Threefold rise in budget to fight tuberculosis

India’s domestic budget for fighting tuberculosis showed a dramatic jump from about ₹700 crore in 2015 to ₹2,500 crore last year, according to a report from the World Health Organisation (WHO).

Typically most of India’s budget to combat the bacterial infection —that claimed 4.2 lakh last year—used to be dominated by international funding.

But, for the first time this has flipped. Domestic resources accounted for 74% of the $525 million spent in India last year, while it was only 38% in 2015.
In 2016, India recorded a 12% dip in the number of TB deaths from the previous year though the incidence dipped marginally by 1%.

The number of notified cases of drug-resistant tuberculosis (MDR-TB) jumped from 79,000 to 84,000 in 2016, pointing to the deployment of better diagnostics.

However, with 1.7 million new cases in 2016, India still continues to be the largest contributor to the global burden with up to a quarter of the 6.3 million new cases of TB (up from 6.1 million in 2015). Inspite of the dip, India accounts for about 32% of the number of people worldwide who succumbed to the disease.

The government has committed to achieve a ‘90-90-90 target’ by 2035 (90% reductions in incidence, mortality and catastrophic health expenditures due to TB). This is premised on improved diagnostics, shorter treatment courses, a better vaccine and comprehensive preventive strategies. In 2016, the WHO said that India had many more deaths and incidence of the disease than had been estimated over the years.

However, several activists say that inspite of the government commitments, TB is still stigmatized and under-reported — especially from the private sector — and top-line drugs are still inadequate to treat people who suffer from the drug-resistant forms of the disease.

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Air pollution affects children’s memory’

Exposure to air pollution on the way to school can have damaging effects on children’s cognitive development and reduce their working memory, a study has found.

The study published in the journal Environmental Pollution, led by researchers from the Barcelona Institute for Global Health (ISGlobal) in Spain, assessed the impact of fine particulate matter (PM2.5) and black carbon during the walking commute to and from school.

The findings of an earlier study had shown that 20% of a child’s daily dose of black carbon — a pollutant directly related to traffic — is inhaled during urban commutes. “The results of studies have shown that these short exposures to very high concentrations of pollutants can have a disproportionately high impact on health,” said Mar Alvarez-Pedrerol, researcher at ISGlobal.

The study was carried out in Barcelona and enrolled over 1,200 children aged from seven to 10, from 39 schools, all of whom walked to school.
Statistical analysis of the findings showed that exposure to PM2.5 and black carbon was associated with a reduction in the growth of working memory — an interquartile range increase in PM 2.5 and black carbon levels was associated with a decline of 4.6% and 3.9%, respectively, in expected annual growth of working memory

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Bacteria can spread antibiotic resistance through soil

When most people think about bacterial antibiotic resistance, they think about it occurring in bacteria found in people or animals. But the environment surrounding us is a huge bacterial reservoir, and antibiotic resistance can be passed between bacteria in the environment, including in the soil.

Sid Thakur is an associate professor of population health and pathobiology at the College of Veterinary Medicine and associate director of the Comparative Medicine Institute at NC State. He studies antibiotic resistance and how it can persist and spread among food animals, humans and the environment they all share. Recently, Thakur found that spreading manure on the ground as fertilizer can also spread antibiotic resistance to bacteria in the soil.

Bacteria contain small DNA molecules known as plasmids. These plasmids are separate from the bacteria’s actual DNA and can pick up and exchange genes between bacteria. Picture a group of people staying in your house, cooking their own food and taking care of themselves independently of what the family is doing. That’s the relationship plasmids have to bacteria’s DNA.

Then picture these plasmid “houseguests” shipping items that they select from your house to your neighbour’s house, and receiving packages in return. Essentially, that’s what the plasmids are doing with genes – including genes that give the bacteria’s “home” the ability to become resistant to antibiotics.

Thakur took soil samples from a swine farm prior to and for three weeks after a manure spread. He had previously tested the manure for antibiotic-resistant strains of salmonella, a pathogen responsible for causing the highest number of bacterial foodborne illnesses in the U.S. every year. There are over 2,500 unique serotypes of salmonella, and they can be found all around us, including in soil.

After sampling the soil, Thakur found that antibiotic-resistant salmonella bacteria were still present in the manure up to 21 days after it had been spread. He also discovered that a particular plasmid associated with the antibiotic-resistant salmonella from the manure, which weighed around 95 kb, was now turning up in different salmonella serotypes from the soil samples (kb stands for kilo-base pair – a measurement used to identify plasmids). And every serotype with plasmid 95 kb was now resistant to antibiotics.

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Poor breastfeeding can cost Indian economy $14 billion: UN

Nearly one lakh children die every year in India due to diseases that could have been prevented through breastfeeding, according to a United Nations report, which also notes that mortality and other losses attributed to inadequate breastfeeding can cost the country’s economy $14 billion.

The Global Breastfeeding Scorecard, a new report by the United Nations Children’s Fund (UNICEF) and World Health Organisation (WHO) in collaboration with the Global Breastfeeding Collective, points out that breastfeeding not only helps prevent diarrhoea and pneumonia, two major causes of death in infants, it also helps reduce mothers’ risk of ovarian and breast cancer, two leading causes of death among women.

In China, India, Nigeria, Mexico and Indonesia alone, inadequate breastfeeding is responsible for more than 2,36,000 child deaths each year.
In these countries, the estimated future economic cost of mortality and cognitive losses attributed to inadequate breastfeeding are estimated to be almost USD 119 billion a year.

The report says that despite a reported 55 percent exclusive breastfeeding rate in children below the age of six months, the large population in India and high under-five mortality means that an estimated 99,499 children die each year as a result of cases of diarrhoea and pneumonia that could have been prevented through early initiation of breastfeeding, exclusive breastfeeding for the first six months, and continued breastfeeding.

Further, the high level of child mortality and growing number of deaths in women from cancers and type II diabetes attributable to inadequate breastfeeding is estimated to drain the Indian economy of $7 billion. Together with another $7 billion in costs related to cognitive losses, India is poised to lose an estimated $14 billion in its economy or 0.70 percent of its Gross National Income.

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NCBC (Repeal) Bill, 2017

The Constitution (123rd Amendment) Bill, 2017, providing for setting up of a National Commission for Backward Classes, was recently passed by the Rajya Sabha. The Bill was passed after dropping Clause 3.

Clause 3 pertains to the insertion of a new article 338B about the constitution and powers of the National Commission for Backward Classes.

The bill is meant to upgrade the Backward Classes Commission from a statutory body to a constitutional body, which will give it powers equal to a court to summon people and inquire into incidents of violence and discrimination against backward classes.

The amended bill will now have to be returned to the Lok Sabha for its fresh approval. The Lower House had already passed the bill but in the Upper House, it had been referred to a Select Committee as the Opposition had wanted more scrutiny. The Constituent amendment bill’s passage requires a two-thirds majority of those present and voting.

Sources: PIB

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Rising temperatures drive up farmer suicides in India: U.S. study

Climate change may have led to over 59,000 farmer suicides over the last 30 years in India, argues a research report from the University of California, Berkeley in the US.

Even a 1°C increase in temperature above 20° C in a single day during the crop growing season results in about 70 suicides on average.

The increase in temperature during the cropping season reduces crop yields, resulting in increased suicides, according to a study published in the journal Proceedings of the National Academy of Sciences.

The study was carried out using data for all States and Union Territories.
It has several limitations, though, including the fact that it has not looked at other factors that could have contributed to suicides.

Tamma A. Carleton from the University of California, Berkeley and the author of the paper, tested the link between climate change, crop yields and suicide by comparing the number of suicides across India between 1967 and 2013 with crop yield and climate data. Data on suicides were collected from the National Crime Records Bureau.

Crop losses due to heat damage cause additional burden on farming households and this at times lead to suicides.

Suicides reported when a single day’s temperature increased by 1°C only during the crop growing season. A similar increase in temperature during other seasons did not result in a rise in suicides.

Crop yield data from 13 States from 1956 to 2000 were compared with climate change data. Dr Carleton found annual yield falling when the temperature was above 20°C during the crop-growing season.
An increase in rainfall by 1 cm during the growing season leads to a decrease of about 0.8 deaths per 100,000, thus lowering the suicide rate by 7% on average.

The effect of climate variation reveals that past growing season temperature strongly influences suicide rates in the following years up to about five years.
For instance, when there is abundant rainfall during one growing season, the suicide rates dip for the next two or three years. Drought apparently does not seem to have any effect on suicide rates, the researcher found.

The study says South India, which is generally hotter, has higher farmer suicide rates.

Comparing the yields to growing season temperature for 13 States, the author found that States, where the yields are more affected by high temperatures, are also the States which report higher suicide rates. Maharashtra, Karnataka, Tamil Nadu, and Andhra Pradesh not only show severe suicide responses to temperature but crop yield is also more negatively affected by higher temperature.

The study did not find any adaptive behaviour to prevent suicides in response to climate change.

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Guidelines for Planning and Implementation of Family Participatory Care

Ministry of Health and Family Welfare has released Operational Guidelines for Planning and Implementation of Family Participatory Care (FPC) for improving newborn health. The new guidelines have been released by the government for improving the health of babies in special units across the country.

Key facts:

The guidelines will serve as a guiding document for those intending to introduce FPC in their facility as an integral part of facility-based newborn care.

The operational guidelines of FPC are for all stakeholders involved in the process of planning and delivering newborn care.

Under the guidelines—Operational Guidelines for Planning and Implementation of Family Participatory Care (FPC)—parent-attendants will be trained in newborn care through a structured programme including an audio-visual module and a training guide. The staff at a newborn care unit would provide continuous supervision and support.

The guidelines address various aspects of attitudes, infrastructural modifications and practice that will help in establishing FPC at Special Newborn Care Units (SNCU) such as sensitization of State and District Managers on FPC, prioritization of SNCUs for initiating FPC etc.

Under FPC, the capacities of parents-attendants are built in newborn care through a structured training programme (audio-visual module and a training guide). The staff at newborn care unit will provide continuous supervision and support. Provisions for infrastructure and logistics strengthening required for implementing FPC are ensured in the annual state Program Implementation Plan (PIP).

Sick and newborn are highly vulnerable and require careful nurturing in order to survive the neonatal period and the first year of life. In recent years, health experts have found that if parents are trained during the stay of their babies in the hospital to provide supportive care to sick newborns, it helps in not only improving survival of babies after discharge but also provides for psycho-social and developmental needs of the newborn.

In this regard, Family Participatory Care has emerged as an important concept of health care which provides for a partnership between healthcare staff and families in the care of sick newborns admitted in the SNCU. The move is expected to bring down infant mortality.

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