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India Plans Major HPV Vaccine Push with Frontline Training and Awareness Drive

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The Union Health Ministry is set to launch comprehensive capacity-building initiatives for frontline workers involved in administering the Human Papillomavirus (HPV) vaccine, as part of its ongoing efforts to prevent cervical cancer among young girls. This follows Union Finance Minister Nirmala Sitharaman’s announcement in the 2024 interim budget encouraging HPV vaccination for girls aged 9–14. Sources indicate that multiple meetings have been held by the ministry to devise a detailed strategy for the rollout. “Capacity building for frontline health workers, along with sensitization through IEC (Information, Education, and Communication) activities, is being planned for smooth implementation of the HPV vaccination program,” a senior official confirmed. The National Technical Advisory Group on Immunisation (NTAGI) had recommended the inclusion of the HPV vaccine in India’s Universal Immunisation Programme in June 2022. Currently, India has access to vaccines from MSD Pharmaceuticals and Serum Institute of India. MSD’s Gardasil 4 and Serum Institute’s Cervavac target four HPV sub-types: 6, 11, 16, and 18. Gardasil 9 — India’s first gender-neutral HPV vaccine — offers protection against nine HPV sub-types and is available for girls (9–26 years) and boys (9–15 years). The vaccines provide protection against cervical, vulvar, vaginal, and anal cancers, as well as genital warts in both males and females. Sub-types 16 and 18 are the leading causes of cervical cancer, officials noted. The World Health Organization (WHO) recommends a single-dose vaccine for optimal protection. India, home to 16% of the world’s women, accounts for nearly 25% of global cervical cancer cases and 33% of related deaths. Each year, around 80,000 Indian women are diagnosed with cervical cancer, and approximately 35,000 succumb to the disease. Source: Business Standard

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Health Ministry Releases National Guidelines on Medical Oxygen Management

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The Union Health Ministry has released the National Guidelines on Medical Oxygen Management, underscoring the critical importance of maintaining and utilizing medical oxygen infrastructure in healthcare facilities. The announcement was made at a workshop held at AIIMS Delhi, where Health Secretary Punya Salila Srivastava emphasized the need for efficient oxygen management to enhance clinical outcomes and emergency preparedness. The event also marked the launch of the National Capacity Building Programme on Oxygen Management, which aims to train 200 master trainers. These trainers will help hospital administrators and medical officers across India improve oxygen handling, reduce wastage, and optimize usage. Key Highlights of the Initiative: The National Guidelines provide a structured framework for the procurement, storage, and administration of medical oxygen. AIIMS Delhi will spearhead the capacity-building program, ensuring training at all levels of healthcare. The initiative, led by the Disaster Management Cell of the Ministry of Health and Family Welfare, is focused on patient safety, infrastructure preparedness, and best practices in oxygen management. Learnings from India’s COVID-19 response have been incorporated into the guidelines to strengthen future pandemic readiness. Addressing the gathering, Dr. M. Srinivas, Director of AIIMS, stressed the importance of awareness and training to ensure optimal oxygen management. The standardized guidelines are expected to enhance India’s healthcare resilience, ensuring hospitals nationwide are better equipped to handle medical oxygen needs during emergencies. Source: Business Standard

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India Records First Suspected Mpox Case; Patient in Isolation After International Travel

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India has recorded its first suspected case of mpox, a virus formerly known as monkeypox, in a young male patient who recently traveled from a country experiencing an outbreak. The health ministry announced that the patient is currently isolated in a hospital and is in stable condition, with ongoing measures to manage the case in line with established protocols. “The case is being managed in line with established protocols, and contact tracing is ongoing to identify potential sources and assess the impact within the country,” the health ministry said in a statement. While the specific strain of the virus is yet to be confirmed, tests are underway to identify the type of mpox infection. The mpox clade 1b variant, recently confirmed in Sweden and linked to an outbreak in Africa, has sparked global concern due to its rapid transmission through close contact. India has previously detected 30 cases of the older clade 2 strain between 2022 and March 2024. Mpox, originally identified in monkeys in 1958 and in humans in 1970, is transmitted from infected animals to humans and can spread through close physical contact. While typically mild, the virus can cause flu-like symptoms and pus-filled lesions, and is fatal in rare cases. The World Health Organization (WHO) renamed monkeypox to mpox last year, addressing concerns that the original name was perceived as racist. Recently, the WHO declared the mpox outbreak a public health emergency of international concern following the emergence of the new clade 1b variant. However, the WHO emphasized that mpox is not another COVID-19, despite its spread. Globally, over 17,500 mpox cases and 629 deaths have been reported in the Democratic Republic of the Congo (DRC) this year alone, where both clade 1b and 1a strains are present. The DRC has received its first batch of mpox vaccines to curb the outbreak, which has also spread to countries like Pakistan, the Philippines, and Thailand. India’s health ministry has assured that the country has robust measures in place to handle the situation, with efforts focused on containment and preventing further spread of the virus. Source: Aljazeera

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Health Ministry Initiates Recruitment for Technical Resource Centres

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The Union Health Ministry, in collaboration with the Indian Council of Medical Research (ICMR), is advancing efforts to establish Technical Resource Centres (TRCs) aimed at synthesizing and evaluating evidence to develop and promote evidence-based healthcare policies. These centres will play a pivotal role in formulating clinical guidelines and enhancing the adoption of best practices within the healthcare sector. ICMR has issued a call for Expressions of Interest (EoI) from researchers, faculty, and scientists to join these centres. Each TRC will receive financial support of up to ₹20 lakh per year, with funding initially set for three years and subject to annual performance reviews. The TRCs will conduct systematic reviews and meta-analyses to generate high-quality evidence, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. The centres will also organize training programs and workshops to disseminate best practices and support effective guideline development. Regular monitoring visits, professional development plans, and biannual training programs are integral components of the TRCs’ operations. Manuscripts based on completed evidence tables are expected to be submitted within three months. The ICMR has outlined eligibility criteria for applicants, including regular employment at medical institutes, research centres, universities, or colleges, along with the necessary experience, resources, and preferably access to relevant databases. Applications will be reviewed by an expert committee, with selected participants to be notified via email and the DHR website in September 2024. The evaluation of applications will be based on expertise in evidence synthesis, available infrastructure and resources, publication history, and the extent of collaboration and networking capabilities. Source: The Hindu

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Doctors’ Strike Continues as Talks with Health Ministry Fail to Yield Resolution

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The Federation of Resident Doctors’ Association (FORDA) announced on Monday that their indefinite strike will continue after a meeting with officials from the Union health ministry failed to bring about a resolution. The strike was called in response to the tragic rape and murder of a trainee doctor at Kolkata’s RG Kar Medical College, leading to the suspension of elective services, including OPDs and non-emergency surgeries, across government hospitals nationwide. Despite extensive discussions with the Union health minister’s team, no concrete solution was reached, prompting FORDA to extend the strike. Dr. Aviral Mathur, President of FORDA, confirmed that the strike would persist into Tuesday, with emergency services continuing to operate. FORDA’s demands include immediate action on the concerns raised by residents at RG Kar Medical College, assurances against police brutality, respectful treatment of protesting doctors, and swift justice and compensation for the family of the deceased. The association also urged the Union government to implement comprehensive security measures for healthcare workers in all hospitals and called for the establishment of an expert committee to expedite the ratification of the Central Healthcare Protection Act.

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Heatstroke Took 374 Lives, Over 67,000 Cases Till July 27: Health Ministry

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India has reported 374 deaths and 67,637 cases of suspected heatstroke from March 1 to July 27 this year, according to Minister of State for Health Anupriya Patel. The alarming figures were disclosed in the Lok Sabha on Friday. The latest data reveals a significant increase from the earlier estimates provided by the Ministry of Health, which reported 110 deaths and 42,000 cases by June 18. The majority of these incidents occurred in rural areas, where strenuous outdoor work associated with agriculture and poor health infrastructure exacerbated the impact of the heatwave. Uttar Pradesh was the worst-hit state, recording 52 deaths. Bihar followed with 37 fatalities, while Odisha and Delhi reported 26 and 25 deaths respectively. These statistics were compiled under the National Heat-Related Illness and Death Surveillance by the National Centre for Disease Control (NCDC). Government Response and Measures The Integrated Health Information Portal has been receiving data on heatstroke cases and deaths from States and Union Territories since 2023, as noted by Minister Patel. State and UT health departments get yearly warnings from the Ministry of Health and Family Welfare (MoHFW) to put awareness, readiness, and response plans into place. The Union Health Ministry’s Secretary communicated with the chief secretaries of all states and UTs on February 29 in order to release this year’s advise. The warning included steps to improve community awareness of heat-related diseases and to bolster health sector readiness. Record-Breaking Temperatures and Weather Anomalies With a blistering 47 degrees Celsius, June 2024 witnessed the hottest temperature recorded in the month in a decade. The hottest temperatures ever recorded in June 2023 were 41.8 degrees Celsius, 44.2 degrees Celsius in 2022, and 43 degrees Celsius in 2021. This is a considerable rise above the prior records. Furthermore, July was the second warmest month overall in India since 1901 and the highest nighttime temperature ever recorded in the country. Significant flooding resulted from the abnormally high rains that followed the record temperatures in various states, including Gujarat, Kerala, and Uttar Pradesh. It was the hottest July on record for both mean and lowest temperatures in the east and northeast of India. The terrible heatwave has made it clear how urgently better infrastructure and readiness are needed to deal with extreme weather, especially in rural regions. The growing frequency and intensity of these occurrences highlight the significance of long-term policies to address climate change and its implications on public health, even if the government’s preemptive actions and advisories play a key role in lessening the impact of such heatwaves. Reference taken from the Hindu

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States Asked to Keep Vigil After 8 Zika Cases in Maharashtra

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On Wednesday, the Centre ordered states to maintain vigilance due to Zika virus spread in Maharashtra, with eight cases reported by July 2: six in Pune, one each in Kolhapur and Sangamner. Spread by Aedes aegypti mosquitoes, Zika usually causes mild symptoms but poses risks for pregnant women, potentially causing microcephaly in the fetus. Atul Goel, Director General of Health Services, issued an advisory for constant monitoring. The Health Ministry urged screening pregnant women and tracking fetal growth as per guidelines, given the infection’s neurological consequences. Affected areas must prioritize vigilance, screening, and monitoring efforts. The Centre on Wednesday asked states to maintain a state of constant vigil over the Zika virus situation in the country amid reports of the spread of the mosquito-borne infection in various districts of Maharashtra. As of July 2, Maharashtra has reported eight cases of Zika virus infection: six from Pune and one each from Kolhapur and Sangamner. Zika virus is transmitted by Aedes aegypti mosquitoes, similar to dengue and chikungunya. It spreads when a mosquito carrying the virus infects a person. Experts say the infection doesn’t cause severe symptoms in most cases and subsides in a few days. However, in the case of pregnant women, the infection is known to affect the fetus and cause microcephaly (reduced head size), making it a major concern. According to the health ministry, Director General of Health Services Atul Goel has issued an advisory to states highlighting the need for maintaining constant vigilance. As Zika is associated with microcephaly and neurological consequences in the fetus of the affected pregnant woman, the health ministry said on Wednesday, states have been advised to alert clinicians for close monitoring. “States are urged to instruct the health facilities to screen pregnant women, monitor the growth of the fetus of expecting mothers who have tested positive for Zika and act as per central guidelines,” it said.

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80% of Public Health Facilities in India Are Substandard, Reveals Government Survey

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A recent government survey under the National Health Mission (NHM) has revealed that nearly 80% of public health facilities in India fail to meet the minimum standards for infrastructure, manpower, and equipment. This self-assessment exercise involved over 200,000 facilities, out of which only 8,089 scored 80% or higher for compliance. The government aims to make 70,000 facilities compliant within 100 days and will conduct surprise inspections to ensure standards are met. Public health facilities from states and Union Territories were asked to provide details on the number of doctors, nurses, and basic medical equipment available. The data shared on the Indian Public Health Standards (IPHS) dashboard showed that 40,451 facilities submitted key statistics through the Open Data Kit, a digital tool developed by the health ministry. The results were alarming, with only 20% of facilities qualifying as IPHS compliant, meaning they had the necessary infrastructure, human resources, drugs, diagnostics, and equipment to provide essential services. Approximately 42% of the facilities scored less than 50%, while the remaining scored between 50% and 80%. A senior health ministry official emphasized that the self-assessment and real-time monitoring are crucial to ensure health facilities maintain required standards, leading to better health outcomes and a more equitable society. The Centre is pushing states and UTs to address the identified gaps with full support to improve service quality. In addition to the IPHS, the National Quality Assurance Standards (NQAS) will continue to physically evaluate district hospitals, sub-district hospitals, community health centres, and primary health centres on best practices such as availability of essential medicines, equipment, waste management, infection control, support services, and patient rights. A new provision of virtual assessment has been introduced for Ayushman Arogya Mandir, the most numerous public health facilities under NHM. The NHM covers 60% of the costs for public health facilities, with the remaining expenses borne by the states.  

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Health Ministry Suspends Mandatory Linking of CGHS and ABHA IDs

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The Ministry of Health and Family Welfare has announced the suspension of the compulsory linking of Central Government Health Services (CGHS) beneficiary IDs with Ayushman Bharat Health Account (ABHA) IDs until further notice. This decision, stated in an office memorandum signed by Satheesh YH, director of CGHS, follows a review of previous orders that had made the linkage mandatory. The mandatory linkage, originally set to be enforced from April 1 and later extended to June 30, aimed to integrate various government health schemes under the Ayushman Bharat Digital Mission (ABDM). However, practical issues, including data privacy concerns and the current state of technology infrastructure, appear to have influenced the decision to make the linkage optional for the time being. The CGHS provides comprehensive healthcare services to central government employees, pensioners, and their dependent family members, covering over 4.5 million people across 75 cities. In contrast, the ABHA ID is a unique 14-digit number identifying beneficiaries within India’s digital healthcare ecosystem. Despite the previous mandate, only 231,134 CGHS IDs had been linked with ABHA IDs by June 26, according to the CGHS dashboard. Experts have pointed out several issues with the mandatory linking of CGHS and ABHA IDs. Sunil Rao, COO of Sahyadri Group of Hospitals, highlighted data privacy concerns and the inadequacies in current technology infrastructure as potential reasons for the decision. An anonymous expert further noted that the government had not clearly outlined how digital records would be protected, despite assurances that records under ABHA ID would be encrypted and safeguarded under the Digital Protection of Data and Privacy Act. Rao welcomed the move, describing it as a balanced approach that allows time to address data security and system integration issues. He emphasized that making the linkage voluntary would enable the government to ensure infrastructural readiness and gain public acceptance before full implementation. The Health Ministry’s decision reflects a cautious approach, ensuring that when the policy is ultimately enforced, it will be with comprehensive preparedness and widespread support.

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Finance Says No to Health Request for $10-Million Fund to Meet G20 Pledge

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The Global Initiative on Digital Health (GIDH), launched during India’s G20 Presidency, remains unfunded by India despite a $10-million pledge. This initiative, a key deliverable from the Health Ministers’ meeting in Gujarat on August 19 last year, was part of the New Delhi declaration. The GIDH, formally initiated on February 20, 2024, by then Health Minister Mansukh Mandaviya, is still awaiting India’s promised contribution. The delay stems from the Department of Economic Affairs (DEA) under the Ministry of Finance, which has not approved the contribution despite India’s commitment. The GIDH, managed by the World Health Organization (WHO), aims to support national digital health transformations within a framework that respects data protection regulations. A source from the Health Ministry indicated the proposal is “under consideration,” but the DEA had previously rejected the request in July 2023 without specifying reasons. The DEA suggested that India should offer technical support instead of financial contributions to avoid creating “committed liabilities.” Despite this setback, the Permanent Mission of India (PMI) to the UN recommended making a “substantial financial commitment” to the GIDH in November 2023. Highlighting India’s role as a leader in digital health, the Health Ministry, with approval from the Health Minister, reconsidered the contribution. In comparison, Indonesia contributed $50 million to establish the Presidency Prevention, Preparedness Response (PPR) Financial Intermediary Fund (FIF) during its G20 Presidency. As Brazil currently heads the G20 Presidency, the GIDH remains a priority within the health sector.

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