce income disparity'

PTI[ TUESDAY, JUNE 05, 2007 09:40:00 PM]


MUMBAI: The Reserve Bank of India (RBI) said nine per cent economic growth will not reduce income disparity unless about one crore people currently engaged in agriculture find remunerative non-agricultural employment.

"An overall growth of nine per cent will further increase income disparity between agriculture and non-agriculture households, unless around 10 million people currently employed in agriculture find remunerative non-agricultural employment," RBI Governor Y V Reddy said at a conference in Argentina.

Stressing on the need to accelerate growth in the farm sector, he said the Planning Commission's target of increasing agriculture growth rate to four per cent would improve rural job conditions by reducing real wages and under-employment.

There was a need to strike a parity between dependence on agriculture and the number of people employed by the sector, he said. More than 60 per cent of the population depended on agriculture while it contributes only 20 per cent to the GDP. Reddy underlined the need of improving quality of delivery of essential public services such as education and health and the need to remove infrastructural bottlenecks.

Talking about the increasing importance of the emerging market economies (EMEs) in the global arena, he said the rise of the EMEs has made globalisation a two-way process where EMEs are changing from passive recipient to being part of active participants in the global economy.

AFTER NRHM COMES THE NUHM

From Deccan Herald

http://www.deccanherald.com/Content/Jun62007/national200706065943.asp?section=updatenews

Govt to launch National Urban Health Mission
New Delhi, UNI: :speech:

The government will launch a National Urban Health Mission to provide health care service to people in cities and towns especially those living in slums.
Health Minister Anbumani Ramadoss told reporters here today the mission was at the conceptual stage at present. However, it would be launched this year, he added.
The idea to launch the National Urban Health Mission cropped up during a meeting with Prime Minister Manmohan Singh yesterday, he said.
At the meeting while giving presentation on the performance of states on the implementation of the National Rural Health Mission, some issues came up which concerned the health care needs of urban people especially slum dwellers, he said and added that following this, it was decided to launch the Urban Health Mission to deal with them effectively.
Dr Ramadoss said that the NRHM, the flagship programme of the UPA government, had done well during the past two years in providing basic health care service to people living in rural areas. A number steps have been taken to augument the health care delivery system in villages.
Meanwhile, the Prime Minister has decided to convene a special meeting of the National Development Council to discuss issues relating to health care, disease control and public health.
He has also urged state Governments to pay adequate attention to health care issues and ensure efficient functioning of public health services.

SSG Hospital Computerises: The SSG Hospital authorities have taken up the task of linking all the wards and important departments through a computer network. The hospital has 27 wards, 20 operation theatres and 25 OPDs (out-patient departments). The entire system of 125 computers is being set up at a cost of Rs. 6.5 million provided by the Gujarat government. The work is expected to be completed this month. The hospital administration has just completed installing 50 CCTVs in the surgical blocks, medical stores, emergency wards and the kitchens.

http://www.baroda.com/diary.html#SSG

Army to manage sanitation in Kerala for outbreak of Chikungunya fever
http://www.hindu.com/thehindu/holnus/004200706091755.htm

We need Army to manage sanitation! :bash:

Army team to help tackle spread of fever in Kerala
Thiruvananthapuram, June. 9 (PTI): With the number of viral fever cases rising in parts of Kerala, the Army's help has been sought to tackle the situation.

An Army medical team is expected to reach the state by this evening to be sent mainly to Pathanamthitta and Kottayam districts which are worst hit by the outbreak of different types of viral fever, including chikungunya, official sources here said.

The army team, comprising medical and paramedical personnel from Secunderabad and Chennai, would help the doctors and paramedics in the state as patients continued to pour in hospitals in affected areas and fever cases were reported from new places, including northern districts.

The Government had also convened an all-party meeting on Saturday afternoon to work out the strategies to contain the situation and seek cooperation of all sections of the people for a massive cleanliness drive across the state.

While media reports said about 30 people had died of fever, the Health Department has refused to confirm any casualty due to fever.

The Health Department, however, confirmed that 7,000 chikungunya patients were admitted to different hospitals and there were a few cases of dengue, rat-fever and malaria.

From today's Economics Times
http://economictimes.indiatimes.com/articleshowcnews/msid-2101371,curpg-1.cms

'Growth not enough to reduce income disparity'

PTI[ TUESDAY, JUNE 05, 2007 09:40:00 PM]



This is something that would always be a headache for the economic planners. Sometimes the marvelous performance of Indian economy gets overshadowed by the near 300 million poor Indians. It is about time that something is done for them.

This is a hard hitting Channel 4 documentary titled 'Land of missing Children' concerning underage sex trafficing in India. It was indeed very shameful to watch how such things still happen. Checkout part II & see what our Mumbai police official has to say about this whole issue(I just hope he could've atleast declined to be interviewed).

Part I - http://www.blinkx.com/burl.php?id=17056083
Part II - http://www.blinkx.com/video/YouTube/Unreported_world-India_Land_of_missing_children_-_2_3~17056079
Part III - http://www.blinkx.com/burl.php?id=17056077

City trauma service cries in pain
13 Jun, 2007 l 0113 hrs IST l TIMES NEWS NETWORK

NEW DELHI: Ten years ago, Delhi had 30 Centralised Accident Trauma Services (CATS) ambulances for accident victims. Ten years later, it has 35 such ambulances providing the services — an increase of just five.

This is shocking considering that in this period, the city’s population has grown from around 84 lakh to nearly 1.4 crore, and the vehicle population — the most obvious cause of a majority of road accidents — has nearly doubled, from 18 lakh in 1990 to nearly 42 lakh in 2003, and counting.

Over 2,000 people are killed and 8,000 injured in road accidents in Delhi every year. Of the 14,000 calls to the fire service, there were more than 2,000 instances of injury or death. In such cases, the only ambulances that can deal with the emergencies are those with CATS.

After all, following an accident, one is least likely to call a private ambulance; one would instead dial 102 — that is, CATS.

Nearly 12,000 calls related to medical emergencies like heart attacks and deliveries are recorded by CATS every year, a minuscule proportion of the total number of such exigencies in the city. The police control room (PCR) vehicles alone take about 45,000 people to hospitals annually.

Despite such large numbers of medical emergencies in the city, why does CATS get just 4,000 calls a month or, roughly, over 130 calls a day? According to special secretary (health) K S Wahi, who was in charge of CATS till recently, CATS does not publicise its services as its ambulance fleet is inadequate to take a flood of calls that would result from advertising.

CATS staff is forced to refuse scores of calls due to shortage of vehicles every day. Though CATS is unable to attend to all calls, Wahi is unhappy that the PCR and fire service do not route all emergency calls to CATS.

‘‘They should route all calls where there is a probability of casualty to CATS instead of wasting precious time by trying to determine this on their own. It should be left to us to decide whether we can take a call or not,’’ says Wahi.

Accident and trauma services in India needs massive revamp, requiring focus on issues such as policy, resources, training and at last, but not the least- Attitude.
My impression while working (and some contact with CATS) in Delhi in 1995-96 was not that satisfactory, but things might have changed to some degree now.
Then there is the JPN Apex Trauma Centre waiting to be commissioned in New Delhi for some time. There is a helipad on the site.

http://www.aiims.edu/aiims/departments/spcenter/TraumaCentre/traumaintro.htm

http://pib.nic.in/archieve/lreleng/lyr2001/rdec2001/03122001/r0312200114.html (Old stuff)

I was totally wrong!

Why are levels of child malnutrition high in India?

"46 per cent of India’s children under the age of three are underweight. The corresponding levels of child malnutrition are much lower in most other countries , 28 per cent in Sub-Saharan Africa and 8 per cent in China."

"within India, we find that Gujarat and Uttar Pradesh report the same proportion — 47 per cent — of underweight children even though the per capita income in Gujarat is several times higher than in Uttar Pradesh. "

"Levels of undernourishment vary widely across Indian States. Punjab, Kerala, Jammu and Kashmir, and Tamil Nadu report the lowest proportions of underweight children (27 to 33 per cent); whereas Chhattisgarh, Bihar, Jharkhand, and Madhya Pradesh report the highest levels of underweight children (52 to 60 per cent). What explains the better nutritional levels among children in the first set of States?" ....read for more details...

http://www.hindu.com/2007/06/22/stories/2007062250151000.htm

Blame it on rice. I think Indian parents better start feeding their kids some meat. Rice and vegetable isn't cutting it anymore. It's a serious case of protein deficiency (if there is such a thing).

Blame it on rice. I think Indian parents better start feeding their kids some meat. Rice and vegetable isn't cutting it anymore. It's a serious case of protein deficiency (if there is such a thing).

That's assuming that all or a majority of malnutrioned children in India are from vegetarian families only.

"within India, we find that Gujarat and Uttar Pradesh report the same proportion — 47 per cent — of underweight children even though the per capita income in Gujarat is several times higher than in Uttar Pradesh. "

"Levels of undernourishment vary widely across Indian States. Punjab, Kerala, Jammu and Kashmir, and Tamil Nadu report the lowest proportions of underweight children (27 to 33 per cent); http://www.hindu.com/2007/06/22/stories/2007062250151000.htm

Hmmm...perhaps there is a chance non vegetarian diet is contributing much to the nourishment levels. In the case of Kerala, where meat is widely eaten, it could be true. Coming from a middle class family I remember I never had a single day all vegetarian food except on some birthdays earlier.

That's assuming that all or a majority of malnutrioned children in India are from vegetarian families only.

May be not..But such high incidence points to the obvious. Just look at Gujarat. What else could be the possible reason for such a high number (higher than sub-sahara!) since I believe that Indian parents do feed their children. How can India do worse than sub-sahara. Also report is about malnutrition, not starvation.

Hmmm...perhaps there is a chance non vegetarian diet is contributing much to the nourishment levels. In the case of Kerala, where meat is widely eaten, it could be true. Coming from a middle class family I remember I never had a single day all vegetarian food except on some birthdays earlier.

Coming from a strict vegetarian family, I don't think the lack of meat is real problem here. Imagine feeding your kid rice and rasam non-stop. I think Indian parents must be taught that rice won't do. Kids have must have protein, iodine and other stuff.

I am very impressed with Chinese figure of 8 % . Could be that Mao encouraged their people to eat anything they can lay hands on. Recently a NDTV anchor was tasting a fried Scorpian at Shanghai.

Ancient Tamils fed on kampu,Cholam,Thinai,raagi,jaggery and toddy , supplemented by hunted rabbit, kaadai meat and looked hefty. When cacausian priests moved in, they advised that these are inferior grains and cajoled them to switch over to Rice to suit their habit. Now the traditional food is history and considered uncivilised though Govt. feed poor children with "Sathu Urundai" [health rolls made out of these grains].

Our Chief Economists Dr Manmohan,Mr Chidambaram and Dr Aluwalia should plan to bring down Child malnutrition to Chinese standard in 10 years instead of concentrating solely on 9 % GDP growth. It is a National Shame.

MUMBAI: For the millions living with mental retardation, this breakthrough holds out a ray of hope. An international group of researchers, including two Bangalore neuroscientists, has identified an enzyme that causes the syndrome called Fragile X and successfully reverses its symptoms in mice.

Fragile X Syndrome is a genetic condition caused by a defect in the X chromosome. It’s the chief cause of mental retardation, and in some cases, a known cause of autism. It can cause varying degrees of impairment, from minor learning problems to cognitive disability. Until now, there’s been no known treatment for Fragile X.

Bangalore, was published in the ‘Proceedings of the National Academy of Sciences’ on Monday. Scientists say we can expect similar results in human beings in five years.

"We found that a specific enzyme in the brain called P21-Activated Kinase (PAK), when inhibited, reversed the debilitating symptoms of Fragile X in mice," said Sumantra Chatterji of the National Centre for Biological Sciences.

The second researcher, Shankaranarayana Rao of NIMHANS, explained that in the brain, connections between neurons are formed by protrusions called ‘spines’. The Indian contribution to the research involved monitoring how these spines were altered in the mentally challenged.

Ancient Tamils fed on kampu,Cholam,Thinai,raagi,jaggery and toddy , supplemented by hunted rabbit, kaadai meat and looked hefty. When cacausian priests moved in, they advised that these are inferior grains and cajoled them to switch over to Rice to suit their habit.

Can you provide any references to back this up?

Can you provide any references to back this up?

He said caucasian priests:lol:

Researchers agree that Rice was found and domesticated by people living in the Yangtse river basin in China 12000 years ago. Its use and cultivation slowly spread to Japan,Korean peninsula,Phillipines,Indo-China,Indoneasia,Thailand,Burma and entered Assam [original] region in India and down to Bengal,Koser,Kalinga, and Pallavan kingdom in the whole of Peninsula along the coast. Another route went to Sumeria.

By the beginning of 1st century, Bhuddist,Jain monks ,Travellers,Vyabaris had developed considerable influence over Tamil culture,language,arts,.literature and social life. Food habits too changed from KaLi,Koozh to 'Nellu Soru'.

Please read history books by K.A.Neelakanta Sastri,M.S. Ramaswami Ayyangar,K.K.Pillai, N.Subramaniyam [M K University,Shillong] etc...

Jeez... another AITist.

For someone who quotes 'researchers' you're really are quite out of the modern scientific loop. :|

Researchers agree that Rice was found and domesticated by people living in the Yangtse river basin in China 12000 years ago. Its use and cultivation slowly spread to Japan,Korean peninsula,Phillipines,Indo-China,Indoneasia,Thailand,Burma and entered Assam [original] region in India and down to Bengal,Koser,Kalinga, and Pallavan kingdom in the whole of Peninsula along the coast. Another route went to Sumeria.

By the beginning of 1st century, Bhuddist,Jain monks ,Travellers,Vyabaris had developed considerable influence over Tamil culture,language,arts,.literature and social life. Food habits too changed from KaLi,Koozh to 'Nellu Soru'.

Please read history books by K.A.Neelakanta Sastri,M.S. Ramaswami Ayyangar,K.K.Pillai, N.Subramaniyam [M K University,Shillong] etc...
And you call them Caucasians? What race are the south Indians then? I recommend you read the book 'History and Geography of human genes'.

Well done! :okay:

A model for sanitation for the urban poor
http://www.indiatogether.org/2007/apr/gov-sangli.htm Mon 02 Jul 2007

A model for sanitation for the urban poor
A systematic, participatory effort to map and understand the need for sanitation in Sangli's slums has helped Shelter Associates bring about a change in the mindset of civic officials and residents alike. Its director, Pratima Joshi believes this is a model that can be replicated in many other cities. Rasika Dhavse reports.

04 April 2007 - "When non-governmental and community-based organisations coordinate with city governments and international funding organisations, a transfer of ideas takes place that creates well-grounded solutions for urban slum areas," says Pratima Joshi, Director of Shelter Associates (SA), a Pune-based NGO working with the urban poor. "The NGO-CBO combination makes the communities themselves aware that a situation can be improved with the active participation of all stakeholders."

SA, comprising architects, social workers, GIS experts and community workers, facilitates and provides technical support to community-managed housing (slum rehabilitation) and infrastructure projects. The organisation is helping the ongoing successful implementation of a community-led toilet project in 12 slum settlements in the Sangli Miraj Kupwad Municipal Corporation (SMKMC) in Maharashtra. The SMKMC area is a rapidly growing city, with a population of nearly a half a million. Almost 15 per cent of residents live in slum settlements that lack access to basic infrastructure and civic amenities. SA pinpointed 12 slum settlements, covering approximately 3500 households, for upgrading sanitation, as well as other improvements. "Not only does upgrading sanitation make a marked difference to health, stress levels and quality of life, but this can also be an entry point for other slum improvements," says Joshi.

Joshi says that the Indo-US Financial Institutions Reform and Expansion Project (FIRE) had started work with the Sangli municipal corporation in 2001 and they got in touch with SA on hearing about the NGO's earlier project mapping poverty in Pune city.

Toilets in slum communities

There are four phases to the current Sangli project, three of which have been completed; the fourth is ongoing. In the first phase, in which FIRE was involved, SA's role was to identify all slums in the SMKMC area and carry out preliminary surveys of settlements in order to find out what kind of services already existed, as a grounded approach for future solutions. Following this, SA implemented the second phase of the project in Sangli in 2001-02 with the assistance of the Canadian based Institute on Governance (IOG). As a pilot effort, this phase's goal was to build two community toilets in two separate slum settlements and its successful accomplishment proved the sustainability of the model. A forum consisting of representatives from the government, media, and civil society (communities and NGOs) worked together. The collaborative effort helped SA and its associate group Baandhani, a federation of slum dwellers, build strong relationships with the local government.

Once the pilot was completed, SMKMC and SA decided to replicate it citywide in Phase III. Mapping and surveys were carried out for slums that had been chosen jointly by the two. This information, which built on the data collected in Phase I, developed a useful tool in planning and designing sanitation projects to ensure that services are equitably distributed.

In the ongoing phase IV, the Cities Alliance (CA) and USAID's Community Water and Sanitation Facility (CWSF) are helping to create the right conditions for citywide, community-driven slum upgradation through community mobilisation, public-private cooperation, and an expanded micro-credit savings plan. The project is helping about 3600 households distributed over various slums in Sangli (about 35 per cent of total slum households of the city) gain access to community toilets. CA supports the actual construction and technical assistance for the project, bearing about 20 per cent of construction costs, while the government of India, the state government and SMKMC incur the remaining costs. SA provides technical assistance by building federations in slums through savings groups, designing the facilities, coordination with the local administration, as well as assisting the local government to access funds for the construction of toilets from the central and state governments. Nearly 400 individual/shared toilets have been constructed so far, covering four settlements with approximately 750 families.


A methodical approach

Both physical and household data were collected in phase III. Physical data entails a detailed map of the settlement using plane table methods: marking houses, electric poles, common water points, street lights, surface gutters, garbage containers, trees, etc. Individual household data includes a breakdown of members, employment records, poverty indicators, educational status and other relevant social data, like each member's ration card and existence on the electoral roll. This two-layered profile of the slum enables it to be examined on a regional or individual household basis. Trained SA staff then processed this socio-economic data with the maps from plane table surveys using GIS software, detailing an analysis of each settlement in individual reports. Through a master list and system of numbering houses, door-to-door surveys were conducted. The results of these compiled surveys were integrated onto the software, also providing crucial comparative information and fact sheets regarding the 12 chosen slums of SMKMC.

With the advantage of this information, SA, in consultation with the municipal commissioner, was able to custom fit its strategies according to local conditions. SA undertook the responsibility of supervising construction of individual toilets in three slums, and extended technical support to the communities in Sangli and Miraj. Further, it helped SMKMC frame the rules and conditions for the implementation and maintenance contract to be signed with selected NGOs, providing for the future maintenance of the sanitation project.

Baandhani, a federation of slum dwellers, has played a pivotal role in the project's success and sustainability. Along with survey work, the federation members work with slum dwellers to create better understanding. "This is a good way to create trust before starting the surveying process, which normally creates apprehension within communities, as they sometimes perceive it as a possible threat to their existence," points out Joshi.


• Intelligent information
• Another struggle needed


The first few successes helped build interest. Many slum households sought individual toilets, and also showed a willingness to contribute financially themselves. In April 2005, five families of the Jatkar Samaj Vasti, one of the slum settlements, took the initiative to build three toilets in their own homes on a shared basis. The households not only contributed 20 per cent of costs, but also took provided materials and unskilled help during construction. "Jatkar Vasti paved the way for change, not only within the settlement, but also in the attitudes of bureaucrats and urged them to adopt a flexible attitude towards sanitation. They were also able to convince families of neighbouring slums to initiate this process within their slums," says Joshi.

Enthused by this, more families came forward with their contributions. Finally SA built 103 shared/individual toilets covering 135 families. After the toilets were constructed, the local councillor decided to pave the roads within the settlement, thereby transforming the face of the settlement completely.

"Khaja Vasti, a small settlement with 107 structures, proved to be the most vexing of all slums," recalls Joshi. "Despite repeated efforts, the families made it clear that they could not contribute anything to the efforts here." The survey findings also showed that this was the poorest settlement of the selected slums. But 16 families had individual or shared toilets even before the project was initiated here. SA decided after consultation with the community that here it would use its contribution to provide the basic pan and connection and three brick walls around. As and when the families could afford it, they would put the door and roof and other finishes inside. "I remember Lailabi, a handicapped woman, weeping after her toilet was built," says Joshi. "For the first time, she was free of the trauma of queuing up in front of the toilet blocks or defecating in the open."
Jatkar slum before and after the project (Pictures by Shelter Associates).
http://img112.imageshack.us/img112/5965/govsanglibefys0.jpg (http://imageshack.us)
BEFORE
http://img178.imageshack.us/img178/9484/govsangliaftqc2.jpg (http://imageshack.us)
AFTER

continue reading article ...

We saw importance of pre natal , post natal care , Child nutrition and development to have good citizens 20 years thereafter. But the most important cog in the wheel of improvement in HDI, is totally forgotton by Central Govt., heads of Bimaru States and many of us.

FAMILY PLANNING ... History says that Morarji Desai, Madhu Limaye, RajNarain and folks had permanantly derailed the scheme in the North. There is no point in multiplying a population segment, who have zero ambition, totally dependant and refuse to progress in Education and skill development and stubbornly stick to age old way of living like collectiong forest leaves, catching snakes, etc etc, . How long we are going to see an army of people doing menial jobs at low wages? A huge responsibility lies on the developed society also as it is their greed/selfishness which to some extent keeps this army going.

Look at population density of Bihar, @ 880 and with 12% urbanisation only... Who is going to carry this burden? The country will sink with the weight of these poor, illiterate mass of unworthy citizens. Even the most Industrialised states of Maharashtra,Gujarat and TN have huge poverty in their back yard.

A 20 year mass sterilization programme agreed upon by all parties in National interest executed in all sincerity can not be delayed any further. Dr Anbumani pl initiate!!!

Scientists !!! Please find a medicine which stops ovalution in women.. and potency in men.

We saw importance of pre natal , post natal care , Child nutrition and development to have good citizens 20 years thereafter. But the most important cog in the wheel of improvement in HDI, is totally forgotton by Central Govt., heads of Bimaru States and many of us.

FAMILY PLANNING ... History says that Morarji Desai, Madhu Limaye, RajNarain and folks had permanantly derailed the scheme in the North. There is no point in multiplying a population segment, who have zero ambition, totally dependant and refuse to progress in Education and skill development and stubbornly stick to age old way of living like collectiong forest leaves, catching snakes, etc etc, . How long we are going to see an army of people doing menial jobs at low wages? A huge responsibility lies on the developed society also as it is their greed/selfishness which to some extent keeps this army going.

Look at population density of Bihar, @ 880 and with 12% urbanisation only... Who is going to carry this burden? The country will sink with the weight of these poor, illiterate mass of unworthy citizens. Even the most Industrialised states of Maharashtra,Gujarat and TN have huge poverty in their back yard.

A 20 year mass sterilization programme agreed upon by all parties in National interest executed in all sincerity can not be delayed any further. Dr Anbumani pl initiate!!!

Scientists !!! Please find a medicine which stops ovalution in women.. and potency in men.
Do you want to take us back to the times of Indira Gandhi and Sanjay Gandhi with their forced sterilization programs? India is a democracy, and people have freedom to breed as they please. Of course, I am all for population control, but you cannot force people to do it against their will. It is simply unconstitutional.

What you CAN do is to cut welfare if a couple has more than 1 or 2 kids. Because having babies is a birth right, but access to welfare programs isn't. If they have more than 2 kids, let them pay for everything (except perhaps emergency medical care) that they get for free now. An alternative is to limit welfare so that the welfare assistance the family gets is capped to the level or parents + 2 kids, and not a penny more. That should teach them a thing or two.

actually, AFAIK the Indian constitution says nothing about a fundamental right to procreation. And also, even today, they offer social initiatives for sterilization. Last but not least, AFAIK it's technically constitutional to sterilized people with genetically-transmittable mental retardation (but recent experiments with mice showing brain repair after protein injections show that some, but not all forms of retardation can be cured).

The Rule of Iron

They were all promising athletes from lower middle class families in Gujarat, but had what seemed to be an insurmountable deficiency. Till a year ago, these talented girls of Kalyani Girls High School in Ahmedabad’s Maninagar area, coming from poor economic background, lived on an uneven diet which meant low hb (haemoglobin) levels and malnutrition. Today, not only are they eating healthy, but are proving their potential in sports, with some even winning laurels at the state level.

Hansa Thakore, 17, an athlete and a 5,000-m champion of the Gujarat School Games in 2006, works as a maid with her mother to eke out a living. Madhavi Barot lives with her handicapped father, has already lost her mother and yet won two state-level gold medals in 3,000-m race. The father of Jashmika Soni, 16, state champion in 400-m race, is a rickshaw puller and lives in a one-room house with his five-member family. “Their transformation has purely to do with the new fortified diet that they have been getting”, says coach Yogesh Modi,

The state Government floated a scheme in 2005 of fortifying edible oil and flour with vitamins at production or packaging stage to tackle malnutrition. A total of 620 women in Ahmedabad’s Daskroi taluka were put on a fortified flour diet for three months last year after which their HB levels went up. Vanitaben Parmar’s is a representative case. Wife of a factory labourer, earning Rs 2,000 a month, her HB count has risen from 7 to almost 11. “I feel much more energetic”, she concedes as do many of her ilk.

A survey conducted by Sanguine Man-agement Consultants recently in several districts of Gujarat at the behest of the State Food and Civil Supplies Department (SFCSD), shows that nearly 80 per cent of the people, both rich and poor, are now consuming fortified edible oils and over 40 per cent are living on fortified flour. Says a jubilant S.K. Nanda, department secretary, who was instrumental in the implementation of the scheme, “there are some small hiccups, but soon we will be able to cover the entire population of Gujarat under the scheme. In edible oil, we are close to achieving it.”

After charting this scheme, SFCSD began working with edible oil manufacturers, packagers and refinery owners and convinced them to add Vitamin-A to the oil at the production stage. Vitamin packs are supplied by four companies and the whole process costs just five paise per kilo.

It was, however, not so easy in the case of iron and folic acid being mixed with flour. The cost for this, too, is five paise per kilo, but small chakki (grinding mill) owners are resisting it as they see it as an extra burden. Apart from this resistance, there is also a problem establishing a time-bound and elaborate supply chain of iron and folic acid packs to mill owners in the far-flung and remote corners of the state.

The scheme, however, is a boon for the below-poverty-line (BPL) families for whom malnutrition is a part of their existence. The Government is as a rule, selling only fortified oil and flour from its fair price shops, making BPL families the fastest beneficiaries of the scheme. If only the Gujarat model could be replicated in the rest of the country, a major front will be opened against the demon of malnutrition.

Source: India Today JULY 16, 2007

Do you want to take us back to the times of Indira Gandhi and Sanjay Gandhi with their forced sterilization programs? India is a democracy, and people have freedom to breed as they please. Of course, I am all for population control, but you cannot force people to do it against their will. It is simply unconstitutional.

What you CAN do is to cut welfare if a couple has more than 1 or 2 kids. Because having babies is a birth right, but access to welfare programs isn't. If they have more than 2 kids, let them pay for everything (except perhaps emergency medical care) that they get for free now. An alternative is to limit welfare so that the welfare assistance the family gets is capped to the level or parents + 2 kids, and not a penny more. That should teach them a thing or two.
Can I add other dimensions, before Constitution?
Morality (for moralists/public), Religion (religious leaders/public), Ethics (professionals/policy makers) and the last, but not the least, Human rights (civil libertarians/disadvataged public):nuts:

We have understood democracy in unknown levels of convenience. Let me borrow the title "The Argumentative Indians"...His penchant for personal rights has ensured that collectively we progress at snails's pace.

Let me recall two news items over the past fortnight. A poverty stricken couple gave birth to their SEVENTH girl child and decided to bury the girl alive. A 10 year old boy narrated his story to a Judge in court and wanted to stay away from his parents and in Govt shelter because his father sold him for Rs 4000. You procreate to do such nasty things?

A couple of States down south have achieved population control to replacement level without any coersion,but by education, incentives, excellent field work, and wide publicity on benefits of a small family. Our maid has got only two kids and both of them are studying in English medium school and a good future is assured.

Derailing such a most important component in people welfare by Bimaru states can not be justified at all. Otherwise UN's Millennium Development Goals will be a mirage for India and every Indian will continue to be " Apologetic ".

^^

TFR - SRS 2004
http://mohfw.nic.in/NRHM/info_center.htm

Kerala - 1.7
Tamil Nadu - 1.8
Andhra Pradesh - 2.1
Delhi - 2.1
Himachal Pradesh - 2.1
Maharashtra - 2.2
Punjab - 2.2
West Bengal - 2.2
Bihar - 2.3
Karnataka - 2.3
Jammu & Kashmir - 2.4
Orissa - 2.7
Gujarat - 2.8
Assam - 2.9
Haryana - 3.0
Chattisgarh - 3.3
Jharkhand - 3.5
Madhya Pradesh - 3.7
Rajasthan - 3.7
Uttar Pradesh - 4.4

Data not available:

Andaman & Nicobar - NA
Arunachal Pradesh - NA
Chandigarh - NA
Dadra Nagar Haveli - NA
Daman & Diu - NA
Goa - NA
Lakshadweep - NA
Manipur - NA
Meghalaya - NA
Mizoram - NA
Nagaland - NA
Pondicherry - NA
Sikkim - NA
Tripura - NA
Uttarakhand - NA

____________

Uttar Pradesh needs to get special attention if India needs to attain its MDG.

Some more data

Infant Mortality Rate (SRS 2005)

Manipur - 13
Kerala - 14
Goa - 16
Nagaland - 18
Chandigarh - 19
Mizoram - 20
Lakshadweep - 22
Andaman & Nicobar - 27
Daman & Diu - 28
Pondicherry - 28
Sikkim - 30
Tripura - 31
Delhi - 35
Maharashtra - 36
Arunachal Pradesh - 37
Tamil Nadu - 37
West Bengal - 38
Dadra Nagar Haveli - 42
Uttaranchal - 42
Punjab - 44
Himachal Pradesh - 49
Meghalaya - 49
Jammu & Kashmir - 50
Jharkhand - 50
Karnataka - 50
Gujarat - 54
Andhra Pradesh - 57
Haryana - 60
Bihar - 61
Chattisgarh - 63
Assam - 68
Rajasthan - 68
Uttar Pradesh - 73
Orissa - 75
Madhya Pradesh - 76

Crude Birth Rate (SRS 2005)

Manipur - 14.7
Goa - 14.8
Kerala - 15.0
Andaman & Nicobar - 15.7
Tripura - 16
Pondicherry - 16.1
Nagaland - 16.4
Tamil Nadu - 16.6
Chandigarh - 17.3
Punjab - 18.1
Delhi - 18.6
Mizoram - 18.8
West Bengal - 18.8
Jammu & Kashmir - 18.9
Maharashtra 19
Andhra Pradesh - 19.1
Daman & Diu - 19.1
Lakshadweep - 19.1
Sikkim - 19.9
Himachal Pradesh - 20.0
Karnataka - 20.6
Uttaranchal - 20.9
Orissa - 22.3
Arunachal Pradesh - 23.3
Gujarat - 23.7
Haryana - 24.3
Assam - 25.0
Meghalaya - 25.1
Jharkhand - 26.8
Chattisgarh - 27.2
Rajasthan - 28.6
Dadra Nagar Haveli - 29.4
Madhya Pradesh - 29.4
Bihar - 30.4
Uttar Pradesh - 30.4

Crude Death Rate (SRS 2005)

Nagaland - 3.8
Manipur - 4.1
Chandigarh - 4.5
Delhi - 4.6
Andaman & Nicobar - 4.7
Arunachal Pradesh - 5.0
Dadra Nagar Haveli - 5.1
Mizoram - 5.1
Sikkim - 5.1
Jammu & Kashmir - 5.5
Daman & Diu - 5.6
Tripura - 5.7
Lakshadweep - 6.3
Kerala - 6.4
West Bengal - 6.4
Haryana - 6.7
Maharashtra - 6.7
Punjab - 6.7
Himachal Pradesh - 6.9
Rajasthan - 7.0
Goa - 7.1
Gujarat - 7.1
Karnataka - 7.1
Pondicherry - 7.1
Andhra Pradesh - 7.3
Tamil Nadu - 7.4
Uttaranchal - 7.4
Meghalaya - 7.5
Jharkhand - 7.9
Bihar - 8.1
Chattisgarh - 8.1
Assam - 8.7
Uttar Pradesh - 8.7
Madhya Pradesh - 9.0
Orissa - 9.5

The above indicators show great variation across habitations. Does Genetics play a part in Human Development ? The Human Resources Ministry has collaborated to research the genetic diversity of India.

Hyper sensitivity, Emotional insecurity are some of the psychological parameters that make individuals to jump to premature conclusions. People with scientific bent of mind must value 'mind' over 'heart. Please be open to discussions and conclusions which are not final. A scientist is always searching for possibilities and is motivated only to find scientific truth and has no competing interest..

quote:

"Human diversity in India is defined by 4693 different, documented population groups that include 2205 major communities, 589 segments and 1900 territorial units spread across the country. Anthropologically, the populations are grouped into four major ethnic categories, which include the Australoid, Indo-Caucasoid, Indo-Mongoloid and Negrito populations and linguistically broadly classified as Dravidian,Indo-European, Sino-Tibetan and Austro-Asiatic speakers. The complex structure of the Indian population is attributed to incessant, historical waves of migrations into India, the earliest, by the Austric speakers around 70,000 years ago, followed by the Dravidian speakers from middle-east Asia and the Sino-Tibetan speakers from China and southeast Asia around 8000 to 10,000 years ago. The last major migration is believed to have occurred around 4000 years ago by several waves of Indo-European speakers.."

If you are interested in 'Human Leucocyte Antigen', 'Alleles', and other genetic markers of certain groups of Indian population, please read..

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1513393&blobtype=pdf

The world Population Day has come and gone without any noise from the PM . The great Economist believes in only the numerator!!!

Another Utopian policy by 'Utopian Policy Alliance'. The so called champions of 'liberalism' are doing exactly opposite to what liberalism stands for.



HT EXCLUSIVE - Govt to monitor pregnancies, abortions

THE CENTRAL government plans to make it mandatory for the country's women to register their pregnancies with it. It also wants abortions to be carried out only under specified circumstances. The ministries behind the move think it will help them stop the exploitation of the girl child and correct India's heavily skewed sex ratio. But there are concerns that this data may be misused. The move might allow babus and lawenforcers to enter - and control - the most personal domains of citizens, and provide state pro- tection to corruption and the possible exploitation of women. "It can lead to too much intrusion in somebody's private life," Ranjana Kumari, president of Women PowerConnect, a group of women's NGOs, said. "It will also be very difficult to obtain such data. In China, the government found it tough to implement the one-child norm. Whether such a thing will be possible in a democracy, I doubt." On Thursday, Women and Child Development Minister Renuka Chowdhury told Hindustan Times that she wanted each pregnancy to be registered. "This will help to check both foeticide and infant mortality," she said. Health Minister Anbumani Ramadoss had said on Wednesday, "We will provide facilities to conduct pregnancy tests in each village. It will help provide better health-care facilities to mother and child." If Chowdhury has her way, abortions wn be allowed only where there is a "valid and acceptable reason". HT could not get officials to reveal the criteria that would make an abortion "acceptable and valid".

HT July 13, 2007.

India’s overlooked ‘grey market’ workforce

http://www.hindustantimes.com/StoryPage/StoryPage.aspx?id=984ae56d-f68f-467d-ab4b-bb9fc5181887&MatchID1=4488&TeamID1=8&TeamID2=10&MatchType1=1&SeriesID1=1120&PrimaryID=4488&Headline=India%e2%80%99s+overlooked+%e2%80%98grey+market%e2%80%99+workforce

Consider this: an estimated one-fifth of India’s current workforce — from shop-floor workers to top managers — which has played a crucial part in the transformation of Indian business, will be out of the workforce by the year 2010. For good.

Not because they would have been ‘downsized’, but simply because they would have passed India’s absurdly low retirement age of 58.

Welcome to the downside of India’s much-touted ‘demographic dividend’, its vast supply of young workers entering the workforce, which will give India a huge edge over other economies, who are faced with a rapidly aging working population.

Young, yes. Talented? There’s a question mark over that. According to a recent study by Citigroup, critical and rapidly growing sectors like retail, civil aviation, telecom services and infrastructure, especially engineering services, are already facing moderate to severe talent shortages.

Meanwhile, experienced, well-trained manpower is simply walking out of the office door, never to return. And most employers do not even appear to be bothered by this. In a survey of 4,742 employers spread across all major sectors, the results of which were released recently, recruitment major Manpower India found that a majority of the respondents did not have any strategy in place to retain or use what it termed the ‘older workforce’ — employees aged 50 years or above.

“Opening the doors to older workers is a major benefit…it will help organisations retain knowledge and experience, widen the recruitment base and could lead to more customers and greater profits,” commented Soumen Basu, executive chairman, Manpower India.

In other words, looking beyond those grey hairs makes sound business sense. Western companies have already begun to engage with the problem. A study by IBM Consulting carried this telling quote from Keith Johnstone, co-lead of Sandia’s Knowledge Preservation Project: “What we’re doing is trying to capture their ideas, but more than that, their psyches, to try to learn not just what they did, but why they did things the way they did; to find out what worked, what didn’t work, what might have worked had the supporting technology been more advanced…”

Another major issue will be the type of labour entering the market. Demographic studies have already found that states with high literacy levels, as well as urban centres, have significantly lower than average fertility levels. The reverse is true for the most educationally backward areas. According to Nicholas Eberstadt of the American Enterprise Institute, “Educated and aging, or untutored and fertile — this looks to be the contradiction for India's development in the years immediately ahead.”

The choice is ours.

Another Utopian policy by 'Utopian Policy Alliance'. The so called champions of 'liberalism' are doing exactly opposite to what liberalism stands for.

HT July 13, 2007.

Curtailing abortion rights? That's crazy, they need abortions to be reasonably avaliable out of concern for women's bodily integrity (since no fetus can claim proper personhood until it is reasonably viable outside the womb, reasonable personhood being defined as the ability to survive as an independent organism without significant chances of premature birth-induced cognitive incapacitation).

Pregnancy registration, however, is acceptable, and technically already happens in every country that has networked and modern hospitals.

IMO, there should be a select number of instances where abortion should be outright mandatory. They are as follows:


Fetal malformation
Irreversible genetic defects in the fetus
Rape


These 3 mandatory instances can be overruled by a medical doctor if aborting a defective fetus or rape fetus is a threat to the woman's life.

All other forms of abortion should be pretty much optional (legal and choice-driven), with mandatory fetus cloning for aborted fetuses (so that the cloned embryos can either be frozen for use at a later date, or given to an infertile couple). This allows a heathy fetus to have its exact DNA sequence (and thus its uniqueness) preserveed after abortion, thus allowing the given DNA sequence to be used to develop an actual person at a later date if desired. (This is one reason why I support human cloning, among many others)

As for the sex ratio, it can be fixed by a combination of education and some radical modifications to India's family law (to create equal value for all offspring save for overall talent+aptitude). The modifications are the following:


NAME LAW:In the new name law, everyone inherits a matrynomic and patrynomic family name (Hispanic style, but the order doesn't really matter), and upon marriage, everyone drops the family name that they inherited from their opposite-sex parent (allowing people of either sex to carry on their family name). For example, Varun Bhatt and Anoushka Bharadwaj have a son named Arjun Bhatt-Bharadwaj. Upon marrying Tanisha Gupta-Patel, Arjun becomes Arjun Bhatt (patrynomic stays) and Tanisha becomes Tanisha Patel (matrynomic stays). They then have a son named Jai Bhatt-Patel and a daughter named Maya Bhatt-Patel. When they get married, they start the cycle again.
FAMILY-BALANCING TAX BREAK:Balanced families (with more or less even gender ratios among their children) can be given a 10% income tax reduction or something similar.
JOINT FAMILY REFORM:In this reform, no person of either sex leaves their birth family upon marriage. Instead, a given joint family is considered to be a group of individual households (created through marriage) associated by kinship ties. Each household is considered to be part of two family units, and everyone can both inherit and bequeath property. The system of assigning a karta to each family unit should either be abolished entirely (since all households should be capable of taking responsibility for its actions instead of dumping them all on their family unit's eldest member), or reformed into a sytem where households within a family unit elect a karta/kartini (no more sex discrimination in family law) using secret ballots.


This will create equal value for equal talent among children of both sexes, since one will not be seen as being a commodity to marry off to some other family unit by the other.

Any additional suggestions?

Parents and Senior Citizens Bill, 2007
http://www.indiatogether.org/2007/jul/law-seniors.htm
:nuts:
A draft bill in Parliament attempts to mandate the care of elderly citizens in law, and envisions the establishment of tribunals to ensure its functioning. But its definitions and methods leave many questions unanswered. Priya Narayan Parker presents a legislative brief.

HIGHLIGHTS OF THE BILL

1. The Maintenance and Welfare of Parents and Senior Citizens Bill, 2007 seeks to make it a legal obligation for children and heirs to provide maintenance to senior citizens. It also permits state governments to establish old age homes in every district.

2. Senior citizens who are unable to maintain themselves shall have the right to apply to a maintenance tribunal seeking a monthly allowance from their children or heirs.

3. State governments may set up maintenance tribunals in every sub-division to decide the level of maintenance. Appellate tribunals may be established at the district level.

4. State governments shall set the maximum monthly maintenance allowance. The Bill caps the maximum monthly allowance at Rs 10,000 per month.

5. Punishment for not paying the required monthly allowance shall be Rs 5,000 or up to three months imprisonment or both.

Any comments? State escaping responsibility?

Its mostly a case of the state abandoning its responsibility. Maintainance of family elders should be left up to each family unit to decide for itself. However, the requirement for senior's centers in each district is a good idea.

Diabetes_mellitus is threatening India as a major Lifestyle disease as per many reports from Doctors. Is it Lifestyle or a change in Food habits straying far away from traditinal way of living. We have started using a Food chain which are listed among having very high Glycemic Index foods like , Rice, Potato,Refined Sugar in all forms, Corn Flakes,Oats meal,Pasta,French Fries,banana etc. For e.g polished Basmati rice has a GI 0f 85. GI benchmark is 100 for Glucose. If you feed three Idlies[a rice preparation] to an Insulin dependant person, the Blood sugar level can shoot up to 350-400 mg/dl in one hour. All the above mentioned food items come at a high cost and people are actually buying a lifestyle disease. Now people at the bottom of the pyramid also have almost started consuming these high GI foods.

Nandan Nilekani's wife Ms Rohini too feels likewise!

The bigger question: Why are both farmers and consumers, even in the lower socio-economic classes, deserting local crops such as ragi? Is it peer pressure? Or is it due to command-and-control procurement, with high prices for some crops and not for others?

http://www.hindu.com/2007/07/07/stories/2007070754381100.htm

A few forumers suggested meat for nutrition. It is . But only the top 20 % population can afford. It is a costly solution. I hence suggested a traditional food.. Finger Millet and proso,pearl millets for health and unshunted growth.

please go through the recipe given in the following link and responses. find out how Kannadiga's in USA/Canada enjoy " Ragi Muddle".[especially Rashmi A.S]

http://worldwidecurries.com/?p=30

I am quoting below a reader's comment...

The Latin name of ragi is Elusine coracana; although it is believed to be native to African highlands of Ethiopia and Uganda, there is another view that ragi is quintessentially a crop indigenous to India. This may explain why it is alternatively called as Elusine indica in Latin. This so called coarse grain or poor man’s millet is actually superior to rice or wheat in nutritional terms being rich in proteins and high levels fibre which makes it digestible slowly, thereby ensuring the release of carbohydrates in small quantities. This may explain why two ragi mudde eaten in the morning with a bit of chilli, onion or sambar may sustain the labouring farmer through the whole day. It is also said to be a cool food ( Ref. `Ragi is Back, but only as exotica’ in the June 30th issue of Down to Earth (www.downtoearth.org.in) by E. Vijayalakshmi of Bangalore). This is because ragi is alkaline while most other foods are said to be acidic. What is more, like grain amaranth or rajgira or ramdana another very high-protein non-cereal crop, ragi is a hardy grain that can thrive on meagre resources. In fact, if you combine amaranth, million-dollar research on which is being sponsored by the Rodell Foundation in American, with ragi, you don’t need meat or milk for your proteins! The story of amaranth, the lost crop of the Incas and Aztecs, and which surfaced in the Himalaya, is another beauty which deserves a separate site of its own.

Vithal C. Nadkarni

Assistant editor in 'The Times of India/Science Today'

Nutritive value of Ragi per 100 g
----------------------------------
Protein 7.3 g
Fat 1.3 g
Carbohydrate 72 g
Minerals 2.7 g
Calcium 344 g
Fibre 3.6 g
Energy 328 KCal
GI <45

... India’s absurdly low retirement age of 58.

well its not so absurd when you look at the average life expectancy

Hunger-free India

While releasing the Food Insecurity Atlas of Rural India at New Delhi on April 21, 2001, Prime Minister Atal Bihari Vajpayee commended the goal of ‘Mission 2007: a hunger-free India’ in the following words:

"Democracy and hunger cannot go together. A hungry stomach questions and censures the system’s failure to meet what is a basic biological need of every human being. There can be no place for hunger and poverty in a modern world in which science and technology have created conditions for abundance and equitable development.

The sacred mission of a 'Hunger-free India' needs the cooperative efforts of the Central and State Governments, local self-government bodies, non-governmental organisations, international agencies, and, above all, our citizens. We can indeed banish hunger from our country in a short time. Let us resolve today to make this Mission substantially successful by 2007, which will mark the sixtieth anniversary of our independence."

In two weeks time India will celebrate 60 th anniversary of Independance.But in 2007 India is still far away in achieving the first among the U.N. Millennium Development Goals, namely the eradication of hunger and poverty.

M.S. Swaminathan suggests two missions for the anniversary.

http://www.hindu.com/2007/07/28/stories/2007072854961200.htm

Is it then a question of realising and accepting what lies ahead for the farmers in future in India? I saw a programme in channel 4 (UK), where a farmer from Gurgaon was complaining that local industries there would not employ them and that as a result of 'mall-ification', they have become unemployed. Interesting?

There are usually three stages in a nation's development. History reveals a nations starts as agrarian..moves to be industrialized....then goes to consulting.

For example, United States employs less than 1% in agriculture but still reaps surplus.. the answer my friend is technology.

I know answer to India's problem would not be what other countries did. Every country has a unique problem but 4 pillars of civilized world need to be solidly erected irrespective of the solution and those are:
Law and order
Infratructure
Human development
Govt Administration

Apollo embarks on massive expansion plan

Chennai, Aug. 5 (PTI): Apollo Hospitals has chartered out a massive expansion plan with multi-location hospitals in Mumbai and plans to set up a full-fledged orthopaedic hospital in Chennai soon, a top official of the company said yesterday.

"We have tied-up with Western Hospitals in Mumbai and will set up Centres of Excellence at various places. Each hospital will have 250-300 beds each," Preetha Reddy, Managing Director,Apollo Hospitals told reporters here on the sidelines of a press conference on the progress of the 'Save a Child's Heart' Initiative.

She said about Rs 600 crore has been allocated for the expansion in Mumbai and they were in the process of finalising and acquiring land in New Mumbai,Thane,South Mumbai and Nasik.

Apollo would also be setting up an orthopaedic hospital in North Chennai with 200 beds at an investment of about Rs 110 crore, Reddy said.

She said the healthcare major would soon start work on construction of their hospitals in Ahmedabad, Vishakapatnam and Bhubaneshwar.

"We expect our turnover to reach Rs 1,200 by the end of this year," she said.

"We want to touch the 10,000 bed mark by 2010. Currently we have about 8,000 beds, both through tie-ups and our own."

The Consultancy division of Apollo would soon foray into Khazakhstan and Turkey, with details of the tie-up for the latter almost finalised.

Also in the plans are two schools and colleges of nursing coming up at Madurai and Chennai by the end of the year, she said.

Source: The Hindu (http://www.hinduonnet.com/thehindu/holnus/004200708050343.htm)

This is the way to go for Human Development in the Hindi Heartland since contribution from local Govt is pathetic.. Hope more 'Samantas' crop up to lift this country out off its backwardness.He has proved that it is very easy to lift the first time learners to enlightenment, once you have sincerity of puropose and dedication to a noble cause.

Five thousand tribal children, a sprawling campus, free food, housing and education 'formal and vocational ' and a hi-tech deemed University next door. This is India’s first tribal University in the making, the Kalinga Institute of Social Sciences (KISS) to be precise, a vision realised in Bhubaneswar, a dream nurtured by philanthropist Achyutananda Samanta.

Plucked out of the neglected, inaccessible and remote tribal backyard of Orissa, the boys and girls are part of a project launched with only 100 children on April 1, 1993. A sister concern of the Kalinga Institute of Industrial Technology (KIIT), KISS is a working dream that trained the tribal children to be self-reliant, resourceful and empowered to tackle the challenges of life.

Dr. Samanta’s faith in their abilities was fully reinforced when every KISS student who took the State Board examination passed. Ninety per cent cleared the Plus Two examinations, a performance far ahead of the State average of 59 per cent.

For details...
http://www.hindu.com/2007/08/08/stories/2007080858082400.htm

This is the way to go for Human Development in the Hindi Heartland since contribution from local Govt is pathetic.. Hope more 'Samantas' crop up to lift this country out off its backwardness.He has proved that it is very easy to lift the first time learners to enlightenment, once you have sincerity of puropose and dedication to a noble cause.





In Orissa, they speak Oriya. You know it's a different language from Hindi, just like Tamil. Anyways, good news indeed.

Fortis plans ‘health cities’ in Rajasthan; looking for land (http://www.thehindubusinessline.com/2007/08/25/stories/2007082551450300.htm)


Fortis Healthcare is looking to acquire land for its planned healthcare projects in Rajasthan. “We are in the process of acquiring land, and are looking at about 50 acres hopefully near Jaipur,” Mr Shivinder Mohan Singh, CEO and Managing Director, Fortis Healthcare, told Business Line.

The company is proposing an investment of Rs 1,200 crore over a period of 10 years in healthcare projects across Rajasthan in a Public Private Partnership with the State Government.

The projects include two medical education hubs, and at least two or three super-speciality or multi-speciality hospitals across the State. The ‘health cities’ would comprise of 800-bed hospitals, and medical, nursing, and dental colleges, and offer clinical and basic research facilities, Mr Singh said.

The investment figure includes the Rs 110 crore that Fortis has committed to ‘Phase One’ of the Fortis Escorts Hospital Jaipur. The Ranbanxy-promoted company is to invest an additional Rs 90 crore in this project when ‘Phase Two’ rolls out in eight to nine months.

Mr Singh submitted the proposal to the Chief Minister of Rajasthan, Ms Vasundhara Raje, at a summit held in the capital on Friday. Dr Praneet Kumar, COO, Fortis Escorts Hospital Jaipur specified that the 10-year time period was so that the company’s medical education plans were in line with the Medical Council of India’s guidelines.

“Eighty per cent of this investment will be made in the first five to six years,” he said.

Close to completing six decades in healthcare delivery, the Manipal Healthcare Group (MHG) had a modest beginning with the Manipal Hospital in Bangalore. Today, with a total of 7,000 beds across all its hospitals, it is easily one of the country’s largest healthcare networks.

Not far behind is another southern healthcare bigwig, one that has also made inroads into the north to become Asia’s largest healthcare group — Apollo Hospitals. Then there is Wockhardt Hospitals, which started in Bangalore, and is now debuting in north India with a hospital in Delhi.

Clearly, the south is the birthplace of private hospital chains in India. For hospital chains in the north, however, the journey has only just picked pace.

Fortis Healthcare and Max Healthcare are yet to register cash break-even. “But that’s because in the north, organised private healthcare is a very recent phenomenon compared to the south where traditionally there has been organised, institutionalised healthcare delivery,” says Vishal Bali, CEO, Wockhardt Hospitals. “For every AIIMS, there are three-four medical institutions in the south.”

In spite of investing close to Rs 250 crore in the last 18 months, MHG’s y-o-y growth is almost 20 per cent, with its top-line growing at an average rate of 30 per cent.

R Basil, CEO, Manipal Health Systems, says, “We are employing numerous strategies for growth and expansion and a major focus is on research and development of therapies.”

This is another area where the south continues to have an edge. While the private sector in the north has still not made it big in R&D, in southern hospitals like Manipal, L V Prasad and Lifeline, breakthroughs in stem cell therapy are common.

Adds Basil, “We have a waiting-list of 300 patients for our stem cell therapy and large numbers are coming from the US.”

However, Mukesh Shivdasani of Max Healthcare believes, “The gap is closing between the north and the south. The hospitals that have come up in the north in recent times, at a cost of more than Rs 500 crore, have made larger investments than their southern counterparts.”

But investments to this tune tend to translate into higher delivery costs for consumers, making the south a cheaper option, especially for patients from overseas.

Max, which is now aggressively pursuing the US market, got only 350 American patients till last year; but it is targetting 700 this year. Fortis, which focused on medical tourism from the beginning, claims to have received almost 4,000 patients last year.

For Apollo, its hospital in Chennai and Delhi are almost at par now, with both receiving 12,000 patients each. “The revenues from these two hospitals are also similar,” says Anil Maini, president, corporate development. “But it’s true that a slight difference comes in also because of cheaper manpower in the south.”

Moving to the north, though both Max and Fortis are yet to break even, their business is growing at a phenomenal rate. Had it not been for the Escorts acquisition, Fortis would have reported cash break-even in the last financial year — a modest time-period for the sector. From a turnover of Rs 300 crore in ’05-06, the company saw its turnover jump 122 per cent in 06-07 to Rs 525 crore.

Says Pawanpreet Singh, corporate controller, Fortis Healthcare, “In terms of profit, we have started improving on a standalone basis but in percentage terms, the consolidated growth is still not great.”

The north’s slow pace has been largely attributed to its private practice-oriented healthcare delivery at a time when the south was investing in specialised hospitals.

Says S Aravind, administrator, Aravind Eye Hospital and Institute, Madurai, “It’s true that the south is currently ahead of the north in terms of healthcare delivery and R&D, but all that is changing now with the coming of private players in the north.”

The changes are clearly visible with more players like Apollo Tyres-promoted Artemis and Wockhardt also entering the north and Fortis making inroads into the south with a green field project in Navi Mumbai.

So, while the south may have been the pioneer, the north seems to be taking forward private healthcare in style. As Shivdasani asserts,” We have changed the method of healthcare delivery with our high standards and non-medical services. I am sure that investment in healthcare will grow even further and we will fill the gap in the next five years.”

HEALTH NETWORK

Manipal Hospitals is present in 11 cities in the south; hospitals in Delhi and Kolkata are on the cards

Fortis Healthcare has 12 hospitals, all in the north. Work has begun on a hospital in Navi Mumbai, and plans are afoot to go further south this year

Apollo Hospitals is present in three southern cities, as also Delhi, Ludhiana, Indore, Ranchi, Bilaspur, Kolkata and Ahmedabad

Wockhardt is present in Kolkata and Bangalore, with one hospital planned in Delhi

Max Hospitals has eight hospitals in the north (no greenfield hospitals are planned in the south)

http://www.business-standard.com/lifeleisure/storypage.php?leftnm=5&subLeft=5&chklogin=N&autono=296165&tab=r

http://www.hindustantimes.com/StoryPage/StoryPage.aspx?id=4597e923-f5ac-4c51-b51f-657699c2f90e&&Headline=Fortis+plans+40+hospitals+across+India+by+2010

Fortis plans 40 hospitals by 2010, to invest Rs 1,800 cr Investment In India
New Delhi, August 27, 2007
First Published: 16:36 IST(27/8/2007)
Last Updated: 16:39 IST(27/8/2007)


Ranbaxy promoter group company Fortis Healthcare on Monday said it is planning to invest Rs 1,800 crore for a pan-India expansion, including setting up a medicity in Gurgaon and 28 hospitals by 2010.

"In the next three years, our plan is to become a national player from a North India-centric player. As part of this we intend to have 40 hospitals under the Fortis group across 14 states by 2010," Fortis managing director and chief executive officer Shivinder Mohan Singh told reporters here.

He, however, said the total outlay for the planned expansion, which could include greenfield facilities, management contracts and acquisitions, could be to the tune of half a billion dollars. Of this, the company's contribution would be around Rs 1,000 crore, he said.

"Presently, the company operates 12 hospitals, of which four were acquired, four under management contract and another similar number are own developed facilities. Going forward, we intend to maintain this ratio," Singh said.

The company plans to tap western and southern parts of India by the end of this year. Post-expansion, the company is targeting to have 7,000 beds, treat 17.5 lakh patients and perform two lakh operations and surgeries annually.

Fortis also announced a multi-speciality medicity project in Gurgaon at an investment of Rs 800 crore. It will have a bed capacity of 950 and will be built in a phased manner.

"In the first phase, to be completed in two to three years, the company would invest Rs 300 crore to create a 350 bed facility. The commencement of the second phase will depend on market demand," Singh said.

India to have 57 mn diabetics by 2025

http://economictimes.indiatimes.com/57_mn_Indians_to_have_diabetics_by_25/articleshow/2317456.cms

India to have 57 mn diabetics by 2025

http://economictimes.indiatimes.com/57_mn_Indians_to_have_diabetics_by_25/articleshow/2317456.cms
That's very sweet!

Large gaps in health services


By all accounts, health indicators in India do not present an encouraging picture. Not only is India seen in a poor light in regard to health status in comparison with countries with comparable levels of development, there are wide differences in the health indicators among different states.


http://business-standard.com/opinionanalysis/storypage.php?tab=r&autono=296775&subLeft=2&leftnm=4

Intel Inside: The digital transformation of Tindivanam. TN

http://economictimes.indiatimes.com/Intel_Inside_The_digital_transformation_of_Tindivanam/articleshow/2338415.cms

Elusive Healthcare for the poor

India’s poor health status, particularly in relation to a country like Bangladesh, which enjoys a lower level of income, has significant implications. If this continues despite high growth and decline in the percentage of people below the poverty line, it will mean that the income growth is not translating into improvements in the level of well being, given the fact that there is a strong correlation between the health status of an individual and her sense of well being


http://www.business-standard.com/economy/storypage.php?tab=r&autono=296906&subLeft=3&leftnm=3

COPING WITH CRISES

IN THE running | Dr Prasad Rajhans is the pioneer of Emergency Medical Services in India

Over a decade ago, when two Indian doctors were travelling by British Rail, an unexpected emergency was to change the life of one of them for ever. A British passenger’s heart stopped beating and an announcement calling for doctors was made. The two doctors promptly rushed to the patient and administered basic emergency care. As the train stopped at the next station, the doctors were surprised to find an ambulance already waiting at the platform and as they put the patient in the ambulance and returned, they were even more astonished to find that the train had actually waited for the doctors all this while.
That was a decisive moment for Dr Prasad Rajhans, one of the two Indian doctors, who resolved that he would come back to India to work in the field of Emergency Medical Services (EMS) and save the lives of Indians with the same efficiency. “I returned to India in 1998 and since then, I have been steadily following my passion for EMS. I joined a socially motivated group of doctors called Jnana Prabodhini Medical Trust to follow my dream,” says Rajhans, chief intensivist of Deenanath Mangeshkar Hospital, who has not only pioneered EMS in Pune, but also in India.
The EMS project was launched in the city with a single ambulance on August 5, 1999. But the beginning seemed bleak with shortage of funds, manpower and equipment. “There was no awareness about the concept and people were sceptical about how it would work,” reminisces Rajhans.
There was no manpower and hence the idea of a training module in EMS came up. Eventually, he approached Symbiosis International University and the first paramedic training programme in India was launched in 2002. Some 1,600 doctors have been trained as part of the programme so far. “We slowly added new ambulances with the help of funds and more hospitals were included as part of the project. And, after much effort, we managed to get the number 1050 as an emergency number in Pune that allows the caller to get an ambulance from the nearest hospital,” adds Rajhans, who has also been working closely with the Emergency Management and Research Institute (EMRI), Hyderabad.
Today, EMS in Pune has saved more than 20,000 lives and the survival rate of cardiac arrest victims attended by EMS in the city is 12 per cent, which is comparable to international standards. “As part of our work at EMRI, we are trying to launch EMS on highways and create a common national network in all states. This will be the ideal thing as there will be a common emergency number for all Indian states,” he says with hope in his eyes.



http://img106.imageshack.us/img106/3249/getimagemv9.jpg (http://imageshack.us)

Lucknow gets hospital exclusively for children (http://cities.expressindia.com/fullstory.php?newsid=255126)

Lucknow will soon get its first super specialty hospital, exclusively for children. Lucknow Development Authority (LDA) on Friday gave its nod to the state Medical and Health department to go ahead with the project.

For the hospital, LDA will allot nearly 2 acres of land along Kanpur Road. LDA Vice-Chairman Harbhajan Singh said, “We will allot the land to Medical and Health department on nominal rates, which will be fixed soon.”

Referring to the blueprint of the upcoming hospital, LDA officials said that it would have at least 100 beds. The hospital will not only have a premiere paediatric centre, but also a play department. It will also have parents’ accommodation cells, where family members can reside, added LDA officials.

Lucknow to have India's first DNA bank (http://timesofindia.indiatimes.com/Lucknow_to_have_first_DNA_bank/articleshow/2328412.cms)

India is going to get its first human DNA bank in Lucknow. Located on the Biotech Park campus at Kursi Road, the bank is probably first of its kind. The company IQRA Biotech Services’ (IBS) website and director Saeed Ahmad claim, "It is a DNA bank and not a lab".

The facility is not research-oriented like rest of the DNA banks world over, including CCMB at Hyderabad and is open to public. So by mid-September anyone will be able get his/her DNA stored for 50 years by paying a nominal amount of Rs 1,500 and exactly four drops of blood.

Along with the blood sample, the company will store basic information about the person like, photograph, name, qualification and contact details. More importantly, it will include fingerprints and retina scans along with signature and handwriting samples.

The emphasis is on giving the person a concrete identity. So, there will be a piece of peculiar information like place of marriage, foot size, sitting height and number of wives person’s father has. To make it more useful the individual profile will include a list of diseases the person is suffering from and any history of drug allergy.
Ahmad says that the need to have a concrete identity is gaining import in present times.

Any agency, once it becomes IBS client, can use any of the tools provided by the bank like cards, code number, retina scan, fingerprints and photograph and handwriting, not to forget peculiar set of information in the profile. What is more, says Ahmad, it can be done anywhere with the use of a laptop, card reader or finger print or retina scanner.

Lucknow to have India's first DNA bank (http://timesofindia.indiatimes.com/Lucknow_to_have_first_DNA_bank/articleshow/2328412.cms)
It's not been made clear how this database will benefit public. They are talking about storing lots of personal and biometric data for benefiting other agencies. In the absence of any data protection law in India, they will need to develop robust internal mechanisms so that privacy is respected and no unwanted use happens. :shifty:

MIOT hospitals chennai (http://www.expresshealthcaremgmt.com/200709/coverstory08.shtml)

MMM chennai (http://www.expresshealthcaremgmt.com/200709/coverstory04.shtml)

Apollo chennai (http://www.expresshealthcaremgmt.com/200709/coverstory07.shtml)

Sankara netralaya chennai (http://www.expresshealthcaremgmt.com/200709/coverstory05.shtml)

Srmc chennai (http://www.expresshealthcaremgmt.com/200709/coverstory09.shtml)

Apollo bangalore (http://www.expresshealthcaremgmt.com/200709/coverstory18.shtml)

Kg coimbatore (http://www.expresshealthcaremgmt.com/200709/coverstory11.shtml)

kovaii medical centre hospital (http://www.expresshealthcaremgmt.com/200709/coverstory10.shtml)

Narayana hrudayalaya bangalore (http://www.expresshealthcaremgmt.com/200709/coverstory15.shtml)

hosmat bangalore (http://www.expresshealthcaremgmt.com/200709/coverstory19.shtml)

Manipal bangalore (http://www.expresshealthcaremgmt.com/200709/coverstory17.shtml)

Ms ramaiah bangalore (http://www.expresshealthcaremgmt.com/200709/coverstory16.shtml)

some important hospitals left out from the list above......especially in chennai and bangalore........

South is not just home to celluloid superstars, but it also boasts of the best of healthcare giants. Express Healthcare gives you a peek into the top 25 hospitals in the Southern states to watch out for.

Since the 70's, the Southern states were known as Mecca for healthcare, attracting patients from various parts of the country for intricate surgeries, be it in ophthalmology, cancer, orthopaedics or cardiology. It has the reputation of offering cutting-edge technology, with high quality and affordable pricing. It houses indubitably the country's best clinical acumen and is a breeding ground for path-breaking research. No wonder then that the region has many firsts to its credit. These include the first paediatric heart transplant, first paediatric heart and lung transplant, conducting first robotic mitral valve replacement, first total knee replacement, Birmingham hip resurfacing procedure, detecting the first HIV/Aids case, and establishing the first corporate hospital in India.

Express Healthcare gives you a peek into the top 25 hospitals in the Southern states of Tamil Nadu, Kerala, Karnataka and Andhra Pradesh.

The names have been selected based on parameters like medical breakthrough, rapid growth, commitment to excellence and quality, skilled manpower, affordability and focus on training and development.

The hospitals chosen have 250 beds and above, and more than three years of market presence.

http://www.expresshealthcaremgmt.com/200709/coverstory01.shtml

http://www.expresshealthcaremgmt.com/200709/coverstory02.shtml

//

Ranbaxy Laboratories today said that it would invest $500-600 million (around Rs 2,025-2,430 crore) in Punjab's healthcare sector.

"We have submitted our project proposal with the Punjab government. The project will involve an investment of $500-600 million in creating healthcare infrastructure such as hospitals and medical institutes in the state in the next few years," Malwinder Singh, CEO and managing director, Ranbaxy Laboratories told reporters today.

The project would also take on board partners from public sector, he added. Singh was here to attend a conference on pharmaceutical industry.

On its proposed 80-acre SEZ in Mohali, Singh said that the company would produce 10 million tablets in the next two years in the SEZ. Ranbaxy had already announced an invest of Rs 265 crore in the SEZ project. "We are open to involve other partners in this venture also," he said.

Cancer centre sets up bone marrow transplant unit

C. Maya

Thiruvananthapuram: The Regional Cancer Centre (RCC) has acquired a modern bone marrow transplant (BMT) unit, which will help the institute offer both autologous and allogeneic bone marrow transplants to those suffering from acute leukaemias or myelomas.

The BMT unit, with sophisticated machinery and patient care units that meet international standards, has been set up at a cost of Rs.2.5 crore using the State Government’s Plan funds (2006-07). With this, the RCC has become the first ever institution in the Government sector in the country to offer this expensive but life-saving procedure.

Health Minister P.K. Sreemathy will inaugurate the unit on October 6. Some other equipment acquired by the RCC, including a radiotherapy simulator and three X-ray units would also be inaugurated on the day.

Read the full story in The Hindu (http://www.hindu.com/2007/10/04/stories/2007100459490300.htm)

Heal thyself

EAR TO THE GROUND

Sreelatha Menon / New Delhi October 14, 2007



Villagers and slum-dwellers in Maharashtra run their own health insurance fund, with spectacular results.

Dandekar bridge slum in Pune is unlike any other slum in the country. When someone here falls ill, the family just has to dial a 24-hour helpline, whose doctor advises them which government hospital the patient should consult. The family also receives money for treatment.

When the rest of the country is going in circles seeking health insurance for the society’s most vulnerable, these slum-dwellers are part of a health security fund to which each person contributes Rs 60 annually. The unique fund is run by the slum-dwellers themselves along with those living in 88 other slums in Pune.

So far, 30,000 have joined the fund, which covers all Pune slums and some villages in two other districts of the state. Dandekar bridge slum in east Pune accounts for 8,000 members.

The fund was started as an experiment four years ago by an NGO, Swayam Sikshan Prayog, and Uplift India Association, a Section 25 non-profit company started by some NGOs who share resources for income-generation projects. The NGO runs 13 offices in Pune slums while a committee comprising members settles claims.

Sailesh Bangali, a daily-wage worker living in Dandekar bridge, is a member of the fund. “When his father had a paralytic stroke recently, he came to us,” says Kumar Shailabh, administrator of the Uplift project.

“We sent him to a government hospital. The treatment was done in Rs 800, whereas otherwise it would have cost him at least 25,000. We are advocating use of government hospitals,” says Shailabh. The annual reimbursement limit is Rs 5,000, he says. While diagnosis is through allopathy, ayurvedic and homoeopathy are allowed for treatment. There have been 140 cases in Pune town this year. In Dandekar bridge slum, there have been 110 cases in four years.

All these cases were taken care of and we saved Rs 7 lakh between January and July this year, said the NGO. In Osmanabad and Sholapur districts of Maharashtra, 30 villages each are experimenting with such funds.

Each village has a security fund, explains actuary and consultant to the project, Frenchman Francois Xavier Hay, the managing director of Uplift and the guiding force behind the project.

He says the working of the project is simple. In France, he adds, 90 per cent insurance takes place through small mutual funds. No one goes for the expensive health insurance, says Hay, who also works for GTZ, a partner in the project. Another partner is French NGO Intel Aid, French Mutual MACIF, besides the International Labour Organisation. A total of 60 hospitals in the area have become a part of the network.

If you ask where are the deposits invested, the actuary has a ready answer: There is no need to invest. Investments are made for operators to make money. Here, the money is enough to take care of the people the project serves.

Adds Shailabh: “While in insurance schemes, there is a transfer of risk, in mutual funds, it is pooling of risks. We pool the funds and keep them locally, to be managed by the community itself. No one takes the money back, but anyone who needs it gets it.”

Won’t the money be exhausted? The money goes on increasing as more and more members are added, explain the enthusiasts of the project. The fund maintains a reserve and it remains with the community to take care of the extra expenses, says Xavier Hay. Trust yourself, it works, he adds.


http://www.business-standard.com/common/storypage.php?autono=301206&leftnm=4&subLeft=0&chkFlg=

Child malnutrition a major challenge: UNICEF

About one-third of the world’s underweight children under age five live in India.

The States with the highest number of underweight children are Madhya Pradesh, Jharkhand and Bihar, followed by Gujarat, Orissa, Chhattisgarh, Uttar Pradesh and Meghalaya.

http://www.hindu.com/2007/12/13/stories/2007121362411300.htm

why did you put Gujarat in bold?

^^
Gujarat concentrates entirely on Industrial development and GDP growth, ignoring important initiatives on Human Development. A State planning for RS 80000 per capita income in the next five years, should not find itself in that list.

Convincing?

http://www.hindu.com/2007/12/13/stories/2007121362411300.htm


Often wonder how accurate these numbers are. Is the situation much better than what is shown or much worse? What is the margin of error? I have often wondered whether political leanings play a huge role in the 'interpretation' of the raw data.

It is estimated that 26 million births take place every year. Of this 9.4 million births are not registered. So that means 19 million births are registered every year. So the 19 million is in writing. The 9.4 million number is fuzzy. Could be 14 million? Or could it be 5 million?

Here's an interesting (but old) piece about birth registrations. Shows that 100% birth registrations is achievable for India.

Making every child count in the streets of Kolkata

http://www.unicef.org/india/media_3024.htm

Paving the way for urban deprived children to access health and education services, protection against abuse and improve planning and monitoring of urban development, 50,000 birth certificates were issued to marginalized and socially disadvantaged children by the Kolkata Municipal Corporation at a ceremony here today. In a one-of-its-kind endeavour led by the Kolkata Municipal Corporation, government departments, UNICEF and partner NGOs, the birth certificates were issued to children born in Kolkata’s underprivileged neighbourhoods.

For the over 700 underprivileged children and representatives of 74 NGOs present at the event, it was a moment of joy and fulfilment of a long cherished dream of making every child on the streets of the city of joy count.

“Birth registration is the first right of a child. Registration secures the recognition of every child before the law and safeguards their rights. Proof of age is also critical to protecting children from abuse and exploitation, child labour and early marriage,” said Mr. Eimar Barr, Deputy-Director-Programmes, UNICEF-India Country Office.

In mid 2005, the Kolkata Municipal Corporation, UNICEF and a group of 74 NGOs led by City Level Programme of Action (CLPOA) had joined hands to identify children who were eligible but not registered in Kolkata. Once the children were identified, the Department of Health and Family Welfare, Government of West Bengal, agreed to reduce the late fee for registration of births of urban deprived children from Rs. 100 to a nominal 50 paisa. The office of the Registrar General of India also demonstrated flexibility by relaxing the requirements for late registration by allowing group affidavits in place of individual affidavits by each child.

Providing 50,000 urban deprived children with birth certificates is just the first step. There are still thousands of children for whom innovative ways will have to be devised to reach the target of registering all births. The policy changes have, nonetheless, served to show the way for other unregistered children in Kolkata and perhaps other cities to get counted.

West Bengal has been doing very well in terms of birth registration. The state has taken a giant leap in registration of births by decentralizing the powers of registrar to Gram Panchayats, thereby maximizing the reach (the state has a total of 3,357 rural registration units and 137 urban registration centres) of this service to people. Consequently, the current rate of registration of births in the state has reached above 97 per cent.

Efforts to register all births have now reached its most difficult stage, with the small percentage of unregistered births taking place in extremely disadvantaged communities that are unaware of its utility and the procedures involved. “A large proportion of these unregistered children live in slums and on sidewalks especially in urban centres like in the city of Kolkata.

The current level of birth registration in India is 63.8 % as per the latest 2005 provisional national estimates, which means that out of the estimated 26 million births taking place each year, approximately 9.4 million children (36.2%) go unregistered every year.

The national target of achieving 100% registration of births by 2010 is the goal set by the National Population Policy, 2000. The joint endeavour in Kolkata is a significant step in the advancement of rights of the most vulnerable children and in achieving the national goal.

^^
Gujarat concentrates entirely on Industrial development and GDP growth, ignoring important initiatives on Human Development. A State planning for RS 80000 per capita income in the next five years, should not find itself in that list.

Convincing?


Dont you think its a chicken and egg story ? wealth creation generation is first step, once its created to a critical mass then wealth percolation/distribution takes place and then nutrition reaches to the wider mass.

Excuse me for saying but I felt, you demostrated a biased mindset, by selectively picking up Gujarat. Appreciate Gujarat for the way it is creating wealth, despite all the isolation it is being forced into. And it is laying strong foundations to further propell wealth creation. And yeah distribution of wealth would also be best in India, it may perhaps still be, who knows.

Maan appreciate where it is due...

suncity..Errors in forecasting will be eliminated once, Governments ensure 100 percent Enrollment in primary school. This can even start earlier with the ICDS programme.

Central Govt is allocating huge funds towards SSA (Sarva Sikhsha Abhiman ?) and ICDS and Maternity care etc. It is left to the Good Govermance of individual States to perform.

SSA officails in Kerala,TN have been asked to round up any child found in the street and initiate them to education.

Due to surge in Construction activity in Chennai, there is a huge migration of families of workers from UP,Bihar,WB,Orissa and Jharkand .TN Govt has asked the Health dept to map them and immunise all kids to prevent any unwelcome virus and put them to some school.

lostashmish..Don't you think that one of the most industrialised states, finding itself in the company of Bimaru states in Child Development is "Odd"?. I only highlighted the odd man out. Otherwise three cheers to Gujarat.

Coimbatore-based poultry operator Suguna Poultry Farm Limited has introduced two more variants to its basket of designer and diet eggs, taking the total to four egg brands.

Entering the fledgling fortified eggs market this year, the Rs1500-crore company has now hatched Suguna Active and Suguna Heart. Its two earlier brands are Suguna Pro and Suguna Sakthi.

"Suguna Active contains high levels of docosahexaenoic (DHA), Vitamin E and organic selenium a must for children, pregnant women, lactating mother and all adults," said Dr. K Ravindran, general manager, sales and marketing.

Suguna Heart, its other new product, is an egg enriched with Omega 3 fatty acids and Vitamin E and helps in reducing serum triglycerides and low density lipoprotein cholesterol in the blood.

"The egg yolk has 24 per cent less cholesterol than the normal table eggs."

Half-dozen packs of Suguna Active and Suguna Heart are priced at Rs23.50 and Rs26.40 respectively and are distributed to retail chains and other big provision stores in Tamil Nadu, Bangalore, Hyderabad and Pune.
(more)
http://www.domain-b.com/economy/agriculture/20071221_suguna_poultry.html

Hepatitis B vaccination included in immunisation programme

http://www.hindu.com/2008/01/01/stories/2008010154390400.htm

Narayana Health City to expand to other States (http://www.thehindubusinessline.com/2008/02/07/stories/2008020751510200.htm)


Bangalore-based heart surgeon Dr Devi Prasad Shetty is now replicating his pet venture, the 5,000-bed Narayana Health City, across the States.

Narayana Hrudayalaya P Ltd, the holding company promoted by Dr Shetty and his family, has roped in more co-investors, the renowned surgeon said on Wednesday but without divulging total investment or equity details.

Biotechnology major Biocon’s CEO, Ms Kiran Mazumdar Shaw, comes on board in her personal capacity; AIG Investments and JP Morgan have come in as private equity investors, together pumping in Rs 400 crore.

20,000-bed hospitals

“Our goal is to add 20,000 hospital-beds in the next five years” across the country, said Dr Shetty, who is currently expanding the 26-acre, 1,000-bed venture in Bangalore into 100 acres. “We believe the need is for a 5,000-bed health city in every State capital offering specialised quality healthcare to working-class and poor people.”

The conglomerate of multi-specialty hospitals will next spread to Kolkata, Jaipur, Ahmedabad, Hyderabad where land or 26-37 acres has been ensured, and then to Delhi, Raipur, Bhopal, Jamshedpur and more cities.

Coming at a time when hospital major Wockhardt Hospitals has rolled out an IPO and ICICI Ventures’ dedicated arm Iven is investing big in brown- and greenfield hospital, Narayana Health cities promise to bring affordable quality healthcare to all.

“Our experience showed us that a complex heart surgery can be done for Rs 60,000 and still remain financially viable. It will stimulate the launching of micro-health insurance programmes for the poor,” Dr Shetty said.

Each health city will have a 1000-bed heart hospital and 3000-4000 beds for specialities like cancer, women and children; orthopaedics; neurology, eye care, among others.

Hepatitis B vaccination included in immunisation programme

http://www.hindu.com/2008/01/01/stories/2008010154390400.htm
I think this is overkill. Unless the baby is at risk, there is no indication for routine Hep B vaccination.

Good lobbying effort by the pharma companies, btw. I wonder how much money changed hands.

Newindpress

Bangalore, Feb 11: The country's first customer (patient) satisfaction study of hospitals across the country has revealed that the silicon city's Manipal Super-specialty Hospital is the best, followed by Indraprastha Apollo of Delhi.

The premier All India Institute of Medical Services ranks fourth in the overall rating. Over 4,000 consumers from six metro cities and nine districts have said that they would recommend these two hospitals to their friends and relatives. The study conducted by Voluntary Organisation in the Interest of Consumer Education (VOICE) in collaboration with Indian Council for Medical Research (ICMR) has some surprises as well.

http://img521.imageshack.us/img521/8549/manipal0211081hq9.jpg (http://imageshack.us)

For instance, the famous Lilavati Hospital of Mumbai, known for treating film stars is at the 15th position. The least recommended was the Apollo Gleneagles. Providing information about fee charged is a major issue with which the patients are concerned.

Unfortunately the study has found that not many hospitals are transparent. A little over 30 per cent feel that the super-specialty hospitals are transparent as far as their financial dealings are concerned. A majority of those surveyed felt that super-specialty hospitals do not inform the patients about the various charges for services.

They did not see any information about hospital service charges near the registration counter. Wockhardt Hospital of Mumbai was found to be transparent as all its patients said they saw the charges displayed clearly.

As for the charges for various services, Wockhardt Super-specialty hospital of Bangalore led the way with 91 per cent of its patients reporting that their charges were higher than that of other hospitals.

The AIIMS patients were the happiest as nearly one-third of them admitted that the AIIMS was a very cost effective hospital. As for the emergency services, 73 per cent of those surveyed felt that they had used the service in Manipal Hospital and the least used emergency service were that of the Apollo Hospital, Chennai. Very rarely patients choose hospitals. Over 49 per cent choose a hospital based on doctor's advice.

Reputation of the hospital came second. Patients were satisfied with regard to doctor's visit and their trust level was also high. More than 7 per cent of the patients had problems like charging excess fee or hidden costs or behaviour of the nurses.

The AIIMS seems to be the most problem- ridden, as one out of every four reported having faced a problem. The study also focused on other facilities for the disabled, provision for parking and waste disposal systems.

Though hospitals were found to be clean, an effective waste disposal system could not be found in any of the hospitals. Is the Pollution Control Board listening?

The survey included some big secondary hospitals. The District Hospital, Palakkad, Kerala, stands first, followed by GNRC, Assam, and Owasi Hospital, Andhra Pradesh (both private). Among the small hospitals, once again Welcare Hospital, Palakkad tops the list followed by Parasiya Community Health Centre, Madhya Pradesh and Cooperative Health Care, Palakkad. Overall analysis show that only in 6 out of 60 patients who used ambulance services said that it did not reach on time.

The study show there is a direct co-relation between the education level of consumers, their financial standing and the call for usage of ambulance.

The usage of ambulances was found higher among post graduates and professionally qualified respondents

I think this is overkill. Unless the baby is at risk, there is no indication for routine Hep B vaccination.

Good lobbying effort by the pharma companies, btw. I wonder how much money changed hands.

there is no such thing as 'no risk' , especially in the case of hepb.........

^^
The expenditure indicated is only Rs 7 Cr per annum. This is small change for the Govt. As long as it prevents contracting a disease, one should welcome. Prevention is always better.

India gets first ''health mall'' in Mohali!
If all that mall hopping is telling on your health, then you can go to a unique mall, a health mall. A venture in which doctors will have a stake and businessmen can invest in health care.

Fh8EmjPN9Zo

R-ADAG plans medical cities across country


As part of its plan for a pan-India foray in the healthcare sector, Reliance ADAG is planning to set up health cities or medical cities across the country. The company is learnt to be in talks to acquire land in Kolkata and Jaipur for the project. According to industry estimates, each of these healthcities would require an investment of about $250 million or Rs 1,000 crore. When contacted, a Reliance ADAG spokesperson said, “We would not like to comment at this stage.”
According to sources, these medicities are expected to provide a complete medical ecosystem with facilities such as hospitals, medical, nursing and para-medical institutes, accommodation facilities for patients, space for retail etc. It is also possible that the company may tie-up with a top class healthcare service provider depending on the project.
Most of the leading Indian healthcare service providers such as Apollo Group, Fortis Healthcare and Hinduja Group among others have chalked out plans for medicities. Typically, the medical cities is a one-stop destination for all healthcare requirements. In addition, it also supplements companies with skilled manpower which is facing huge shortage in the fast booming domestic healthcare industry. Although, Reliance ADAG has ambitious healthcare plans, it has only one hospital—Kokilaben Dhirubhai Ambani Hospital, a tertiary care facility in Mumbai. It is believed that once this hospital gets operational later this year, the company would expedite its expansion plans.

economictimes epaper

Gujarat to soon unveil Public Health Act

In order to improve health management, the Gujarat government will soon come out with a public health act that will essentially focus on monitoring all health institutions in the state. From directives to healthcare institutions to treat medico-legal cases, to streamlining the growth of clinical research organisations (CRO) to bringing noncommunicable diseases under its purview, the act promises to reform the health sector.
The draft law if passed by the assembly, will be known as The Gujarat Public Health Act, 2007 (GPH Act 2007) and will set guidelines for health institutions and improve quality of life.
Confirming the development, the state’s minister of health and family welfare Jay Narayan Vyas told ET that the purpose was to streamline the health sector and address the entire gamut of health-related issues. “There should be a system to enforce the quality of health service and provide quality life to the people,” he said.
The Act proposes to have monitoring mechanisms at all levels for the public health care system. Right from village, block levels to urban areas, monitoring committees will be set up that will have the powers to receive reports for all grievance applications. While making registration mandatory for all healthcare entities, the Act also makes an attempt to create a standard quality of care in the healthcare establishments. The standards relate to the use of material and disposal management procedure followed by the healthcare establishment.
One of the interesting features of the draft law is that the authorities are trying to address the problems of medico-legal cases faced by people during the accidents.
The proposed law says that no healthcare provider or establishment shall delay treatment merely on the grounds of receiving police clearance or a police report. It also proposes to provide relief to the people by saying that the healthcare provider shall not refuse a person emergency medical treatment, until such person stabilises, irrespective of the person’s capacity to pay.
The proposed law also seems to address the impact of development projects on citizens and focuses on the assessment and mitigation of health impact of development projects. Clearances would be necessary for projects as per the health impact assessment.
The draft law also tries to address the recent development of clinical research organisation (CRO) in the state as it tries to streamline the system. The proposed law says that a healthcare establishment shall not provide a health service for experimental or bio-medical or clinical research purpose, except according to guidelines laid down by the Indian Council for Medical Research (ICMR). The proposed law says that every bio-medical and clinical research studies shall be carried out only after registration with authority designated by the State Public Health Board at the stage of the proposal.
It also proposes to set up a State Public Health Board that will serve as an advisory body and in certain respects, as a decision-making body to the state health department and the health minister on all matters related to the public health system, including the development of a comprehensive State Public Health Plan.
There is an attempt to provide special provisions to address the health-related issues for victims of domestic violence and sexual assault. Tribals, elderly people, those with disabilities, migrants, workers and sex workers, have been covered for special provisions.
The Act also tries to bring the non-communicable disease under its preview. As the minister of health and family welfare said, in the recent years, major health challenges are coming from the non-communicable diseases like diabetes, hypertension, cardiac problems etc, which are basically life-style diseases.


source economictimes epaper

Small firms all set to pep up pharma retail

Organised pharma retail, dominated by the likes of Apollo and Subiksha, is set for more action at the regional level. Players such as Hyderabad-based API firm Hetero Drugs and Chennai-based Regenix Drugs are ramping up numbers, after the pilot phase, in a market that is ruled by mom-n-pop chemist stores.
India has 5.5 million chemists and druggists who constitute the lion’s share of the retail industry. Organised retail market accounts for just 2% of the industry but is registering year-on-year growth at 30%-40%. Interestingly, both Hetero and Regenix have a pharma industry background. While Hetero Drugs is an API manufacturer, Regenix is owned by former Grandix Pharma promoter Dr A Ramamoorthy. Grandix had sold its manufacturing facility to global generics player Actavis while its marketing rights were bought by Strides Arcolab.
It is believed that Bangalore-based healthcare major Manipal Group is also firming up plans for pharma retail. It already has a wellness retail format under the Manipal Cure & Care umbrella. Regional player MedPlus, based in Hyderabad, is ramping up and has also raised private equity from iLabs.
South India will be the focal point for their growth plans. Hetero Drugs, whose pharmacy goes under the same banner, has over 40 stores in Hyderabad and around 20 in tier-II pockets of the state. Hetero, which has set up a subsidiary to drive the new venture, is looking at leveraging on its manufacturing strengths of generics in the long-term.
The Regenix chain, under the Supermed brand, will stock pharma products and hospital consumable such as gloves, BP readers and stethoscopes. This, promoter Dr A Ramamoorthy says, will help the company shore up margins in a sector where they are wafer-thin. Typically, surgical consumable enjoy gross margins of up to 50% while the same for pure pharma products hover around 20%. “We will be located in areas where there is a catchment of neighbourhood household population as well as nursing homes and clinics,” he says. Supermed, which kicked off early this year, looks at setting up 50 stores at the end of first year and 150 stores in two years. The company is looking at an investment of Rs 25 crore in the first phase.
Commenting on the trend of new entrants, Ernst & Young healthcare practise head Utkarsh Palnitkar says, “Due to limited investment capabilities and a regulatory environment, big corporations avoided this market. Now, the high interest levels in this sector is due to rising consumer spending and demographics, lifestyle ailments, recognition of patents and expanding private healthcare services and medical insurance.”

source economictimes epaper

Gujarat to soon unveil Public Health Act



source economictimes epaper

This is a great step forward! No denying emergency treatment to anybody, no waiting for a police report..just like in the US! Now lets hope they improve quality..

Ranbaxy to develop anti-infective drugs for Merck

India’s Ranbaxy Laboratories Ltd is to develop new anti-infective drugs for Merck & Co Inc, in a major deal underlining the growing use of Indian pharmaceutical research by multinational companies.
Ranbaxy will carry out drug discovery and clinical development through Phase IIa clinical trials, with the U.S. drugmaker responsible for later development and commercialisation, the companies said in a statement on Monday.
The Indian group will get an undisclosed upfront sum and could receive more than $100 million for each drug target, depending on successful development and regulatory approval. It will also be entitled to royalties under the five-year deal.
The tie-up reflects a drive by Ranbaxy, which is best known as a generic drug producer, to increase its activities in discovering novel medicines. It already has a sizeable research agreement with GlaxoSmithKline Plc.
“We believe that our philosophy of partnering with Big Pharma will continue to gather momentum as companies continue to recognize the strength and breadth of our R&D expertise and resources,” Ranbaxy Chief Executive Malvinder Singh said.
“This collaboration with Merck positions Ranbaxy to extend its capability set and move up the value chain for drug discovery and development,” Singh added.
The Merck collaboration will focus on finding both new anti-bacterial and anti-fungal drug candidates.

source livemint.com (http://www.livemint.com/2008/05/12145516/Ranbaxy-to-develop-antiinfect.html)

news on AIIMS revamp

New surgical tower to come up in AIIMS

A new surgical tower with a separate surgical speciality block will be one of the new additions to All India Institute of Medical Sciences (AIIMS) when it undergoes a revamp.

Renovations and additions would be made to the existing set-up to improve patient care, AIIMS Deputy Director, Administration, Shailesh Yadav told reporters.

Beginning with the projects listed in the sixth proposal, he said, "We plan to have a new surgical tower. There is already one neurosurgery tower, the cardio-thoracic tower and a separate opthalmology and cancer tower. This new surgical tower will have a surgical speciality block, OPD and surgical wards."

It will help in better care for patients who will undergo surgery. Plans are also on to connect the trauma centre with the main hospital building.

"The trauma centre is miles away from the main hospital building. It poses problems for trauma patients as there is lots of traffic which pose hurdles to the treatment that they immediately need. So we decided to go in for this underground tunnel that connects trauma centre and the hospital," Medical Superintendent Dr D K Sharma said.

The hospital has approached the DMRC in this regard. "The DMRC has chalked out an expenditure of Rs 28 crore for it. We are yet to finalise it," he said.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Healthcare/New_surgical_tower_to_come_up_in_AIIMS_/articleshow/3129254.cms)

Plethico Pharma plans acquisitions in US, Brazil (http://www.financialexpress.com/news/Plethico-Pharma-plans-acquisitions-in-US-Brazil/324370/)

India's Plethico Pharmaceuticals Ltd plans to buy one company each in the US and Brazil in the next couple of years, spending a total $150 million, a top official said on Wednesday.

Plethico plans to bid for a nutraceutical firm in the United States, and has also signed a preliminary confidentiality agreement with another nutraceutical firm there, Sanjay Pai said, adding the aim is to strike one deal for $80-$100 million.

............................................................

In Brazil, Plethcio is in talks with two Companies, one a herbal products maker and the other a maker of allopathic and over-the-counter products, Pai said. One of these firms could be acquired for about $50 million, he added.

Biocon plans unit to make tablets.

Biopharma major Biocon is planning to set up a dedicated greenfield facility to manufacture tablet formulations.

The Bangalore-based company currently outsources this activity. Biocon is in the tablet formulation market in a small way now across the nephrology, diabetology, cardiology and oncology verticals.

This segment accounts for about 10% of Biocons revenues, which it hopes to more than double to 25% in the next three to four years with its own manufacturing facility. Biocon manufactures its own injectable formulations across all bio-pharma verticals that it operates in.

TOI had reported in April that Biocon was looking at manufacturing tablet formulations at its upcoming facility in Visakhapatnam.

Speaking to TOI this week, Kiran Mazumdar Shaw, CMD of Biocon, said, “We are looking at manufacturing our own tablet formulations, but it definitely won’t happen at the new facility in Andhra Pradesh. We are planning to set up a greenfield facility for this purpose which will be finalized only in the next fiscal.”

Analysts say this move will widen firm’s base in branded formulations market. Mazumdar said the facility would require an investment of a few hundred crore. Testing and development of tablet formulations is happening at firm’s formulation development centre in the Biocon Park.

Source: TOI

Govt to hike spend in child-nutrition plan.

With child malnutrition levels stagnant at 46% for the past 10 years, the government has been forced to restructure its programme for nutritional intervention for children between 0-6 years. If approved by the Union cabinet, the government will spend an average Rs 4.21 per beneficiary per day, up from Rs 2 per day.

The restructured Integrated Child Development Scheme (ICDS) will be implemented in mission mode under a National ICDS Mission Directorate and increase financial powers at the grassroots level.

The Prime Minister had in a letter to the women and child development (WCD) ministry expressed concern over the poor implementation of the ICDS programme pointing out that it had failed to curb child malnutrition. He had also noted that with 11 crore out of the total 16 crore children out of the ambit of this programme, there was an urgent need to universalise the scheme following Supreme Court orders.

Keeping in view the PM’s concerns, the draft ICDS recommends that the money spent on supplementary nutrition, that is woefully low, be addressed. With rise in prices and new population norms, the WCD ministry has suggested an increase in expenditure. So the amount spent on supplementary nutrition for children between the age of 6 months to 72 months will be increased from Rs 2 to Rs 4, while severely malnourished children in the same age group will get Rs 6 per child per day instead of Rs 2.70 at present. The government now spends Rs 2.30 on pregnant women, nursing mothers and adolescent girls which will be hiked to Rs 5.

The ministry is also keen on changing the funding pattern. At present, the scheme is funded completely by the Centre except the supplementary nutrition quotient that is split equally between the Centre and the states. The new funding pattern proposes a 75:25 sharing ratio for the ICDS programme and a 50:50 sharing of the supplementary nutrition scheme.

The draft ICDS suggests an increase in the number of anganwadi centres and a sweeping hike in the financial powers for anganwadi workers.

Source: TOI

JHS Svendgaard moves into expansion mode (http://in.biz.yahoo.com/080623/139/6uugq.html)

JHS Svendgaard, India's leading dental and oral health care manufacturing company, is on an expansion and has recently raised approximately Rs. 9.2 crores.

The funds will be utilized to fund its future plans and ramp up its business not only in the domestic market but also globally.

JHS Svendgaard Laboratories has set up a new subsidiary in the Ras-Al-Khaimah, Free Trade Zone, UAE.

The subsidiary shall initially be engaged in import; export and trading of oral care products and personal care products.

Speaking about the growth in oral healthcare market and company's expansion plans, Nikhil Nanda, Managing Director, JHS Svendgaard Laboratories Ltd. said, "At present, 700 million units of toothbrush are being sold in India and the demand is projected to grow to 1700 million by 2012. With our diverse platform of product offerings and excellent manufacturing capabilities, we are well positioned to serve the demand."

"With infusion of new funds and our overseas initiatives, we see JHS achieving its business objectives rapidly and surpassing growth targets", he added.

The Company is also looking to diversify its portfolio and entering tie-ups for new products. The company has earlier bagged order from Subiksha retail to manufacture toothbrush and tooth paste under the brand name "Dr Beam" for the chain, one of country's largest retail chains, for the last one-year.

With the growth of organized retail and the requirement of Private Label products, the overall market for oral care products in India is likely to multiply exponentially in the next two to three years.

The dental and oral care market expected to grow at 10 per cent compounded annually for next five years.

cross posting from the investment thread


Apollo Hospitals to invest Rs 1400cr for expansion

Apollo Hospitals Group is planning to invest Rs 1400 crore over the next two years to expand its healthcare delivery capacity by 2300 beds adding to its current capacity of own beds of 4000. The expansion will be partly funded by capital infusion by the promoters -- Reddy family which also plans to increase its stake in the group's flagship company Apollo Hospitals Enterprise (AHEL) to 31.15 per cent from the present level of 27.47 per cent.

An estimated Rs 200 crore will come from the internal accruals to fund this expansion plan, said company executives. The group is also considering the ECB route to part fund this expansion project.
The group's executive director-finance Suneeta Reddy said that the next round of expansion will be in ‘B' cities like Hyderbad, Bhuvaneshwar and Vizag. Through its association with JP Morgan, Apollo Hospitals Group will also expand in Mumbai where it plans to add 300 beds in Navi Mumbai.

Of the proposed Rs 1400 crore investment, an estimated Rs 120 crore has already been spent in land acquisition in various locations.

The promoters of the group will infuse Rs 160 crore (to part fund the expansion) by converting warrants issued to them by the company. Discussing the promoter family's plans to increase the stake in the company, Reddy said, "We will be happy to have a 51 per cent stake in the company, but in the next few years, I think we should be holding 40 per cent stake in the group. The board today approved issue for more warrants to the promoter family."

Highlighting significant achievements in the previous financial year, group president, K Padmanabhan, said that the average length of say by patients in the group has been brought down to 4.4 days from 6 days. "The hospital makes most of its money in the first 3-4 days. Hence bringing down the average length of stay by patience would help in improve our financial performance." For every one day reduction would mean additional 2500 bed-night in a typical 500 bed hospital. Well managed hospitals in the US follow the 4-day stay by patients as standards to improve their financial performance.

The group is also in talks with a leading insurance company in the US to offer special services for American clientele. The group is trying to increase the number of its hospital having Joint Commission International (JCI), an American accreditation that patients from the US avail of the group's services. "US insurance companies provide medical cover only patients treated in JCI recognized hospitals," Padmanabhan said.

Plans also on to add 350 stand alone pharmacies in the current fiscal. Average revenue from each such pharmacy is Rs 36 lakh a year.

source business standard (http://www.business-standard.com/common/storypage_c_online.php?leftnm=10&bKeyFlag=IN&autono=40728)

Indian American medicos join hands with Apollo (http://www.financialexpress.com/news/Indian-American-medicos-join-hands-with-Apollo/331357/)

pollo Hospitals Group has agreed to provide ground support and other assistance to 17 dispensaries set up in India's rural areas by the Association of American Physicians of Indian Origin (AAPI).

Apollo will also help in extension of the programme and provide telemedicine services at the dispensaries.

An Memorandum of Understanding (MoU) signed during the just concluded four-day convention of AAPI, the largest ethnic medical organisation in the United States, also provides for training of medical students from the United States in the Indian hospitals.

AAPI, which claims to represent over 40,000 physicians, on its part would help arrange a network of physicians in the United States who would offer post operation care to US patients who return home after surgery in the Indian hospitals.

The MoU was signed by Hemant Patel on behalf of AAPI and Prathap C Reddy, founder- chairman of Apollo Hospitals and chairman of the National Committee on Healthcare of Confederation of Indian Industry.

Reddy said Apollo Hospitals had brought new hope for people "who had no access to healthcare which was a prerogative of only the rich and powerful".

His vision, he said, is to bring quality care to all people in the country and to ensure that Indians do not look abroad for treatment.

In the next decade, "my vision for Apollo is not just as a practitioner of medicine but as a technology innovator to bring healthcare to all people no matter their means," he added.

Ranbaxy completes phase II trials for anti-malaria drug (http://www.financialexpress.com/news/Ranbaxy-completes-phase-II-trials-for-antimalaria-drug/331344/)

Drug major Ranbaxy has succesfully completed the phase II clinical trials for the first malaria drugs being developed in India since many decades and expects to start marketing it in next 3-5 years.

“The proof-of-phasing for phase II of the trials have been successfully undertaken and the drug will now undergo phase III of trials before being introduced in the market,” Ranbaxy Laboratories Senior Vice President for New Drug Discovery Research Pradip Bhatnagar told PTI.

The company has not decided upon any trade name for the drug research on which it started clinical trials in 2003-04, he said on the sidelines of the Public Private Partnership summit for Lifesciences Sector here.

The anti-malarial combination of arterolane and piperaquine is sought by the company to be exported to malaria affected countries of Asia, Africa and South America at an affordable cost once developed.

Earlier, Ranbaxy was working with the Geneva-based Medicines for Malaria Venture (MMV) on the drug development project as part of joint malaria drug research. MMV walked out of the joint project in November, 2007.

Panacea Biotec enters hospital biz

VACCINE maker Panacea Biotec is foraying into the hospital business by setting up a 220-bed multispecialty hospital with Gurgaon-based Umkal Medicals. Panacea Biotec has picked up 75% stake in Umkal’s project at Gurgaon and expects the hospital to be operational by January 2010. The Delhi-based pharma company has signed an agreement with shareholders of Umkal. Umkal has three hospitals in Delhi and the national capital region (NCR). However Panacea’s interest in Umkal will be limited to the Gurgaon project.
According to initial estimates the project will cost around Rs 80 crore. The company will target overseas patients and affluent Indians, which would be close to 25-30% of the market. Panacea Biotec joint MD Rajesh Jain said: “It is the company’s long term strategy to enter the private healthcare segment to make the company a leading health management company. Based on the experience from this project, we may look at starting a hospital chain.”

source economictimes epaper

Amway India targets Rs 3000 cr turnover (http://www.financialexpress.com/news/Amway-India-targets-Rs-3000-cr-turnover/332086/)

Direct selling FMCG firm Amway India is eyeing close to four-fold topline growth in the next five years to Rs 3,000 crore by expanding reach, widening product basket and strengthening marketing activity.

Amway India, a wholly-owned subsidiary of the US-based Alticor, had recorded Rs 800 crore turnover in 2007 and expects it to go up to Rs 1,000 crore this year, company's Managing Director and Chief Executive Officer William Pinckney told reporters here.

In its first year of operation in 1998, the company's turnover was only Rs 91 crore.

Pinckney said Amway India plans to increase the number of branch offices to 300 in the next three years across the country from 120 now.

Amway India sells over 100 products in five categories of personal care, home care, nutrition and wellness and cosmetics.

Pinckney said that the company would bring in more products in the existing categories.

Nutrition and wellness contributes to around 50 per cent of the company's turnover, cosmetics 20 per cent and the rest from personal and home care divisions with equal contributions.

"I don't think that there will be significant change in contribution from these divisions as we clock a turnover of Rs 3,000 crore by 2013," Pinckney said.

Nutrition and wellness will be the main focus of the company, he added.

Fortis to focus on expanding Escorts network

With the litigation between Escorts Heart Institute and Anil Nanda behind him, Fortis Healthcare Managing Director Shivinder Mohan Singh said the company will now focus on growing the Escorts network and brand.

"Now we are free to do what we have planned for Escorts Heart Institute and Research Centre (EHIRCL). We intend to grow the Escorts network and the brand," Singh told PTI. The Delhi High Court had last week rejected Anil Nanda's petition that sought quashing of EHIRCL's decision to convert the public trust hospital into a company.

The civil suit, which was filed by Nanda in September 2005, was on the basis that merger of the two societies and the subsequent incorporation of the company was not valid. With the court ruling in their favour, Singh said it would facilitate "a lot of free movement and flexibility to our plans".

The company would be looking at opening more heart command centres. As of now, Fortis and Escorts together have 16 such centres. Singh added with the case now over, the company expects to get cheaper loans to fund expansion plans for Escorts. It was difficult for it to get loans due to the litigation. Escorts, that was acquired by Fortis in 2005, is present in Jaipur, Amritsar, Raipur and Faridabad.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Healthcare/Fortis_to_focus_on_expanding_Escorts_network_post_court_ruling_/articleshow/3202871.cms)

Sterlite, Apollo tie-up to support heart surgeries for kids

Medical care services provider Apollo Hospitals today joined hands with Sterlite Industries to support heart surgeries for 50 children from economically weaker sections.

Apollo Hospitals Managing Director Preetha Reddy and Sterlite Industries CFO Sushil Gupta inked the pact to help needy children under Apollo's Save a Child's Heart (SACH), a corporate social responsibility (CSR) initiative of the health services major.

Later, Gupta told reporters his company was involved in a number of CSR initiatives, including helping women self help groups and said it looked forward to carry on with more efforts with Apollo Hospitals.

Citing the growing number of children born with heart problems, Preetha Reddy said more such sponsors were the need of the hour as timely treatment can help many affected children lead a normal life.

The SACH Foundation was presently working in Chennai and Hyderabad and would soon step into Ahmedabad also, she said. According to a release, under the SACH scheme, 30,000 children have been screened so far in the country and over 1,000 underprevileged children had undergone surgeries.


source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Sterlite_Apollo_tie-up_to_support_heart_surgeries_for_kids/articleshow/3223475.cms)

Max India approves JV with UK-based firm (http://www.financialexpress.com/news/Max-India-approves-JV-with-UKbased-firm/334389/)

Analjit Singh-led healthcare services provider Max India said the board has approved its joint venture with UK-based Bupa Finance Plc for setting up a health insurance company in the country.

In the JV, to be set up with an initial capital of Rs 100 crore, Max India would hold 50 per stake, the UK firm would hold 26 per cent, while the remaining 24 per cent would be held by Max India Chairman & MD Analjit Singh and his family through certain intermediate companies, the domestic firm said in a filing to the Bombay Stock Exchange.

Bupa is an international health and care company with main focus on health insurance business. The company has presence in three continents with more than seven million customers.

Apollo, Lupin unveil disease management plan (http://www.financialexpress.com/news/Apollo-Lupin-unveil-disease-management-plan/335894/)

Apollo Hospitals Group has joined hands with Lupin Limited, a leading pharma major, to create the first Disease Management Programme (DMP) for Bronchial Asthma and COPD (Chronic Bronchitis) in the name of Apollo's 'BreatheEasy Clinic' RPT 'BreatheEasy Clinic.'

Apollo Hospitals CEO George Eapen said in a release in Chennai on Tuesday that this new concept of DMP would revolutionalise doctor-patent relationship and empower the patient enormously.

"We have taken the first step in transforming the way Lung airway diseases - Asthma and COPD - is treated in India", he said.

Quoting PricewaterhouseCoopers recent findings, George said DMP,apart from immunization and wellness, was going to be one of the important element, which would create "360 degree turn in healthcare."

Apollo Hospital General Manager Preetish Toraskar said approximately, one in every 12 asthamatic patients in the world is an Indian.

About 50 per cent of school absenteeism and about one third of the work absenteeism was all related to asthma, he said adding about 50 per cent of asthmatic hosplitalisation and emergency visits can be prevented by patient education and awareness. "Surprisingly, only two percent of asthmatics have a 'Peak Flow Meter, a key home diagnostic tool for any patient", he added.

Under the DMP, this important tool will be given free of cost to each enrolling patient, he said.

Preetish said this joint venture by Apollo Hospitals and Lupin would open 40 clinic centres over a period of four years in not only metropolitan cities, but also tier two and three cities too.

IDBI Fortis plans 100 branches by March

IDBI Fortis Life Insurance Co Ltd, which on Tuesday kick-started its expansion drive in the North with the inauguration of its first branch at Gurgaon, plans to have 100 branches across the country, including 28 more in the North, by the end of this fiscal. The company, which is a recently-launched joint venture of IDBI Bank, Federal Bank and Fortis, Europe’s banking and insurance giant, already has 30 branches across India.
Talking about the innovative products of IDBI Fortis, G V Nageswara Rao, MD & CEO, IDBI Fortis Life Insurance, said that Wealthsurance is one such product that helps consumers create wealth with protection.
“Wealthsurance is a unique combination that aims to provide people with protected growth. The product is designed to ensure that the hard-earned money that is invested is not susceptible to unforeseen circumstances. The plan has a multitude of investment options, tailor-made to suit the changing Indian consumer today," he said.
According to him, Wealthsurance is a first-of-its-kind combination of comprehensive investment choices, protected by powerful insurance options, all presented with a reasonable charge structure, making it a one-stop solution to a customer’s wealth building plans.
Filip Coremans, CFO, IDBI Fortis Life Insurance, said: “It is exciting for Fortis to be in one of the fastest- growing insurance markets in the world. The focus is now to expand our tied agency network to cater to this huge country with so many different languages and dialects, in addition to our wide bancassurance networks with IDBI Bank and Federal Bank.”

source economictimes.com (http://economictimes.indiatimes.com/News_by_Industry/IDBI_Fortis_plans_100_branches_by_Mar/articleshow/3237598.cms)

ADAG care for personal health

ANIL Ambani-owned ADAG is entering the personalised healthcare services. Medybiz, part of the group’s Reliance Health Ventures, is learnt to be in the final stages of developing a home-based disease management programme that aims at addressing chronic ailments. Touted to be the first of its kind in India, the programme is based on a partnership between physicians and their patients and is serviced by an expert panel of medical and para-medical professionals.
The programme will seek to address ailments such as diabetes, coronary heart diseases, hypertension, obesity, cancer, as well as orthopaedic disorders, neurological disorders including Alzheimer’s disease and Parkinson’s disease. According to the World Health Organization, India will record an estimated loss of national income to the tune of $54 billion on account of chronic diseases by 2015. “Our teams of medical specialists are developing unique home-based disease management programmes,”
said a company spokesperson.
These unique home-based programmes will help people change unhealthy lifestyles that lead to chronic diseases and improve selfcare skills during an illness. It will also make cost-effective healthcare decisions. The service will be provided only through the doctors and on their advice. No patient will be approached directly and the company’s medical professionals will only implement and ensure that the doctor’s advice is followed. The company, however, did not want to comment at this stage on when they expect the service to be launched.

source economictimes epaper

Bill Clinton taps 4 Indian pharma cos to cut malaria drug price (http://timesofindia.indiatimes.com/Bill_Clinton_taps_4_Indian_pharma_cos_to_cut_malaria_drug_price/articleshow/3249751.cms)

Former US President Bill Clinton has roped in four Indian pharmaceutical firms and two from China to cut the price of anti-malarial drugs by a whopping 30 per cent which is likely to benefit 500 million people worldwide.

The firms have also agreed to lower the price volatility of artemisinin, the key raw material for artemisinin-based combination therapy (ACT), by 70 per cent, said Clinton, whose charitable foundation helped broker the deal.

The agreements make prices for malaria drugs more affordable and sustainable to help meet growing global demand. The prices will be available to the 69 countries in Africa, Asia, Latin America and the Caribbean that make up the Clinton HIV/AIDS Initiative (CHAI) purchasing consortium.

"Nearly every life lost to malaria could have been saved with access to effective medicines," Clinton said.

Under the agreements negotiated by CHAI, the Mumbai-based Ipca and Cipla will offer a co-blister formulation of artesunate+amodiaquine (AS+AQ)-one of the most widely used ACTs-at or below an average ceiling price of 48 cents per treatment, a reduction of more than 30 per cent from current market rates.

They also will offer artemether-lumafantrine, the other most common ACT, at or below an average ceiling price of 91 cents, the current price available from Novartis.

Among the other manufacturers party to the agreements, the two Mumbai-based firms -- Calyx and Mangalam Drugs are active ingredient suppliers, and Holleypharm (Chongqing in southwest China) and PIDI Standard (Guangzhou in southern China) are suppliers of the raw material, artemisinin.

Biocon is World's Top 20 Biotechnology Company : Med Ad News (http://in.biz.yahoo.com/080717/138/6vm87.html)

Biocon, India's pioneering biotechnology enterprise, announced today that the company has been featured amongst the top 25 global biotechnology companies according to a report released by Med Ad News. The report takes into consideration drug based firms, as these companies provide the best numbers to track the progress of the sector. Companies have been ranked by revenue and by income and Biocon Limited is the only Asian company to feature in this ranking at Number 20.

BIO 2008, held in San Diego last month, stated that the global biotechnology industry will be a $100 billion annual business by 2010. The actual revenue has reached $85 billion in 2007. There are close to 5000 biotech companies across the globe. The top 25 biotech companies represent 62 percent of all biotech sales and probably over 90 percent of income.

Reacting to the listing, Ms. Kiran Mazumdar-Shaw, Chairman and Managing Director, Biocon Limited said, "It is a matter of immense pride for Biocon to be ranked amongst the top global league of Biotech companies. This is a validation of our consistent effort at attaining global leadership and also highlights the true potential of this sector in a country like India. This industry will be a key driver in India?s progress towards economic development."

Nineteen of the top 25 companies are based in the U.S., while six companies hail from Europe to India to Australia.

NHPL in pact with two Jamshedpur hospitals (http://in.biz.yahoo.com/080718/203/6vnzn.html)

Devi Prasad Shetty-run Narayana Hrudayalaya Pvt Ltd (NHPL) on Friday signed two separate MoUs with Jamshedpur Eye Hospital (JEH) and Ardeshir Dalal Memorial Hospital (ADMH) to develop 'Medicity' at their premises.

The MoU with JEH aims at creating necessary infrastructure in the premises of JEH at Sakchi for developing advanced high-end super-speciality medical care for the masses, and the one with ADMH will envision, detail and facilitate creating the necessary infrastructure at the ADMH premises at Baridih.

The first MoU was signed between NHPL CMD Devi Prasad Shetty and JEH chairman S Muthuraman in the presence of Tata Steel managing director B Muthuraman.

Biocon Limited, in alliance with the US-based Abraxis Bio Science, today announced the launch of Abraxane, an oncotheraputic drug for treatment of breast cancer, in India.

The drug could be administered if combination therapy for metastatic disease failed or there was relapse within six months of adjuvant chemotherapy.

The drug has been approved by the Drug Controller General of India in October 2007.
Link: http://www.business-standard.com/common/storypage_c_online.php?leftnm=10&bKeyFlag=IN&autono=42579

cross posting from the chennai thread


Chennai gets India's first heart implant training centre

India has got its first training centre for doctors to learn how to place implants in the heart.


Medtronic, a US-based medical technology service provider, opened its first therapy and procedure training centre (TPTC) in South Asia, in Chennai on Saturday.

A recent report in the premier medical journal The Lancet has said that by 2010, 60 percent of the world's heart patients will be in India. The majority of these patients will suffer from cardiac arrhythmias, heart failure and coronary artery diseases.

Implantable cardiac devices such as pacemakers, de-fibrillators, cardiac therapy devices and coronary stents play a major role in the treatment of these life-threatening conditions.

The process of implanting these cardiac devices is complex and requires highly specialised and technically skilled practitioners.

Launched in 2004, Medtronic has a TPTC mobile unit that travels all over the US, training doctors. It has, so far, trained over 8,500 physicians, nurses and other health professionals via its mobile training unit.

It also has 18 virtual training labs throughout the world, including in the US, central America, Brazil, Argentina, Mexico, half a dozen European countries, China, Japan and Australia.

The Chennai centre, the first in India, is aimed at increasing the number of heart specialists who will know how implant life saving devices in heart patients.

The centre's state-of-the-art classroom and programmer lab will provide training to cardiologists on the programming and follow-up management of these devices. Besides hands-on training, there will also be simulator-equipped class rooms at the centre.

"The therapy and procedure training centre in Chennai is an example of effective training and education used by the company worldwide," Joon Hurh, Medtronic's regional vice president, said on the occasion.

"As more people around the world are in need of implanted medical devices like pacemakers, ICD's and other cardiac devices, so too is the growing need for well-trained clinicians to care for these patients," said Milind Shah, managing director, Medtronic India.

"India has a small number of electro-physiologists (just about 50) who implant high-end devices like CRTs and ICDs to manage heart failures and reduce mortality due to sudden cardiac arrest (SCA)."

"Medtronic is committed to increasing this number in India so that physicians are able to deliver these therapies effectively to more and more patients who need them," Shah said.

The use of simulators is quickly becoming a standard approach to Medtronic training programmes.

Introduced in 2003, Medtronic's virtual labs with state-of-the-art simulator technology provide a safe way for physicians to develop the skills and confidence to implant devices, and for other health professionals to better understand the implantation process, "with life-like implant scenario", the company said.

The simulators are designed to provide a safe environment in which to learn new techniques while avoiding complications and minimising costs.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Chennai_gets_Indias_first_heart_implant_training_centre/articleshow/3253889.cms)

Docs with foreign PG can practise.

In a bid to allow Indian doctors practising abroad to return and plug the acute shortage in healthcare back home, the government may soon recognize postgraduate medical degrees of 10 foreign countries.

Degrees from France, Germany, Russia, Denmark, Ireland, Sweden, Italy, Singapore, South Africa and Spain are under consideration, which will allow Indian doctors settled in these countries to return home and practise without even a physical verification, health ministry officials said. The move was aimed at reducing the country’s shortage of trained doctors, especially in super speciality disciplines, they said.

So far, doctors who had completed MBBS from a recognized university in India and completed the PG degree from any of these countries were unable to return and practise in India as their PG degrees were not recognized.

The intention also comes four months after the ministry allowed Indian doctors with PG degrees from UK, US, Canada, Australia and New Zealand to return and practise in India in any public or private hospital.

The ministry is also working on amending the Indian Medical Council Act, 1956, to allow Indian doctors returning home from these 15 countries to automatically become a faculty member of a medical college, if they want to teach under-graduate students.

So far, India recognized the PG degree of a foreign country only as a reciprocal gesture, limiting the bracket to Ireland, Bangladesh and Nepal which recognized Indian degrees. However, the shortage of both doctors and faculty has made the health ministry reconsider the rule.

Source: TOI

DU students launch campaign on AIDS.

A student of Delhi University Karan Deep has a ‘special assignment’ on hand everyday, a tete-a-tete with 100-odd rickshaw-pullers in the Capital’s campus area.
He chats with them for around two hours daily on various aspects associated with HIV/AIDS and also educates them on the use of condoms.
He is part of a group of 20 students from various DU colleges who are currently running an awareness campaign about HIV/AIDS and its prevention to shed misconceptions associated with the deadly disease among youth and socially-backward classes.
They are leading an aggressive campaign among newcomers, hostelers, ‘rickshawallahs’ plying in the campus as well as tea vendors, gardeners and other people in and around the area.
“Generally people are aware of the disease and the stigma associated with it. However, they are not so informed about its method of spread and the various misconceptions surrounding it. We encourage the use of condoms so that it can be prevented,” says Sandeep, a volunteer from Ramjas College.
Moving about in groups and interacting with people, these volunteers first gauge the existing level of awareness among people by conducting a survey based on a questionnaire and then work towards filling up the gaps by removing their misconceptions.
The questionnaire has 37 questions involving various aspects of the disease — its causes, effects and the means to prevent it.

Source: TOI

Govt may buy MNC drugs in bulk and sell cheap

THE government is examining the possibility of barring multinational companies who hold monopoly over costly, patented drugs and medical devices from accessing Indian patients directly. Instead, the government may purchase the entire requirement of the country including that of private hospitals and use the collective purchasing power to negotiate a far lower price than what the companies may charge if allowed to directly sell to consumers.
The move may be the most effective way of making affordable the cutting-edge therapies of multinational companies which even affluent families find difficult to afford.
Direct selling to consumers through retailers or hospital pharmacies involves promotional expenses. Therefore, the proposal would be beneficial for the companies too as it would assure them of a massive contract besides lowering their promotional expense.
Big pharmaceutical corporations like GSK and Merck are aware of the need for affordable therapies and have started selling their sophisticated new medicines in the country at a fraction of the price at which they sell in developed countries like the US.
Merck, for example, sells its diabetes drug Januvia in India at roughly a fifth of its price in the US.
The government’s move is interesting
as it would put to efficient use its clout as
a major buyer of medicines instead of asking companies to lower prices using its sovereign powers.
It is, however, unlikely that the government may venture into distribution of medicines to consumers, which may lead to leakages and inefficiency that characterises the country’s public distribution of food. Once procured at the central level for the requirement of the entire country, the drugs may be released to the respective users such as
the railways, state governments, corporate
hospitals and nursing homes.
Disallowing a company from directly reaching patients is not new to the country. The government had prevented Cipla from selling its version of Swiss drug maker Roche’s bird flu therapy in the retail market. The apprehension was that such sales may lead to panic consumption and lead to the virus developing immunity.

source economictimes epaper

Max builds up interest in JV

CONTRARY to the popular trend of Indian companies diluting their economic interests in joint ventures, Max India has probably become the first domestic company to do the opposite. It has raised its economic interest in its life insurance joint venture company, Max New York Life (MNYL), from 50% to 74%. MNYL is a joint venture between Max India and US-based New York Life. This means Max India’s share in the valuation of MNYL has gone up by 24%. A recent research report by an Indian broking house pegged the value of MNYL at over Rs 10,000 crore based on 2009-10 premium estimates. MNYL accounts for about 80% of Max India’s consolidated revenues.
As per the options agreement signed between the partners in 2003, for every equity investment made in the 26:74 joint venture, New York Life used to contribute 26%, Max used to pump in 50%, and the Indian company’s remaining 24% used to be funded through an advance paid to it by New York Life. It had also been agreed that when the 26% FDI sectoral cap in the insurance sector was relaxed, New York Life would have the option of increasing its shareholding in the joint venture to up to 50% at par value. These provisions had been approved by the Insurance Regulatory and Development Authority (IRDA), and were disclosed in Max India’s successive annual reports.
However, under the fresh joint venture agreement, Max has repaid the Rs 174-crore deposit paid by New York Life and increased its economic interest to 74%.


source economictimes epaper

Pharma companies going slow on drug launches

IN WHAT is seen as a fallout of the product patent regime, drug makers are launching lesser number of brands in the Rs 33,000-crore domestic pharma retail market. For the two-year period ended March 2008, the total number of drugs launched in India has come down to 4,700 from 4,830 for the two-year period ended March, 2005. Also, most of the drugs launched in the last two years are not new molecules but combination and new forms of existing molecules.
Incidentally, companies have also not been able to rake in much revenue from their new brands. Around 10,000 drugs were launched between April 2003 to March 2005 and between April 2006 to March 2008, but about 100 or 1% of them managed to cross sales of Rs 4 crore annually, according to a study by market-based consultancy firm ORG IMS.
The highest number of drugs, 646 brands, were launched in the anti-infective segment — the largest thereupatic segment — in the last two years. The least number of drugs, 108 brands, were launched in the anti-diabetes segment.
Traditionally, new drugs have been the major driving force behind the growth of companies, but those days may be over. “As the window for the pre-95 molecules becomes smaller, lesser number of drugs are being launched. For example, only four new molecules were launched in the anti-diabetic segment over the last four years. The trend is expected to continue in the coming years also. Companies will have to focus on augmenting their existing brands and increasing their penetration in smaller town and cities,” ORG IMS India MD Shailesh Gadre said.
Top brands continue to garner a significant portion of the domestic market. The country’s top selling drug Novartis’ Voveran posted sales of Rs 143.5 crore for the year-ended May, up 13.3%, followed by Pfizer’s Corex, which notched up Rs 142.8 crore, also up 5.7%.

source economictimes epaper

Elder Pharma to market Cymbiotics drugs in India

THE California-based bio-pharmaceutical company, Cymbiotics, has signed an in-licensing deal with Elder Pharmaceuticals to market six of its patented products in India, reports Rajesh Unnikrishnan from Mumbai. As per the agreement, Elder will market Cymbiotics products in pain management, diabetics, dermatology, besides OTC products. Cymbiotics develops disease-specific formulations in pain management, cardiovascular, urinary incontinence and other inflammation management-related conditions. Initially, Elder will market Cymbiotics’ arthritis drug Flexasur and diabetic drug Diaperin. Cymbiotics CEO Raj Barathur said, ”The deal will strengthen our presence in the Indian market.”

source economictimes epaper

Piramal Health inks marketing deal with US co BioElectronics

PIRAMAL Healthcare is set to clinch yet another in-licensing deal. The company has concluded a marketing deal with US-based firm Bio-Electronics to market the latter’s pain management equipment, ActiPatch. The deal is likely to be announced sometime next month, sources said.
Confirming this, Piramal Life Sciences vice-chairperson Swati Piramal said, “We have a strong marketing and distribution network and we are capitalising on that. We have a team that is continuously on the look out for such alliances. The product is going to be launched in August.” This alliance, she added, was solely a marketing one.
BioElectronics is the developer and marketer of ActiPatch, a medical device which deliver pulsed electromagnetic frequency (PEMF) therapies to accelerate healing of soft tissue injuries.
Meanwhile, Piramal Healthcare on Tuesday said, it has joined hands with Pierre Fabre, a French-based company to launch ‘Ducray’, a range of dermo-cosmetic products. The two companies have invested Rs 10 crore in setting up the required infrastructure in India. Since the products are derived from plants, the active plant ingredients will be made in France with the formulation done in India. This, Dr Piramal says, has helped to bring down the price of the products, the benefit of which will be passed on to the consumers.
“The dermo-cosmetic market in India is new and nascent but has a lot of potential. So far there is no product in this category that is being sold. Since these products are non-schedule H they will only be sold on a prescription basis from dermatologists,” she said. Both companies, however, hope that in the near future, the products will be allowed to be sold over-the-counter.
“We hope to reach a target of Rs 20 crore in the next couple of years for these products. We also have plans to launch another 10-12 products in the coming years,” said Ducray Laboratories director Pierre Bottino.

source economictimes epaper

Small pharma companies to get pricing antidote

The government is believed to be considering a proposal to free from price control about 5,000 small pharma companies having turnover of up to Rs 10 crore based outside the excise-free zones. The move is aimed at providing relief to small units facing problems due to introduction of MRP-based excise and rise in prices of raw materials imported from China.

In a presentation to the pharma department, the SME Pharma Industries Confederation (Spic) sought exemption from price control to small units which operate under MRP-based excise regime. “The government has assured us that it would consider our proposal,” Spic secretary general Jagdeep Singh said. He said it is unfair to compare small units with large companies.

“MRP-based excise is the suitable way of price control (as compared to DPCO). Most big companies like Cipla manufacture non-scheduled medicines in excise-free zones and charge high prices. For instance, the ex-factory cost of Cetrizine (sourced from excise free zone) is Rs 2 for a strip of ten tablet but the company sells it on an MRP of Rs 36.

Firms based outside excise free zones cannot do it because they have to pay excise based on that MRP, said Mr Singh. Units in Jammu & Kashmir, Himachal Pradesh and Uttarakhand are exempted from excise payment.

However, a senior government official ET spoke to denied any such proposal is being considered. The National Pharmaceutical Pricing Authority (NPPA) has already refused to increase prices of drugs and asked the industry to approach it with individual applications.

According to pharma majors, selective exemptions will give undue benefit to some sections of the industry. Organisation of Pharmaceutical Producers Of India general secretary Tapan Ray said: “If there is any directive by the government, it should be applicable equally to all sections of the industry to provide a level-playing field. Any selective exemptions will be unfair.”

“Creating artificial barriers brings distortions and imbalances which should in fact be eliminated rather than encouraged,” Novartis India MD Ranjit Shahani said.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Small_pharma_companies_to_get_pricing_antidote/articleshow/3272023.cms)

From '09, 1-year rural stint a must for MBBS students (http://timesofindia.indiatimes.com/Now_1-year_rural_stint_a_must_for_MBBS_students/articleshow/3276540.cms)

NEW DELHI: From next year, a one-year stint in the villages will be a mandatory requirement for MBBS students before they can apply for a postgraduate degree in India.

Reviving the proposal that was earlier shelved following nationwide protests by medical students, the Union Health Ministry has just sent the final proposal for a compulsory rural stint to the Medical Council of India for approval.

Once it approves the proposal, MCI will have to make changes in its regulation defining who is eligible to apply for a PG medical degree in India.

Officials made it clear that the rule will apply from the next academic year.

The government has, however, decided to spare students applying for PG degrees in courses like anatomy, biochemistry and physiology ‘‘as the country is facing an acute shortage of students opting for such courses’’.

If an MBBS doctor completes his PG course from a foreign university, he can come back and practise provided the PG degree is recognized in India. In such cases, the mandatory rural stint will not be applicable.

According to officials, MBBS doctors will have to spend four months each in a primary health centre, community health centre and district hospital. They will be paid a monthly stipend of Rs 10,000.

^^Good news, I say, because of this:

‘8% of primary health centres don’t have docs’

In the wake of the d i s m a l state of rural health services, government may make a one-year stint in the villages mandatory for MBBS students before they can apply for a postgraduate degree.

According to the recent National Rural Health Mission report, nearly 8% of the country’s 22,669 primary health centres don’t have a doctor while nearly 39% were running without a lab technician and 17.7% without a pharmacist.

The condition of the 3,910 community health centres, supposed to provide specialized medical care, is equally appalling. Out of the sanctioned strength, posts of 59.4% surgeons, 45% obstetricians and gynaecologists, 61.1% physicians and 53.8% paediatricians are vacant.

India churns out 29,500 medical graduates annually, but most of them are reluctant to serve in villages and would rather join the private sector for better salaries and an urban posting. In effect, 67% of doctors enrolled for rural posting remain absent from duty.

Also, there is only one allopathic doctor for 1,634 people. According to MCI, the total number of registered allopathic doctors in the country is 6,83,582.

Source: TOI

Now, India-Brazil partnership high on pharma tie-ups (http://www.financialexpress.com/news/Now-IndiaBrazil-partnership-high-on-pharma-tieups/341548/)

India and Brazil have joined hands to promote business interest between the two countries in the pharma sector. “Brazil and India together can herald the next era for the pharmaceutical and healthcare sector” was the general sentiment that was echoed at the India Brazil Seminar on Health and Medication organized by CII on Monday.

José Gomes Temporão, minister of health, Brazil said, “There is a need to develop links between the two countries in the health sectors as a lot had to be gained through this exchange of knowledge, skills and technology.” He identified health policies, sanitary regulations, traditional medicines and production of medicines and medical equipments as potential areas of cooperation between India and Brazil.

Chandrajit Banerjee, director-general CII said, “CII intends to increase the level of interaction and engage more closely with Brazil across sectors, especially in the pharma and healthcare sector”. He also added that CII would soon open its first Latin American office in Brazil.

Identifying the Brazilian pharmaceutical industry as one, that the country is determined to develop, Temporão said that the country's government aims to provide maximum incentives for foreign participation and partnerships through the new production development policy (PDP).

He highlighted the considerable trade deficit in medicines and active ingredients and expressed great interest in partnering with a medically advanced country such as India.

Arun K Khanna, executive director, Emcure Pharmaceuticals said, “Indian pharmaceutical and healthcare industry are the sunrise sectors in India, which is increasingly gaining global recognition.”

Projecting sector growth at 12-14% over the next 3-5 years, Khanna identified high disease prevalence, increased access to healthcare facilities, changing healthcare model and medical tourism, increasing spending capability and the population dynamics at large as reasons for growth.

He said that the average Indian household spends 11% more on healthcare and medical services today, as compared to 1996, and therefore, the industry has more than doubled in the last six years.

Columbia Asia plans hospitals in all metros (http://www.thehindubusinessline.com/blnus/14301732.htm)

Kuala Lampur-based multinational hospital chain Columbia Asia plans to set up hospitals in all the four metros.

"Within next two years we would have presence in all metros, Tier I and Tier II cities of India. We would like to be in a position where we are competitive in numbers with other hospital chains," Columbia Asia Hospitals Chief Executive Officer, Mr Tufan Ghosh told PTI.

He, however, refrained from quoting the exact number of hospitals it plans to set up or the investment it would make. Mr Ghosh added that the company has also entered into an agreement with real estate major DLF, under which it would set up its hospital in all townships developed by the real estate group.

He, however, refused to tell anything about the locations identified for the project. At present, Columbia Asia has four hospitals in the country, two hospitals in Bangalore, one in Kolkata and one at Gurgaon, inaugurated this week.

"We have around 600 rooms available at present taking together the four hospitals. The new hospitals which are to come up during next two years would have on average around 100 rooms each," Mr Ghosh said.

Vote for larger healthcare spend in coming election

EVEN as some 20% of the world population in the 30 OECD countries benefits from about 90% of the world’s money spent on health, the developed countries continue to spend heavily on healthcare infrastructure and services. In contrast, in the last threefour years, public expenditure on health in India has risen only marginally – not only in absolute terms but also as percentage of gross domestic product. This increase in spending is clearly not enough to take India anywhere near what could be considered a respectable slot on this front, leave alone correct the asymmetry.
About a year ago, India’s public spending on health was just over 1% of GDP and private spending, about 5%. We are aiming at increasing public expenditure on health to 2% of GDP by the end of the current Five-Year Plan. Compare this with the US’ current health spend of about 16% of GDP (which is projected to increase to 19% by 2017), of which about a half is public spending. China spent 5.6% of its fastgrowing GDP on health in 2003, and the figure has since risen significantly. In fact, India’s position would look hopelessly indefensible if per capita spending on health is reckoned — it is just $80 compared to US’ about $4,900, UK’s some $2,000 and China’s $230. Policy managers do admit that we should aim at some 6% of GDP as public expenditure on health (till the time the necessary infrastructure is created), but this is hardly reflected in annual budgetary outlays.
Spending is but just one thing, more important than that is effective use of the money spent. And here, Indian situation is even more deplorable, which few wouldn’t know. This is reflected in the country’s healthcare service delivery system which is in a shambles. “Public healthcare has been on a serious decline during the last two or three decades because of non-availability of medical and paramedical staff, diagnostic services and medicines,” notes the Planning Commission in one of its recent reports. This is why despite the high and sometimes prohibitive cost of accessing private healthcare services, there is an increasing, and mostly forced, shift from the public to private sector.
Bolstering of healthcare infrastructure — hospitals and attendant facilities and clinical establishments — is a prerequisite for efficient service delivery. It’s redundant to emphasise on the pitiable conditions of our government hospitals — especially primary and secondary centres. The country is also yet to have acceptable (minimum) standards for clinical establishments, forget about uniform standards. A very vexatious issue is the absence of qualified medical and paramedical staff. Government doctors are increasingly opting for the more gainful private sector and many among those who remain on government pay roll surreptitiously do private practice, in neglect of government duty. The government is not doing enough to arrest the flux. One idea being flagged is to legalise private practice of government doctors or alternatively grant them ‘non-practising allowance’. This might help retain doctors in government services. It is however unlikely that the service practices will improve as a result.
Drug testing and pathology laboratories in the country don’t fully adhere to standards set by the national accreditation body. The Clinical Establishments Regulation Bill, introduced in Parliament, is yet to pass the muster. Only in the last few years has the government revamped the laws related to drug manufacturing, imports and clinical trials to make the relevant norms globally compatible. But even as the laws are now in place, there is really no guarantee that these are being unfailingly enforced. The drug regulatory establishment is simply not able to cope with the enormity of the challenge it is facing.
And if that is the case of the infrastructure and services standards, the medical insurance coverage in the country too is quite low. Insurance companies don’t find the segment attractive enough. The National Commission for the Unorganised Sector had proposed a government-sponsored health insurance scheme that would cover all 30 crore BPL population. No action on this front is forthcoming so far.
As for drug prices, which is a significant factor in healthcare cost of Indians, the extant government controls are not of much use, as these are on a set of drugs that were selected some 15 years ago. Most of these drugs have therapeutic alternatives in the market and since patients go by the prescriptions, the benefit of price controls is often denied to them. The fact that the controlled segment in the retail pharma market has been steadily shrinking establishes beyond doubt the futility of price controls. It would have been much more useful for the low-income population if the government had encouraged production of generic (unbranded) medicines and distributed these through the public healthcare system.
Manifestoes of major political alliances in the coming Parliament election can give top priority to healthcare, for a change.

source economictimes epaper

India needs Rs 3.7 lakh cr by 2025 for healthcare facilities

India will need investments of Rs 3,70,000 crore to provide just two hospital beds for every 1,000 people, from the present level of 0.86, a joint study by industry body Ficci and global consultancy firm Ernst & Young said.

According to the study 'Fostering Quality Healthcare for All', in order to achieve the target the country would require 17.5 lakh additional beds by 2025. The study added that there is also a huge shortage of qualified doctors in the country. Against the requirement of 7,00,000 doctors by 2025, it said, there is a net addition of just 17,000 doctors per year.

The study added that boosting human resource and public private partnership as key to achieving India's aim of quality healthcare for all. It further pointed out that if neglected, poor healthcare facilities will not only have an impact on the quality of the life of common man but would also lead to huge economic losses in terms of GDP.

"This will lead to huge economic losses estimated at 1.3 per cent of GDP presently. If the health care issues are not addressed holistically, these losses to mount to 5 per cent of GDP, a whopping Rs 6.1 lakh crore by 2015," Ficci Secretary General Amit Mitra said.

It added that though the government has undertaken positive initiatives and recognized the sector as priority in 11th Five year Plan but there is still a lot to be done, the study indicated.

source economictimes.com (http://economictimes.indiatimes.com/News/Economy/Policy/India_needs_Rs_37_lakh_cr_by_2025_for_healthcare_facilities/articleshow/3311082.cms)

Metro cities to get blood banks

Gearing up to meet high standards of safety in blood transfusion, the Government on Thursday approved providing the four major metros with blood banks, which would also be centres of excellence for transfusion medicine.

The Cabinet Committee of Economic Affairs (CCEA) cleared the setting up of the blood banks at a cost of Rs 468 crores out of which Rs 228 crores will be used for the ongoing National AIDS Control Programme-111.

The centres would be located in New Delhi, Mumbai, Kolkata and Chennai, Union Finance Minister P Chidambaram told reporters after the CCEA meeting. Each centre will ensure 24-hour availability of blood and would be designed to meet the highest standards of safety. They will collect more than 100,000 units of blood annually which would be processed into three blood components resulting in generation of more than 300,000 units, he said.

The centre would also be designed to handle any type of natural or man-made disasters or outbreaks like dengue, which often requires large volumes of blood transfusions at short notice and collect blood only from voluntary donors through state-of-art blood mobiles, qualitatively improving the system of blood collection.

"Out of the Rs 468 crores, Rs 168 crores will be for building construction and equipment, Rs 80 crores for manpower and Rs 220 crores for consumables and other recurring expenditure," he said. These centres would benefit in strengthening blood transfusion services in the country for access to safe and quality blood and blood products in metro cities as comparable to international standards, he added.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Healthcare/Metro_cities_to_get_blood_banks/articleshow/3310526.cms)

Ranbaxy's drug Abacavir gets WHO approval (http://www.financialexpress.com/news/Ranbaxys-drug-Abacavir-gets-WHO-approval/343369/)

Pharma major Ranbaxy on Friday said the World Health Organisation has approved its anti-retro viral drug Abacavir 300 mg tablets in pre-qualification list.

Anti-retro viral drugs are used for the treatment of infections by retroviruses, primarily HIV.

Abacavir will be manufactured at Ranbaxy's WHO pre-qualified manufacturing site at Paonta Sahib in Himachal Pradesh, the drug maker said in a statement.

With this approval, the pharma company has 18 anti-retro viral drugs in the WHO pre-qualification list.

Fortis plans medical institute in Punjab, to invest Rs 100 cr

Medical service provider Fortis Health Care plans to set up an institute, which will also house a cancer research hospital, in Punjab at an initial investment of Rs 100 crore.
"We have submitted a detailed plan to Punjab Government to upgrade the healthcare services in the state which includes setting a medical education centre that would include nursing school, OPD centre and a large cancer hospital," Fortis Healthcare CEO Shivinder Singh said.
State officials said Fortis' plans include setting up a chain of medical centre on a private-public-partnership model.
The total investments in the initial phase would be to the tune of Rs 100 crore, the officials said.
Fortis is looking at setting up a large hospital with capacity of 100-250 beds linked to the OPD services, the officials said, adding the firm was looking at replicating the model in other parts of the state.
A high rate of cancer in Punjab, particularly in Malwa region, and absence of proper treatment facilities force people to go to hospitals in neighbouring state of Rajasthan.
The hospital would also help in providing medical care to the patients coming from across the border, officials said.
According to the data available with the government a large number of patients from countries like Afghanistan and Pakistan come to India via Amritsar for treatment and there is a big demand for a quality private hospital in the region.
"We are seriously concerned about the welfare of the people. As a company in the business of health care, we consider it imperative to provide the best possible medical aid to the people," Singh said.
The company had earlier said it was targeting to own 40 hospitals by 2011 and it can be through acquisitions, setting up greenfield facility or through PPP model.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Fortis_plans_medical_institute_in_Punjab_to_invest_Rs_100_cr/articleshow/3320732.cms)

Emami give its OTC biz national push (http://www.financialexpress.com/news/Emami-give-its-OTC-biz-national-push/344951/)

Kolkata-based FMCG major Emami is giving a booster dose to its over-the-counter (OTC) health care segment with plans to launch some of the products nationally.

The company that made its foray into the OTC segment in 2006 by launching a range of products, including blood purifiers, uterine tonics and memory products in selected states, has identified brands that it plans to make national.

"We have reached a stage where some of the products can be taken at a national level and very soon we will be launching them...," Emami Ltd Director Aditya Agarwal said.

He said some of the products that the company intended to launch across the country included blood purifier brand 'Lalima', 'Sardija' range of cough and cold syrup and vaporub products.

The company had made pilot launch of its OTC products in eight states -- Bihar, Chattisgarh, Delhi, Jharkand, Madhya Pradesh, Rajasthan, Uttar Pradesh and Uttaranchal.

"Our test markets in these states have found that the identified products are ready to be taken at a larger level, while the rest needs to be tweaked a bit to suit customer requirements," Agarwal said.

He said the company's sales team for the OTC business, which are currently focusing on the eight states would now expanded for the planned national launches of some of the products.

"The idea is to make our OTC business contribute more to our overall turnover as compared to about just 2 per cent," Agarwal said.

Emami's OTC focus is on remedies for cough and cold, stress, diabetes and blood pressure, being developed by its research arm - Himani Ayurvedic Science Foundation. It had earlier announced that it plans to launch about 20 products in two years.

Aurobindo Pharma gets FDA nod for marketing Alendronate (http://www.financialexpress.com/news/Aurobindo-Pharma-gets-FDA-nod-for-marketing-Alendronate/344949/)

Drug firm Aurobindo Pharma on Tuesday said it has received US regulatory approval to manufacture and market Alendronate Sodium tablets, used in the treatment of bone diseases, in that country.

"The company has received final approval from the US Food and Drug Administration (US FDA) to manufacture and market Alendronate Sodium tablets in variants of 10 mg, 35 mg and 70 mg," Aurobindo Pharma said in a filing to the Bombay Stock Exchange.

Alendronate Sodium tablets, used in the treatment of Osteoporosis, are generic equivalent to Merck & Co's Inc Fosamax tablets of variants in 10 mg, 35 mg, 70 mg, it added.

The approval came within eight months of the date of filing with the US FDA. With this, the number of Abbreviated New Drug Application (ANDA) approvals from the US FDA stands at 73, the filing added.

"Aurobindo got the US FDA nod on the first day of the expiry of the relevant patent and the product will be launched immediately in the US market," the company said.

RPG Life Sciences to focus on new biotech drugs, markets (http://www.financialexpress.com/news/RPG-Life-Sciences-to-focus-on-new-biotech-drugs-markets/344632/)

RPG Life Sciences, a part of the Rs 13,500-crore power-to-retail RPG Group, has drawn up a strategy for resurgence, which includes creating a strong pipeline of drugs in the biotech space, moving up from active pharmaceutical ingredients (APIs) to high-value formulations and strengthening its presence not only in the regulated markets of US, Europe and Japan, but also other emerging markets of the Middle East and northern Africa. The company, which posted just around Rs 6 crore of profits for fiscal 2008, is now targeting profits to the tune of Rs 100 crore in the next three years, said Harsh Goenka, chairman, RPG Group.

"As a group, we think very positively about the life sciences business in general," Goenka told FE. "It may be a very small part of our group, but a very important one, for two reasons. One, India has a sustainable advantage in the pharmaceutical business. Second, we have certain special, niche areas, where our core competencies are very high," he said. The company had posted a total income of Rs 130 crore for fiscal '08.

Although an early starter in the biotech space (earlier known as Searle India Ltd, the company started in 1968 as a joint venture with GD Searle, USA), RPG Life Sciences tailed many others in the segment, owing to capacity constraints and a thin product pipeline. In 1993, GD Searle withdrew from India, selling its holdings to RPG Group.

According to sources, the company will invest Rs 50-60 crore for expanding its business organically over the next three years, and may rope in a private equity entity or a strategic partner for its biotech business.

In the immunosuppressant space, the company has products like cyclosporin. "In the anti-cancer range, which is our biotech range, we have three products that are niche and have 10% of the world marketshare," Goenka said. The company also aspires to be one of the top three players in the chosen segments of oncology and immunosuppressants. "Since we have recently got the USFDA approval for the API plant, we need to build more alliances in the US and Japan and Europe," Goenka said.

According to Arvind Vasudeva, managing director, RPG Life Sciences, the company will launch one product per annum in the next five years from biotech. "Focus will be on immunosuppressants and oncology in the biotech space, and 80% of the products will be launched in this space. Antibiotics and antifungus products are also high value, and products will be launched in this space as well," he added

IFC to invest Rs 55 crore in Rockland hospitals

World Bank group member International Finance Corporation on Monday said it will invest Rs 55 crore (14 million dollars) in Delhi-based Rockland Hospitals to support its expansion plans.

Rockland Hospitals plans to expand its facility in the national capital and set up a 250-bed hospital in Manesar, Haryana.

"IFC will provide 10 million dollars through equity investments and another 4 million dollars in convertible preferred shares to Rockland Hospital," IFC said in a statement.

The project will help broaden access to high-quality health care and good administrative and patient care to common people, it added.

"This project demonstrates IFC's commitment to social sector development. It also aligns with our strategy to invest in health care, one of India's largest service industries where the private sector's involvement is most critical," IFC Director for Health and Education Guy Ellena said in a statement.

IFC, a member of the World Bank Group fosters sustainable economic growth in developing countries by financing private sector investments.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Healthcare/IFC_to_invest_Rs_55_crore_in_Rockland_hospitals/articleshow/3325543.cms)

WB announces $520 mn Malaria project for India (http://www.financialexpress.com/news/WB-announces-520-mn-Malaria-project-for-India/346376/)

In a bid to help combat Malaria and other fatal diseases in India, World Bank has announced a USD 520 million scheme, the largest such project by the world body in any country.

Over 100 million people in India will be provided prevention services and treatment under the scheme designed by the Indian government, the UN World Health Organization (WHO) and the Global Fund to Fight AIDS, Tuberclosis and Malaria Welcoming the scheme, UN Secretary-General’s Special Envoy on Malaria congratulated both the World Bank and the Indian Government for their “tremendous commitment” to combating malaria and like diseases.

More than two million cases of the disease are reported yearly in the country, causing India to lose nearly 80 million days in productivity annually.

“Malaria continues to be a major threat to the lives of millions of poor Indians through premature death, disability, and unnecessary suffering,” said Isabel Guerrero, the World Bank’s Vice President for South Asia, when the body’s new initiative that will cost USD 520.75 million was announced on July 31.

Falciparum malaria, a severe form of the disease which is often fatal, is on the rise in India due to increased resistance to chloroquine treatment, which was previously the primary anti-malaria drug, the world body said.

“This project uses the latest science on malaria control, including a new highly effective drug regimen, to effectively address this problem,” Guerrero noted.

Govt plans medical tech park in Chennai

THE government is setting up a medical technology park in Chennai soon to help cut costs of healthcare equipment and research for new vaccines. The park would include medical device manufacturing units, healthcare infrastructure and vaccine technology facilities.
“The medical park will enable us to manufacture cost-effective medical equipment for the country. The vaccine park will research on developing new vaccines,” drug controller general of India (DCGI) Surinder Singh said on the sidelines of a FICCI healthcare event here on Friday. However, details about financial benefits the government might give to companies are not known as the proposal is at a discussion level, Mr Singh said.
The DCGI said that while the work for setting up the vaccine park has already started, the ministry of health and family welfare will shortly invite private players to set up facilities in the park. The state government has already given 300 acres for the vaccine technology park at a concessional price. The park is expected to be in place within four years. State-owned Hindustan Latex will set up its facility in the vaccine centre.
According to industry estimates, 90% of the medical equipment used in India are imported. The medical technology park is likely to help tackle this situation as manufacturing products in India for domestic use would reduce the cost of equipment by 40%. The medical equipment market in India is estimated to be around a billion dollars.
The government plans to keep the park open to both national and international companies.

source economictimes epaper

AIDS control society plans testing centres in pvt hospitals in Kerala

The Kerala State AIDS Control Society (KSACS) will open 50 Integrated Counselling and Testing Centres (ICTCs) in private hospitals this year.

This is in addition to the 72 ICTCs that will also come up this year at the government-run health centres. The society also has plans to open an anti-retroviral therapy (ART) centre at Palakkad.

At present, Kerala has five ART centres functioning at government medical colleges and 101 ICTCs. The ICTCs provide free HIV testing facilities and counselling for the HIV infected.

"We will provide free test kits for the ICTCs coming up at private hospitals and will provide necessary training to their technicians and counsellors," O Sasikumari, the deputy director of KSACS said.

With the opening of ICTCs, the private hospitals will be able to provide reliable HIV testing facilities to people.

"At present many of these hospitals are providing only card test facilities for HIV. This test is not reliable as it may give false results. The ICTCs always follow standard three-test procedure which is a reliable method," she added.

The KSACS decided to open ICTCs at private hospital as 60 per cent of the patients in the state approach to private hospitals for health care.

According to the society there are around 25,000 HIV infected people in the state. "At present around 7,800 HIV infected persons have registered at various ART centres. Out of this around 4,000 are under treatment," Rita Cross, joint director of KSACS said.


source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/AIDS_control_society_plans_testing_centres_in_pvt_hospitals/articleshow/3346125.cms)

‘Health facilities available in HP within 5 km radii’ (http://www.financialexpress.com/news/Health-facilities-available-in-HP-within-5-km-radii/347062/)

Himachal Pradesh has the maximum rural health outreach and, with elaborate infrastructure facilities available within radii of about 5 km, the state excels in national averages in terms of health indicators, chief minister Prem Kumar Dhumal has said.

The state has accorded top priority to road, education and health sectors and created a network of allopathic, ayurvedic, homeopathic and Unani health institutions to cater to healthcare requirements of the people,

Dhumal said, while addressing the inaugural session of a four-day long conference of spine surgeons. The conference, attended by doctors from India and Europe, has been organised by the Association of Spine Surgeons of India, Himachal chapter.

He said the state has over 4,000 health institutions in the government sector and its healthcare endeavours are supplemented by a number of private health centres. The CM also added that the state has recently recruited 139 doctors on a contract basis to man health institutions in difficult rural areas.Health minister Rajeev Bindal said the government is encouraging public-private participation in opening health institutions and medical colleges.

ICICI Venture eyes stake in KIMS

An ICICI Venture associate fund and a Singapore-based private equity (PE) player are in talks to invest Rs 300 crore in Kerala Institute of Medical Sciences (KIMS). The hospital will use the fund for Indian and overseas expansion. KIMS CMD M Sahadulla told ET, “We have been talking to several PE players to fund our expansion plans. We have now zeroed in on two funds—an ICICI associate fund and a Singapore-based healthcare focused PE player.” However, he did not disclose the amount of stake that KIMS would offload to these two funds.
Mr Sahadulla added that apart from funds from PEs, KIMS was also looking at a strategic partner who would stay with the hospital for a longer period. “We would like our partners to stay with the hospital for 5-7 years instead of exiting the hospital within 3-4 years with 25% annualised returns,” he said. KIMS plans to list the company in five years. India’s largest PE fund, ICICI Venture, has a healthcare-focused fund, I-Ven Medicare, which has a corpus of $250 million. The fund has already invested in several hospitals in the country, mostly in regional hospitals in tier-II and III cities. A source said that KIMS has had initial discussions with I-Ven Medicare. However, KIMS has not finalised the valuation of the hospital and the investment plans.
KIMS is the first venture of KIMS Healthcare Management, started by a group of doctors and entrepreneurs. The hospital, which was commissioned in 2002, runs a 450-bed multi-specialty hospital in Thiruvananthapuram.

source economictimes epaper

Fresenius unit to invest 10-30 mln euros in Dabur plant (http://in.news.yahoo.com/137/20080812/371/tbs-fresenius-unit-to-invest-10-30-mln-e.html)

Fresenius Kabi, a unit of German drug maker Fresenius SE, will invest 10-30 million euros in the active pharmaceutical ingredient plant of Dabur Pharma Ltd, a top official said on Tuesday.

The investment will be made over the next three years to double capacity, Rainer Baule, President and Chief Executive of Fresenius Kabi, told reporters.

Fresenius SE's wholly-owned unit, Fresenius Kabi, acquired 90.9 percent in the Indian anti-cancer drug maker, by acquiring the founders' stake in April followed by a public offer, to help expand its intravenous drug portfolio.

Indian Aura bullish on medical tourism

Indian Aura, a new venture of Airline Travel & Tours Centre, plans to make Gujarat the medical tourism destination of Asia. Speaking to press persons, Mr I.J. Patel, Chairman, said, “Of the total number of non-resident Indians, 59 per cent are Gujaratis and we hope to tap this segment to bring them to India for medical treatment and recuperation and hardsell Gujarat for the same.”

Tie-up

The company has tied up with HRH Group of Hotels, Grand Intercontinental Group, Columbia Asia Hospitals, Wockhardt Hospitals and is in talks with the Taj Group of hotels as service providers.

Indian Aura will be the marketing agency for the spas, hospitals and palaces of these organisations, facilitating services for mainly the NRI populace.

In Gujarat, the company has tie-ups with Bhailal Amin Hospital, Baroda, SAL and Shalby Hospitals in Ahmedabad.

The company also hopes that by tying up with the hotel groups, they will be able to convince them to set shop in Gujarat, where, currently, very few national five-star hotel chains are present.

The company is in talks with the HRH group to start operations in Gujarat, said Mr Patel.

The company, however, intends setting up and managing around five to seven spas under its brand, three of which will be in Gujarat.

Investment

It will invest Rs 10 crore in three years, out of its own funds and expects a turnover of Rs 9 crore by end of 2009, said Mr Vinod Kumar, consultant to the company.

The spas will provide Mediterranean, Indian and Oriental systems of medicines with Naturopathy, Allopathy and Ayurveda treatments.

The company will tap its network of Indian embassies, and NRI associations abroad to market Indian Aura and sees retired pensioners, senior citizens, single women and professionals as potential customers.

According to a recent CII/McKenzie report, the medical tourism industry in India is expected to reach Rs 12,000 crore by 2012, becoming the second highest export earner after the IT industry.

source businessline (http://www.blonnet.com/2008/08/08/stories/2008080852432100.htm)

xposting from the insurance thread:

India's first health insurance policy for HIV launched (http://www.financialexpress.com/news/Indias-first-health-insurance-policy-for-HIV-launched/348474/)

A group insurance plan for HIV positive people, covering their treatment cost among others, was launched in Bangalore in a first such effort in India.

The pilot initiative will provide Rs 30,000 insurance cover for 250 people living with HIV in Karnataka's six districts of Bellary, Mangalore, Mandya, Kolar, Mysore and Udupi.

The insurance cover entails the beneficiary Rs 15,000 assistance for hospitalisation and a similar sum to his family in the event of his death, Sanjay Rao Chaganti, Programme Director of Population Services International (PSI), an NGO behind the project, said here.

PSI in partnership with Star Health and Allied Insurance Company and the Karnataka Network for Positive People (KNP+) has introduced the insurance plan.

"It is a problem to enroll HIV positive people, because they either don't disclose or come forward. It is only through the help of organisations like KNP it can be done," Sanjay explained.

Andhra Pradesh Aids Control Society has identified 3,000 such persons and they would soon be brought under similar insurance programmes, he said.

The annual premium for the policy works out to Rs 1500 per person and the NGO will bear half of the amount.

Karnataka State Aids Prevention Society Project Director, Manjunath Prasad said the state had 2.5 lakh HIV infected and 33,000 suffering from AIDS.

National Aids Control Organisation Director General K Sujatha Rao said out of the Rs 1100 crore budget provided during 2008-09 for AIDS control, about Rs 150 crore was being spent on creation of awareness about the disease.

Fortis acquires CRS Health

FORTIS Healthworld has acquired CRS Health, a Delhi-based pharma and wellness retail chain. It is also planning to rebrand itself and the pharma chains it acquires in future as Religare Wellness. CRS is the drug retailing arm of the diversified Delhi-based SAK Industries. Though the size of the deal is not big, it is Malvinder Singh and Shivinder Singh’s first acquisition since they sold their pharma company Ranbaxy to Daiichi Sankyo. Fortis will pay around Rs 15 crore to acquire 90% stake in CRS Health. Ravi Rajan & Company was the advisor to the deal.
CRS has 30 stores which will help Fortis expand in the South. The promoters of CRS Health will hold 10% stake. Fortis has around 40 stores and plans to expand its presence to over 100 cities in 18-24 months.

source economictimes epaper

Poor can now have heart surgery with bank loan (http://www.financialexpress.com/news/Poor-can-now-have-heart-surgery-with-bank-loan/350691/)

SBI and private heart hospital Narayana Hrudayalaya on Tuesday launched a novel loan product on a pilot basis for ‘poor heart patients undergoing cardiac treatment.’ Officials said Under the SBI Hrudaya Suraksha Scheme, carrying an interest rate of 8.5 per cent, the patient would get as a loan 80 per cent of the total medical expenditure or Rs 50,000 whichever is lower.

The borrower would have to repay the full amount with interest within a maximum period of six months. Narayana Hrudayala’s Chief Dr Devi Shetty said the interest component in the first three months of the repayment period would be borne by his hospital.

The scheme was launched by Nobel laureate Prof. Muhammed Yunus, Founder of Grameen Bank, Bangladesh, who hailed the initiative, in the presence of SBI Chairman O P Bhatt and RBI Deputy Governor V Leeladhar.

Shetty said the pilot project is to evaluate the concept of offering loan on easy interest terms for poor patients who need urgent cardiac intervention. “Once the proof of concept is available, the same plan can be rolled out in other health cities of Narayana Hrudayalaya in Kolkata, Ahmedabad, Jaipur and Jamshedpur”, he said.

A good number of people belonging to the lower middle class have some means of revenue generation but they do not have large sums of cash at hand for medical eventualities. In the pilot phase, poor patients undergoing cardiac treatment at the Narayana Hrudayalaya Health City in Bangalore can avail the loan, without collateral, officials said.

A lengthy but highly informative article on the globalization of health care (mostly from the demand side). From the Indian context - Wockhardt hospitals is put in focus. Also I recently read an article elsewhere that John Hopkins is planning to setup a health city near MIHAN which fits in well with what this article covers.

Link (http://www.economist.com/business/displaystory.cfm?story_id=11919622)


Globalisation and health care: Operating profit

Why put up with expensive, run-of-the-mill health care at home when you can be treated just as well abroad?


ROBIN COOK knows how to spot the latest scare in medicine. Mr Cook, a Harvard-trained doctor, is author of over a dozen medical thrillers, including “Coma” and “Outbreak”, which have anticipated pandemics, anthrax attacks and the black market in organs. “Foreign Body”, published this month, is about the next big thing: medical tourism.

Central to the plot is the story of Maria Hernandez, a working-class American woman who travels to Delhi to get a hip replacement she could not afford back home. Alas, she and other medical tourists die in mysterious circumstances. Contrast Ms Hernandez’s fate with that of another American health tourist, Robin Steele. Mr Steele, a real patient, recently went to India’s Wockhardt hospital chain for a heart operation. Not only is he in fine shape, but he also enjoyed a holiday afterwards and saved several thousand dollars to boot.

Mrs Hernandez’s tragedy may sell books, but Mr Steele’s good health is more typical. The future of health care, long one of the most local of all businesses, promises to be increasingly global. Over the next few years the world is likely to see a lot more investment, medical staff and patients crossing borders—bringing economic benefits and greater access to care as they do so. Even a modest surge in global medical tourism could prove a powerful catalyst for government bureaucracies and sclerotic American health-maintenance organisations to think afresh about what they do. It may even introduce competition to private health care in America and elsewhere.

Globalisation is not new to medicine. The outsourcing of record-keeping and the remote transcription of doctors’ notes and X-ray analysis are becoming common. Jagdish Bhagwati, an economist at Columbia University, thinks that the offshoring of, for instance, customer service and claims-processing could save America alone $70 billion-75 billion a year. In recent years leading American hospitals such as the Mayo Clinic and Johns Hopkins have set up offshoots in the Middle East and Asia.

Some wealthy patients have always travelled for fancy medical care. Denis Cortese, head of the Mayo Clinic, in rural Minnesota, observes that “we have been global for a hundred years.” A few years ago Britons fed up with waiting for elective surgery started heading overseas to get joints replaced or cosmetic surgery—sometimes at government expense. Recently, shorter queues in the National Health Service and restrictions on reimbursements have undermined this trend.

However, globe-trotting patients only ever occupied a niche. What is getting people excited today is the promise of a boom in mass medical tourism, as a much bigger group of middle-class Americans prepares to take the plunge. A report published last month by Deloitte, a consultancy, predicts that the number of Americans travelling abroad for treatment will soar from 750,000 last year to 6m by 2010 and reach 10m by 2012 (see chart). Its authors reckon that this exodus will be worth $21 billion a year to developing countries in four years’ time. Europe’s state-funded systems still give patients every reason to stay at home, but even there, private patients may start to travel more as it becomes cheaper and easier to get treated abroad.
Pills and pils

Asian hospital chains stand to be the biggest winners, as their rising stars, such as Singapore’s Parkway Health, look for foreign patients. Thailand’s modern Bumrungrad hospital in Bangkok already sees tens of thousands of Americans a year. It has just opened a new extension, designed to handle 6,000 foreign patients, which it claims makes it the world’s biggest private clinic. The surge of American patients flocking to India’s Wockhardt hospitals has convinced Vishal Bali, the chain’s boss, that medical travel is now “truly reaching an inflection point.”

Not everyone is as gushing. Paul Mango, the chief author of a report by McKinsey, a management consultancy, disputes wild-eyed claims that millions of patients are already travelling abroad. Yet even he predicts that the future for medical travel is bright, and that in the long run it may even “largely dispel the idea that health care is a purely local service.”

Regina Herzlinger, of Harvard Business School, broadly agrees: “The medical travel market is a bit over-hyped today, but economics dictates why it will become huge over time: if a supplier has very high prices and erratic quality, it creates an opening for nimbler rivals.” That supplier is America’s health-care system, a $2.4 trillion colossus in desperate need of reform.

This prospect of an American-led boom in global medical travel raises two questions. Why is it happening now? And what will be the effect on the health-care systems of poor and rich countries?
Impatients

Until recently, few Americans went abroad for medical treatment. Over the past decade, however, that has begun to change. Americans seeking medical care are increasingly making trips far from home, often at their own expense—not just short hops to Caracas for a nip and tuck or dashes across the frontera for cheap Mexican pills. As Mr Steele’s testimonial suggests, they are now travelling across the world for knee and heart surgery, hysterectomies and shoulder angioplasties.

One motive is to save money. America’s health inflation has consistently outpaced economic growth, making it the most expensive health market in the world. The average price at good facilities abroad for a range of common medical procedures is, by Deloitte’s reckoning, barely 15% of the price a patient would have to pay in the United States (see table).

But costs have long been much higher in America than in poor countries, so this alone does not explain the new exodus. Two other factors are now at work. One is that the quality at the best hospitals in Asia and Latin America is now at least as good as it is at many hospitals in rich countries. The second, more worrying, factor is that America’s already imperfect insurance safety net is fraying.

Over 45m Americans are uninsured, and many millions more are severely underinsured. Such people may find it cheaper to fly abroad and pay for an operation out of their own pockets than to find the money for deductibles or “co-payments” charged for the same procedure at home. Arnold Milstein of Mercer, a consultancy, calls them America’s “medical refugees”.

Big business may soon join this wave. Epstein, Becker & Green, an American law firm, says that in the past year big employers have become interested in promoting medical travel among the employees they insure. Many are struggling to cope with soaring health costs and some, they report, are willing to take radical steps to save money.

Hannaford, a grocery chain based in New England, now offers its 27,000 employees the option of getting a number of medical procedures done in Singapore rather than America—at a saving to the employee of $2,500-3,000 in co-payments and deductibles. Blue Ridge Paper Products, a firm in North Carolina that makes milk cartons, also offered employees the option of medical travel, but a backlash from a union has put a stop to the plan. Despite that setback, the general rise in corporate interest is such that in June the American Medical Association, the chief lobbying group for the country’s doctors, issued (surprisingly supportive) guidelines for foreign medical travel.

That has emboldened insurance firms, which had thus far been cautious. A few are beginning to offer voluntary “global medical travel” options on their corporate plans. According to the industry watchers at Epstein Becker, other insurers fear that they may be at a disadvantage if they do not offer such schemes.

Overcoming initial scepticism, Aetna, a giant American insurer, has this year launched a pilot scheme in partnership with Singaporean hospitals. Charles Cutler of Aetna notes that the savings for his firm are not as great as they may be for some others, since it gets volume discounts from American hospitals thanks to its size. Therefore travel abroad for Aetna’s clients makes sense only for procedures costing $20,000 or more, which might include heart surgery. But he remains bullish, observing that quality at the best foreign facilities can be much better than at the average American hospital, thanks to greater transparency and better information technology. He thinks this is inspired by the Asian hospitals’ need to market to a sceptical foreign audience.

David Boucher of Blue Cross and Blue Shield of South Carolina, another big health insurer, at first doubted the quality of care abroad. So he visited Thailand’s Bumrungrad hospital a couple of years ago to see for himself. He recalls sipping coffee at the Starbucks in the hospital’s lobby and thinking that “this is not a straw-village clinic with rusty scalpels!” He has persuaded his firm to let him run a division, called Companion Global Healthcare, to pursue this “blue ocean” opportunity.

Mr Boucher says his division’s customers, mostly manufacturers and other firms with margins that are squeezed by global competition, are keen to experiment with an idea that he reckons could easily replace 5-8% of a company’s health spending with cheaper options; in time, he reckons that share may rise to a fifth. Medical travel may be unfamiliar to individual patients, but he points out that thinking globally is nothing new to his corporate clients: “They may be based in Columbia, South Carolina, but they have competitors and customers in Colombia, South America, as well as in South Africa and in Asia.”

Curtis Schroeder, boss of Bumrungrad, thinks the search for value will push people in his direction: “After all, we’re selling Cadillacs at Chevy prices,” he says. He has good reason to beam: some 33,000 Americans came to his outfit last year alone.
Behind the mask

How will that affect the health systems in rich and developing countries? Listen to critics of medical travel, and you might think that all of this is a tragedy. It has come about, they argue, because of the terrible state of America’s health care, and its consequences for developing nations will be dire. The flow of foreigners will encourage capital and trained staff to flee state-run health-care systems in poor countries in favour of better-paying jobs catering to foreigners and local fat cats.

It is surely right that medical tourism is partly the result of the failings in America’s health system. Moreover, recent research by the World Bank does indeed suggest that “internal brain drain” is a worry in some countries, especially those with few doctors and nurses.

However, in many huge net exporters of doctors and nurses, such as India and the Philippines, an internal brain drain is hardly much of a worry, because there are plenty of medics to go around. And shortages, in countries where they exist, can be alleviated by reforms changing the way nursing education is funded, for instance, that would help to improve their ailing state-run health systems.
A good prognosis

What is more, there are good reasons for thinking that medical tourism will help poor countries. For one thing, private hospitals did not cause the state sector’s neglect of the poorest. Long before medical tourism or private hospitals took off, the state-run hospitals of India and most other developing countries were a shambles. This was chiefly the result of bureaucratic incompetence and corruption, not poverty—as the decent health-care systems in other developing countries like Costa Rica, Malaysia and even Cuba make clear.

Besides, the rising standards at private facilities promise to have important knock-on effects that may benefit even the poor. The World Bank has observed that the rise of high-quality private clinics in Trinidad and other parts of the Caribbean, for example, has encouraged highly educated doctors to return home.

Mr Bali has seen this reverse brain drain at work in his own company. In the past few years, more than two dozen top doctors returned to India from Britain and the United States, he says, because his firm offers them world-class facilities and rewarding work. He rejects the notion that only a handful among the elite benefit from his chain’s excellence, pointing out that Wockhardt’s expansion into second and third-tier cities in India means many ordinary people now have ready access for the first time to such specialisms as cardiac care and orthopaedics.

Standards, as a result, are rising. Several decades ago very few hospitals in poor countries could claim to offer the highest quality of heath care. Today, there are dozens of hospitals around the world that meet the stringent requirements for accreditation by the respected Joint Commission International, a non-profit outfit that assesses the quality and safety of health-care programmes. Indeed, gaining the commission’s seal of approval has become a price of entry into the serious market for global medical travel.


Tom Johnsrud of Parkway Health, a big Singaporean hospital chain with operations in Brunei and China, explains that foreigners make up 35-40% of his firm’s patients: “American patients will not make or break any international hospital, but being able to attract them will enhance its reputation.” So although hospitals may raise standards to attract foreigners, local patients will benefit too.

Some international hospitals may even leapfrog over their American counterparts. The best of the bunch are being created from the ground up, without the burden of old buildings and equipment, politicised unions and other baggage that weighs down American hospitals. When Bumrungrad looked for information technology to run its operations a decade ago, it found that vendors were so wrapped up in the arcane and fragmented ways in which rich-country firms do business that they could not manage to design a complete computer system from scratch.

Undaunted, the firm set about the job itself, using best practice from other industries. This was possible, says Mr Schroeder, because his firm’s edge is not only based on cheap labour, though labour costs make up 18% of his total, compared with perhaps 55% at American counterparts. He says, “the bigger difference is the way health care is delivered.”

The firm’s IT proved so much better than that from American or European specialist firms that Microsoft last year took over Bumrungrad’s Global Care Solutions division. Peter Neupert, who heads the American software giant’s efforts in this area, was so impressed that he has decided to put the headquarters of his international health efforts in Bangkok. This leapfrogging is an example, he says, of how “innovation will come from many places as the health-care market goes global and flat very fast.”
Costectomy

As far as America is concerned, there will be limits to the impact of health tourism. Many medical procedures cannot be done abroad safely, concerns about legal liability and malpractice will always linger, and the medical lobby may yet try to blunt this trend. Bumrungrad’s Mr Schroeder argues that his hospital is “not the solution for America’s health-care problem.”

He is right that health care abroad is not a substitute for difficult reforms at home. But medical travel could serve as a catalyst for those reforms. Rajesh Rao of IndUSHealth, a middleman that helps insurers and employers co-ordinate medical care in India, reckons medical travel “is not really about exporting patients, it is importing competition.”

A bit of rivalry from top foreign facilities may introduce transparency and price competition into an inefficient system riddled with oligopolies and perverse incentives. For example, American and European hospitals may cut prices once they realise how much potential business they stand to lose. By Deloitte’s reckoning, medical travel will represent $162 billion in lost spending on health care in America by 2012. There are signs that American health-care administrators are starting to feel the heat. European hospitals may not be immune from such pressure, either. On one estimate, some 50,000 British medical tourists headed overseas in 2006, spending millions of pounds for care in such places as Turkey, India and Hungary.

Aetna’s Charles Cutler confirms that hospital authorities are now “very aware of the competitive threat,” from abroad. The case of Hannaford, the New England grocer, has already prompted local hospitals to reconsider their pricing policies. Christus Health, a health-care provider in the American southwest, has hedged its bets by buying Muguerza, a hospital chain based in northern Mexico, and is now touting its own medical tourism schemes there. And its boss, Thomas Royer, says that his firm is about to expand further, into Peru.

Medical tourism promises to be what Aetna’s Dr Cutler calls “a disruptive market force that improves cost and quality here in America.” Whether or not it turns out to be all its boosters wish for, it will be a force to be reckoned with.

TSC receives approval of Cent Outlay of Rs 7,816 crore (http://economictimes.indiatimes.com/articleshow/3394836.cms)

NEW DELHI: Government's ambitious Total Sanitation Campaign (TSC) that envisages the achievement of providing total sanitation in all villages of the country by 2012, has received an approval of Central Outlay of Rs 7,816 crore for the 11th Five Year Plan.

Minister for Rural Development Raghuvansh Prasad Singh told mediapersons today that under TSC, the Union Cabinet last week also approved the increment in the unit cost for construction of latrines to Rs 2,500 from the existing Rs 1,500.

The unique aspect of this scheme is that even though the government has increased the unit cost, villagers on their part would only have to pay Rs 300 from their pockets, an amount that they have been giving since 2004.

Marksans Pharma acquires UK-based Relonchem (http://www.financialexpress.com/news/Marksans-Pharma-acquires-UKbased-Relonchem/354455/)

Drug maker Marksans Pharma on Thursday said it has acquired UK-based generic pharmaceutical company Relonchem for an undisclosed amount.

"The acquisition give us an immediate marketing, distribution and sales presence in the highly profitable but regulated generic markets of UK and Europe," Marksans Pharma Managing Director Mark Saldanha said.

He added that "with its profitable operations and immense market of opportunity, this acquisition will be profitable from the beginning, adding value to all stakeholders."

Relonchem is engaged in licensing, marketing and supplying generic pharmaceutical products in major therapeutic classes.

The company has registered sales of around 32 million dollar in financial year 2007, Marksans Pharma said in a filing to the Bombay Stock Exchange.

"This is our second acquisition in Europe after Bell's & Sons and is significant milestone which will become one of the key drivers to Marksans' global growth strategy," Saldanha added.

UK accounts 26 per cent of the generics market in the European Union. The country's generics market is one of the worlds' largest in terms of both size and generic penetration with a projected size of 7.6 billion dollar by 2009.

"A value added Indian manufacturing base of the company will give us tremendous cost benefits and create value among our customers locally," Relonchem CEO John Rupral said.

Dishman to invest Rs 500 cr in two SEZs (http://www.financialexpress.com/news/Dishman-to-invest-Rs-500-cr-in-two-SEZs/354536/)

Drug maker Dishman Pharmaceuticals on Thursday said it will invest Rs 500 crore in two special economic zones and has completed acquisition of land in this regard.

Total area acquired for its pharmaceutical and chemical SEZ is 390 acres and the land acquisition for its engineering SEZ is on the verge of completion, Dishman Pharmaceuticals said in a filing to the Bombay Stock Exchange.

The company would apply for notification of both the SEZ in next 15-30 days and expects to begin work on both the SEZs by last quarter of this year, Dishman added.

Further, the company said it is venturing into manufacturing and marketing of disinfectant and sensitisation products in India, Saudi Arabia and Australia and expects to reach 100-crore sales in three years from this new division.

"Dishman will make formulated products for hospitals, domestic use and industrial disinfection. In India and Australia, this will be done by the company and its Australian subsidiary where as in Saudi, this will be under a JV called Dishman Arabia Ltd with a Saudi partner," Dishman added.

Meanwhile, the company has said it is building Asia's largest facility to manufacture Cancer drugs and other high potency drugs at its Bavla plant in Gujarat and has invested Rs 50 crore in building this facility.

NEW DELHI: Eight states are already imposing penalty on those caught smoking in public, even before the official ban on tobacco consumption in gov
Ban on smoking in public
ernment or private buildings comes into effect from October 2.

The states include Delhi, Jharkhand, Andhra Pradesh, Orissa, Kerala, Tamil Nadu, Madhya Pradesh and the UT Chandigarh. The rest of the states, health ministry officials said, will start penalising smokers with a maximum fine of Rs 200 from Thursday.

Delhi, in fact, started imposing a penalty against smoking in public in 1997 and has eight raid teams in place. The state, on an average, collects Rs 7 lakh annually by way of penalty. In 2007-08, the teams fined 5,739 men and 18 women for smoking in public after raiding 22,988 premises and 32,239 vehicles.

Speaking to TOI, a health ministry official said: ‘‘All health secretaries have been given the prototype of the challan. It is now the duty of the health secretary to print these centralized challans and distribute it to their gazetted officers. States which don’t have the challan books ready can ask its traffic police to use the challan used for traffic violation.’’

Health Minister A Ramadoss said the law will discourage smokers and help them quit. ‘‘I’m confident that in due course of time, all states will implement the law in toto.’’ According to Ramadoss, the health department in every state has to print the numbered receipt books and challan books immediately for distribution to authorized officers for ensuring proper accounting of fines imposed on the offenders.

The Centre has also given the states options on what to do with the fines collected — create a new account and pump the money back into the state’s tobacco control programme or retain some amount and deposit the rest into the treasury.

‘‘This is a social movement. First, there has to be increased awareness about the new law that bans smoking in public. This will improve voluntary compliance. The law also empowers the non-smoker. Challaning and penalizing people with a fine will be the last resort,’’ an official said.

According to the latest law — Prohibition of Smoking in Public Places Rules 2008 — tobacco consumption is banned in all government or private buildings and public places like small cafes, restaurants, schools, pubs or discos, stadiums, airports, hospitals and bus stands.

Source (http://timesofindia.indiatimes.com/India/8_states_already_penalising_smoking/articleshow/3546530.cms)

THIRUVANANTHAPURAM: The National Rural Health Mission (NRHM) has allowed many states to innovate themselves in the health sector and this has resulted in an unbelievable 150 innovative schemes that have been implemented in different states.

This was the major benefit the NRHM has produced in the country after three years of its launch. The states have started thinking on their own on how to improve their health standards, said National Mission Director, NRHM, G C Chaturvedi.

Till few years ago the health sector across the country was concentrating just on the inputs like providing drugs, equipment and doctors to hospitals.

But now with the implementation of the NRHM the entire states have started concentrating on the output that has to be produced. Rather than concentrating on individual factors, the NRHM has paved the way for a holistic approach in concentrating on the service provided by the healthcare institutions, he said while speaking to Express.

The focus is now on empowerment of ASHA workers. This would make people demand the kind of services they want from the hospitals, which is the ultimate aim. The strong force of ASHA workers will be empowering people on their health needs, which in the next few years time is all set to make a revolution in the health sector, said the Mission Director, who was in the city to attend the regional review meeting of the reproductive Child Health programme.

While setting aside all the apprehensions on the future of NRHM after 2012, Chaturvedi said if the Centre-State share for the scheme is 85-15 percent respectively, after 2012 it would become 75-25 percent. It was the commitment given by the Centre during the launch of the NRHM.

On the performances of different states on implementing NRHM schemes, he said Tamil Nadu and Gujarat have given exemplary performance since they started it on time. Though Kerala was a bit late, it has picked up very well and has given an impressive result. The Centre has identified 18 states in the high focused category, which has been found very poor in disease control due to diverse reasons.

He said, in Kerala the focus now should be on geriatrics, mental health and deafness, among others. The state has already set an example in dealing with the management of non-communicable diseases. It is on par with the parameters of several developed countries. The mental health programme is going to be launched in a big way in Kerala.

But is the shortage of doctors affecting the NRHM activities in Kerala? Pat came the reply from Chaturvedi: ``Come to Bihar, Chattisgarh or Jharkhand, I will show what the real shortage is. Kerala is blessed in that way.’’

Source (http://www.expressbuzz.com/edition/story.aspx?artid=aanS0qDwMXg=&Title=NRHM+revolutionising+health+sector&SectionID=lMx/b5mt1kU=&MainSectionID=lMx/b5mt1kU=&SEO=NRHM,HEALTH&SectionName=tm2kh5uDhixGlQvAG42A/07OVZOOEmts)

Quality marks for generic drugs may be must soon

A quality mark for generic medicines is on the cards. The government and the industry are in talks to introduce quality marks for these
medicines to ensure consumers don’t buy sub-standard drugs.

It is learnt that suggestions to this effect were made in a recent meeting of the department of pharmaceutical and the industry. As the department plans to open drug stores which would sell only generic medicines, the latest initiative would help it to ensure only quality medicines are sold through the proposed network.

Generic drugs are medicines sold without any patent protection. However, they are identical to their branded counterparts in terms of dose, strength, efficacy and use.

Quality of all medicines is now monitored by the health ministry. The Drugs Controller General of India (DCGI), which is under the ministry of health and family welfare, looks into the safety and quality of drugs before giving them marketing approval. However, there is no provision for quality marks in the Drugs and Cosmetics Act, 2005.

It is understood that the government is planning to act tough to deal with quality of drugs manufactured and sold in the country. While quality parameters are being made mandatory, quality marks on the lines of ISI and Agmark would further strengthen the system and help consumers distinguish between approved generic medicines and substandard drugs.

The idea of introducing quality marks for generic medicines was first mooted by the Pronab Sen Committee since a number of small scale pharmaceutical units are getting into manufacturing of these drugs. The idea was also supported by the Planning Commission in its recommendations for the 11th five-year Plan ending 2012.

According to experts, India has achieved a strong foothold in the global generics market. In 2002, Indian companies accounted for less than 7% of all generic drugs approved for marketing by the US Food and Drug Administration, but the share grew to more than 20% in 2006.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Quality_marks_for_generic_drugs_may_be_must_soon/articleshow/3582097.cms)

P&G to launch new health care products from parent co's stable

Proctor & Gamble Hygiene and Health Care Ltd plans to launch personal health care and feminine care products developed by its parent c
ompany, Proctor & Gamble Co, a top company official said.

"We will launch personal health care and feminine care products in the Indian market shortly," P&G's Chairman Bharat Patel told shareholders at the company's annual general meeting (AGM) here today.

However, Patel declined to says which products would be launched first.

In FY 2008, the company's premier brand, Vicks Vaporub, touched the 25 per cent share mark for the first time and Vicks cough drops recorded its highest-ever sales in a single year, registering a growth of 27 per cent over last year.

Its another brand, Whisper, also grew its market share for the fifth consecutive year and reached the golden 50 per cent share mark, Patel said.

Commenting on royalty payment to its parent company, Patel said, "we pay 5 per cent of royalty to our parent and in return get products from P&G, which spends USD 2-billion on research and development."

The company also continued with the expansion of capacities for manufacturing feminine products at its Goa plant with a capital outlay of Rs 10-crore. Similarly, the company made a further capital investment of Rs 26.7 crore in its two manufacturing units at Baddi in Himachal Pradesh, Patel said.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/PG_to_launch_new_health_care_products_from_parent_cos_stable/articleshow/3581728.cms)

cross posting from the science and technology thread


Biocon invests Rs 100 cr in R&D

Biotechnology major Biocon will be investing Rs 100 crore in the next fiscal in enhancing its Research and Development to keep pace with increased orders from multi-national firms as leading global firms have cut down on their expenditure of R&D.

"We will be investing Rs 100 crore in 2009-10 for enhancing our Research and Development," Biocon Chairperson and Managing Director Kiran Mazumdar Shaw told reporters on the sidelines of India Economic Summit here. The company has earmarked an investment of Rs 60 crore for the current fiscal, she added. "We have seen an increase in research activities coming to our company during the current financial crisis as there has been a pressure on big pharma companies, mainly from western world, to cut expenditure on R & D," Shaw said.

The current economic downturn has not affected Biocon much, she added. On the source of funding the expansion plan, she said, it would be through internal accrual. When asked about the company's forecast during the current fiscal Shaw said, " We will meet what we had internally forecasted.... It will be a double digit growth".

On its R and D programme she said, two of its molecules for the treatment of diabetes and psoriasis is under development and have entered in phase-III of clinical trials.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Biotech/Biocon_invests_Rs_100_cr_in_RD/articleshow/3722997.cms)

India turning affordable, quality option for medical tourists

India was soon growing to be a popular medical destination following the availability of health care facilities that matched
international standards but offered it at a fraction of the cost abroad.

The estimated international medical tourist arrivals to India was 4,50,000 as against Singapore's 4,20,000 and over a million in Thailand, said Vishal Bali, CEO, Wockhardt.

Nearly 13 hospitals in India had been JCI (Joint Commission International) accredited. JCI was the US-based quality assessor that awards accreditation to hospitals outside US.

The Deloitte Study on medical tourist estimates that 750,000 Americans travelled abroad for health care in 2007 and the number is estimated to increase to six million by 2010.

The study estimates that the Global market for Medical tourism tobe currently at 60 billion dollars.

The growing cost of healthcare in the US, the high premium to be paid is leaving a lot of American out of the insurance cordon. Nearly 70 million US citizens were underinsured or not insured. In comparison health care cost in India was nearly just a fraction of the cost incurred in the US.

A cardiac surgery, which would cost 9000 USD, in India would cost around 75,000 to 100,000 USD in the US. A spine surgery costing around 8000 to 9000 USD in India could cost around 65,000 USD while a joint replacement in India would have a patient paying up around 8500 USD while it would cost around 55,000 to 65,000 USD in the states, says Bali.

Even with the travel to India and stay cost involved, patients would still end up paying much less if they chose India as an option to undergo treatment, he said which was leading to more US patients looking to India.

source economictimes.com (http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Healthcare/India_turning_affordable_quality_option_for_medical_tourists/articleshow/3729654.cms)

Apollo launches breast clinic



BANGALORE: Apollo Hospitals on Thursday announced the launch of an exclusive breast clinic for diagnosis treatment and complete management of
breast health and issues.

The clinic would not only cater to detection, diagnosis and treatment of cancer but also cater to non-cancerous cases. Persons keen in going for cosmetic surgery for augmentation or breast reduction could also avail of the services available in the clinic, said Dr Bapsy, senior consultant oncologist.

The multi-disciplinary breast clinic would offer consultation, diagnosis, treatment and surgery for all breast related issues. It would have oncologists, cosmetic surgeons, radiologists, pathologists, genetic counselors, nutritionists, physiotherapists, Gynaecologists, social worker and nurses.

"Every case will be reviewed by team of doctors giving the patient a benefit of a broad range of specialist opinions. The treatment involves a collective approach ensuring better accuracy and patient recovery time", said Dr Naveen Rao.

The tests on patient will be conducted over the course of just one visit to the clinic. The treatment of options for cancer cases would include chemotherapy, radiation, surgery and other innovative treatment procedures available.

"Patients will be counselled and put through rehabilitation programmes", said Dr Anil Kamath, consultant oncologist.One in every 22 Indian women are likely to develop breast related disease during their life time as per the Indian Council of Medical Research, said Dr Bapsy.

However, most women continue to be extremely shy and were reluctant in approaching a doctor with complaints relating to breast related problems.Eighty percent patients came very late due to excessive shyness,the doctor said,adding the clinic would attempt to disseminate information to get women seek faster diagnosis

Genzyme to set up R&D centres in India



NEW DELHI: Biotech major Genzyme may develop advanced biotech drugs targeting the specific need of Indians. The company also plans to bring its
complete range of global pipeline used to treat ultra rare diseases and set up research and manufacturing plants in India.

“Some of our molecules are at an advanced research and pre-clinical stages. We are looking at developing some of them keeping Indians in mind if the disease has a wide prevalence among Indians," Genzyme CEO Henri Termeer told ET. The company currently markets two drugs in India while some others are being examined for regulatory approval.

In the next 12-months, the company will launch a few more products and increase its workforce of 13 employees to over 50 in the next year or so. It will also bring all its 15 products and those undergoing development in India in the next few years.

The $4.6-billion company may also conduct research in India and manufacture products here. “Earlier, drugs were launched in India after they have met the needs of other markets. Now, India is the driver of innovation and not stabiliser. It makes sense for us to have local manufacturing and clinical development in India over a time period,” he said.

Although the company’s drugs are not patented in India, the company says it will not have competition in India. “Our products are highly complex biotech drugs which will not be easy for generic companies to develop.

Since they target ultra rare diseases there is little economic sense for generic companies to develop a similar generic version, “ Mr Termeer added. For example, one of its drug cerezyme used for enzyme replacement in treatment of gaucher diseases has treated only 5,500 people globally in the last 19 years.

Apollo to invest Rs 1,400 cr on hospital, clinic expansion


NEW DELHI: Medical care provider Apollo Health and Lifestyle plans to invest around Rs 1,400 crore in the next three-four years on expanding its
presence across the country with its different formats.

The company will spend Rs 600 crore in setting up around 30 hospitals in Tier II cities across the country under the brand 'Reach Hospitals' and Rs 600 crore to increase the number of Apollo Clinics to 300 in a period of three to four years. It is also investing Rs 200 crore on expanding network of maternity hospital chain, Cradle.

"The Reach Hospitals are specifically designed hospitals for the Tier II cities and some of them would have specialised services such as cardiology or cancer care and each of them would costs around Rs 20 crore, excluding real estate costs," Apollo Health and Lifestyle CEO Ratan Jalan said on the sidelines of retail event 'Franchise India 2008'.

Each of these hospitals would have a capacity of around 100 beds and would require an investment of around Rs 20 crore each, he added.

The company is also looking to increase the number of Apollo Clinics to 300 from the present 45 within a period of three to four years.

Jalan said most of these clinics would be set up through franchise mode. They would require an investment of around Rs 2-3 crore each.

The company would also invest around Rs 200 crore in the next three years on expanding its maternity hospital chains under the brand, Cradle by setting up around 30 more such centres in Tier I and Tier II towns.

Govt plans tax-free bonds to fund drug research venture

http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/Pharmaceuticals/Tax-free_bonds_to_fund_drug_research_venture/articleshow/4247901.cms?curpg=1

The government is planning to issue tax-free bonds worth up to Rs 10,000 crore ($2 billion) to the general public every year until 2020 as part of an ambitious plan to fund a massive drug discovery plan aimed at making India a global leader in new drugs.

The amount, which will be used to build institutions, train people and discover drugs, figures in a proposal by chemicals and fertilisers minister Ram Vilas Paswan being considered by Prime Minister Manmohan Singh now. The intention to make heavy investments in drug research was announced earlier this month.

India accounts for less than 1% of the $130 billion spent worldwide on drug discovery, despite having the fourth-largest drug industry in the world by volume. Much of India’s strengths in this sector are in making copycat versions of popular drugs discovered abroad and making medicines whose patents have expired. The government now aims to have one out of every five new drugs discovered by 2020 to be from India.

An official in the department of pharmaceuticals said the government may hire a fund manager such as UTI Asset Management Company to raise the funds, which will be available to companies for undertaking research into new drugs.

Once the Prime Minister signs on the proposal, it would take about six months to work out further details, said the official, who asked not to be named. The finance ministry has to give the necessary approvals for the project before the implementing agency, which will have officials from several ministries, raises funds from the public.

The Centre cannot fund this large amount for drug discovery from its tax receipts or its regular borrowings, particularly now, since tax receipts are falling and borrowings are well ahead of budget.

The fiscal deficit — the gap between most of its receipts and expenditure — is expected to more than double the budgeted target to 6% of the
total value of the country’s economic output, or GDP, in the current fiscal year to end-March. The government expects it to remain high at 5.5% of GDP next fiscal year.

Tax-free bonds will give retail investors an opportunity to take part in the fortunes of the scheme, especially it leads to the discovery of blockbuster drugs. Even in cases where the project fails, the government would guarantee a minimum return on investments. It is estimated that only one in six experimental drugs makes it to the market.

Industry leaders and analysts welcomed the government move to fund drug research by private companies, especially to find drugs relevant for diseases that afflict emerging economies. “The move by the government is very encouraging and desirable. New drug discovery is a high-risk activity with very low success rate. It is like finding a needle in a haystack,” said Ramesh Adige, president at Ranbaxy Laboratories.

“Since Indian companies have scientific capabilities, financial support from the government will go a long way in helping them come out with new chemical entities, particularly in the neglected disease areas and for diseases endemic in the Indian sub-continent,” he added.

PricewaterhouseCoopers associate director Sujay Shetty said the move was appropriate at a time when drug firms find it difficult to invest in risky research due to the global financial meltdown.

Pfizer to set up 600 smoking cessation clinics in 2 years

http://economictimes.indiatimes.com/News/News-By-Industry/Cons-Products/Tobacco/Pfizer-to-set-up-600-smoking-cessation-clinics-in-2-years/articleshow/4247846.cms

Pfizer India plans to launch 600 smoking cessation clinics across the country in the next two years in partnership with private sector hospitals and clinics. Pfizer India director (pharmaceutical marketing) Anjan Sen said, “We have already tied up with 150 clinics in 17 cities, including Max Healthcare, and are in talks with more hospitals for partnerships. We are also in talks with the government to use this as a treatment option in the 600 clinics that they plan to set up.”

The government had last year announced to launch same number of clinics. The government clinics will use nicotine replacement therapies (NRT) like chewing gum and patches, along with counselling, to help people quit smoking, a method that doctors say has far less success rate than medication which blocks the receptors in the brain absorbing nicotine.

According to Mr Sen, the government will shortly conduct a clinical trial of the Pfizer drug, Champix, to check its efficacy and if satisfied it will become a part of the government’s anti-smoking programme.

Anti-smoking aids are scarce in India. Nicotine chewing gums and patches that are sold over-the-counter (OTC) in developed countries are rarely available in the country. While select pharmacies have started stocking nicotine chewing gums, patches that deliver the nicotine directly to the brain without the add-on chemicals which are present in cigarettes are available in the grey market.

Sandeep Budhiraja of Max Healthcare said: “Nicotine patches are not available in pharmacies because there are some procurement issues. So, we cannot prescribe this to smokers. Nicotine chewing gum, which are available now in pharmacies, has problems with dosage.” A smoker looking to chew gum to kick his smoking habit has to chew 12 pieces of gum a day. Mr Budhiraja feels that drugs, however, give better results and fewer cases of relapses.

Reports estimate that there are at least 120-million tobacco users in India and by 2010 one million people will die each year from tobacco related illnesses. According to World Health Organisation (WHO) reports, 80% of the eight million people who will die every year from smoking related diseases will be from developing countries by 2030.

The ‘New England Journal of Medicine’ in 2008 said smoking could soon account for 20% of all male deaths and 5% of female deaths between the age of 30 and 69. It also said men who smoke cigarettes in India shorten their lives by 10 years.

“Drugs block the receptors in the brain which absorb nicotine. So even if a person was to smoke while on the drug, he won’t feel the benefit. With a patch, the dosage for each person becomes difficult to estimate,” said YA Matcheswalla, a psychiatrist who counsels people looking to quit smoking. Pfizer is also in talks with Masina Hospital for a possible partnership, he said.

Govt to spend $2 b annually till ’20 on drug discovery

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Govt-to-spend-2-b-annually-till-20-on-drug-discovery/articleshow/4262518.cms

he Department of Pharmaceuticals (DoP) will soon come out with a White Paper on Vision 2020. The purpose of the report is to promote
drug discovery and innovation-based pharma industry in the country, and it entails government spending to the tune $1-$2 billion annually until 2020.

During a seminar on ‘Scenario of Pharma Industry, Present & Future’, Ashok Kumar, secretary, DoP, said in Ahmedabad on Friday that his department would prepare a study report promoting drug discovery. The seminar was held on the second day of informEX India 2009, an exhibition on pharmaceutical and chemical industries, being held outside the US for the first time in 25 years. Apart from Mr Kumar, other speakers included PV Appaji, executive director, Pharmexcil and Pankaj Patel, CMD of Zydus Cadila and chairman of advisory committee of InformEx 2009.

The initiative will enable India capture about 10-20% share of the world’s R&D business. “Thus we can expect that one out of every five to ten new drugs would be discovered and developed in India,” Mr Kumar said. During the seminar, Mr Kumar said that global slowdown had lesser impact on India and a minuscule effect on pharma companies. However, the fact is, there is a worldwide curb on spending. Even government spending has been curtailed.

The DoP initiative aims at creating India as a hub for cheaper drugs. “This is an advantage also for us, especially during the slowdown phase,” he said, adding that our industry has lot of problems to face right from logistics, bank finance and exchange rates fluctuation. “In government, we do not understand business, but we are trying to sort it out,” he remarked.

“We are good in generics and this is our strength. We have ability of backward engineering, but we lack innovation,” he added. Mr Kumar said about $103 billion worth of patented drugs will go off patent in the years to come. If India and China are able to secure even 30-35% of these, then the entire industry will be well off.

Frontier Mediville gets India’s first hospital SEZ

http://economictimes.indiatimes.com/News/Economy/Infrastructure/Frontier-Mediville-gets-Indias-first-hospital-SEZ/articleshow/4261711.cms

CHENNAI: The upcoming Frontier Mediville project of Frontier Lifeline at Elavur near Gummidipoondi has been accorded the status of a special economic zone, making it the first hospital SEZ in India.

Frontier Mediville would be established as an international and diversified platform providing medical services in concepts namely, healthcare, education, and research. It will house India’s first national medical science park (NMSP) as its maiden venture under SEZ.

In November 2007, the project was formalised through a collaboration with the Tamil Nadu Industrial Development Corporation (TIDCO).

The NMSP would be a hub for research and training and develop treatment methodologies with specific focus on regenerative medicine. It is proposed as an advanced medical technology research facility that would use biosciences, involving micro-level concepts such as nano-technology and genetic application, and biotechnology.

This facility would be exclusively dedicated to basic and applied clinical research, development and commercialisation of technology for use of both preventive and curative healthcare, a release from the hospital said on Friday.

It would also have a symbiotic relationship with the proposed 1,000-bed multi-speciality bio-hospital; an emerging concept combining present-day clinical medicine with regenerative medicine and basic sciences enhanced with holistic therapy. The bio-hospital in Frontier Mediville will be the first of its kind in India and one of 18 proposed around the world, it said.

India has got a good chance in pharmaceutical segment....I hope govt spends as it has planned....

^^

Yeah, let's hope so. We all know the government usually don't put its words into action.

An artificial heart for Rs 1 lakh, courtesy IIT-Kharagpur

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/An-artificial-heart-for-Rs-1-lakh-courtesy-IIT-Kharagpur/articleshow/4284972.cms

It'll be to coronary care what Nano is to cars, say scientists at Indian Institute of Technology, Kharagpur, who have devised an artificial heart that could save lives for just Rs 1 lakh.

The research team says trials of the prototype lab—constructed heart have been successful on small animals and the gadget is being perfected on goats. The institute has applied for permission to conduct human trials.

The Total Artificial Heart (TAH) — said to be the first such in the country — has been developed by a team of scientists at IIT-Kgp's school of medical science and technology.

After four years of painstaking research, the scientists say their creation is better and far more affordable than the first artificial heart developed in the US, which showed a ''high rate failure'' and at Rs 30 lakh, beyond the reach of the common man.

The inventors hope to fit the heart into an ailing patient within a few months, once permissions from the Indian Council of Medical Research come through. The unique 13—chamber heart is working fine in small animals, said a member of the team. Human tests are to be conducted at Medical College and Hospital (MCH), Kolkata. Senior cardiac surgeons — Madhusudan Pal, Bhaskar Ukil, Tarun Saha and Kalishankar Das from MCH and Rajiv Narang of AIIMS, Delhi — will conduct the human trials.

''We are also in touch with P Venugopal, former AIIMS director and one of the leading cardiac surgeons of the country. We expect him to be part of the team as well,'' said Sujoy Guha, IIT-Kgp faculty member and bio-medical engineering expert, who is leading the artificial-heart team.

''The TAH will be of great help to patients whose heart muscles have become so weak that they need immediate transplantation. Angioplasty, stents and even bypass surgery are of no use for such patients because they cannot strengthen muscles. It is difficult to find donor organs and even if transplantation is done, the body develops auto rejection and severe medication is required to suppress immune reactions," said Guha. ''TAH will be a life-saver, for the price of a Tata Nano,'' said one of the scientists. ''Bengal may have lost the Nano, but the world cannot miss this Rs 1-lakh invention.''

Zydus Cadila eyes $3 bn annual sales by 2015

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Zydus-Cadila-eyes-3-bn-annual-sales-by-2015/articleshow/4289120.cms

Ahmedabad-based drug maker Zydus Cadila is aiming to clock USD 3-billion sales by 2015, while it expects to cross the USD 1-billion mark by 2010.

In a presentation made to investors, the company said it "shall be a leading global healthcare provider with robust product pipeline and sales of over USD 1 billion by 2010. We shall achieve sales of USD 3 billion by 2015 and be a research -based pharmaceutical company by 2020."

While it did not specify how it will become a USD 3- billion firm by 2015, the company is looking at its overseas sales to contribute 45 per cent to its overall sales by 2010, compared with 37 per cent in 2007-08.

Exports contributed around USD 217 million to its over- all revenue in 2007-08 fiscal, which the company expects to increase to USD 450 million in 2010-11 fiscal, a growth of over 100 per cent.

Of the projected USD 450 million from exports, Zydus cadila expects USD 250 million from sales of formulations to developed countries and USD 80 million from emerging markets.

Besides this, the company plans to file around 12-15 abbreviated new drug applications (ANDAs) every year and it also plans to launch 8-10 products every year as part of its plans to achieve the 2015 target.

The company has clocked a revenue of Rs 2,325 crore in 2007-08 fiscal.

B. Anand, Joint Secretary, Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, has said that 60 per cent of the people in the country depend on traditional medicine for their health. All these systems were recognised by the government. For the development such systems, Rs. 1,200 crore had been released in the 10th five-year-plan and Rs. 4,000 crore in the 11th plan.


Source: The Hindu (http://www.hindu.com/2009/03/22/stories/2009032252580300.htm)

Ranbaxy says India plant gets UK, Australia nod

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Ranbaxy-says-India-plant-gets-UK-Australia-nod/articleshow/4304352.cms

Ranbaxy Laboratories Ltd said on Monday drug regulators in the UK and Australia had approved its manufacturing facility in north India that was earlier the target of US regulatory action.

Ranbaxy, majority owned by Japan's Daiichi Sankyo, said Medicines and Healthcare products Regulatory Agency (MHRA) of the UK and Australia's Therapeutic Goods Administration issued "good manufacturing practice" certificates for the Paonta Sahib facility after a joint audit conducted last October.

The drugmaker said the MHRA approval would apply to its product filings for the entire European Union.

In February, the US Food and Drug Administration halted reviews of drug applications from Paonta Sahib plant saying test results submitted in approved and pending drug applications were found to have been falsified.

Surya Pharmaceutical to open 500 healthcare outlets

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Pharmaceuticals/Surya-Pharmaceutical-to-open-500-healthcare-outlets/articleshow/4310726.cms

CHANDIGARH: City-based Surya Pharmaceutical will set up 500 healthcare and pharma retail stores in the next three years at an investment of Rs.250 crore, a top official said here on Tuesday.

"The total capital outlay of nearly Rs.250 crore is proposed for this project. Many other big names are also lined up to venture into this field in the next one year," Surya managing director Rajiv Goyal said.

In the first phase, 100 stores will come up in the the national capital region (NCR), he said.

"By March 2010, we would open 100 stores in the NCR (national capital region) and then gradually expand our business towards Chandigarh and Punjab."

Asked about the impact of the slowdown on the pharma sector, Goyal said: "There has been no decline in our exports and in business. This sector is somewhat safe from this slump."

He added that the Rs.40,000-crore Indian healthcare retail market was now growing at 15 per cent.

"We can even expect more than 100 per cent growth as many big MNCs (multi-national corporations) are venturing into the healthcare retail sector," Goyal added.

GE enters home healthcare market in India

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/GE-enters-home-healthcare-market-in-India/articleshow/4311103.cms

GE Healthcare on Tuesday said it has completed the acquisition of medical products manufacturer, Vital Signs Inc and its subsidiary Breas medical AB.

The acquisition of Vital Signs would help the company in expanding its product folio in the home health solutions, GE Healthcare said in a statement.

"Home Healthcare is largely untapped, this global acquisition is consistent with GE's strategy to invest in high technology, innovative business that delivers top-line growth and earning expansions.

This acquisition takes us one step closer to our vision," GE Healthcare South Asia President and CEO V Raja said.

GE Healthcare is 17 billion dollar unit of General Electric Company and it employs more than 46,000 people globally.

India key market for vaccine makers

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/India-key-market-for-vaccine-makers/articleshow/4316693.cms

The vaccine market, earlier regarded as a commodity sector, is re-emerging as a key revenue generator for the Big Pharma.

With the national immunisation program (NIP) gaining more importance, several multinational companies now see India as a key market for their vaccines business. According to market analysis firm Datamonitor, the Indian vaccine market was $665 million in 2007-08 and is growing at over 20%. This market is primarily driven by exports worth more than $360 million. The domestic market for vaccines is $300 million with the private sector accounting for half of it at $120 million.

Novartis, the Swiss-based pharma leader, has a significant presence in the vaccines space in the country. The company has a rabies manufacturing plant as well as a joint ventures with Panacea Biotech and Chiron Panacea Vaccines to develop vaccines for the paediatric immunisation and its commercialisation, respectively.

Ranjit Shahani, Vice Chairman & Managing Director, Novartis (India) told ET, “Novartis already has a presence in the vaccines segment in India and we look to being a significant player in this area by bringing new generation vaccines to the people through innovative business models. We have a strong presence in the oral polio vaccine eradication programme and operate through partnerships with UNICEF and WHO and with Indian companies present in the vaccines market.”

There are six essential vaccines that are a part of the national immunisation programme. Additionally, there are vaccines categorised as newer vaccines and Indian Academy of Paediatrics committee on immunisation recommends medical practitioners to use them after one on one discussions with parents.

GlaxoSmithKline (GSK), an MNC with possibly the largest presence in the country and with a strong vaccines portfolio spanning paediatric, adolescent and adult vaccines, has a strong focus on India. “Globally our DTP and Rotavirus vaccines are a part of immunisation programme in many countries. The decision to include particular vaccines in the National Immunisation programme is the purview of the national health policy,” said a spokesperson.

The company, however added, that would work towards having the Rotavirus vaccine included in the NIP given the epidemiology in the country.

Centre to talk MNC pharma cos into keeping a check on prices

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Centre-to-talk-MNC-pharma-cos-into-keeping-a-check-on-prices/articleshow/4422350.cms#

A government move to regulate prices of patented medicines imported and marketed in India by multinational drug-makers may come as a big relief to those suffering from diabetes, arthritis, cancer and heart diseases.

The proposed mechanism, whereby prices will be regulated in consultation with the drug marketers, is currently being finalised, said a senior official who didn’t want to be named. “After negotiations with the government, companies will sell imported drugs at two different prices—one for bulk medicines sold to the government-run hospitals and the other for the retail market,” he said.

“Forced pricing may lead to shortage of imported drugs and free market would mean these drugs will not be affordable for the poor. Therefore, we decided to arrive at a price through negotiation,” he said.

An official in the department of pharmaceuticals confirmed the move saying the government has called for a meeting on Monday with all the stakeholders, including multinational drugmakers, consumer organisations and patient groups.

While the National Pharmaceutical Pricing Authority (NPPA) regulates prices of all notified drugs sold in the country, the government finds it difficult to keep a check on prices of imported medicines even if they are under price control. Imported brands often circumvent price control norms as the pricing authority has no means of verifying their production cost. To determine the cost, the NPPA relies on MNCs’ version of the production cost and sets profit margins as a percentage of their landed costs. As the margin is decided in percentage terms, raising the landed cost helps MNC drug companies get a higher margin.

The move is expected to benefit consumers as big pharmaceutical companies launch their patented medicines in the country at high prices and with a 20-year patent protection, resulting in monopoly pricing. The proposed pricing mechanism for patented drugs would ensure that essential medicines are affordable for the common man.

A panel chaired by Pronab Sen had first suggested price negotiation for monopoly drugs. The ministry of chemicals and fertilisers appointed a high-level government committee in February 2007 to look into high cost of new medicines in the country.

The committee, chaired by a deputy secretary in the department of pharmaceuticals, comprises representatives from the National Pharmaceutical Pricing Authority, department of industrial policy & promotion, National Institute of Pharmaceutical Education & Research and the Drug Controller General of India.

Govt to stock up on anti-viral pill

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Govt-to-stock-up-on-anti-viral-pill/articleshow/4469984.cms

The ministry of health and family welfare will stockpile 10 million doses of anti-viral tablet ‘oseltamavir’ in the next seven days as a precautionary measure against a possible outbreak of swine flu, which has been officially reported in 11 countries so far.

The medicine will be stocked in different locations across the country to ensure a quick response to any emergency situation, said Vineet Chaudhary, joint secretary in the health ministry.

“We have received price quotations from companies today and will soon place orders,” he told reporters at a press conference. The ministry had sought price quotations for oseltamavir from five drug makers — Ranbaxy, Cipla, Hetero, Natco Pharmaceuticals and Roche.

The government order will provide domestic drug makers a business opportunity of around Rs 250 crore, said a pharmaceuticals industry analyst who asked not to be named. On an earlier occasion, the ministry had procured the anti-viral medicine at around Rs 250 for a strip of 10 tablets.

A Ranbaxy executive said the company could supply 1 million capsules of oseltamavir immediately and will meet additional orders in the next few weeks. Roche India MD Girish Telang confirmed that the company had submitted its quotation to the government and was willing to supply 5,000 doses immediately.

According to the health ministry, there is no suspected case of swine flu in India so far and the threat of the disease is minimal. But the WHO has raised the 'pandemic alert' from phase-4 to phase-5, implying wide-spread human infection of swine flu, which has so far claimed 168 lives in Mexico.

Meanwhile, the government has started screening passengers coming from swine flu-affected countries. Mr Chaudhary said the reported case of one patient
at Hyderabad airport was not correct. “The patient is not showing any symptoms of the flu,” he said. The passenger was returning from Mexico.

The spread of swine flu, caused by influenza Type A virus, have been officially reported in 11 countries including the US, Germany, Canada, Israel and New Zealand.

The rich world’s bloated health-care systems can learn from India’s entrepreneurs (http://www.economist.com/displayStory.cfm?story_id=13496367)

Source: The Economist

That is why Stanford’s Dr Yock wants to turn innovation upside down. He has extended his bio-design programme to India, in part to instil an understanding of the benefits of frugality in his students. He believes that India’s combination of poverty and outstanding medical and engineering talents will produce a world-class medical-devices industry. Tim Brown, the head of Ideo, a design consultancy, agrees. In the past, he notes, health bosses thought all devices had to be Rolls-Royces or Ferraris. But cost matters, too. Pointing to another recent example of India’s frugal engineering, he says: “In health care, as in life, there is need for both Ferraris and Tata Nanos.”

Uniform ethical code for drug cos on anvil

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Uniform-ethical-code-for-drug-cos-on-anvil/articleshow/4537261.cms

The government has directed drug manufacturers to have a common code of conduct for marketing their medicines in the market.

Companies spend a huge amount of money in pampering doctors for prescribing their brands and make these costly for consumers, an official in the department of pharmaceutical said, requesting anonymity.

“Drug companies need to limit promotional expenses and, in certain cases, unethical trade practices. We have asked the industry to frame a uniform code of conduct and it will be enforced,” he said.

Unlike the US, where doctors prescribe formulations and not brands, in India doctors specify medicine brands in their prescriptions. Most of the companies find it easy to market their brands through doctors.

Promotional expenses also include trade margins. While determining price of a medicine, a manufacturer also factors in the marketing costs that make the medicine costly. As consumers are dependent on doctors to choose medicines, they are often forced to buy a costlier brand. “The effort of the government is aimed at restricting the marketing margins so that consumers don’t have to pay more,” the official said.

Marketing margins vary between 5% to 1,000%. The margin includes companies’ expenses on freebies, gifts and jaunts offered to doctors and chemists so that they prescribe and promote their brands. “These promotional costs come as a huge component in the retail price of a drug,” an industry analyst, who didn’t wish to be named, said.

Most of the pharmaceutical organisations like Organisation of Pharmaceutical Producers of India (OPPI), Indian Drug Manufacturers Association (IDMA) and Small Pharmaceutical Industry Confederation (SPIC) have their own codes for their members, but they are not enforced strictly.

The Indian pharmaceutical market is estimated to be at Rs 70,000 crore. Of this, exports account for Rs 25,000 crore and imports Rs 15,000 crore.

Medical tourism has a lot of potential in India
I think our government needs to pay a little more attention to revenue from medical tourism in the country. Our healthcare infrastructure attracts patients from over 56 countries. However, as of today, Thailand is the hub of healthcare because of the country's phenomenal connectivity. In my opinion, if there is a little more flexibility in the system, our country can beat Thailand any time because India's healthcare infrastructure is better than that of Singapore, Hong Kong and Malaysia's put together.



Bangalore will soon be sought after in healthcare
Indian doctors are known for their compassion and warmth all over the world and they have already established their credentials in European and American countries. Given great healthcare infrastructure in the state -- maximum number of medical colleges in the country -- Bangalore will become the most sought after city within the next five years.
Today, India is on par with the US or maybe even better in terms of health care -- our country produces 33,000 doctors in a year, whereas US produces only 25,000. I think it's time we stopped referring to the past to predict the future because today we have the equipment, we have the infrastructure and we have the manpower to become the best.as told to nidhi bhushan

Source: DNA (http://www.dnaindia.com/health/report_city-will-be-a-healthcare-hub-in-five-years_1269148)

Apollo Hospitals net rises 16% to Rs 118 crore
30 Jun 2009, 0127 hrs IST, ET Bureau

Source (http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare--Biotech/Apollo-Hospitals-net-rises-16-to-Rs-118-crore-/articleshow/4718059.cms)

CHENNAI: Apollo Hospitals has reported a 15.6% rise in net profit at Rs 118 crore (including an extraordinary item of Rs 4 crore) for the year
ended March 31, 2009, from Rs 102 crore in the year-ago period. During the period, it clocked a turnover of Rs 1,458 crore compared with Rs 1,125 crore in the previous year.

Apollo Hospitals Group executive chairman Prathap C Reddy said on Monday it had exceeded targets set for last year. Apollo, which has a bed capacity of over 7,500, plans to increase its capacity by 2,400 beds with an investment of Rs 1,500 crore. The group has spent Rs 500 crore on land acquisition and added 200-beds in 2008-09.

About Rs 300 crore had already been deployed by the group on several projects, its ED Suneeta Reddy said on Monday. As part of tying up the debts, she said Rs 300 crore would be brought in through internal accruals, while the international financial institu-tion, IFC had agreed to lend Rs 250 crore by investing in FCCBs issued by the company and in the form of ECB. By way of subscribing to war-rants, the family would chip in with Rs 120 crore.

Within a year, Apollo would commission eight new hospitals. Six hospitals under Apollo Reach initiative were already under construc-tion while the group has decided to engage L&T and Shapoorji Pallon-jee as contractors for the projects in the pipeline, Dr Reddy said.

Apollo invested Rs 300 crore on technology upgradation last year, he added. On the performance of the pharmacy business, Apollo group presi-dent K Padmanabhan said its turnover is expected to be Rs 470 crore this year (Rs 335 crore). On a query regarding debts on books, he said Apollo has Rs 390 crore debts with Rs 110 crore added this year, and its average interest costs were 11%.

Pfizer to set up 600 smoking cessation clinics in 2 years

http://economictimes.indiatimes.com/News/News-By-Industry/Cons-Products/Tobacco/Pfizer-to-set-up-600-smoking-cessation-clinics-in-2-years/articleshow/4247846.cms

It's good to see some corporate social responsibility from the drug giant Pfizer. Nicotine is a major public health problem and setting up clinics to sell nicotine replacement agent or Champix is a good idea.:banana:

Malaysian co plans to set up 15 hospitals in India

http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare-Biotech/Healthcare/Malaysian-co-plans-to-set-up-15-hospitals-in-India/articleshow/4775615.cms

Malaysia-based hospital chain Columbia Asia Hospitals plans to set up 15 new multi-speciality hospitals in India in three years. It plans to invest around $100 million for the expansion which will take up bed strength from 570-odd beds now to over 2,000.

Columbia Asia intends to set up these facilities under the ‘community hospital’ model. Community hospitals are essentially 90-to-100 bed facilities which have expertise in nearly all disciplines, excepting some hi-end treatment. The company has identified few locations like Ghaziabad, Meerut, Lucknow, Pune, Ahmedabad, Trivandrum and Hyderabad for the new hospitals.

"Since we prefer to go alone and invest through the 100% FDI route, the slowdown has not impacted our India expansion plans. Our parent company in Kuala Lumpur is financially strong. In fact, funds for the 15 new hospitals are already in place. We are just finalising the real estate deals," Columbia Asia Hospitals CEO (India) T Ghosh told ET.

Incidentally, Columbia Asia currently operates five hospitals in India — two in Bangalore and one each in Delhi, Kolkata and Mysore. Excepting the Kolkata facility, which is a JV with a local partner, all other facilities are owned by the company. This apart, the group operates 13 hospitals in Malaysia, Vietnam and Indonesia.

"We are also planning to set up smaller 30-bed hospitals in tier IV cities and the first one is coming up in Karnataka. Once we’ve developed the community hospital network, the next step will be to set up 200-bed referral hospitals which will have expertise to treat rare and difficult cases. We plan to expand on the hub-and-spoke model," said Mr Ghosh.

Columbia Asia’s partnership with DLF to develop hospitals in their township projects is also yet to take-off. "We are DLF’s partner of choice and have the first right of refusal wherever they plan to set up a hospital in their township. But due to the realty slowdown, such plans are yet to be implemented," Mr Ghosh said.

PerkinElmer Expands Presence in India with New Center of Excellence in Hyderabad (http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare-Biotech/Healthcare/PerkinElmer-Expands-Presence-in-India-with-New-Center-of-Excellence-in-Hyderabad/articleshow/4776032.cms)

PerkinElmer, Inc, a global company focused on improving the health and safety of people and the environment, has announced plans to establish a
state-of-the-art Bio-pharma Center of Excellence in Hyderabad, India.

The Center which will open in October will be the second high-tech facility recently established by PerkinElmer in India. The Hyderabad facility complements the recently-opened PerkinElmer Technology and Innovations Facility in Mumbai, established in May 2008 and dedicated to environmental health sciences.

The new Bio-pharma Center will provide regional PerkinElmer clients and partners in India with access to established and emerging drug discovery and pharmaceutical quality assurance and control applications and technologies, training facilities and expertise. The Hyderabad facility will also support focused research efforts in screening and profiling technologies. PerkinElmer India customers will have early access to new applications as they are developed, as well as the opportunity to help guide development of future technologies based on their current and emerging research requirements.

Apollo eyes more business overseas, plays down Fortis-Wockhardt deal (http://economictimes.indiatimes.com/News/News-By-Industry/Healthcare-/-Biotech/Apollo-eyes-more-business-overseas-plays-down-Fortis-Wockhardt-deal/articleshow/4933775.cms)
25 Aug 2009, 1956 hrs IST, ET Bureau

CHENNAI: Apollo Hospitals, the largest healthcare provider in the country, plans to set up three more hospitals abroad, even as Fortis, its
closest rival in the domestic market, narrowed the gap by buying 10 hospitals from Wockhardt.

With Wockhardt’s ten hospitals in their kitty, Fortis seems to have made the opening moves in a gambit that could bring them closer to Apollo. The Wockhardt deal will give Fortis an additional 1,902 beds, taking its total capacity to over 5,000 beds compared to Apollo’s 8,000 plus beds.

But Apollo hospitals chairman Prathap C Reddy on Monday played down the development. “I don’t know what’s getting narrowed. We welcome other players in the market. Besides, Apollo is not just a hospital but has other interests such as wellness and nursing colleges.”

Apollo was rumoured to be in the race for Wockhardt’s hospitals but Dr Reddy maintained that he wasn’t interested. “We never valued it. We do not regret not buying it or not considering buying Wockhardt.”

Instead he touched upon the hospital’s plans in the overseas market, particularly, Asia and Africa. Dr Reddy also said that Apollo would continue to add 1,000 beds 1,000 beds every year for the next three years and not shy away from any acquisitions.

It proposes to set up a 200-bed hospital in Shanghai at an investment of $120 million, 150-bed hospital in Vienna for $95 million and a hospital in Nigeria. After hospitals, Apollo would also look at opening pharmacies in these countries, as it tries to maximise its revenues abroad.

Mr Reddy was talking to reporters on the sidelines of a press conference held to announce the completion of 25,000 coronary bypass procedures including 10,000 beating heart surgeries by Apollo.

Of the 36,000 heart operations performed at Chennai, 26,000 have been coronary bypass surgeries. Increasing use of "beating heart" technique has resulted in significant reduction in post-operative complications and a reduction in hospital mortality to around 0.6%, the hospital’s chief cardiovascular surgeon Dr M R Girinath said.

After IT, BPO, medical tourism emerge as fastest growing sector (http://economictimes.indiatimes.com/news/news-by-industry/services/travel/After-IT-BPO-medical-tourism-emerge-as-fastest-growing-sector/articleshow/5038895.cms)

MUMBAI: Despite the global economic downturn, medical tourism has emerged as the fastest growing sector of the Indian tourism industry as it
provides first world treatment to patients at an affordable rates.

Medical costs in India are only 1/3rd or 1/4th of the costs at comparable hospitals in the US, Europe or South Africa, a medical referrals agency said today.

Over 3,00,000 patients have so far come to India for medical treatments from over 30 countries this year earning the country over Rs 8,500 crore in revenue, it said.

"The Indian medical tourism industry is at a nascent stage, but has an enormous potential for future growth and development. This sector has the highest growth potential after IT and BPO and will bracket India among the world's elite healthcare providers," Aarex India, said.

Aarex India is a leading medical referrals agency which receives over 200 enquiries every month from all over the world.

Medical tourism is expected to generate revenue of Rs 10,000-crore by 2012 and over 3,50,000 patients from across the world are expected to come to India for treatment, it said.

Aarex India said countries like the US, UK, Canada, Russia, the Middle-East, Tanzania, Kenya, Uganda, Sri Lanka, Pakistan, Mauritius and the Central Asian Republics are preferring India's affordable medical tourism.

Sunday Celebrity: Dr. Pratap Reddy who revolutionized health care system in India (http://www.asiantribune.com/news/2010/02/01/sunday-celebrity-dr-pratap-reddy-who-revolutionized-health-care-system-india)


By Gopal Ethiraj, Chennai
Chennai, 01 February, (Asiantribune.com):

The Chairman of the Apollo Group of Hospitals, Dr. Pratap C. Reddy, who revolutionized the health care system in India and pioneered the establishment of private specialty hospitals in India, got the Padma Vibhushan, the country’s second highest civilian award, on the occasion of this year’s Republic Day.

Talking to this Asian Tribune writer on Saturday, Dr. Reddy who was receiving a stream of visitors greeting him on his getting highest National award, was in his contended cool spirits. He said 84,000 heart surgeries have been done in 27 years so far with 99.4 per cent success rate comparable with one or two lead hospitals abroad.

Today the Apollo Hospitals Group has over 46 centers in major metropolises (Bangalore, New Delhi, Chennai and Hyderabad) in India with a combined turnover of over US $ 100 million. Mr. Reddy has recently made announcement about the opening of its 47th hospital with 300-bed capacity in Bhubaneswar "by mid-February 2010, in the Temple City of Bhubaneswar (Orissa) with modern diagnostic equipments and super-speciality services.” It will be linked to global centres via a dedicated telemedicine network.

Chennai city is already known as the Health capital of India; Dr Reddy wants to make Chennai, a Diabetics capital, Heart capital and Cancer capital of the world. He says Cancer is ‘death sentence’; however, if it is detected early 100 per cent cure can be found; chances with heart cases are about 60 %. “We must reverse the trend with health care awareness, and making available the best treatment programmes,” he says.

Apollo over the last decade has demonstrated that Indian skills are equivalent to the best centers in the world and has produced world-class results in the most complicated Cadaver Transplant, he says.

Those in power and affluent, used to go for the best medical programmes to the West, a fifty years before. Dr. Reddy brought the ‘West’ here and made it available to the common man at his affordable level. Today people have the opportunity in India to receive the best that healthcare has to offer worldwide.

Dr. Reddy proudly declares that 17 per cent of his patience are from overseas.

How milestone in Indian Healthcare Industry came to be set

What prompted him to do this? In 1979, Dr. Reddi was just back from the States, opting to give up his successful practice in the US in deference to the wishes of his parents to serve in India, and was practicing as a cardiologist, operating to one extent—medical treatment. The complicated cases, he used to refer for surgical treatment to the Houston hospital, US. Dr. Reddy lost his young patient who couldn't make it to US for an open heart surgery for he could not afford to pay $4000. His wife and children’s cries drove him to think how to bring the same that health facility here. That was how the milestone in the Indian Healthcare Industry came to be set in Chennai.

Dr. Reddy says there were about 45, 000 Indian medical doctors in the States, of which about 6000 were specialist doctors. It is the same doctors who handle critical cases that is referred there. He saw through what was lacking here was technology and latest infrastructures, in the absence of these those doctors who have roots in India could not be lured. He got down to narrow down the margin. Driven by a deep urge to create world-class medical infrastructure in India and make it more accessible and affordable to a large cross section of our people, Dr. Pratap Reddy brought both to India—the talented Indian doctors and modern gadgets.

Undeterred by initial constraints Dr. Reddy succeeded in setting up the first center of the Apollo Hospitals Group in Chennai in 1983. He called it Apollo as he wanted to mix ‘medicine’ and ‘science’ together, he says.

This was soon followed by India's first hospital consultancy body - the Indian Hospitals Corporation - and the commissioning of two more Tertiary Care Centers in India. Not only did he set a precedent for corporate healthcare in the country, but the Government of India soon recognized his enterprising efforts leading to Financial institutions amending their funding legislation to include hospitals and board basing the scope of medical insurance.

Dr. Reddy said how two Gandhis helped his venture to grow. Not only that if a small village today is having an ultra sound equipment, it is because of them. When he told Mrs Indira Gandhi that best medical treatment was available to only those in power and affluent, she listened to his point and cut the duty on import of medical equipment from 180 per cent to nil per cent.

When Rajiv Gandhi was Prime Minister in 1989, on Reddy’s representation, the former amended in three days in the Parliament and removed all hardships leading to liberal funding. And so the costliest medical equipments made in roads into Indian hospitals and were equipped on par with the western. Rajiv Gandhi also gave a tax exemption of Rs. 10,000.

He says when he represented the present government; he promptly got the nod for rural health care. He represented his group of hospitals numbering 46 and others numbering about 100 were only placed in metros, what about the 70 per cent of the rural India. The Finance Minister in his latest budget gave 5 year tax exemption to the rural hospitals, that enabling the Apollo-Reach hospitals opening in rural areas

The first three Reach Hospitals would become operational shortly, and financing for the initial stage involving establishment of 20 Apollo Reach Hospitals is ready.

Recently, Apollo Hospitals received $50-million as term loan from World Bank's subsidiary International Finance Corporation (IFC) for growth of its 'Reach' Hospitals.

Dr.Reddy has also been pro-active in modifying government regulations to suit current medical trends. He helped to ease import restrictions and made the government take a more liberal view on organ transplants among others.

Wants to back in Sri Lanka

Having steered the Apollo Hospitals Group to a number of locations within India, Dr. Reddy embarked on an Asian expansion plan with the first clinic in Dubai established in March 1999. Then he launched the Sri Lankan project, which was later taken over by the Insurance partner, and he had to bow out. It pains him, it was to be one of the bests there, it is in doldrums. Apollo here attends to a lot of Sri Lankans. He hopes to get back to Sri Lanka, if the President Mahinda Rajapaksa, who also has peoples’ health care as his prime interest, gives nod. He says he already written to him.

He also has plans to establish hospitals in all SAARC countries.

His newest initiative is to integrate into healthcare, the digital nervous system that will eventually create a virtual Apollo Center anywhere any time. Apollo's major Web initiative, Med Varsity -a virtual medical university providing total access to experts in the field of medicine anywhere in the world and "Mednet" - Hospital Systems Management package are slated to transform the way medicine is practiced in the country.

His plans for improved accessible and affordable healthcare for the millions of our people are an ongoing process and to bring country-wide, comprehensive health insurance scheme to our people is now his obsession.

The telemedicine technology that has been successfully introduced by Dr. Reddy in India will be a key enabler in transforming the healthcare delivery in India. His blueprint for the nation includes setting up of many rural hospitals. Dr. Reddy is now looking at secondary health centers in semi urban and smaller cities and has already identified 23 sites for the same. The maiden effort in this venture has been at Aragonda, his native village and Dr. Reddy envisages that this center will serve as a model for all such projects of the Apollo Group in rural India.

Dr. Reddy has been a keen promoter of active research and exchange programmes for Doctors at Apollo with leading medical institutions for providing excellent opportunities for clinical interaction with their counterparts abroad and also for constant update of their knowledge for the optimum benefit of the mankind.

Honours he received

On receiving the Padma Vibhushan last week Dr Reddy said it was an honour he shared with the 62,000 members of the Apollo family. “At this moment, I miss my parents who brought me back to India (from the US).” The commendation to Dr. Reddy from the Government of India is an acknowledgment of the untiring pursuit for excellence in healthcare and an expression of encouragement from fellow Indians as Apollo strives towards touching a billion lives.

He was earlier awarded the prestigious Padma Bhushan in February 1991. He was also presented with the Sir Neel Ratan Sarkar Award for medical excellence in June 1998. Nominated by Business India as one of the Top Fifty personalities, who have made a difference to the country in the fifty years since Independence, the country has certainly recognized his contributions. The Royal college of Surgeons of Edinburgh has conferred the Award of fellowship Ad hominem.

Dr. Reddy's firmly believes that the Indian doctors have not got their true entitlement. He is convinced that India is not only well poised to meet the healthcare challenges of the millennium, but also equipped with the talent and strength to contribute in further developing the health and economy of the world.

Dr. Reddy aims to touch a billion lives across India over the next decade and work closer with the government to make Chennai a global healthcare hub that delivers world-class tertiary care to all sections of society.

Ties up with CM’s health insurance scheme

Dr. Reddy has tied up recently with the popular Tamil Nadu government’s Kalaigner’s Insurance Scheme for Life-Saving Treatments. So far, the hospital has performed about 70 surgeries.

This way Apollo was able to reach out to the poor through the Chief Minister’s Insurance Scheme and was able to deliver tertiary care to patients from remote areas.

He says India’s healthcare challenge was to add at least one lakh hospital beds, double its healthcare human resources of doctors, triple the number of nurses and quadruple the number paramedics.

He says that Apollo Hospital will invest about Rs 1,800 crore by 2013 for strengthening its bed capacity to 13,500 across 70 operational hospitals in India as well as abroad.

For the three month period ended December 30, Apollo Hospitals Enterprise has recorded a growth of 48.70% to Rs 439.10 million. During the period, net sales of the company surged 28.92% to Rs 4,808.70 million, whereas total income increased by 29.18% to Rs 4,915.20 million. It reported an EPS of Rs 7.10 per share during the third quarter. The shares of the company closed at Rs 684.15, up 3.6%, on the Bombay Stock Exchange (BSE). The share price as seen a 52-week high of Rs 749 and a low of Rs 350 on BSE.

New Delhi: The promise of a sound sleep is creating a huge market for the medical industry in India. Medical technology and top pharma companies are waking up to a potentially $3-billion Indian market for their products and therapies.

Action has begun in the last few months with players like Philips Healthcare setting up sleep labs, GSK Consumer Healthcare and Modi Omega Pharma launching anti-snoring products ranging from nasal strips to mint-flavoured throat sprays to aid better sleep, and others are planning to follow suit.

A study by market research firm Nielsen during November-December 2009 found 93% of urban Indians are sleep deprived and 62% display high risk of obstructive sleep apnea. According to industry estimates, the number of sleep apnea patients in the country could be somewhere between 40 million to 70 million.

http://static.expressindia.com/expressindia/newpic/city4.jpg

That’s still quite small compared to the US market, which is estimated at over $23 billion. But the $5-million Indian market, as per industry estimates, is growing massively at a CAGR of almost 25%.

The nascent sleep therapy market in India was kick-started last year when the $17-billion GE Healthcare brought to the Indian market continuous positive airway pressure (CPAP) machines to treat sleep apnea, a breathing disorder common among adult diabetics. GE has since installed 3,500 units throughout the country, a company official said.

Currently, the country has around 100 sleep labs, which is slated to double once Philips sets up another 100 by the end of the calendar year.

“When we compared the magnitude of sleep deficit related disorder here to the number of sleep labs that we had, we were appalled. That is when Philips decided to take the initiative to at least double the number of sleep labs to 200 from the present 100,” Anjan Bose of Philips Healthcare said.

Philips has partnered with Delhi-based Medicity, branches of Fortis, R&R and Mumbai-based Hinduja and Seven Hills, among others, to execute the project.

Healthcare and pharma firms are also offering products over the counter. Modi Omega Pharma, a 50:50 venture between Modi Mundi pharma and a leading European pharma OTC company Omega Pharma, last week entered the sleep market by launching an anti-snoring spray. UK Modi, chairman, Modi Omega, said, “We clearly understand the shifting mindset of urban Indian consumers from treating illness to managing wellness. Anti-snoring is an untapped category but offers huge potential. We have ambitious plans for the product to be retailed through pharmacies and retail.

FE (http://www.financialexpress.com/news/putindiatosleepandsteala3bnmarket/597826/)

India's health care industry stands at a crossroads. While corporates are eager to take charge of public health care, they only understand the problem partially. Privitisation of the health system is hardly the answer.

With World Health Day just past us, (April 7) we in India might have something to cheer. Government initiatives like the rural medical course and health insurance for the poor (including specialist care) are good, fresh ideas. But they need the right heads to think them through. A high-profile specialist in Bangalore wrote some months ago: “Millions will still perhaps be living in slums with no running water or sanitation, but when they are unwell, they will have access to high-tech health care with dignity, like in the developed world.” He feels that health care is a complicated business, best handled by people like himself.

Many corporate hospitals endorse this idea and have started expanding their empires. They will build mega hospitals in more cities and towns, train more specialists, increase their bed-strength and wait eagerly for patients to fall ill. With cheap health insurance paid for by the government, they are assured of their clientele and applauded for their altruistic service to the poor. Privatisation of the entire health system is what they would like, with the government merely bearing the financial burden of providing insurance. They also want low lending rates from international funding agencies, exemption of import duty for expensive medical equipment and subsidised rates for land to build their hospitals. The government may actually go along with this idea and thus shrug off its own responsibility in the delivery of health.

Specialists' understanding

My reservations about turning health care into a private, corporate industry stem from the fear that these experts do not understand health. What they understand are the diseases that fall within their specialist domain and which they are trained to cure. These comprise less than 20 per cent of all illnesses in our country. They should continue their excellent work in what they know best and not demand that they be made health care providers for the entire country. That will be much like an instant-noodle company being asked to provide nutritious meals for school children. I hope my esteemed specialist colleagues will not take offence but there can be no mincing of words when the health of an entire nation is at stake.

Four-fifths of diseases in India are caused by five factors: lack of clean drinking water, insanitary living conditions, pollution of all types, inadequate nutrition and stress. Typhoid, malaria, dysentery, TB, skin and lung infections – which kill millions every year – are produced by insanitary conditions. Stress causes heart disease, high blood pressure, peptic ulcers, asthma, allergy and mental illness. Although many see stress as a privilege of the upper class, the poor are subject to unrelenting anxiety and stress caused by hunger, homelessness, unemployment and the loss of dignity. No Art of Living or Stress Management course will give them relief. To wait for them to fall sick and then rush to their doorstep with high-tech cures is as insulting as throwing a piece of chocolate to a hungry stray dog.

Simple measures can prevent 80 per cent of diseases afflicting our people. Every developed country has dealt with them decades ago and done away with most infectious and communicable diseases. India, which has built steel plants, huge dams and National Highways, can surely provide clean drinking water to its citizens. A nation that can reach the moon can certainly attend to its garbage and provide clean public toilets. Doctors who boast of attracting patients from foreign countries will surely be able to address every one of our public health woes.

In most important health care indicators like nutritional status, maternal and infant mortality, India is near the bottom of the list. We can learn some valuable lessons by seeing how welfare works in other countries. The British National Health Service (NHS) established in 1948 is one of the most successful medical organisations in the world. It is funded by the government and through National Insurance by which a percentage is deducted from the salary of every working citizen. The NHS has a two-tier system of general practitioners and hospital doctors. The GP provides the first-contact care and treats common ailments. Serious cases are referred to hospital. All NHS doctors and staff are salaried. Once they reach a senior position, the job is permanent, with no transfers.

Private practice is allowed at a senior level but it is carefully monitored so as to not allow malpractice or exorbitant fees. The NHS pattern of welfare is followed in Commonwealth countries like Canada, Australia and New Zealand and is an excellent example of socialised welfare. For the last ten years, the NHS has faced problems caused mainly by increasing expenditure. If misuse (like patients seeking emergency service for trivial complaints and the mindless wastage of hospital resources), are left unchecked, its efficiency will be undermined.

In the USA, the health care bill introduced by Obama is set to change things for the better. What I record here is the state of their welfare system until now. Doctors usually opt for specialised, post-graduate training and work in groups that are attached to private hospitals. About 60 per cent of citizens pay a premium towards their medical expenses. Health Maintenance Organisations provide this insurance. Besides doctors, HMOs decide the level of treatment, sometimes even the type of tests and procedures, including surgery. Everything depends on the amount of premium paid. Doctors and insurance companies make a killing out of the deal. This has led to a general hostility towards doctors and increasing medical litigation.

In the USA, the government hospitals which serve the non-insured public are fairly well-run and staffed adequately. The USA government spends $5000 per citizen every year on health. Most of it is spent on their hospitals, treatment of defence personnel and administrative work. Yet, three million hospital beds across the country stay empty and one-sixth of the population has no access to satisfactory treatment. A recent study from Harvard shows that two million Americans are driven to bankruptcy every year by medical bills. In India, too, health costs are the single biggest factor in driving people below the poverty line.

Is socialised medicine relevant in today's world? Non-rich Costa Rica is the envy of many developed countries. The working population pays 15 per cent of its salary towards health care. Every citizen is entitled to free treatment without any distinction between the classes. This is possible because a large number of middle-level health workers are trained to treat simple ailments. Private medical care is available for those who wish to pay but only 30 per cent ever opt for it. Costa Ricans live to 78 years and infant mortality is 11 per 1000, much better than our own. And their expenditure on health per person is one-tenth of the USA's.

Nearer home, Sri Lanka and Bangladesh have better health indicators than we have. Communist and socialist countries like China, the erstwhile USSR and Cuba have done much better than India. In Malaysia, government-funded health care is free and of good quality. Primary health centres called ‘Klinik Desa' give basic health care in remote areas. Their life expectancy is 79 years and infant mortality nine per 1000. (Ironically, with globalisation there is a move to abandon socialised welfare and follow the failed US system!)

Wide gaps

What are our priorities in India? The training of doctors for rural areas and a cheap health insurance scheme will certainly help the poor. But good planning is needed to ensure that these programmes are free of corruption. The advice of professionals experienced in rural and public health is invaluable. We have several internationally acclaimed doctors working in these areas and they have transformed health in hundreds of villages around the country. Why is their example being ignored? We have some very good centres like the National Institute of Mental Health in Bangalore, AIIMS in Delhi and others but the majority of government hospitals have little to commend them.

The health insurance scheme has started well in a few states, particularly Kerala and Gujarat. My own experience with the much talked-about Yashaswini scheme in Karnataka was otherwise. I first heard of it from a well-to-do farmer who had availed of the benefits, because the scheme stipulates that an individual must own a certain area of land to qualify. It had nothing for the landless who are the poorest among rural folk. So while this owner of a farm underwent heart surgery at no expense, his labourer's wife had to pay for surgery on her fractured hip. Rural hospitals registered to treat insured patients complain that they have to overcome a lot of red tape and long delays before being paid by the government.

In Haryana, in a district which was under the insurance scheme, the number of Caesarean sections increased to 50 per cent of all deliveries. Why not, when the insurance cover for a normal delivery is Rs. 3,000 and for a Caesarean, 25,000?

India has come to a turning point. The government is all set to introduce such far-reaching initiatives and it cannot afford to be short-sighted. The corporate health industry is eager to expand its empire. With its powerful influence in government circles, that may happen soon. However, if we genuinely wish to “revolutionise” health, we must turn our attention towards the prevention of disease through public health measures. The only reason for the indifference towards public health is that unlike curative health care, there is no profit in prevention. No wonder our corporate specialists carefully avoid the issue while expanding their curative facilities.

Preventive health care is simple. Take for example the fact that 47 per cent of our children are malnourished (it is 46 per cent for Bangladesh and 37 per cent for Pakistan) and it kills a million every year.

Many NGOs have proposed ways of overcoming the problem. One group in Pune has developed a ‘ Nutribar' costing less than a rupee and made of cereals, groundnut and jaggery. If used as a supplement to food, it will provide essential proteins, iron, vitamins and minerals. The government, or a corporate house with a big heart, could produce and market it. If gutka,shampoo, instant coffee and sugary toffees can sell for a rupee, why not the Nutribar which can put millions of children on the road to health?

We say “Prevention is better than cure” but it remains a platitude. If the government, the medical professionals, and the corporate health industry could enlarge their tunnel vision, we may, one day, pride ourselves in being a healthy nation. Merely pumping in money will not transform health. What it takes is empathy, imagination and common sense.

The Hindu (http://beta.thehindu.com/arts/magazine/article393518.ece)

WB provides $118 mn to improve health systems in Tamil Nadu

The World Bank today approved a $ 117.70 million credit to improve quality of and access to health services in Tamil Nadu. The latest World Bank financial assistance is in addition to the Tamil Nadu Health Systems Project that was approved on December 16, 2004 with an IDA (International Development Association) credit amount of $ 110.83 million, a media release said.

“Tamil Nadu has made impressive progress in improving maternal and child health, and further improvements would be achieved by improvement in the overall quality of care, particularly for provision of comprehensive emergency obstetric and neonatal care,” said Preeti Kudesia, World Bank Sr Public Health specialist and project team leader.

“The additional funding will support the continuation of successful activities, and will particularly focus on improving the quality of health care provision. The project will also enhance access to and utilization of health services by the state’s poor, remote, and tribal populations,” Mr. Kudesia said.

The World bank said over the past four years, the project has helped establish 80 Comprehensive Emergency Obstetrics and Neonatal Centres throughout the State, leading to improved access and quality of care for pregnant women and infants.

It has also provided 385 ambulances, which have strengthened the Emergency Transport Services in rural areas in Tamil Nadu.

Health services in tribal areas of the state have also improved through mobile outreach services and supporting sickle cell anaemia screening interventions and patient counselling services.

http://beta.thehindu.com/news/states/tamil-nadu/article418269.ece

Excellent news

"We will invest $ 15 million to design this system in the GE John F Welch Technology Centre in Bangalore

http://economictimes.indiatimes.com/news/news-by-industry/healthcare/biotech/healthcare/GE-Healthcare-to-invest--15-mn-to-develop-PET/CT-scan/articleshow/6091977.cms

http://timesofindia.indiatimes.com/City/Chennai/Hospitals-cry-foul-over-curb-on-cashless-cover/articleshow/6148987.cms

CHENNAI: Several hospital chains across the country have written to the Insurance Regulatory and Development Authority (IRDA) complaining against moves by public sector insurance companies to restrict cashless transactions provided under medical health cover to their best corporate and group clients.

TOI in its edition on Friday had reported on an emerging crisis in the medical insurance sector where PSU insurers have knocked off the names of several leading hospitals across the country from their empanelled lists. The move was prompted by a rise in fraudulent claims and overbilling by certain healthcare providers. Since July 1, many patients, who are not part of corporate group insurance schemes, have been asked to deal directly with hospitals on their payments and then claim reimbursements instead of using the cashless facility.

On Friday, a Confederation of Indian Industry (CII) committee on health, comprising senior doctors and hospital administrators, met in New Delhi to discuss the problem. "Insurance companies and healthcare providers have always been playing this cat and mouse game all over the world. Things will change only if we bring in laws that will punish every stakeholder if any fraud is detected," said senior cardio-thoracic surgeon Dr Naresh Trehan, who chairs the committee.

The current impasse has triggered a fresh round of allegations by all sides, including senior doctors, hospital administrators and consumer activists. Since consumers are getting caught in the crossfire — they have to cough up cash upfront in lakhs to hospitals even after paying hefty premiums — the CII panel has decided to recommend to the IRDA legal provisions that will plug loopholes and enable patients as well as healthcare providers and insurers to seek swift redressal in case of deficiency in service or inflated billing.

...

http://timesofindia.indiatimes.com/City/Chennai/Docs-uneasy-over-interference-of-insurance-cos-in-treatment/articleshow/6148992.cms

CHENNAI: Who decides if a patient should be managed medically or undergo a surgery? Who decides whether a patient requires an open surgery or the less invasive keyhole surgery? Doctors.

"But that's in an ideal world. We now see insurance companies often making noises and questioning the doctor's decisions," says Sanjay Rai, director (marketing and consumer management) Max Healthcare, New Delhi. "We seem to be going the US way. It's time we learnt our lessons. Insurance companies must advocate good medical practices instead of controlling hospitals," he says. The six centres of the hospital have had over 60 rejections in the last ten days. Several doctors in leading hospitals complain that they are now forced to spend time explaining to insurances companies about their decisions and why they think it is best for their patients.

"Sometimes, the price they offer for some complicated procedure is ridiculous. They compare the rates of a corporate hospital with those in a nursing home. What they fail to see are the results in the corporate hospital," says Chennai-based cardiac surgeon Dr K R Balakrishnan. "Take for instance, the cost offered under the Tamil Nadu state health insurance scheme. It's impossible to do a coronary artery by-pass at Rs 70,000 without compromising on quality. There has to be a compromise on nursing, sterility and even quality of antibiotics. It's important to know that there is cost attached to safety," he said.

Insurance firms, both private and public sectors ones, say they had taken the regulatory role due to increasing fraudulent claims. Star Health Insurance had said that even in the state employee health scheme, hospitals had carried out needless surgeries, including hysterectomy on young women.

"Most hospitals push up treatment costs by around 20-25% when a patient walks in with a policy. The pricing policy for a patient with health insurance cover is different from others who pay from their pockets. They hand over packages for every procedure," said a senior official of Bajaj Alliance Health Insurance.

Most hospitals admit that they have comprehensive tariffs for at least 40 standard medical procedures such as deliveries, heart surgeries, hip and knee replacement and abdominal surgeries. "But it's not different for non-insurance holders," says Shivakumar Pattabiraman, vice-president of Apollo Hospitals.

"Our pricing is different for different kinds of facilities. For instance, the charges for procedure in the general ward is lower than for those who choose twin sharing or single occupancy. The difference in billing is not just the room rent but every other component as well," he said.

While hospitals and insurance companies argue over their rights, it's the patient who get caught in the battle. "A private hospital sends a mail to the insurance company to approves money for an elective heart surgery. I have been told to pay upfront. I thought I was doing myself a favour by paying the premium. But I was wrong," says S Santharaman, 45, a private firm employee.

...

Ambulance and emergency services available across all districts of Assam.
http://img710.imageshack.us/img710/225/ambulancer.jpg (http://img710.imageshack.us/i/ambulancer.jpg/)

Uploaded with ImageShack.us (http://imageshack.us)
Source- Assam Tribune 22.07.10.

Assam is also launching the 104 service (health information on telephone) from October this year.

^^That's great news. Other states should try to model this.
Good Job Assam.

http://www.thehindubusinessline.com/2010/08/31/stories/2010083152041900.htm

Bangalore, Aug. 30

Disease detection has gone the mobile phone way. Narayana Hrudayalaya and the Mazumdar Shaw Cancer Centre said they have tied up with SANA, a research group at Harvard/MIT, to try out smart phone-based detection of oral cancer and other diseases.

Medical personnel of the cancer centre and two hospitals in Bangalore and Raichur have started screening high-risk individuals for oral cancer using smart phones with camera.

They will diagnose the condition either by using the pre-loaded software on the phone, or by uploading the data to Narayana's EMR (electronic medical records) system for specialist feedback. The patient can be advised treatment through interactive videos on the phone or referred to a specialist, Narayana Hrudayalaya said in a release.

Ms Kiran Mazumdar-Shaw, CMD of Biocon Ltd, has individually invested in the cancer centre. She and Dr Devi Prasad Shetty, Chairman of NH, unveiled the pilot project in Bangalore. Dr Shetty said, “The opportunities are unlimited and using technology we will enable provision of high quality medical care at minimal price. This is truly ‘care anywhere'.”

Dr Paul Salins, Medical Director of the Mazumdar Shaw Cancer Centre that is housed in the NH health city campus here, said, “We have already screened about 400 high-risk cancer patients and detected numerous lesions using the SANA platform. In the next few months, we will be scaling this to other medical institutions within the State and hopefully by next year cover other chronic diseases such as heart disease, diabetes and chronic kidney disease.”

These hospitals — including KLE Dental Hospital in Bangalore and Navodaya Medical College in Raichur — cover 20 lakh people. They will train general physicians, nurses and medical students to screen for high-risk individuals using automated questionnaires on the phone and take high-quality pictures of lesions on the phone camera.

...

http://timesofindia.indiatimes.com/city/chennai/Hospital-gets-3D-mapping-system-to-detect/articleshow/6488701.cms

CHENNAI: Sudden deaths of people, mostly young men and women, caused by arrhythmia could be prevented if they are diagnosed early by the doctors. The diagnosis has been made easy with the 3-D imagining system now available with doctors, said Dr Ulhas Pandurangi, senior consultant cardiologist at the Madras Medical Mission.

Arrhythmia is a condition when the heartbeat goes haywire. Like the mechanical activity, there is also an electrical activity of the heart. When this becomes abnormal, the heart beat may be too fast or too slow, regular or irregular. Though in some cases it can be ignored, many require medical intervention and in some others can even be fatal.

In a press conference ahead of the three-day annual conference of Arrhythmia Heart Failure Academy, Dr Pandurangi said, "We now have 3-D imagining system that will help cardiologists shows the insides of the heart. It helps look at the mechanics into specific regions by delivering radio frequency energy at the desired spot. This makes diagnosis accurate." Already 100 cases of arrhythmia have been treated at the hospital using this device.

...

Healthcare sector to touch $280 bn by 2020: FICCI

NEW DELHI: The Indian healthcare sector is expected to become a USD 280 billion industry by 2020 with spending on health estimated to grow 14 per cent annually, according to a report by industry chamber FICCI.

"Healthcare has emerged as one of the most progressive and largest service sectors in India with an expected GDP spend of 8 per cent by 2012 from 5.5 per cent in 2009. It is believed to be the next big thing after IT and predicted to become a USD 280 billion industry by 2020," the report said.

At present the sector is estimated to be around USD 40 billion and will grow to USD 78.6 billion by 2012, it said.

"Increase in personal income, government healthcare outlays and private domestic investments, combined with longer life expectancy should lead to annual average growth in healthcare spending of around 14 per cent in the forecast period," the report said.

According to the report, India spent 5.2 per cent of the GDP on healthcare, of which 4.3 per cent was spent by the private sector valued at USD 22 billion.

Private sector expenditure in the healthcare segment is expected to reach USD 45 billion by 2012, it added.

The report pointed out that the hospital segment alone is expected to reach USD 54.7 billion by 2012, representing more than 70 per cent of healthcare sector revenues.

In terms of employment, the healthcare industry is expected to provide jobs to 9 million people by 2012, it said.

Among the healthcare sectors, medical devices and supplies market in India is expected to touch USD 1.7 billion in 2010. It is expected to reach USD 2.2 billion by 2012.

"Free market environment, a developed industry and investment in health infrastructure are amongst other factors resulting in the growth," it said.

http://economictimes.indiatimes.com/news/news-by-industry/healthcare/biotech/healthcare/Healthcare-sector-to-touch-280-bn-by-2020-FICCI/articleshow/6507764.cms


:banana::banana::banana:

Chennai's leadership position in medical tourism in India has been reinforced with this foreign Govt agreement. :banana::banana::banana:

Cross-posting. Courtesy: satchitananda

http://www.thehindubusinessline.com/2010/09/09/stories/2010090951941600.htm

After a gap of 29 years, there will be a direct air link between India and the Republic of Seychelles giving a major boost to movement of Indian tourists to the island nation and inbound medical tourists and traders.

Air Seychelles will commence a weekly ‘hop' service to Chennai from Seychelles' largest island Mahe on November 1 in the present Mahe-Singapore route, according to Mr M.S. Sai, Honorary Consul, Republic of Seychelles, Chennai.

The previous service between Mumbai and Mahe was suspended in 1981 following a hijack of the Air India flight, he told Business Line.

...

The Republic of Seychelles has tied up with MIOT Hospitals and Madras Medical Mission in Chennai for providing healthcare to the islands' citizens (the island's population is around 87,000). At any point of time there are around 35 patients undergoing treatment in India, he said. :cheers:

...

The current Bilateral Air Service between India and Seychelles of 1978 restricts Air Seychelles operating only to Mumbai, which was stated as the ‘point of access' for the airline under the Confidential Memorandum of Understanding to the BASA. As the Mumbai-Seychelles was not making money, Chennai has replaced as the access point, he said.

...

http://www.deccanchronicle.com/chennai/1st-state-launches-h1n1-immunisation-drive-578

Sept. 13: The Tamil Nadu government launched the country’s first public immunisation drive against swine flu on Monday at the state-owned King Institute of Preventive Medicine’s Guindy campus. Following the launch of the swine flu clinic by health minister M.R.K. Panneerselvam, two vaccines - VaxiFlu-S, an injection priced at `250 a dose, and Nasovac, nasal spray, are available at nearly half the price sold in the open market.

On day one, 334 people were immunised against the influenza with 168 people going for the nasal spray. Inmates from a home for the mentally retarded were given the shot free of cost. “Anybody from three to 70 years of age can take the vaccine, though we will have to check for immunocompromised conditions like AIDS or bronchial asthma before administering the nasal vaccine,” said Dr P. Gunasekaran, deputy director, King Institute, that is receiving about 50 throat swabs to test for the infection a day of which one-fourth are positive.

...