TB: way ahead

DOTS (directly observed treatment, short-course), is the name given to the  control strategy that combines five components:World Health Organization-recommended tuberculosis

• Government commitment (including both political will at all levels, and establishing a centralized and prioritized system of TB monitoring, recording and training)
• Case detection by sputum smear microscopy
• Standardized treatment regimen directly observed by a healthcare worker or community health worker for at least the first two months
• A regular drug supply
• A standardized recording and reporting system that allows assessment of treatment results

·         WHO’s directly observed treatment shortcourse strategy aims at reducing TB incidence by 2015

DOTS IN INDIA

• Lack of political commitment has hampered its impact
• Poor supply of anti TB medicines

HOW WEST TACKLED TB?

• TB in western world dropped drastically without any major anti TB meciation
• This was possible through following steps
• Adequate housing
• Reduction in overcrowding
• Improved nutrition
• Better work environment
• India should learn lesson from this
• For long India has focused exclusively on medical inteventions and neglected socio envirnmental interventions

UNIQUE PROBLEMS IN INDIA

• DOTS involves provision of foced dose combination recommendation of medication
• In India most of poor are under nourished
• These doses of medicines may cause side effects on the undernourished people
• Also for lack of time/money many leave the medication course midway leading to increased susceptibility to multi drug resistant TB

THE FLAWED NUTRITION POLICY

• Our national nutrition policy focuses on provision of calories through carbohydrates to the poor while neglecting other essential components that make up a balanced diet
• This leads to lowered immunity

WAY AHEAD

• Educate general population
• Provide good housing
• Develop new diagnostic tests to replace smear tests

Manmohan singh (MMS) resets afghan policy

·         In 1992, mujhaideens in agreement with pakistan came to power in afghanistan rplacing a communist government headed by najibullah

·         Najibullah ahd sought assylum in India and India agreed to it but before he could leave country, the mujahideens captured him

·         India’s policy towards afghan between 1992-96 was

o   We will always keep contact with afghan irrespective of whoever is in power

o   We will try to build people to people contacts

o   We won’t support nor attack any of the militant groups

·         Taliban captured power in 1996

·         Since then we have cut ties with afghan

Outcome of MMS visit 2011

·         He has made it clear that India will not provide any militairy support in afghanistan

·         India is willing to provide trianing to its police.

o   In the long term an efficient police force is more important than a huge standing army

·         For first time India has indicated its openness towards the reconcilliation process with taliban

·         India has offered a 500 mn $ aid package

·         However India’s stand on foreign troop presence is not yet clear

o   US plans to draw down its troops by 2014 but envisages a long term militairy presence in region like in case of iraq

[Scheme Watch] Panchayat Mahila Evam Yuva Shakti Abhiyan

Panchayat Mahila Evam Yuva Shakti Abhiyan (PMEYSA) was launched in the year 2007.
The Scheme has two components namely,
Panchayat Mahila Shakti Abhiyan
Panchayat Yuva Shakti Abhiyan.

Aims of PMEYSA

to organize the Elected Women Representatives (EWRs) in a network and through group action to empower themselves, so that both their participation and representation on local governance issues improves.

Activities under the PMEYSA include holding of State Sammelans and Divisional/District level Sammelans of Elected Women Representatives, formation of Associations, setting up of State Support Centers, sensitization programmes for the Elected Women Representative and Elected Youth Representatives.

Threat from chronic diseases

·         Non communicable diseases are of 4 major types

o   Cardiovascular disease(CD)

o   Diabetes

o   Cancer

o   Chronic respiratory diseases

·         NCDs account for 63% of deaths in world

·         80% of NCD deaths are in low and middle income countries

·         Major cause for NCDs are

o   Physical inactivity

o   Alcohol consumption

o   Smoking

o   Unhealthy diet

·         India is expected to lose over 200 bn $ 0over next decade due to NCD

WAY AHEAD

·         Government needs to implement effective low cost interventions

o   For example finalnd and japan have drastically reduced CD mortality by mandating lesser salt content in packaged foods

Rethinking inclusive growth

·         Last few decades have seen a gradual withdrawal of state from economic activities

·         State is trasforming from being a strong regulator and policy setter to a facilitator of economic activities

·         The aim of 11^th FYP was inclusive growth through

o   Increased rates of growth in key sectors

o   Critical interventions in socials ector

11^th plan report card

·         Mid term appraisal of the plan indicated that none of sectors except “personal and communication services” performed satisfactorily

12^th plan challenges

·         Serious concern over government finances

·         Near jobless growth in primary sector

·         Growing informalisation of 2ndy and 3ry sector

WAY AHEAD

·         Policysetting should aminstream inclusive growth through strong regulatory