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National Health Policy: what does it entail?
Guest: Abhijit Das, Director, Centre for Health and Social Justice;T.K.Rajalakshmi, Dy. Editor Frontline;Shailja Chandra -Former Secretary Ministry of Health & Family Welfare GOI;Rajib Dasgupta, Professor, Centre of social Medicine And Community Health Social Sciences, JNU;Abhijit Das, Director, Centre for Health and Social Justice
Anchor: Arfa Khanum
Air Date: March 17, 2017
Published on 1 Jan 2017
Thanking people for their support and co-operation to his demonetisation drive, Prime Minister Narendra Modi on December 31 made a series of announcements reiterating his government’s focus on the welfare of farmers and the poor.
He was making a televised address to the nation on New Year’s eve and said he was grateful for the patience that people had shown amid a cash crunch that followed the ban on Rs 500 and Rs 1000 notes that he announced on November 8.
The decision was aimed at combating tax evasion and money laundering and the Prime Minister praised the people for working shoulder to shoulder with the government to defeat corruption.
Shailaja Chandra, former Secretary in the Ministry of Health and Family Welfare and the Chairman of the Public Grievances Commission and Appellate Authority under the Delhi Right to Information Act, says: “A poor woman can earn anything between Rs1-3 lakh from surrogacy, and with debts and growing expenditures hanging over her head, she agrees or is forced to agree. In most cases, it’s actually the women’s relatives and middlemen who compel them to go through it.”
She adds that the myths around being childless and the reluctance to consider adoption need to be addressed through proper awareness campaigns, and adoption promoted as a first choice. “Not only is that humane, but is also less exploitative on the surrogate, who has to be bolstered with hormones to prepare her to accept the embryo.”
Chandra also believes that IVF centres need to be registered. “The process should be open only to Indians or if one partner is of Indian origin. We must not permit foreigners to enter into surrogacy arrangements because it is akin to using Indian women to make a takeaway baby for them. While foreigners are generous in looking after the woman’s health and nutrition, problems of citizenship, and fulfilling the responsibilities attached to accepting the infant, even if it suffers from physical or mental deficiencies, can arise.”
About how it can be checked if the ban is being upheld once the Bill is passed, Chandra says, “Such a law, if made, will remain like so many other laws — unimplementable. There is no machinery to police what happens between two or three people by mutual consent; desperate couples and future surrogates’ families will find a way of doing it secretly. Can a woman who leaves for her native village for nine months be taken to task? It’s tough to push such laws. Do you think kidney transplant rackets have stopped and all such transplants are altruistic?”
The issue of demonetisation has divided political and public opinion. Inside Parliament, there have been stormy scenes, and outside at ATMs and banks, there have been serpentine queues. There are stories of hardship and suffering, but some also say the pain is worth the gain. On We The People, we look at the politics and economics of demonetisation. What is its aim – hit at black money or digitise the economy? Will it net the big fish? Will Modi government’s gamble pay off? We get you the stories of those who are struggling to cope with this move as well as of those who have adapted to the digital economy.
Consumer must be protected from misleadingly advertised
A colleague inherited diabetes from his father. For the last 20 years, he has been taking insulin injections. A few days ago he asked me about a new ayurvedic drug for diabetes formulated by a research body — the Central Council for Research in Ayurvedic Sciences (CCRAS) — under the AYUSH Ministry. He sent me a full page advertisement that used the Council’s logo and extolled the virtues of a commercially sold diabetes drug claiming that it was “based on tough clinical and lab experiments and scientific tests”. The faculty of reputed ayurvedic institutions were incensed and one of them sent me a YouTube link in which scientists from CCRAS were claiming their formulation was capable of reducing the allopathic drug dose. Worse, that with six months of use, the drug could end insulin dependency.
The Journal of Ayurveda and Integrative Medicine, which is a peer-reviewed, open access journal, wrote an editorial expressing shock over such claims as no supportive data was to be found from published sources. It has been reported that the controversial advertisement has been taken off, after four months. But a lot more must be done to protect the consumer.
A little background would put things into perspective. In 1964, India’s drug laws were amended and a new chapter was introduced for Indian medicine with a category called Patent and Proprietary (P&P) Ayurvedic medicine. By the end of the 1990s, branded products accounted for 90 per cent of the sales and classical ayurveda lost its pre-eminence. The commodification of ayurveda had commenced but it had also been “contemporised” to suit modern lifestyles.
By the new law, individual vaidyas were permitted to prepare formulations for their patients but factory-based manufacture, whether of classical ayurveda products or of the P&P category, required compliance with pharmacopoeial standards relating to the identity and purity of the ingredients and the process to be followed. In 2010, a new drug rule was added specifically for Indian medicine drugs .This was amplified in 2013 by notifying detailed guidelines spelling out how the safety and efficacy of ayurveda formulations were to be safeguarded. Government research councils, although they do not themselves manufacture drugs, have a responsibility to ensure that the prescribed regulatory requirements are met before their drugs are marketed. The laws on advertising prohibit claims about treating or curing specific medical conditions and making such assertions about diabetes is expressly proscribed. CCRAS should have shown greater circumspection knowing how desperate people are to find a cure for diabetes.
Undoubtedly, ayurvedic texts list scores of formulations to treat diabetes and ayurvedic drugs have been in the market for decades. The anti-diabetic properties of turmeric, cinnamon, fenugreek, aloe vera, tulsi, etc, are well known. They have been sold as single drugs or as formulations. But never before have claims about reducing the need for anti-diabetic allopathic drugs and ending insulin dependency been made so aggressively. When such statements come with the legitimacy of government backing, it is bound to lull already apathetic patients into a false sense of security. Intervention is, therefore, badly needed.
First, the CCRAS laboratories which conducted research must reveal the inclusion and exclusion criteria for patients who were enrolled in the clinical trials along with their informed consent and the result of pathological tests done before, during and after being treated with the ayurvedic formulation. They must clarify whether it was a stand-alone treatment or was used as adjuvant therapy alongside modern medicine. This is the only way now of safeguarding the credibility of the research and protecting the consumer. Second, the research councils must be prevented from making sensational claims referring to their diabetic drug as “revolutionary”, and endorsing the sale of what is now a commercial product. To blame the manufacturer is simply shirking responsibility. Nothing short of a public retraction can undo the damage. Third, the companies that are selling the drugs and using the logo and the name of government-run research labs to back their claims should be stopped. Regulatory authorities must ensure that the licensees do not exploit the government connection to promote sales.
Finally, with more than 50 million people in the country already suffering from diabetes, dependency on drugs is no answer. The advice of Nikhil Tandon, professor of endocrinology at AIIMS, needs to be heeded and broadcast in the media: “Diabetes cannot be controlled unless consumption of sugar and fat are reduced drastically and people start regular exercise.”
Last month when the Namaste India festival was launched I was in Paris in a French museum — at the Musee Guimet devoted to Asian culture. I joined a queue of people into the auditorium to find an intense discussion on new wave Indian cinema. The panellists and audience, all French, exhibited an deep interest in Indian cinema, an advantage we ought to have exploited long ago by creating a pool of film commentators to discuss the socio-political environment on which parallel Indian cinema is based.
Cultural diplomacy is accepted as a powerful instrument of soft power whose outreach is often underestimated. It has been found to be the most effective way of influencing foreign audiences. Other countries reach out to the youth, non-elite and other audiences outside the traditional embassy circuit because this form of diplomacy derives its credibility when it is seen as being independent of government institutions. Instead, our official cultural institutions are directly marketing culture in a way that is often hackneyed, stale and superficial — cardboard cut-outs of the real thing.
People are tired of the same old stuff and all the Indian stereotypes that have been done to death. Instead of a fresh approach to contemporary realities there is a bureaucratisation of culture and far from seeking inputs from artistes, intellectuals and professionals, government organisations and officials decide what to showcase and how. Sadly patronage often has its role in all this, resulting in the resurrection of individuals who have been around for decades. Repackaged content, which we have showcased for decades, no longer attracts audiences who can easily access the best productions at the touch of a button.
Professor Alain Supiot of the College de France and the founder of the Institute of Advanced Studies at Nantes in France feels that “there is a need for the intellectual horizons of culture to go beyond western ways of thinking to establish a dialogue between cultures. The focus of cultural exchange should embrace culture in its broadest sense of the term, by being attentive to the diversity of civilisations.”
For this to happen, there must be an understanding of what French people want. Discussions with Indian authors are big attractions but not two years after a book is released. Textiles are another. “French people are enthralled by Indian textiles and the art of embroidery, weaving and block printing from so many regions” commented an avid admirer of India and who has long been a leading light of the Parisian couture industry. Another comment I heard was “why do you not introduce veg/ non-veg express thalis as a diversion from those “sempiternelle” (French for eternal) pizzas? Or run a shopping arcade of Indian groceries next to Gare du Nord railway terminus?”
And that brings one to ask whatever happened to the Indian cultural centre in Paris? What is the story behind why premises purchased years ago are still lying unused even as Namaste India is launched with so much fanfare? The property bought by the embassy is beautifully located within walking distance of the Eiffel Tower, the Qui de Bramley, and a host of cultural centres representing foreign countries. Possibly a critical CAG paragraph, lack of funds or simple apathy prevents the Centre from starting to function.
What is needed is an effort to refurbish our efforts at cultural diplomacy to demonstrate to a foreign audience that we have the ability to collect and interpret ourselves in a way that responds imaginatively to what people want. We need at the helm of affairs persons who have an understanding of local attitudes that transient embassy employees cannot possess. We also need some way of ensuring that the people who decide how to represent India abroad have the necessary gravitas and the intellectual bandwidth to do so.
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