Health

Bengal Police Conduct Searches at Doctor’s House Days After He Speaks to Reporters on ‘Saline Scam’

A team of over 30 Bidhannagar police officers conducted a search of Asfakulla Naiya’s residence in the Kakdwip block of the South 24 Parganas district. Naiya told The Wire that the search took place in his absence.

Kolkata: Days after he publicly criticised an alleged medicine adulteration scam in West Bengal’s state-run hospitals, police raided the home of junior doctor Dr. Asfakulla Naiya. Naiya was a prominent figure in the protests which took place in the aftermath of the trainee doctor’s rape and murder at the R.G. Kar Medical College and Hospital.

A team of over 30 Bidhannagar police officers conducted a search of Naiya’s residence in the Kakdwip block of the South 24 Parganas district. Naiya told The Wire that the search took place in his absence and that he was staying at his designated hostel at R.G. Kar Medical College in Kolkata at the time of the search.

Speaking to The Wire, Naiya said, “I don’t know why they searched my house or what the charges are. I woke up in the morning to this news. My family informed me that a large police force with cameras entered my house and conducted a search. My elderly mother and siblings at home were shocked. If I have done anything illegal, the police should call me.”

Prior to the search, Naiya had spoken to The Wire on January 13, alleging significant corruption within the healthcare system in Bengal.

On January 15, he was slapped with a show-cause notice following a complaint alleging that he practised as an “ENT specialist” at a private medical service provider’s clinic in the state despite lacking the necessary qualifications for that specialisation.

Naiya is convinced that the search is meant to coerce him into silence. “As the day of the trial for the murder of the doctor at R.G. Kar is approaching, we doctors are preparing for that legal battle and at the same time fulfilling our duty of providing medical services too. At this time, it is plain to see that the administration has taken such a step to deliberately flummox us,” he said.

“If the police secretly leave something in my house in my absence, who will be responsible for it? This is a deep conspiracy!”

The deputy commissioner of the Bidhan Nagar Police Station, Anis Sarkar, told The Wire that the search was conducted legally.

“After receiving a complaint, we obtained permission from the Bidhan Nagar court. With a search warrant from the court, we conducted a search at the junior doctor’s residence today,” said Sarkar.

The complaint against Naiya was first brought up publicly last month by a spokesperson of the ruling Trinamool Congress party, Kunal Ghosh and the Junior Doctors’ Association (JDA), a doctors’ body with close ties to TMC. During the several month-long agitation for justice and systemic changes after the R.G. Kar murder, several doctors had been vocal in alleging corruption and a threat culture perpetrated by some JDA office-bearers.

Naiya had been a prominent face of the Junior Doctors’ Forum which led the protests, which culminated after a meeting between the doctors and chief minister Mamata Banerjee.

The forum had notably opposed the reinstatement of doctors Avik De and Birupaksha Biswas to the West Bengal Medical Council. The duo had been removed in September last year for allegedly promoting a culture of intimidation and corruption in medical colleges. Both were affiliated to the TMC.

Several doctors’ bodies have spoken in support of Naiya.

In a strongly worded statement, the Joint Platform of Doctors’ Organisations had said, “The Medical Council can never send police to a doctor’s house. If a doctor does anything illegal, they can ask for an explanation by letter. Here, the police have been sent to the house of a protesting doctor as an act of political vendetta. If the government does not stop such actions, doctors and health workers will have to take to the streets again.”

The Association of Health Service Doctors has also strongly condemned the TMC government’s vindictive politics.

This is not the first time that the government has executed such action.

During the R.G. Kar movement, Alok Kumar Verma, a doctor from Uttar Pradesh working at North Bengal Medical College in Siliguri, participated in the protests and went on a hunger strike in solidarity with the junior doctors in Kolkata. Following instructions from the West Bengal Police, the Uttar Pradesh Police had visited his home in Lucknow and conducted a search. His family was reportedly pressured to convince him to withdraw from the movement.

Similar incidents occurred with other doctors, including a woman from Bankura, whose home was also searched by the police, allegedly to intimidate her family.

Also read: What the Deaths of Women Due to the Use of Expired Saline Says About Bengal’s Healthcare

Medinipur Medical College death controversy

Meanwhile, the Bengal government on January 16 suspended 12 doctors from Midnapore Medical College and Hospital following the death of a woman and the illness of four others after childbirth, allegedly due to the administration of expired intravenous fluid. Chief minister Banerjee condemned the incident and announced a compensation of Rs 5 lakh and a government job for the deceased woman’s family.

It was alleged that the maternal death and subsequent illnesses were linked to Ringer’s Lactate saline supplied by Paschim Banga Pharmaceuticals, a company previously blacklisted by the Karnataka government. Since then, the state government has issued a directive stopping use of medicines supplied by the company in state-run hospitals. However, the health secretary maintained that the saline batch sent to MMCH had undergone proper testing.

Translated from the Bengali original and with inputs from Aparna Bhattacharya.

What the Deaths of Women Due to the Use of Expired Saline Says About Bengal’s Healthcare

The suspected cause of the sudden complications is Ringer’s Lactate (RL) solution, supplied by Paschim Banga Pharmaceuticals. The government has issued no directives regarding the disposal or return of the existing stock.

Kolkata: For nine months, twenty-six-year-old Nasrin Khan had been experiencing a healthy and uncomplicated pregnancy. Nasrin was admitted to Midnapore Medical College, a state-run super-specialty hospital, on Wednesday (January 8) for childbirth. The doctors recommended a C-section, and Nasrin and her husband, Salim Khan, welcomed their daughter into the world.

Despite a seemingly uneventful delivery, Nasrin’s condition deteriorated rapidly after being administered a post-surgery saline solution. She is now on life support, raising serious concerns about the irregularities in the health system in West Bengal, five months after the R.G. Kar Medical College incident laid it bare.

“I was happy, but then I heard that my wife Nasrin had been given a saline solution that had made her condition worse. The condition of many other patients had also deteriorated after receiving the same saline. My wife was admitted to the ICU. Meanwhile, I heard that a woman had died after receiving the same saline. As I was listening to all this and inquiring about my wife’s condition, I realised it was very critical,” said Salim Khan, Nasrin’s husband, waiting anxiously at the S.S.K.M. Hospital in Kolkata where his wife and two other women were brought through a green channel on Sunday night.

Last week, twenty-two-year-old Mamoni Ruidas died two days after childbirth at Midnapore Medical College. The cause of death was suspected to be the administration of an “expired” and previously banned saline solution. Following the administration of this saline, 47 patients at the hospital fell ill. Six were admitted to the ICU, and two remain on life support at the time of this report.

“I lost my wife due to the government’s adulterated saline. My newborn son did not see his mother. Who will judge if the government itself gives such adulterated saline to patients?” said Debashis Ruidas, Mamoni Ruidas’s husband who works as a daily wage earner from Chandrakona in Paschim Medinipur district.

Mamoni Ruidas gave birth to a healthy boy on Wednesday who is still in the hospital. Their elder daughter is being looked after by the family members as Debashish waits for his son to recover.

“The doctors said my wife’s condition is better now. But I am terrified,” said Md Saifuddin, whose wife Minara Bibi was also brought to Kolkata.

The suspected cause of the sudden complications is Ringer’s Lactate (RL) solution, supplied by Paschim Banga Pharmaceuticals. The Siliguri-based company, founded in 2014, known for supplying medicines to government hospitals across India, is under investigation for distributing potentially contaminated RL saline. This saline was banned by the West Bengal health department eight months ago due to quality concerns, but it allegedly resurfaced in government hospitals, including Midnapore Medical College.

On Sunday, Mamoni Dolui visited Suri Sadar Hospital in Birbhum for sterilisation. She started vomiting blood from her nose and mouth after the procedure. Even after being taken to the ICU, she could not be saved.

“After taking a medication, my wife started vomiting blood from her nose and mouth. She was rushed to the ICU, but unfortunately, we couldn’t save her. I suspect she might have taken a counterfeit or adulterated drug,” said Sachin Dolui, Mamoni Dolui’s husband. Sources at Suri Sadar Hospital have confirmed the recent arrival of 90,000 bottles of saline manufactured by Paschim Banga Pharmaceuticals.

The use of D5 saline, also manufactured by Paschim Banga Pharmaceuticals, at Tehatta Hospital in Nadia recently sparked protests from a patient’s relatives. The hospital subsequently replaced the saline. D5 saline is used for short-term fluid replacement therapy. It works by replenishing lost fluids, effectively treating hypovolemia caused by dehydration, injury, or burns.

These incidents highlight a broader pattern. While hospitals are currently using saline from other manufacturers, till Saturday, the government has issued no directives regarding the disposal or return of the existing stock, leaving hospital authorities uncertain about its storage and potential use.

Banned in Karnataka

In November 2024, Karnataka blacklisted the Bengal-based pharmaceuticals company after an investigation into the deaths of five pregnant women in in Bellary District Hospital was linked to the company’s saline. The investigation found the saline to be filled with low-quality fluid, prompting 27 complaints regarding its quality.

In December 2024, the Karnataka government requested an investigation by the drugs controller general of India regarding the clearance issued by the central drug laboratory (CDL), Kolkata, for the sodium lactate injection supplied by Paschim Banga Pharmaceuticals to the Karnataka state medical supplies corporation limited (KSMSCL) for use in government hospitals.

Despite the ban, the company continued to supply saline to West Bengal hospitals. The state health department initiated an investigation into the deaths of several pregnant women in April and June last year, but the report remains unreleased.

The company’s factory in North Dinajpur has been closed since December 11. Sources within the company claim the owner, Kailash Mitruka, had close ties with ruling Trinamool Congress (TMC) leaders and health department officials were facilitating the supply of 14 types of medicines and the saline to various government hospitals in the state.

Doctors express concern

The incidents raise serious concerns about the quality of medical supplies used in government healthcare facilities and the potential for corruption in the procurement process. On Saturday (January 11), a team of 13 doctors, led by S.D. Ashish Biswas, arrived to investigate the incident. He told the media, “It cannot be said right now. We have taken the batch number of the saline sample.”

“If this incident had happened for the first time, we might have considered it an accident. However, this issue has been ongoing for over a year, and the company has even been blacklisted by Karnataka. Despite numerous complaints within our state, the government remains unresponsive. We have seen the use of this particular saline leads to rapid kidney failure, followed by other complications that quickly deteriorate the patient’s condition,” said Dr Manas Gumta of the Association of Health Service Doctors.

In Midnapore Medical College, families of the affected patients were forced to sign indemnity bonds after their deliveries, acknowledging potential complications from saline use, including the risk of death. These bonds, containing the saline batch numbers, were likely created after patients fell ill, raising concerns about a hospital cover-up.

During the agitations after R.G. Kar Medical College incidents, many doctors from the state-run hospitals warned about substandard drug supplies leading to complications and even fatalities. On Saturday, the West Bengal health department issued a notification restricting the administration of 10 drugs in state-run hospitals.

“Not only RL, there was severe allergic reaction after NS [normal saline] as well as IV [Intravenous] antibiotics too at a stretch a few days back in my hospital. Had reported to higher authorities but was told that there’s nothing wrong in medicine but in injection procedures and keep checking on that only. Don’t know what will be the next!” a doctor working in a government hospital told The Wire on conditions of anonymity.

“Such incidents have been happening for a long time, and now it is coming to light due to the media. One of the main issues in our movement is to break this den of corruption, and we will continue to agitate in the future,” claimed Dr Asfakulla Naiya, one of the key organisers of West Bengal Junior Doctors’ Forum which was at the forefront of the protest after the R.G. Kar incident.

Also read: Less Than a Third of People Suffering from Diabetes Get Treatment in India, World’s Diabetes Capital

The family and colleagues of the slain doctor at R.G. Kar Medical College had earlier alleged that she had previously made complaints to both the health department and the college principal regarding the low quality and adulteration of numerous hospital medicines.

In a statement, the Joint Doctors’ Forum criticised the state government for “inhumane treatment”. “On January 7, the government’s statement did not address what should be done with the medicines stored in the warehouse. RL is still in the warehouse. Now that the matter has come to light, these salines are being hidden. We have repeatedly drawn the government’s attention to the issue of adulterated and low-quality medicines, but have received nothing but inhumane treatment.”

Minister of state for health Chandrima Bhattacharya told The Wire that “the government is investigating the matter and the truth will be known when the report is published.”

The Opposition reacts

On Sunday, the left organisations Democratic Youth Federation of India (DYFI), All India Democratic Women’s Association (AIDWA) and Students’ Federation of India (SFI) protested in front of the Midnapore Medical College, demanding stern action against those responsible for Mamoni Ruidas’s death. Led by Minakshi Mukherjee, the DYFI’s state secretary, the protest included the symbolic locking of the hospital superintendent’s already locked office and temporary road blockades.

“Fake medicines will continue to infiltrate Bengal’s medical colleges unless the deep-rooted corruption involving the police, administration, and health department is eradicated.Why are the police unable to act against corruption? Are they being hindered by higher authorities? Now hospitals are asking patients to supply expensive medicines?” asked Mukherjee.

The state unit of the Congress party also staged demonstrations demanding the resignation of health minister Mamata Banerjee.

Translated from Bangla by Aparna Bhattacharya.

72-Year-Old Cancer Patient Dies by Suicide in Bengaluru, Was Refused Benefits Under Ayushman Bharat

The scheme’s implementation has been stalled by the state government, which has resulted in senior citizens being forced to pay hefty amounts at private hospitals.

New Delhi: A 72-year-old resident of Bengaluru allegedly died by suicide on December 25, after 15 days after he was diagnosed with gastric cancer.

The retired state government employee was shocked to know that the hospital declined to provide him Rs. 5 lakh insurance cover under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), a scheme for senior citizens in which he was enrolled, reported The Times of India.

“Even though we had created an AB PM-JAY senior citizen card providing him with Rs 5 lakh annual cover, the Kidwai Memorial Institute Of Oncology (KMIO) denied the benefit, saying that the state govt orders had not arrived yet. However, it extended us a 50% discount,” said a family member of the deceased man.

The health insurance scheme provides cover of Rs. 5 lakh for senior citizens who are of 70 years and above.

“We had just started tests and scans and spent Rs 20,000. The treatment entailed a major surgery after chemo. We planned on starting two rounds of chemo at Kidwai itself. We were ready to pay, but then we lost him to suicide in just two days. I am not saying it was directly due to unavailability of the benefit, but he knew it did not come through and was already stressed,” said the family member.

Implementation of scheme stuck in Karnataka due to standoff between state and Centre

A confrontation between the Congress government in Karnataka and the BJP-led NDA government in the Centre over the funding of the Ayushman Bharat senior citizen’s scheme has resulted in several senior citizens in distress.

The scheme’s implementation has been stalled by the state government, which has resulted in senior citizens being forced to pay hefty amounts at private hospitals, reported CNBC TV18.

Karnataka Health Minister Dinesh Gundu Rao has said that the state has to pay 75 per cent while the Centre’s share is 25 per cent.

“It’s a burden on the state,” said Rao.

The scheme enables senior citizens to avail cashless hospitalisation in empanelled hospitals.

Meta’s Fact-Check Exit is Dangerous For India’s Public Health Security

Meta’s decision to phase out its third-party fact-checking program and shift to a community-driven system has generated debate over the future of information verification on its platforms. With billions of active users across Facebook, Instagram and Threads, this move has the potential to be transformative – but not necessarily in the ways we hope.

For India, where social media acts as both a source of legitimate information and a conduit for misinformation and fake news, this decision has far-reaching consequences that stretch beyond public health to national security and political stability.

India’s attitude to social media is a conundrum. On the one hand, networks such as Facebook and Instagram are critical tools for sharing health information. From vaccine drives to disease awareness campaigns such as for tuberculosis and diabetes, social media has proven effective in mobilising resources and communities. During the COVID-19 epidemic, these networks were critical in informing millions about safety precautions and vaccinations.

On the other hand, social media also provides a rich breeding ground for health misinformation. The pandemic’s “infodemic” – as the World Health Organization (WHO) dubbed it – revealed how quickly incorrect information spreads and how harmful its effects can be.

Unverified claims about miracle cures, vaccine side effects, and pseudoscientific treatments inundated newsfeeds, often overshadowing actual public health messages. The effects were catastrophic, including delayed treatment, increased vaccination reluctance, and, in some cases, avoidable fatalities.

Meta has effectively shifted the burden of truth to its users by replacing professional fact-checkers with a crowd-sourced mechanism. Mark Zuckerberg justifies the change as a move towards democratising information and eliminating allegations of biased content management.

However, this vision appears to be disturbingly out of touch with the Indian reality.

Why community-driven fact check doesn’t work for India

India’s linguistic diversity, diverse literacy levels, and geographical variations in internet access make it particularly susceptible to misinformation. A community-driven fact-checking system implies a certain level of internet literacy and media savvy, which many users in India do not possess.

In a country where WhatsApp forwards are frequently used as medical advice, the lack of expert fact-checking could contribute to an increase in health-related misinformation. Unsubstantiated claims about cures and miracles might swiftly escalate out of hand and its implications would particularly be disastrous for vulnerable people.

Also read: Why the Elderly Are More Susceptible to Social Media Misinformation

India’s polarised sociopolitical context also heightens the likelihood of unscrupulous actors exploiting the system to advance their agendas. People throughout the world have used social media platforms to destabilise nations, skew elections and spread extreme views.

However, in India, which is known for its tremendous diversity and structural issues, the lack of professional control on platforms such as Meta fosters an unchecked atmosphere for politically tinged falsehoods to thrive.

Furthermore, Meta’s decision does not only risk public health but also includes major threats to India’s health security.

Recent occurrences have demonstrated how misinformation – particularly on issues such as disease outbreaks – can snowball into public crises, leaving institutions rushing to manage both perception and fact. Health misinformation, which is linked to public faith in governance and institutional credibility, has the ability to destabilise both the social fabric and crucial health systems. In this setting, uncorrected misinformation poses a direct threat to India’s resilience and security.

The WHO is expected to be among the first UN institutions to face major financial cuts under the incoming Donald Trump administration in the United States. The US president-elect has repeatedly expressed discontent with the WHO’s operations, implying that his administration has little faith in the institution.

As the WHO tries to charm back the US administration for funds, India must understand that the organisation may not be a credible source of support in combating health misinformation in this new geopolitical environment. So, India must defend its population by utilising its own resources and expertise to solve the challenges posed by misinformation and its impact on public health.

Consider the commercial dynamics of social media networks to gain insight into Meta’s decision. Meta thrives on engagement metrics such as likes, shares, comments and views. Controversial or sensational content usually excels in these metrics, regardless of the reality. Combating misinformation is inherently incompatible with the platform’s financial objectives under this business model.

In other words, Meta’s values user engagement over user well-being, at least in territories like India where regulatory monitoring is still suboptimal. By eliminating expert fact-checkers, Meta risks turning its platforms into misinformation echo chambers, especially for a social media scene where pseudoscience is already common.

How India could prevent the misinformation risk

Given India’s economic, education and health gaps, any strategy of combating misinformation must account for these differences in order to be both realistic and scalable.

The lack of comprehensive access to education and healthcare contributes to the spread of misinformation, particularly in rural and poor areas where people rely significantly on unverified sources.

The government should begin by establishing a high-level legal and technology group of experts tasked with facilitating quick public discourse and developing tangible recommendations. These ideas should address both state-specific problems based on human development indicators and national threats that make health disinformation appear to be a security issue.

Creating dedicated monitoring cells within regulatory organisations to track and rebut misinformation in real time is critical. For example, India might be inspired by successful models such as Taiwan’s “Fact Check Centre”, which works quickly with the government and media to dispel any misleading information. To adapt similar approaches in India’s setting, these monitoring cells might involve multisectoral collaboration by integrating skills from technology, public health, and media institutions to respond decisively to damaging narratives.

In the medium run, India requires strong laws to hold social media corporations accountable for spreading misinformation and fake news, supplemented with cross-border collaboration in South Asia. Given the interrelated nature of misinformation, a collaborative framework would enable nearby countries to share experiences, standardise best practices and respond rapidly to transnational misinformation attempts.

The government should advocate for collaborations with Meta and other platforms to develop AI-powered solutions detecting misinformation that are appropriate for India’s linguistic and cultural diversity.

Meta’s withdrawal from professional fact-checking is a watershed moment in internet history, with far-reaching repercussions for public health security. This action, framed as an effort to defend free expression, runs the risk of establishing an environment in which misinformation can flourish unchallenged.

The stakes are enormous in India, a country of such size and diversity. As the Mundaka Upanishad tells us: Satyameva Jayate (truth alone triumphs), and truth’s triumph warrants focused activity. The health security of the Indian people requires nothing less than a clear and unwavering commitment to the truth.

Sunoor Verma is the president of The Himalayan Dialogues and an international expert in leadership, strategic communication and global health diplomacy. More on www.sunoor.net.

HMPV: No Possibility of Mutation Causing Large-Scale Epidemic, WHO Tells The Wire

Replying to The Wire, the WHO has clarified that it has not received any alarming news from China. The virus is neither new, nor COVID-like but appears to have led to a panic outbreak in India.

New Delhi: The conduct of a large section of mainstream Indian media in the first week of 2025 was an unpleasant reminder of over a year ago. On both occasions, the media contributed to panic over a “new” virus outbreak in India, which it said was followed by a “new” virus scare in China.

Throughout January 6, breaking news flashed on Indian TV channels on the detection of Human Metapneumovirus (HMPV) cases. As many as five cases of HMPV, mostly among children, have been reported in the country till January 6 evening. Patients tested positive in Karnataka, Gujarat and Tamil Nadu.

In November 2023, various news channels had reported that China was facing an outbreak of a “mysterious” virus. The resultant panic was clearly visible on social media.

However, neither in November 2023 nor in January 2025 was there a “new” virus outbreak in China. Both the times, what has happened is an outbreak involving a combination of respiratory viruses – something that does happen in winter.

The build-up to the hysteria this year started about a week ago when a couple of Indian media outlets (here and here) ran reports and others screamed headlines about a “new fear” while trying to draw similarities between the COVID-19 outbreak and what is happening this year.

Some have, incredibly, even gone on to predict a possible pandemic.

A simple scientific explanation is enough to gauge the fundamental differences between the Sars-Cov-2 – the virus causing COVID-19 – and the HMPV.

Sars-CoV-2 was a virus of unknown origin. No scientist had known about it before it appeared and therefore, it was termed a novel (or new) coronavirus. Also, 2020 saw the first ever outbreak of Sars-Cov-2. On other hand, a Google search reveals within seconds that HMPV was first found in 2001.

Further, Sars-Cov-2 is an RNA virus while HMPV is a DNA virus. This would mean that the former has the capacity to mutate and change its variants faster while the same probability with the latter remains quite low because of this one difference in property.

So far, there is no scientific evidence to claim that the HMPV has mutated to spread faster or more lethally this time.

Any outbreak can be labelled a pandemic only if it spreads globally and it is caused by a new virus, according to the textbook definition. Neither of these two conditions have been met in the current outbreak.

Alarm bells have not been sounded either by a global health think-tank or the World Health Organisation (WHO).

What the WHO said to The Wire

In fact, replying to a query of The Wire on January 4 the WHO said, “The WHO has not received reports from China of any unusual increase in respiratory illness.”

“WHO continues to track respiratory pathogens in the Region, including changes in strains and variants [emphasis ours], and supports outbreak detection and response efforts,” it added.

Thus, it gave a clear indication that no mutation has so far been reported that could potentially reveal a bigger outbreak this time.

The UN body also clarified:

“According to updates from China’s Center for Disease Control & Prevention (China CDC) surveillance data from 16-22 December 2024, although there has been a rise in acute respiratory infections – including seasonal influenza, human metapneumovirus (hMPV), rhinovirus infection, respiratory syncytial virus (RSV) and others – particularly in northern provinces of China.”

These viruses are previously known and have been spreading over the years.

The WHO also highlighted that the ‘scale and intensity’ of respiratory diseases outbreak in China “this year was lower than during the same period last year,” thus, suggesting that there is no potential cause for worry right away.

Incidentally, The Wire got this response from the WHO a day before India demanded timely updates from it. It is not immediately known whether any other country has made a similar demand.

The Program for Monitoring Emerging Diseases, popularly known as ‘ProMed’ is a publicly-available platform that reports global developments on disease outbreaks. It reported on December 28 that a China’s National Disease Control and Prevention Administration (NDCPA) official stated in a press conference that infections had risen significantly in the week of 16 to 22 December 2024. The official, though, added that the total number of cases in 2025 were projected to be lower than that of the previous year.

So far, there is no evidence in the public domain to doubt the WHO’s or China’s stand.

Interestingly, the ‘panic wave’ originated in Indian media when none of the international news agencies or global publications were reporting anything unusual about China. Reuters reported on December 27 that China was going to launch a new monitoring system to track unknown viruses. It also quoted the NCDPA official, referred to in the ProMed alert, to point out the surge in respiratory infections. But the Reuters report did not point to anything significantly extraordinary.

Also read: No New Pathogen, WHO’s Line, Why China?: What We Know About the ‘Unknown Pneumonia’ Outbreak

An upsurge in cases of what is known as ‘common cold’ caused due to influenza (flu) viruses during winters does not lead to a hysteria in India. So one wonders why a spike, if any has taken place, in HMPV cases – another respiratory infection – would be made to create shockwaves. Influenza, too, is a respiratory virus.

Many Indian news reports alluded to a viral video doing the rounds on social media about China’s hospitals being overwhelmed, but there has been no confirmation on it.

Meanwhile, many Indian scientists and doctors have posted on social media to inform people of the facts. Some of them can be read here (Dr Abdul Ghafur) and here (Dr Maulik Shah); and watched here (Gautam Menon) and here (S.C. Mande).

“Since the outbreak of respiratory viruses in winters is common in India and across the world, the more a country tests, the higher the number of infections it would find,” Vindo Scaria, a scientist working in the area of genomics, said. Therefore, an upsurge in China is not inexplicable. Detection of cases in higher numbers, especially of diseases which have been known to be mild, is not necessarily a cause for worry, he said.

“It is ideal from the perspective of public health that we should test more and be vigilant enough for infections during this season but the panic is uncalled for, unless an outlier is clearly visible,” Scaria added.

“HMPV has been in circulation for so long that many of us would already have been infected by it at some point without even knowing it,” Scaria said. This, he noted, would have also led to many of us developing antibodies against this virus.

Scaria’s observations regarding winters being an optimum season for surge in respiratory infection worldwide can be corroborated through some examples too. For example, NHK World reported on December 27 that Japan is reporting a big surge in influenza infections, caused by a respiratory virus, as noted before.

However, Scaria said that such occasions must serve as a reminder about the fact that India has not approved diagnostic tools for quite a few viruses like HMPV and Zika.

A private diagnostic lab can make primers of its own and use it with RT-PCR or a similar kit to detect HMPV. The kits may be available at a few hospitals/labs in the public and private sectors. But without approval, they can’t be sold in the market. So they are not available to be deployed at a large scale.

These [HMPV and Zika] viruses have been in circulation for a long time and we have had enough time to make kits for them. These kits would have to be scaled up for use should a sudden spike happen in any given year,” Scaria said. In such a scenario, India might be caught off-guard due to lack of these diagnostic tools.

Characteristics of HMPV

HMPV belongs to the ‘Paramyxoviridae’ family of viruses, similar to that of another respiratory virus, RSV. Both have a common seasonality. The symptoms are also similar. They are fever, cough, a runny nose, and wheezing – true for almost all respiratory infections.

Children, the elderly and those who have compromised immune systems are more vulnerable to HMPV. Those consuming immunosuppressants – drugs used to reduce the immune system’s working and given to patients who get organ transplants – or have infections which target the immune system itself, have a compromised immune system.

According to the US Centers for Disease Control and Prevention, HMPV spreads through the secretions from coughing and sneezing close personal contact, such as touching or shaking hands touching objects or surfaces that have the viruses on them then touching the mouth, nose, or eyes.

There is no specific antiviral for this virus – a case with many other viruses. Similarly, HMPV causes, largely, a self-limiting disease. Thus, care for treating symptoms like fever and cough is enough to treat it. According to the American Lung Association, if symptoms worsen and one develops shortness of breath, one should see a doctor.

There is no preventive vaccine for it. Again, this is not specific to this virus but is true for many others. Good hygiene, avoiding close contact with infected patients, and using masks if necessary, can prevent an HMPV infection.

Not Caring about Care: How Greed Dictates Our Hospital System

The system takes over, decides and retains the rights of admission, administering, excluding, or doing whatever it deems necessary with our body.

“Can you hear me? Hello!”

Yes, I could. Just that my body was limp. I was two minutes late in starting from home, to catch the university bus. I didn’t see the iron pipe protruding from the ground.

My pulse was slightly low but I did not lose consciousness. The doctor at the University health centre recommended a CT Scan to rule out any blood clot in my brain. I had no option but to go to the hospital, which I wanted to avoid. I was taken in an ambulance. My first and last hospitalisation was 29 years ago when my daughter was born; I was 23 then.

‘Levipil’

The neuro-surgeon confirmed that there was no blood clot, and asked me if I had lost consciousness. I asserted that I hadn’t, but reported being disoriented for about 10 minutes.

“We need to hospitalise you and keep you under observation for 24 hours, or give you medicines and release you. But then, someone has to watch over you for the next 24 hours.” I stay alone; so I agreed to the hospitalisation, where they created a channel for a administering an injection.

“What was the medicine?” I asked. They said: “Levipil”

I googled it and found it’s an anti-epileptic drug. It’s side-effects include breathlessness and suicidality. They didn’t tell me why they were administering it or it’s side effects. They did what they did because without inject-able meds through channel, and without hospitalising me for a day – insurance claims cannot be extracted.

I messaged a doctor-friend who specialises in emergency medicine. He enquired: “Why did they give you seizure med if you did not have one?” He confirmed that anti-seizure meds cannot be given as preventive measure.

He advised me to sign a bond and get out of the hospital. A colleague called and said, when she had a blackout a couple of years back, they gave her anti-seizure medicines for three years and she got addicted to it. Getting out of that was a whole new story.

On a different occasion, just a year ago, I was recommended an unnecessary hysterectomy by overplaying the risk of cancer, after my uterus was deemed useless beyond the reproductive years. 67% of hysterectomies in India are done in the private sector and 95% of these might be unnecessary. 40% of women have hysterectomy by the age of 64, world-wide, but less than 10% of these are performed with any type of cancer or pre-cancer indications, and are done simply with the intent to avert ovarian/uterine cancer. They do not warn you about the increased risk of other kinds of cancer when you remove your reproductive organs, like that of thyroid or kidney; or association of hysterectomy with cardiovascular events, cancer, depression and dementia. Withholding of information, and instilling fear and uncertainty in patients is a business strategy.

Next morning, when I told the junior doctor that I wouldn’t take anti-seizure med, he screamed at me: “Well, then you clear your bills yourself; don’t expect any insurance-coverage.” The hospital wanted to give three dosages of anti-seizure medicines. Finally, it was negotiated down to two.

The CT scan report surprisingly mentioned ‘loss of consciousness’. Not only did I not lose consciousness, I had no prior history of seizure. Anti-epileptic drugs cannot be administered, as a preventive measure. It is a malpractice.

The line of medical-malpractice was quite clear. I had to be compulsively hospitalised with the sole motif of claiming (read extracting) insurance. If a conscious patient, who has suffered minor injuries, feels so helpless, one can imagine the belittled condition of those who are unconscious. The system takes over, decides and retains the rights of admission, administering, excluding, or doing whatever it deems necessary with our body.

A common practice

Here is another example of total loss of agency of the patient’s family, the unequal power-relation and its extractive tendencies. My neighbour lost her dad in the same hospital a week back. When her Dad was in his last stage, they did a bronchoscopy without the consent of the family. When they were in the ICU in his last hours, they got bouncers to get the family out of the space, and her dad passed away alone surrounded by tubes and beeping machines. They fleeced out as much as they could.

Another person my neighbour knew, was kept on ventilator for two more days after she had passed away. A colleague confirmed from her experience that hospitals will declare a patient dead only after medical insurance money has been completely exhausted. The system – premised on maximisation of profit – conceives patients purely as consumers, offers packages, exploits every bit of the insurance-coverage, and denies treatment to all those who are unable to pay.

Patient-doctor relationship, where patients are at the receiving end – is often fraught with mistrust and contention. It has turned out to be entirely transactional in the neo-liberal era. The system of expertise-asymmetry, makes it dark, closed and unreceptive. The patient is at the mercy of an arrogant and extractive system. A system that is dripped in rampant malpractices due to incentives, commissions, sales targets of big pharmaceuticals. In such a context, resistance of the medical system to prescription-audits is self-explanatory.

The clinical gaze was always unequal. It offered power to those who are in the position to gaze. Now, it is even more detached and utterly disinterested to empathise with our pain and stress. Its sole commercial interests lie in prescribing tests, mandating scans, manipulating medical records, charging medicines, at times over-medicating, and conducting surgery even when it is unnecessary – making health-care more expensive, inaccessible, discerning, dehumanising and literally ‘pathological’. The power and monopoly of the medical system over patients can literally strip the patients of dignity and expose their vulnerabilities and lack of choice.

To say that the system does not care about its subjects is not the right diagnosis; rather the system relies on converting the patients into objects of impositions. Medical decisions, financial burdens and unchallenged authority of the system are often enforced at every stage. Even if one remains perpetually suspicious about the inner and outer operating procedures of the system, one can do little to alter its proceedings.

Once you are admitted behind the glass-doors, you surrender completely to the unequal power-equations and lack of transparency. You are at the receiving-end. You have very limited access, limited knowledge and almost no power to make decisions. The greedy system, takes advantage of the ‘information asymmetry’, ‘power asymmetry’ and ‘fear psychosis’. They have a free-run and you have nowhere to escape. And most importantly, the system does not care much about caring.

Paromita Goswami and Sreedeep Bhattacharya teach at Shiv Nadar University.

This piece was first published on The India Cable – a premium newsletter from The Wire & Galileo Ideas – and has been updated and republished here. To subscribe to The India Cable, click here.

In RTI Reply, Govt Says ‘No Data’ on Compensation for Families of Doctors Who Died by Covid-19

The Indian Medical Association (IMA) had submitted its report to the health ministry on the number of doctors who died due to Covid-19 during the first two waves.

New Delhi: The Union government has refused to release information on the number of families of doctors who died from Covid-19 during the first and second waves who have been compensated so far, saying it does not have enough data.

In an RTI (Right to Information) response, reported by The New Indian Express, the health ministry said that “data is not available in material form” on the compensation received by families. The RTI was filed on December 7 by RTI activist KV Babu seeking information on the total number of beneficiaries who have received compensation under the Pradhan Mantri Garib Kalyan Package (PMGKP) since its launch on March 30, 2020.

In an earlier RTI filed by him in November 2023, the ministry had revealed that 475, or 29% of the families, had been compensated.

The Indian Medical Association (IMA) had submitted its report to the health ministry on the number of doctors who died due to Covid-19 in the first two waves. According to the organisation, which has over 4 lakh members, 1,600 doctors had died fighting Covid-19 between 2020 and 2022.

Also read: Why PM-CARES Is a ‘Government Fund’ and Well Within RTI Purview

However, this is not the first time the ministry has refused to reveal data. In 2022, when the health ministry was asked in the Rajya Sabha how many healthcare workers had died in the pandemic, they said they have “no data”, despite the numbers provided by the IMA.

In a written reply, later, the minister of state for health and family welfare Dr Bharati Pravin Pawar had said “disaggregated data on deaths due to Covid-19 by profession or otherwise is not maintained centrally.”

In 2020, when the first wave of Covid-19 pandemic was at its peak, the government had promised Rs 50 lakh to the family of every health worker who died fighting Covid. To date, there is no clarity on how many families have received the compensation.

How Coaching Classes are Undermining Medical Education in India

When a first-year student joins college for MBBS, her eyes are full of aspiration and hope. There is contentment in her heart as she finally enters the world of her dream of becoming a great doctor after battling one of the toughest entrance exams in the country.

But soon, she realises that she has thrown herself into another battle – a battle where people are once again fighting to ace the NEET PG. The desire to win this race often surpasses the dream of being an exemplary doctor.

The coaching culture

Various factors push a medical student, mostly in the second or third year, towards coaching – the exhaustive syllabus, misguidance from seniors (who were themselves misguided by their seniors), peer pressure, and the deteriorating quality of medical education in some colleges. Above all, during the COVID-19 pandemic, the vulnerability of students and futile online lectures provided fertile ground for the deep roots of the coaching industry to grow.

All these factors have led to a situation where many students limit their learning to the screens of their iPads and tablets. It’s a common sight in libraries to see thick books being used merely as stands for mobile phones.

College bookshops that did not adapt by selling pirated coaching study materials remain empty. With easy access to recorded lectures on all possible topics, students often confine themselves to their hostel rooms and avoid clinical postings.

Among peers, the extent of one’s knowledge is frequently measured by the number of modules covered with clinical skills, patient care, empathy, and ethics, not even making it to the list of evaluation metrics.

Marketing strategies used by coaching platforms

Just like any other commercial group, coaching platforms use various tactics to promote themselves and create a “FOMO” (fear of missing out) among medical students.

The process of trapping students begins in the early years of MBBS. It starts by incentivising them based on their NEET UG ranks. One well-known platform is known to provide a four-year subscription to NEET PG, promising students that this will help them succeed in their PG exam just like it did in the UG exam.

The first year of MBBS is a rollercoaster ride of ups and downs for most students. They are suddenly faced with a bulky syllabus and the complexity of subjects. Initially, it is rare for them to understand the clinical relevance of basic subjects like Anatomy, Physiology, and Biochemistry. Without proper mentorship from faculty and seniors during this period, students can easily be drawn toward coaching classes.

Also read: Constitution@75: From Govt to Opposition, Everyone is United in the Assault on Scientific Temper

“As soon as my first-year results were announced, I received scholarship offers from major coaching platforms. When I initially declined, they emphasized that the offers were only valid based on my first-year performance. So, I decided to take the subscription at the start of my second year,” says A, a second-year medical student who was among the top 10 students in his first-year exams.

Additionally, batch representatives are selected to act as intermediaries between students and coaching institutions. These representatives receive incentives, including a coupon code that allows them to earn a share of the subscription payments made using their code.

These incentives typically range from 7% to 10% of the subscription fees they manage to sell. Some institutions also offer them extensions of their existing plans. Many students are easily drawn to these offers and enjoy the monetary benefits.

Some institutes are also notorious for emotionally manipulating students. A well-established platform is known to romanticize the idea of finding a “perfect study partner” on Valentine’s Day. They also excel at filming NEET PG toppers during emotional moments with their families, emphasising that their secret to success was watching all the videos available on their platform.

As a medical student enters their final year, the pressure to pass final exams and ace NEET PG simultaneously builds up. The anxiety of a final-year student is targeted through the “crash courses.” For instance, Medicine – a vast and challenging subject – is condensed into a 10-day crash course.

Free test series are another frequent offering during NEET PG preparation, often clarifying in their terms and conditions that they reserve the right to use students’ photos and names for promotional purposes if they achieve a top rank, regardless of the extent of their use of the platform. It remains a mystery how this year’s NEET PG AIR 1 managed to attend coaching from every available platform.

Coaching institutions do not limit themselves to academic involvement. They often serve as lead sponsors for annual fests and other events in many medical colleges. In exchange, they expect students to attend their promotional events. Recently, a renowned medical college struggled to secure sponsorship for their annual fest because, the previous year, they failed to fill the hall for the coaching platform’s promotional event.

While coaching industries are leaving no stone unturned to lure students, medical colleges seem to have turned a blind eye to the declining quality of medical education. Most lectures are reduced to reading from powerpoint slides, and students are not adequately engaged during clinical postings. There is no proper portal for providing feedback to faculty, leaving no avenue for improvement and making students increasingly dependent on coaching classes.

Impact of coaching

Although a student’s reasons for seeking coaching are rooted in the desire to excel academically and be a good doctor, unfortunately, coaching often leaves them with a lot of factual knowledge but weak basic concepts.

They join the race for NEET PG too early, and the desire to be that superhero doctor gets buried under stacks of coaching material. Coaching often helps with acquiring comprehensive knowledge but fails to provide the clinical skills essential for patient care.

“We learn all the facts but because we barely learn in clinical postings, it is difficult to translate that knowledge into proper patient care,” said a recent MBBS graduate who was struggling to clinically diagnose and treat patients with common diseases like pneumonia.

The students also miss out on gaining essential soft skills. Empathy, compassion, and good communication, which make a significant difference in patient care and outcomes, are picked up by observing experienced professors in clinical postings.

Also read: Less Than a Third of People Suffering from Diabetes Get Treatment in India, World’s Diabetes Capital

The impact that this coaching culture has on medical education, patient care, and ultimately the health system is therefore more serious than it is currently considered to be.

There is an urgent need to address the evident decline in the quality of medical education in India. This problem is compounded by the sudden increase in the admission seats without a proportional increase in good-quality teaching faculty.

To address this, vacancies for teachers in medical colleges should be increased, and the existing faculty should be trained in better teaching techniques.

Additionally, it is high time that colleges start restricting the intervention of coaching platforms within their campuses. Misguidance by immediate seniors who themselves have fully relied on coaching should be replaced by proper guidance from competent and experienced mentors.

The focus must be shifted towards creating knowledgeable, skilled, compassionate, and empathetic doctors, not just a greater number of doctors.

Note: Written by author(s) who wish to stay anonymous.

This article first appeared on Nivarana, a platform founded by Dr Parth Sharma, which focuses on India’s health issues. Read the original piece here.

Reproductive Futures: The Promises and Pitfalls of In-Vitro Gametogenesis

Although IVG is still a new technology, its probable risks and potential for misuse in a regulatory vacuum call for caution rather than any call for optimism.

In-vitro fertilisation (IVF) as assisted reproductive technology (ART) has been in vogue for quite a few decades now. While IVF has been hailed as a significant scientific advancement, with many advantages, here are some limitations which bear keeping in mind in discussions about the possibilities and extent of its use in the present and the future.. It is in this context that we discuss in-vitro gametogenesis (IVG) – a new experimental reproductive technology that is currently being developed and refined, and thus debated on a number of different fronts.

The concerns about reproductive autonomy, ethics, and equity ought to be at the forefront of any discussion of advanced and experimental reproductive technologies, including IVG. Although IVG is not currently under research in India, this technology is gaining more attention in the global scientific community. Thus, it becomes imperative to engage with it critically.

Researchers claim that IVG would reduce the risks of IVF procedures by creating sperm and oocytes (eggs) directly in a lab, unlike in the case of the IVF, which requires the retrieval of eggs from ovaries, and hormonal injections. The retrieval of eggs can be painful and risky.

Therefore, unlike traditional methods, which rely on naturally produced sperm and eggs , IVG enables the creation of these reproductive cells, known as gametes (reproductive cell – sperm and egg), artificially. This can be in a laboratory from ordinary body cells such as those from the skin. These cells are changed, or “reprogrammed,” into a special type of cell called stem cells, which can turn into almost any kind of cell in the body. In the lab, these stem cells are further transformed into sperm or eggs. The lab-made (or artificial) sperm and eggs then combine to form an embryo outside the body. This embryo can later be placed into the uterus of the woman, which can grow into a baby. This is the process which is known as in-vitro gametogenesis or IVG.

At the Third International Summit on Human Genome Editing in London in March 2023, a presentation outlined technological advancements in IVG. Skin cells taken from the tails of mice were successfully developed into gametes leading to the growth of healthy mice.One of the pioneers in the field of lab-grown oocytes and sperm is Katsuhiko Hayashi, who led the work at Kyushu University in Japan. Relatedly, scientists have also grown embryo-like structures in the lab, made entirely from human stem cells, that are more advanced than any previous efforts.

Some companies and academic institutions with significant private funding are already planning to translate the work for human use. Biotech startups in the United States, funded by venture capitalists and tech investors, have been marketing IVG as a radical new technology that will be available in a few years.

While still an experimental technology, IVG is being reported as “a milestone for human IVG research and its potential translation into reproductive medicine.” However, this transformation of human reproduction with advanced genetic technologies raises serious ethical, moral, and legal issues, even if they are still in the experimental stage.

Scientific claims

Researchers have presented IVG as aspirational, claiming that it drastically changes the way families, genetics, and reproduction are conceived and opens up reproductive possibilities for many hitherto excluded from the ability to have genetically related children.

IVG may also enable older individuals, same-sex persons, and transgender people to have genetically related children without using donor gametes. IVG proponents contend that it gives older women the opportunity to become mothers later in life, as well as women going through an early menopause – which is not the case with the IVF.

India’s Assisted Reproductive Technologies (Regulation) Act, 2021(ART) Act and Surrogacy (Regulation) Act, 2021 defines eligibility criteria for access to ARTs and surrogacy in India. Notably, they include age, nationality, marital status, sexual identity, and (implicitly) gender.

The focus on IVG is that IVF is not a foolproof way to overcome infertility, especially for women 35 years of age or older who want to have their own child. Also, according to the ART Act, only women and men between 21 and 55 years of age are eligible to access ARTs. The Surrogacy Act requires the intending couple to be a woman aged 23 to 50 and a man aged 25 to 55 years. And, therefore, the apparent advantage of the IVG, which allows women at a later stage of their life to conceive, may have little to limited impact in India.

Furthermore, the ART Act has legal limitations for oocyte (naturally – and not artificially produced sperms or eggs) retrieval. According to the law, an egg donor shall donate eggs only once in her life, and no more than seven eggs shall be retrieved from the donor. Similarly, the Surrogacy (Regulation) Rules, 2022, puts a cap on embryo transfer. One embryo is allowed to be transferred into the uterus of a surrogate mother, while up to three embryos may be transferred only in special circumstances.

With IVG, researchers claim they can create a large number of sperms and eggs, and embryos, in the lab, potentially providing an ‘opportunity’ to persons experiencing difficulties in producing sperms or eggs, naturally, to conceive through IVF.

The IVG is, thus, perceived as an expanded opportunity for ‘non-normative’ reproduction for same-sex partnerships and transgender or intersex individuals who want a child. It does not need natural reproductive cells and is genetically related to both partners. However, some same-sex couples would still require a surrogate to carry the pregnancy.

Additionally, IVG could generate multiple sperms and eggs, potentially improving success rates for those facing infertility challenges or unable to produce viable sperms or eggs naturally.

IVG could also be claimed to offer a solution for persons with genetic disorders who wish to have children without passing on their condition. Overall, IVG has the potential to expand options for family-making and address a wide range of reproductive concerns. It could ‘benefit’ diverse populations seeking to start or expand their families.

Concerns

Beginning with IVF in the 1970s, concepts surrounding birth, genetics, reproduction, and family-making have been challenged and transformed, sparking debates about fertility, genetics, family, kinship, and parenthood. Research on infertility, ART, and surrogacy has led to a rethinking of biotechnological reproduction. The use of IVG for genetic parenthood raises concerns about reinforcing genetic essentialism and undermining non-traditional families based on adoption or gametes or other forms of family.

Advocating the use of these experimental procedures in the name of genetic relatedness may also exacerbate existing inequalities for those already experiencing marginalisation. For example, researchers have claimed that IVG provides equity for same-sex couples and individuals, but legal frameworks still prioritise heterosexual couples. In many countries like India, LGBTI persons are not allowed to access surrogacy legally.

The Surrogacy Rules in India allow only married couples of Indian origin to access surrogacy. The Act denies the rights of homosexual couples to commission a child and refuses to acknowledge such couples as ‘legitimate’. Thus, the current legal framework limits surrogacy to cis-heterosexual married couples and operates within a cis-heteronormative framework that prioritises and, indeed, normalises a certain experience of childbearing and family-making over all others. If equity were a goal, IVF and surrogacy would be regulated differently.

Furthermore, IVG’s ability to create large numbers of embryos in a lab allows people to choose from dozens of potential embryos, enhancing embryo screening potential. This further enables the selection or rejection of embryos based on the likelihood of genetic diseases, chromosomal abnormalities, and even characteristics such as skin and eye colour, intelligence, or height.

While some of these genetic diseases might be patently ‘undesirable’, the procedure raises questions about the desirability of specific traits and genes. There are enough examples historically where the existing reproductive technologies have been misused to promote eugenic selections and discrimination against people with disabilities, intensifying societal disparities and race and caste based discrimination.

Caution over optimism

IVG has the potential to revolutionise families, genetics, and reproduction, but there is a significant gap between speculation about its benefits and the actual outcomes of research studies. Additionally, ongoing research will be necessary to understand this technology’s long-term effects and consequences on society as a whole. It is crucial to consider the potential impact on future generations and ensure that safeguards are in place to protect the rights and well-being of children created through IVG.

As IVG research progresses, carefully considering this technology’s ethical implications and potential consequences will be crucial. Furthermore, it is important to address discussions about the legal rights and status of children created through IVG.

As this technology advances, it will be essential to have open and transparent conversations about the ethical, social, and legal implications of IVG. These conversations should involve diverse people, including ethicists, scientists, policymakers, and the general public. These discussions and critical analyses can help navigate the complex science, ethics, and policy nexus around IVG. These discussions should distinguish between concepts like therapy and enhancement or disability and disease rather than rely solely on the scientific community to characterise the claims with IVG.

Although IVG is still a new technology, its probable risks and potential for misuse in a regulatory vacuum call for caution rather than any call for optimism.

Sarojini Nadimpally is a social scientist and public health researcher; Gargi Mishra is a lawyer and public health researcher. Authors work on the issues of infertility, ARTs, surrogacy, and genetic technologies.

The authors would like to acknowledge Sandhya Srinivasan, Vrinda Marwah, Keertana K.T., and Adsa Fatima for their inputs.

‘India Reduces Malaria Caseload, Deaths by 69%’: WHO Report

India is no longer classified as a High-Burden-High-Impact (HBHI) group for malaria according to the World Malaria Report 2024.

New Delhi: India is no longer classified as a High-Burden-High-Impact (HBHI) group for malaria according to the World Malaria Report released on Wednesday (December 11).

According to the report, India has reduced its malaria caseload by 69% from 6.4 million in 2017 to 2 million in 2023. Registered deaths attributed to malaria too decreased by 69%, from 11,100 to 3500 during the same period.

Dr Rajni Kant Srivastava, Indian Council of Medical Research (ICMR), Chair for Disease Elimination told the Indian Express that this was possible due to Artemisinin-based combination therapy (ACT) and long-lasting insecticidal nets (LLIN).

ACT works by killing most malaria parasites through one component [artemisinin], while a partner drug clears any remaining parasites. This, coupled with insecticide-treated nets or LLINs, which work by killing mosquitoes that come in contact with their insecticide coating, has made an impact, Srivastava said.

“The use of these tools in forested and tribal areas in Jharkhand, Odisha, Chhattisgarh and North-East has made an impact,” he said, adding that effective monitoring and evaluation have helped with case management.

“India has made progress in reducing the malaria burden because of its multi-sectoral approach and political commitment to bring down the burden,” said Dr Daniel Madandi, Director of Global Malaria Programme.

“It’s never as fast as we would like, and there are some worrying plateaus but the trends are still encouraging. Apart from India, countries like Liberia and Rwanda have seen huge drops in cases,” added Dr Arnaud Le Menach, lead author of this year’s report and head of the Strategic Information for Response unit within the WHO Global Malaria Programme.

The report also provides global trends and data related to malaria control. Between 2000 and 2023, 2.2 billion cases and 12.7 million malaria-related deaths were averted worldwide, it said.