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(DAWS) 05-07-2022

DAWS

Syllabus GS III-Achievements of Indians in science & technology; indigenization of technology and developing new technology. 

  1. Explain in detail the reasons why India should support antibiotics development.

Antimicrobial resistance (AMR) is a looming public health crisis impacting every country globally with a disproportionate impact on lives and livelihood in low and middle-income countries.

The reasons for India should support antibiotics development:

  • AMR is one of India’s major public health problems, directly contributing to about 30% of deaths due to neonatal sepsis across India. These are due to multidrug-resistant (MDR) hospital-acquired infections in many cases.
  • Over 30% of the COVID-19 deaths in India could be attributed to our failure to treat the secondary bacterial infections caused by MDR pathogens with the appropriate antibiotics.
  • Irrational antibiotic use by the medical community, the general public and the farmers generate drug-resistant superbugs. Inadequate infection control measures in the hospitals and the sanitation issues in the community result in the dissemination of these superbugs.

To tackle the AMR crisis,

  • Need robust investment in research and development of new antibiotics, rapid and affordable diagnostics, strengthening infection control and prevention practices, formulating and implementing antibiotic stewardship programmes across the country and ensuring equitable access to life-saving antibiotics.
  • One such immediate intervention is a welcome move by the Government of India to pass legislation banning the use of streptomycin and tetracycline in agriculture and the growth promotional use of colistin in poultry farming.
  • With India’s reputation as the pharmacy of the global South, with numerous global compliant manufacturing plants, it’s time to expand our focus and investment in early R&D of life-saving antibiotics.

Reasons for the big pharma companies exiting the business:

  • The exit of big pharma from antibiotic development coupled with a lack of investment from venture capitalists and the paucity of enabling regulatory and policy solutions to support the commercial viability of antibacterial agents has pushed AMR into a global health crisis.
  • Unlike most new drugs, post-approval, new antibiotics are used sparingly (antibiotic stewardship practices) and reserved mainly for cases in which older antibiotics are ineffective.
  • These unique challenges in the current treatment guidelines and archaic reimbursement models contribute to commercial failure and restricted or lack of access for patients in dire need of these live-saving agents.
  • Most major pharma companies have exited the AMR space because of the low return on investment (ROI).

Way Forward:

  • To incentivise the creation of new treatments, the U.S. Congress enacted the Generating Antibiotic Incentives Now Act (GAIN Act) of 2012, which provides benefits to manufacturers of Qualified Infectious Disease Products (QIDPs) including five years of additional non-patent exclusivity.
  • In addition, the recent creation of the AMR Action Fund with a mandate to invest more than $1 billion to address the current funding gaps in the development of new antibiotics will give a boost to late-stage molecules in clinical development.

~Source The Hindu

Syllabus GS II:Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources. 

2. Preconception nutrition, maternal nutrition and child feeding practices in the first 1,000 days of life need priority. In this context, explain the current status, challenges and also give suggestions to improve the conditions of women and children.

As India launches the celebrations of its 75th anniversary of Independence, there is much to be proud about; significant advances have been made in science, technology, and medicine, adding to the country’s ancient, traditional, and civilisational knowledge base, wisdom and wealth.

Current status:

  1. It is disconcerting that even after seven decades of Independence, India is afflicted by public health issues such as child malnutrition (35.5% stunted, 67.1% anaemic) attributing to 68.2% of under-five child mortality.
  2. Poor nutrition not only adversely impacts health and survival but also leads to diminished learning capacity, and poor school performance. And in adulthood, it means reduced earnings and increased risks of chronic diseases such as diabetes, hypertension, and obesity.
  3. Data from the National Family Health Survey (NFHS)-5 2019-21, as compared to NFHS-4 2015-16, reveals a substantial improvement in a period of four to five years in several proxy indicators of women’s empowerment, for which the Government deserves credit.
  4. There is a substantial increase in antenatal service attendance (58.6 to 70.0%); women having their own saving bank accounts (63.0 to78.6%); women owning mobile phones that they themselves use (45.9 % to 54.0%); women married before 18 years of age (26.8 % to 23.3 %); women with 10 or more years of schooling (35.7% to 41.0%), and access to clean fuel for cooking (43.8 % to 68.6%).
  5. Alarmingly, during this period, the country has not progressed well in terms of direct nutrition interventions.
  6. Preconception nutrition, maternal nutrition, and appropriate infant and child feeding remain to be effectively addressed.
  7. India has 20% to 30% undernutrition even in the first six months of life when exclusive breastfeeding is the only nourishment required.

Challenges :

  • Neither maternal nutrition care interventions nor infant and young child feeding practices have shown the desired improvement. A maternal nutrition policy is still awaited.
  • Despite a policy on infant and young child feeding, and a ban on sale of commercial milk for infant feeding, there has only been a marginal improvement in the practice of exclusive breastfeeding (EBF). Child undernutrition in the first three months remains high. Creating awareness on EBF, promoting the technique of appropriate holding, latching and manually emptying the breast are crucial for the optimal transfer of breast milk to a baby. Recent evidence from the Centre for Technology Alternatives for Rural Areas (CTARA), IIT Mumbai team indicates that well-planned breastfeeding counselling given to pregnant women during antenatal checkup prior to delivery and in follow up frequent home visits makes a significant difference.
  • The daily weight gain of a baby was noted to average 30 to 35 grams per day and underweight prevalence rate reduced by almost two thirds.
  • NFHS-5 also confirms a gap in another nutrition intervention — complementary feeding practices, i.e., complementing semi-solid feeding with continuation of breast milk from six months onwards.
  • Poor complementary feeding is often due to a lack of awareness to start feeding at six to eight months, what and how to feed appropriately family food items, how frequently, and in what quantity.
  • The fact that 20% of children in higher socio- economic groups are also stunted indicates poor knowledge in food selection and feeding practices and a child’s ability to swallow mashed feed.

Suggestions

  • Creating awareness at the right time with the right tools and techniques regarding special care in the first 1,000 days deserves very high priority.
  • There is a pressing need to revisit the system spearheading POSHAN 2.0 and overhaul it to remove any flaws in its implementation.
  • There is a need to revisit the nodal system for nutrition programmes existing since 1975, the Integrated Child Development Scheme (ICDS) under the Ministry of Women and Child and examine whether it is the right system for reaching mother-child in the first 1000 days of life.
  • By depending on the ICDS, we are in fact missing the frequent contacts with pregnant mothers and children that the public health sector provides during antenatal care services and child immunisation services.
  • There is also a need to explore whether there is an alternative way to distribute the ICDS supplied supplementary nutrition as Take- Home Ration packets through the Public Distribution (PDS) and free the anganwadi workers of the ICDS to undertake timely counselling on appropriate maternal and child feeding practices.
  • This would address the mismatch that exists on focussing on delivery of services in the first 1000 days of life for preventing child undernutrition by having an effective accountable system.
  • It is time to think out of the box, and overcome systemic flaws and our dependence on the antiquated system of the 1970s that is slowing down the processes. Moreover, mass media or TV shows could organise discourses on care in the first 1,000 days to reach mothers outside the public health system.

Source ~The Hindu