Revisiting Healthcare in 2019
Dr KK Aggarwal
President CMAAO , HCFI and Past
National President IMA
The year 2019 saw a lot on new
health promises. Let us review some of the important ones.
Disease Outbreaks
1.
As per
Who list https://www.who.int/csr/don/archive/year/2019/en/
No major health outbreak in India in 2019.
2.
No case
of Polio was noted.
3.
In June
2019, an outbreak of acute encephalitis syndrome occurred in Muzaffarpur and
the adjoining districts in Bihar state of India, amidst the second-longest
heatwave in the region, resulting in deaths of more than 100 children, mainly
due to hypoglycemia.
4.
The index
case of Nipah in Koci in June was contained the disease was controlled before
it took off
5.
Congo fever: 17 cases were reported in Gujarat and three tested positive
in Rajasthan.
6.
More than 67,000 people across India have been diagnosed with dengue so
far this year, reports by the National Vector Borne Disease Control Programme
(NVBDCP) show. By mid-October, reports show, the disease had claimed 48 lives.
7.
The number of HIV-infected people who go on to develop Tuberculosis (TB)
is increasing in India, according to the India TB Report 2019,
which was released by the government on September 25, 2019.Nearly 25 per cent
of all deaths among PLHIV are estimated to be due to TB. The highest percentage
of patients who tested positive for TB and were also infected with HIV came
from Nagaland (15.6 per cent), followed by Karnataka (10 per cent), Chandigarh
(9.1 per cent) and Manipur (8.9 per cent).
Major Concerns of the year
1.
Pollution
in North India
2.
Rising
AMR
Parliament Bills
1.
The
parliament passed the National Medical Commission (NMC) Bill. The bill provided
for setting up a National Medical Commission (NMC) in place of the MCI to
develop and regulate all aspects of medical education, profession and
institutions in India.
2.
The
government in November referred a bill, which seeks to ban commercial surrogacy
in India, to a 23-member select committee of Rajya Sabha.
3.
The
government passed Prohibition of Electronic Cigarettes (Production,
Manufacture, Import, Export, Transport, Sale, Distribution, Storage and
Advertisement
4.
The draft
bill Healthcare Service Personnel and Clinical Establishments (Prohibition of
violence and damage to property) Bill, 2019 is pending to be passed
5.
The
Allied and Healthcare Professions Bill, 2018 was introduced in Rajya Sabha by
the Minister of Health and Family Welfare, Mr. J P Nadda on December 31, 2018.
The Bill seeks to regulate and standardise the education and practice of allied
and healthcare professionals. Jan 02, 2019 referred to standing committee
6.
The
Occupational Safety, Health and Working Conditions Code, 2019 pending
Delhi
1.
Delhi
health bill, which will replace Delhi Nursing Home act
2.
The Delhi
Government will shift serious patient to private ICU. The payment will be done
by DG if no bed is available with them
Major Courts Decisions
1.
Delhi
high court on ‘courts in its own motion’ has asked the CDSCO to release a list
of over the counter drugs
2.
Delhi
high court on ‘courts in its own motion’ has asked the Railways to have
emergency medical services at all major stations
Strikes
On 11 June 2019, following the
assault of two junior doctors at Nil Ratan Sircar Medical College and Hospital
(NRSMCH) the previous night, junior doctors in Kolkata began protesting and
demanded the Chief Minister of West Bengal, Mamata Banerjee to intervene and
provide adequate security to medical professionals, culminating into the
collapse of healthcare facilities in the state. Despite attempts at mediation,
protests continued through 13 June, finally resulting in the Chief Minister
issuing an ultimatum to the protesting doctors, which was eventually defied by
the protesting doctors who wanted the government to meet their demands for
security and a public apology from the Chief Minister.
Life expectancy and Vital
Statistics
1.
Life expectancy
in India has increased from 49.7 years in 1970-75 to 68.7 years in 2012-16, as
per the National Health Profile 2019. For the same period, the life expectancy
for females is 70.2 years and 67.4 years for males.
2.
HIV virus
now can be made untraceable undetectable and an HIV positive person will be
able to live a normal married life on daily uninterrupted treatment
Major Campaigns
1.
Fit India
Movement by Ministry of Sports GOI
2.
Perfect
Health Mela by Heart Care Foundation of India
Economics
1.
The
downfall in the economy was a major issue in 2019.
2.
In 2019, Fortis
Healthcare announced that it has completed
the acquisition of RHT Health Trust (RHT) assets for an enterprise value of Rs
4,650 crores.
3.
Rs 5,800 cr Medanta-Manipal deal falls through as sides disagree over
valuation
Medical Update
1.
For
patients with heart failure and low heart pumping function with persistent
symptoms and an elevated serum natriuretic peptide level on optimal
pharmacologic and device therapy a new ray of hope came for better due to
availability of a new drug dapagliflozin
2.
In patients
with type 2 diabetes with kidney involvement (urine albumin excretion >300
mg per day and eGFR >30) the incorporation of an SGLT-2 inhibitor into the
patient's glucose-lowering regimen has been shown to improve the diabetics
complications.
3.
We expect
in 2020 all patients with an LDL-C >100 mg/dL and a greater than 10 percent
risk of a cardiovascular disease event within 10 years, will be put on statins.
Also, All patients with cardiovascular disease independent of the
baseline low density lipoprotein cholesterol (LDL-C) level they will be put on
lifelong high-intensity statin therapy (atorvastatin 40 to 80 mg or
rosuvastatin 20 to 40 mg) rather than moderate intensity statin or no LDL-C
lowering therapy.
Ayushman Bharat
As on 2nd December
19590 hospitals empanelled, 6800774 patients benefitted via admissions
and 11.46.69,820 cards issued
IMA
Dr Rajan Sharma took over as the
National President
New Drugs introduced in India in
2019
1.
Fenspiride hydrochloride film coated extended
release tablet 80 mg and Fenspiride hydrochloride bulk for allergic asthma
2.
Bilastine
tablets 20 mg and Bilastine Bulk for urticaria
3.
Iguratimod
film coated tablets 25mg and Iguratimod Bulk for rheumatoid arthritis
4.
Fingolimod
Capsules 0.5mg and Fingolimod hydrochloridebulk for multiple sclerosis
5.
Remogliflozin
etabonate bulk and Remogliflozin etabonate film coated tablets 100 mg for diabetes
6.
Concentrate
of Proteolytic enzyme enriched in Bromelain topical gel for eschar
7.
Menotrophin
injection 600 IU/ml, 1 ml & 2 ml multi dose vial (Highly purified) for
infertility
8.
Rifapentine
150mg film coated tablet for TB
9.
FDC of
Bictegravir, Emtricitabine and Tenofovir alafenamide 50mg/200mg/25mg tablets
for HIV
10. Levomilnacipran
ER capsules 20mg/40mg/80mg/120mg for depression
11. Bosutinib
bulk and Bosutinib tablets 100mg, 400mg, 5600 mg for cancer
12. Algard
HWS-256 (didecyl dimethyl ammonium chloride 10.14% w/w + n-Alkyl dimethyl
benzyl ammonium chloride 6.76% w/w as disinfectant
13. Algard -
R-82 (octyldecyl dimethyl ammonium chloride 6.510 w/w + Dioctyl dimethyl
ammonium chloride 2.604% w/w + Didecyl dimethyl ammonium chloride 3.906% w/w +
Alkyl dimethyl benzyl ammonium chloride 8.680% w/w as disinfectant
14. Safinamide
methane sulphonate bulk drug and Safinamide tablets 50, 100mg for Parkinson
disease for Parkinson disease
15. Droxidopa
bulk drug and Droxidopa capsules 200mg/300mg for postural hypotension
16. Acalabrutinib
100mg capsules for multiple myeloma
17. Abemaciclib
50mg, 100mg, 150mg and 200mg film coated tablets for breast cancer
18. Ripasudil
hydrochloride hydrate bulk drug and Ripasudil Eye drops 0.4% w/v for glaucome
19. Diperoxochloric
acid concentrate and Diperoxochloric acid topical solution for diabetic
neuropathy ulcers
