NFHS-5 Data Shows India Forgot Its Obesity Burden while Fighting Undernutrition

A few decades ago, obesity was not considered a public health issue. Even as late as the 1990s, obesity was only seen as a western concern, whereas undernutrition was more of a problem for developing nations like India. However, obesity is now afflicting more than 44 per cent of the world’s population. According to the data from the fifth round of the National Family Health Survey (NFHS), India is not far behind. Most government regimes have focused their efforts in recent years on combating malnutrition, with many schemes launched across the country. While the focus was important for that time, new data on obesity suggests that we may have forgotten the obesity burden.

Vaccine Nationalism of Rich Countries: A Self-Defeating Approach With No Winners

Just a week ago, Danish officials confirmed that they will be doing away with more than 1.1 million doses of COVID-19 vaccines as their efforts to give them to other countries have failed. While on one hand, several rich countries like Denmark have vaccines in surplus, on the other hand, The Duke Global Health Innovation Centre has estimated that the majority in low-income countries will have to wait until 2023 to be vaccinated.

Health Star Rating for Packaged Food is a Welcome Move. But is It Enough?

In India, consumers have always had a difficult time separating unhealthy food items from their healthy counterparts. The country’s plan to implement a Health Star Rating (HSR) system for packaged food items is a long-pending move. The decision to approve HSR was made with an eye on rise in obesity, diabetes and hypertension in India. This rating will help in bringing about a behavioural change in the population. The Food Safety and Standards Authority of India (FSSAI) has been tasked with overseeing its implementation. The decision was made after a report was released by IIM Ahmedabad on ‘Consumer preferences for different nutrition front-of-pack labels in India’. The rating’s aim is to make customers aware and capable of making informed food choices.

From Libya to Afghanistan and Syria, Vaccination Rates in War-Torn Nations Are Alarmingly Low

Fear grips the lives of people in various disputed regions around the world. Fear of several years of war and destruction and now the fear of a fatal global pandemic. The already hobbled healthcare systems have further been overwhelmed with high infection rates of Covid-19. As newer variants continue to keep coming up, the best possible way out of the situation is to get the maximum possible number of people vaccinated. However, vaccinating people in crisis zones has been fraught with difficulties thus far. Many of these areas have not even partially vaccinated one-fourth of their population. Rapid and concerted efforts in the coming months are critical to closing the vaccine distribution gap.

Ayurveda to Unani—traditional medicine systems can’t run on anecdotal evidence. Need research

In the last few years, there has been a push towards traditional medicine. And interest in indigenous medicinal systems has witnessed a boom in the ongoing Covid-19 pandemic. A big reason for this shift in public opinion can be credited to the massive promotion done by the Ministry of AYUSH. AYUSH was once a mere department under the Union health ministry and got promoted to a full ministry in 2014. Although there has been some anecdotal evidence that suggests that ancient forms of medicine such as Ayurveda, Unani, and Siddha are effective in treatment of a variety of diseases, there is dearth of reliable research to support such claims.

There have also been countless incidents that prove that harms caused by the traditional treatment are sometimes more than their supposed benefits. As we move towards achieving healthcare for all, it becomes extremely important that only evidence-based medicine is promoted and allowed.

Missing Females: Underreporting of COVID-19 Cases Among Women Shows A Persistent And Global Problem

In the healthcare sector, relevant and accurate data has become everything. Public health across the globe can be tremendously improved with the help of accurate and timely data. But data on women’s health has always remained in the dark. Several surveys and reports have repeatedly shown that “Missing Women,” a term coined by Indian economist Amartya Sen, is a global problem. This underreporting of females has come to light yet again. A recent research study has demonstrated that many countries have failed to report female infections throughout the pandemic equally.

In a fast-paced, digital world, data becomes essential at each step. Developing a blind spot for continued underreporting adds to the “normalisation” of men representing the entire population’s health. The missing data is a significant impediment to a country’s holistic development and improvement in overall health. It is now that the world should turn towards addressing and filling in the data gap; otherwise, we would fail to produce better outcomes for women’s health.

Omicron: Is India testing enough?

With the onslaught of the third wave, low testing rates have become a point of concern. With positivity rates touching 30 per cent in some cities as against the World Health Organisation (WHO)’s recommended five per cent, we do not see a proportional rise in the number of cases. This low number contributes to the narrative about the meekness of the Omicron variant hindering our implementation of the 3T strategy of testing, tracking and treatment.

Omicron: Clinically milder but potentially deadlier

There has been a sudden surge in Covid cases across the country in the past few days. This increase can be attributed to the newest Covid-19 variant: Omicron. Ignorance, misconception, and a delay in response could result in India's even more fatal third wave. With India still reeling from the effects of earlier waves and the economic crisis, a new variant, while less fatal, could turn out to be deadlier.

Omicron Scare - Why International Travel Ban Will Do India More Harm than Good

The possibility of another disastrous wave in the country has increased with the discovery of a new SARS-CoV-2 variant, Omicron, and two such cases being detected in Karnataka. This has come along with the Union government issuing new travel guidelines on November 30. A likelihood of the country putting a partial or complete international travel ban is doing the rounds. Recently, Delhi Chief Minister Arvind Kejriwal issued a statement urging the government to not further delay the curbs on international flights. But contrary to popular belief, an immediate air travel ban can do more harm than good. Moreover, the question arises: is it economically feasible, logically valid and morally correct? 

Effective communication about COVID-19 could save lives – but India’s strategy has been flawed

Over the past few decades, public health emergencies across the globe have shown us that a timely and efficient risk communication plan could help in minimising fatalities and managing situations on the ground. In unprecedented circumstances such as the Covid-19 pandemic, implementing effective communication methods becomes even more necessary. At the start of the pandemic, it was critical for the Union government to use all means to convey the gravity of the situation to the public. To do so, several communication plans were devised in order to maximise efficiency while minimising casualties.

Why India shouldn't allow COVID-19 booster dose

The Delta variant caused a fresh wave of Covid-19 infections worldwide, aggravating the global public health catastrophe. The currently available Covid-19 vaccines are effective against the Delta variant, which prompted researchers to evaluate whether booster doses for vaccinated people are necessary and when they should be given. The objective of the booster dose is to extend vaccine efficacy in people already administered with primary vaccination. However, this decision should be taken after careful analysis of the necessity of boosters and their timing. India, however, should refrain from administering booster doses to its population until further studies are done to show its utility.Read the full article in the Deccan Herald

COVID-19 outbreak underlines need for India to develop its own epidemic intelligence service

Recently both WHO and the US have announced the establishment of centres to monitor the emergence and spread of new diseases. WHO’s new Hub for Pandemic and Epidemic Intelligence in Germany, and the US’ Center for Forecasting and Outbreak Analytics under the CDC system will gather data on emerging diseases and forecast their spread to prevent a repeat of the COVID-19 pandemic. These are going to be dedicated facilities in addition to the already robust system of centres, agencies, departments etc. employed in monitoring global health trends.We argue that it is in India’s national interest to develop its own National Epidemic Intelligence System {NEIS}, instead of only depending on global agencies. The NEIS should incorporate existing domestic machinery for disease surveillance with newer technologies and analyse biological events with a strategic lens.READ THE FULL ARTICLE ON FIRSTPOST.

xhttps://www.firstpost.com/india/covid-19-outbreak-underlines-need-for-india-to-develop-its-own-epidemic-intelligence-service-10013961.html

India's Vaccine Diplomacy should take a Backseat Now

As a major vaccine manufacturer, India is expected to lend its hand to protect global health by exporting vaccines to other nations which are yet to administer vaccination doses to the majority of its population. Sources in the Indian government have mentioned India's plans to restart the export of vaccines to African nations in the coming weeks. There have also been reports that the Prime Minister's visit with the United States President later this month will discuss the possibility of India's role in vaccine exports. Biden is expected to convince Modi to make India release a number of doses as humanitarian aid to other countries to combat the spread of the virus and its deadly variants.But is it time to go back to vaccine diplomacy or should India take time to assess the situation better and make a rational decision? There are reasons to suggest that India, despite being a benevolent state, should adopt a wait and watch approach when dealing with vaccine exports from the country.

How should India's Vaccine Mandate Policy look like?

The recent wave of Covid-19 infections across the United States has been a setback for employers, schools, and universities who were readying to open their offices and campuses. From a "no mask needed for the fully vaccinated" policy 50 days back to vaccines being made compulsory by both state administrations and private companies alike, the Covid-19 vaccine has become imperative for the recovery process from the pandemic.Given the population size of India and the current pace of vaccinations in the country, the threat of future waves of Covid-19 infections still looms large. Recently, employer institutions (both government as well as private) along with public service provider businesses in the country have mandated the Covid-19 vaccine for their employees and customers, respectively.But if there is a vaccine mandate issued in India, what would be the ideal strategy for implementing it?

Digital health cooperation with Israel is in India’s health interest

By Shambhavi Naik and Gedaliah AftermanIndia’s dramatic surge in COVID-19 cases has refocused the local debate on the mismatch between demand and supply of medical services across the country. This discrepancy is aggravated by local lockdowns impeding access to doctors and fear of infection, as people are encouraged to seek medical attention at home. Pleas on social media have demonstrated the need to use digital tools to address issues of information asymmetry and access of health services in non-urban areas.Noticeably, countries have been able to direct their existing digital health solutions to augment their health infrastructure to respond quickly to COVID-19. Israel, which this week removed most COVID-19 related restrictions, is an excellent example of deploying digital health solutions. India can collaborate strategically with Israel to develop capacity in digital health, in preparation for future pandemics.India’s experiments in recent years with adopting digital health have led to mixed responses. Challenges include lack of digital infrastructure in non-urban areas, language barriers, and the absence of basic health services in remote areas. Thus, a blanket one-size-fits-all approach to digital health adoption is unlikely to work in India.Instead, a tiered approach or ground up building of infrastructure is required. Nonetheless, it is important to build to this goal, as digital health tools can help close several current gaps in healthcare. Electronic health records (EHR) maintained in an inter-operable manner, as envisioned under India’s Data Empowerment and Protection Architecture (DEPA), can reduce diagnostic costs and ease access to a patient’s health history for medical professionals. Such records can also form the basis for health information exchange, where EHR from remote areas can be sent to specialist doctors for their opinion.Telemedicine can be used by doctors to patients or consult amongst his peers. COVID-19 has highlighted the importance of developing telemedicine services even in urban centers, so that patients can continue receiving health services without endangering their lives. In addition, diagnostic tools such as wearables can enable real-time monitoring of patient’s health data, leading to more effective decision-making by medical professionals.While these tools cannot replace core medical functions, they can supplement operations and increase medical outreach. The implementation process is however accompanied by concerns about consent mechanisms for data acquisition, storage, and possible cybersecurity threats. Successful implementation of digital health therefore depends on an ecosystem that fosters not only innovation, but also trust and an adequate formulation of appropriate policies to govern digital health.Extending the India-Israel partnershipTo effectively plan and implement digital health policies, governments can learn from each other and work together. Furthermore, only by creating long-lasting cooperative structures and partnerships can they effectively prepare for future crises. Israel and India offer a particular case in point.Israel has actively engaged digital health tools in its public health service and is well placed to share its experience and knowhow with international partners. Under the aegis of Healthcare Israel, it has already provided professional assessments on health care programs in Africa, Asia, and Europe.Israel has successfully deployed digital health tools, but its population and infrastructural challenges are relatively small. On the other hand, India’s adoption of digital tools is still in its infancy, and choosing the right partner can help it expedite this growth. Both stand to benefit from increased cooperation in this field: India can provide an opportunity for Israel to trial technologies at scale in preparation for their international deployment. An effective way to achieve this, while safeguarding rights and health of Indian citizens, would be to create “regulatory sandboxes,” where innovators can trial promising solutions in a controlled environment under a regulator’s supervision. In exchange, Israel’s innovative capabilities make it a highly suitable partner for India.A good starting point for such a collaboration would be to map technologies for preventive healthcare. Point-of-care diagnostics and screening, as just one example, can help in the early detection of cancer and early intervention, which would not only save lives but also reduce the demand for tertiary healthcare and the costs of surgical treatments. Collectively gathered population-level data could inform on developing infectious disease outbreaks, underpinning a health response to prevent further spread. Such preventive strategies would provide relief to strained health resources and allow their effective use, even as India builds up more capacity.Increased investment in health infrastructure, legislation safeguarding the privacy of citizens, and the strengthening of the health regulator are three key actions that are critical for the successful adoption of digital health in both Israel and India. Creating this ecosystem can not only enable government-to-government collaboration, but also facilitate the growth of the domestic and international private sectors providing digital health services. Private sector participation will underline greater outreach of health services, contributing to improved health outcomes.The ongoing COVID-19 outbreak has demonstrated the urgency of increased international cooperation to protect global health interests. No country can be safe from a pandemic unless all countries have adequate, accessible, and affordable healthcare. Therefore, it is a national and global interest for India, Israel, and others to use this opportunity to collaborate and lead the way in creating world-class products and services that can benefit all.Download this article as a pdf.Authors: Shambhavi Naik (PhD) is the Head of Research at the Takshashila Institution  Gedaliah Afterman (PhD) is Head of the Asia Policy Program at the Abba Eban Institute for International Diplomacy.

The Pandemic has shown how Dysfunctional our World Order is

What is the best way to fight a pandemic in an era of intense globalization? The answer, clearly, is for humanity to throw its combined resources against its common adversary. Since no one is safe until everyone is safe, the longer it takes for the world’s population to acquire immunity against the coronavirus, the greater the risk that whatever protection immunized populations currently enjoy will be broken by new variants.

And what would a common global response to a common threat look like? Here too the answer is clear: temporarily suspend intellectual property rights restrictions, lift export controls, remove trade barriers and eliminate regulatory friction on vaccine supply chains. Essential drugs and medical equipment should flow unrestricted to wherever they are necessary. Amid a firefight with a common enemy, it makes no sense to demand payment from an ally who urgently needs bullets.Read the full article in The Mint

What the COVID-19 Second Wave tells us about Twitter

The Covid-19 pandemic has given us several painful images in the last two years. During the first wave, the image that stayed with us was of migrant workers walking inhuman distances in the wake of an arbitrary national lockdown.During the second wave, the enduring image has been that of our social media feeds awash with desperate calls for help. Yet, amidst the shortage of critical medical equipment and the overflowing of cremation grounds, one cannot help but be struck by the great altruism and activism of thousands of regular social media users.Read the full article on Indian Express

The banal geopolitical fallout of the laboratory leak hypothesis

On 11 September 2001, the US suffered four coordinated terrorist attacks that claimed nearly 3,000 lives, injured over 25,000 people and caused at least $10 billion in property damage. Within hours, the US National Security Agency had intercepted phone calls that led them to suspect Osama bin Laden’s Al-Qaeda of having planned and carried out the attacks. On that same evening, the CIA director confirmed this assessment to the US president. In two weeks, the FBI identified the specific attackers, and by the end of the month had published photographs and nationalities of all 19 terrorists who carried out the attacks. Of them were 15 Saudis, two Emiratis, a Lebanese and an Egyptian. Bin Laden himself was a Saudi national and Khaled Sheikh Mohammed, a key conspirator, was Pakistani. The US authorities knew Bin Laden and his outfit quite well, for they had together fought the Soviets in Afghanistan in the 1980s, along with the Saudi and Pakistani intelligence agencies. So it is fair to say that one would have to have one’s head firmly buried in the sand to miss the glaring Saudi and Pakistani links to—and possible complicity in—the attacks.Read the full article in The Mint

Focus on getting on most of India vaccinated as quickly as possible

Let’s say a Mr Melon Rusk, one of the world’s richest billionaires, approaches the Indian government and makes an offer to deliver 2 billion doses of a covid vaccine within 2 months for ₹2 trillion. At ₹1,000 per dose, Mr Rusk’s price is at least three times that of domestic vaccines, and would make an incredibly rich man with a flashy lifestyle even richer. Should the government take the offer?

The right answer is yes, it should. Mr Rusk’s wealth, opportunism and lifestyle choices are irrelevant details and ought not to cloud our mind. Last year, the Indian economy shrank 8% due to disruptions caused by the pandemic. By this estimate, the ₹195 trillion Indian economy might be currently losing ₹300 billion every week. The financial cost of vaccinating everyone will be ‘recovered’ by the Indian economy in less than two months. The government’s own ‘business case’ for vaccination is an open and shut affair. If the economy shrinks by 8% this year, the Union and states together would suffer a revenue loss of ₹2.3 trillion (as the overall tax-to-GDP ratio is around 15%). The government should thus pay Mr Rusk ₹2 trillion to avoid suffering a bigger revenue loss.These rough estimates highlight three important points. First, that it makes abundant sense for the government to finance the cost of universal vaccination. Second, at this time, how much the vaccine costs is less important than how much and how fast it is available. Third, it does not matter which government—Union or state—is paying, as long as the citizen gets the vaccine free.Unfortunately, a lot of the public and political discourse in India is still caught up with pricing, the level of profits that manufacturers are making, and which government should bear the fiscal burden. The behaviour and utterances of some vaccine manufacturers have not helped either. Most importantly, the Union government has not bothered to explain the rationale of its vaccination policy, thereby both isolating itself and preventing public debate from being more constructive.A democracy is only as good as its discourse. If it is misdirected, the political priorities go askew and public outcomes suffer. This is not a time to obsess about prices, image or narrative. The most important national priority is to vaccinate everyone as fast as possible. Like China, India can achieve 10 to 20 million jabs per day if we recognize our strengths and play to them. So how do we get that many doses, and how do we administer them fast?In the past few weeks, the government has taken the crucial step of opening the Indian market to all vaccines approved globally. The types of vaccines available has gone up from two to eight, and the government expects over 2 billion doses to be available by December. Given that there can be many a slip between the cup and the lip, the government must focus on making more vaccines available, and available faster.We need more than 300 million doses a month. Will compulsory licensing and patent waivers help? The historical discourse on this topic has been focused on lowering the cost of essential drugs. In our case and at this time, the issue is not cost, but quantity. It is unclear that compulsory licensing will by itself lead to additional manufacturing capacity coming online fast enough. But there is no harm in trying.There is a ready case for the government to let Covaxin be manufactured by more companies, with free licensing for domestic markets until the pandemic has ended. Bharat Biotech should be compensated if necessary. This will enable state governments and private manufacturers to explore how they can create or use existing plants to produce vaccines. The Indian government will be justified in doing the same for Oxford/AstraZeneca and other vaccines, but it is prudent to start with the partly-publicly funded indigenous vaccine.Some of the heartburn over the liberalized vaccination strategy is unwarranted. Equity considerations can and should be addressed by the government making vaccines available to everyone free of cost. As long as this baseline is ensured, there is no equity argument against private and decentralized vaccination. Also, the government’s vaccination programme can respond to epidemiological triggers by redirecting its supplies to where they are needed most.Finally, it is misplaced thinking that government channels alone can take us to 10 million jabs per day. Remember, large-scale covid testing took off only after private labs were allowed to carry them out. The Indian healthcare model is a mixture of the public and private, the Union, state, municipal, panchayat, NGO and, yes, unfortunately sometimes the shady and underhand. But now is not a time to pass judgement on it or attempt its reform—now is a time to put it to work. The government’s role is to enable the system, not fight it.Mr Melon Rusk, by the way, is a fictitious character. But if we agree that it is sensible to accept his offer, we need not begrudge paying our domestic manufacturers ₹300-400 per dose. For a billion people, the cost is a mere 0.4% of GDP and incurring it could allow the government to recover 2.5 times that amount in otherwise lost taxes this year.This article was originally published in ThePrint

Blaming the government’s pandemic response? Do it for the right reasons

The Union government has received a lot of flak over its management of the pandemic response, and deservedly so. But I want to look at three incorrect — or at least problematic — frames being used to blame the government’s pandemic response, inadequate and confused as it already is. The intention is to focus on questions that matter.Incorrect Frame #1: Blame Vaccine DiplomacyAs cases have skyrocketed and vaccine supplies have plummeted, India’s vaccine diplomacy has come under the scanner. Today’s dominant narrative is that by prioritising vaccine exports over domestic inoculation, India did a disservice to its people. I disagree. It’s not altruism but national self-interest that guides international humanitarian assistance efforts by all states. By giving away vaccines to smaller states in the subcontinent, India signalled the positive role it can play in the world order. Another way of thinking about vaccine diplomacy is to think of its opportunity cost. At the current vaccination rate, India would’ve had just five additional days of supplies had it not given any of the nearly 10.7 million doses as gifts to other countries. A majority of the deliveries (almost 35 million) have been under commercial terms between manufacturers and other countries. Moreover, had India blocked commercial exports earlier, India would’ve received much less enthusiastic support from other countries in this moment of crisis.Holding the Union government accountable for its mistakes is essential. Equally important is identifying what the exact error was. The original sin was not placing enough vaccine orders because the government was complacent about having conquered the virus. It calculated that the pandemic would peter out even with a snail-paced domestic vaccination campaign.By internalising that India was wrong in extending its help to other countries in its own time of predicament, we would be learning the wrong lesson. Such heuristics tend to stick around for long in the Indian strategic affairs community. Try arguing for developing overseas operations military capability of any kind, and the idea will be shot down, citing the Indian Peace Keeping Force (IPFK) failure in Sri Lanka nearly three decades ago. Vaccine diplomacy mustn’t be perceived as another IPKF moment.Read the full article in Times of IndiaImage credits: Illustration by Freepik Storyset