PSM News

May 27,2024 Mumbai: Dr Nancy Y Lee, MD, FASTRO, Radiation Oncologist and Early Drug Development Specialist, Memorial Sloan Kettering (MSK) Cancer Centre, interacted with ETHealthworld’s Prabhat Prakash on the rising burden of head and neck cancer cases in India, the role of HPV vaccination in HNC prevention and how low-dose radiation is demonstrating encouraging outcomes with a lower dose. Edited Excerpts: The uptick in HPV-related cancers, particularly impacting men’s head and neck areas, is quite a concern, alongside its better-known link to cervical cancer in women. Recent data from the Centers for Disease Control and Prevention (CDC) show around 25,000 cases of HPV-associated cancers in women and 19,000 in men between 2013 and 2017. Notably, more than four out of every ten cases of HPV-related cancer occur in men. Looking ahead, the projections are equally alarming. According to GLOBOCAN 2020, India is expected to see a staggering 57.5 per cent increase in new cancer cases by 2040, totalling 2.1 million cases. Factors contributing to this surge include a lack of awareness and screening, leading to delayed diagnosis and treatment. Multiple sexual partners and oral sex contribute to the rise of this cancer. Additionally, tobacco and alcohol consumption, prevalent among Indian men, interact with HPV infection, further increasing cancer risk. Furthermore, limited HPV vaccination coverage, especially among boys and young men, perpetuates HPV transmission. In India, one in 33 males and one in 107 females are at risk of developing HNC. Every step of cancer care has hurdles, right from diagnosis to follow-up. There is an increased diagnostic delay in these patients among the Indian population, either due to limited access to healthcare, a lack of understanding of the gravity of the situation, or financial constraints. According to the Indian Council of Medical Research (ICMR), over 60 per cent of HNC cases are diagnosed at an advanced stage, primarily due to the absence of widespread screening programmes and low awareness levels. Tobacco and alcohol consumption, prevalent cultural practices, are significant risk factors; the World Health Organisation (WHO) estimates that nearly one-third of all cancer-related deaths in India are attributed to tobacco use. Furthermore, a study published in the Indian Journal of Cancer highlighted the disparities in healthcare infrastructure, with rural areas facing a shortage of trained medical professionals and diagnostic facilities. IFHNOS has revolutionised head and neck cancer care on a global scale, uniting experts from 70 countries to share cutting-edge research, techniques, and best practices. One of the key ways in which IFHNOS has made an impact is through its international conferences, workshops, and educational programmes. These events provide a platform for experts from diverse backgrounds to share their insights, discuss challenges, and explore solutions in the diagnosis, treatment, and rehabilitation of head and neck cancer patients. In a recent collaboration with MSK and its Chennai centre, IFHNOS introduced a HNC summit. Additionally, MSK offers a Head and Neck Oncology Fellowship accredited by IFHNOS, showcasing its dedication to excellence in head and neck cancer care. We’re observing a notable shift in HNC care, moving away from traditional invasive procedures toward more precise and patient-friendly approaches. Techniques like microsurgery and minimally invasive procedures such as transoral laser and robotic surgery are preserving vital functions and enhancing outcomes. Advanced radiation therapies like proton beam and intensity-modulated radiation therapy deliver targeted treatment, minimising collateral damage. Immunotherapy is also revolutionising cancer care by leveraging the body’s immune system to combat tumours, while genomic testing allows for personalised treatment plans, optimising efficacy. Furthermore, participation in clinical trials provides access to cutting-edge therapies, offering hope for patients. Looking forward, these advancements will continue to redefine the head and neck cancer care landscape, emphasising personalised treatment and improved quality of life for patients. Source: Healthwolrd

May 25,2024 Abu Dhabi: The Board of Directors of the Emirates Drug Establishment (EDE) held its fourth meeting since its establishment at the end of last year, to review and develop the main initiatives to be taken for the regulation and management of the UAE’s healthcare and pharmaceutical sectors – all of which are designed to reinforce the UAE’s reputation as a global and regional hub for the medical industry. The meeting was chaired by Dr Thbin Ahmed Al Zeyoudi, Minister of State for Foreign Trade and Chairman of the Board of Directors of the EDE, and was attended by Dr Maha Tayseer, Deputy Chairperson of the Board, Dr Fatima Mohammed Hilal Al Kaabi, Director General of the EDE, as well as board members Dr Issa Abdul Fattah Kazim, Badr Saleem Al Ulama, Dr Amer Ahmed Sharif, Dr Farhan Malak, and Professor Chris Evans. Ahmed Al Rumaithi has recently joined the Board as a representative of the UAE’s youth. During the meeting, the Board of Directors discussed the development of plans for the establishment of various specialised committees to enhance the EDE’s operational efficiency. The attendees also reviewed the latest developments regarding plans to integrate the activities of all relevant government agencies and services, including the transfer of supervision of more than 160 services from the Ministry of Health and Community Prevention and the Ministry of Climate Change and Environment to the EDE. Dr Thani said that the EDE is continuing its work to establish a fully integrated organisational structure that will regulate and manage all healthcare and pharmaceutical activities in the UAE. Its goal is to enhance standards, drive innovation, and stimulate cooperation in advanced research that will elevate the UAE’s healthcare industry to be in line with global best practices. Al Zeyoudi said, “We are focused on developing the institutional, organisational and administrative structure of the EDE, which will support the integration of relevant government agencies and services into our mandate. This is an important part of our efforts to enhance the UAE’s healthcare and pharmaceutical sector in line with global standards. We are determined to elevate the production capability and capacity of the local pharmaceutical sector in order to better cater for our needs, foster national excellence in this vital sector and attract both investment and talent from around the world.” As Director General of the EDE, Dr Fatima Al Kaabi stated that they are working on plans to implement previous recommendations of the Board of Directors, including the establishment of the EDE’s organisational structure and the appointment of a highly skilled and experienced team to oversee the continued improvement of healthcare standards in the country. Al Kaabi stated, “The EDE is working to establish its organisational structure that will help us achieve our strategic goals, elevating the standards and accelerating the expansion of our country’s healthcare and pharmaceutical sectors, increasing their contribution to the well-being of the UAE’s citizens as well as contributing to sustainable economic growth.” The UAE Cabinet approved the formation of the Board of Directors for the Emirates Drug Establishment in December 2023. Source: Healthworld

May 27,2024 Chicago: The United States and Europe are taking steps to acquire or manufacture H5N1 bird flu vaccines that could be used to protect at-risk poultry and dairy workers, veterinarians and lab technicians, government officials said, moves influensa experts say could curb the threat of a pandemic. U.S officials last week said they were moving bulk vaccine from CSL Seqirus that closely matches the current virus into finished shots that could provide 4.8 million doses of vaccine. European health officials told Reuters they were in talks to acquire CSL’s prepandemic vaccine. Canadian health officials said they have met with GSK, maker of Canada’s seasonal flu shots, to discuss acquiring and manufacturing a prepandemic bird flu vaccine once its seasonal flu production capacity is freed up. Other countries, including the UK, are discussing how to proceed on prepandemic vaccines, scientists said. The actions follow the explosive spread of a new strain of bird flu that emerged in late 2020 and has caused unprecedented numbers of deaths among wild birds and domestic poultry and has begun infecting many mammal species. In March, US officials reported the first outbreak of the virus in dairy cattle, which has infected dozens of herds in nine states and two dairy workers. The US Food and Drug Administration has estimated that 20 per cent of the US milk supply shows signs of the virus, indicating a wider spread is likely. Human exposures to the virus in poultry and dairy operations could increase the risk that the virus will mutate and gain the ability to spread easily in people. “All of our efforts need to be focused on preventing those events from happening,” said Matthew Miller, co-director of the Canadian Pandemic Preparedness Hub at McMaster University. “Once we have widespread infections of humans, we’re in big trouble.” Dr Angela Rasmussen, a virologist at the University of Saskatchewan, said she has been in discussions with US and Canadian officials about using vaccines to protect workers following the virus’ spread into new mammal species. Dawn O’Connell of the US Administration for Strategic Preparedness and Response said the government is “looking closely” at the possibility of vaccinating farm workers and others in close contact with the virus. The US has contracts with CSL and GSK to test prepandemic vaccines that more closely match the circulating virus than older H5N1 vaccines in the stockpile. The US is moving forward with the CSL vaccine, a Department of Health and Human Services official confirmed. Discussions about prepandemic vaccine use are going on at government levels and among scientists in a number of places, including in the UK, said Wendy Barclay, chair in influensa virology at University College London, who also researches avian flu for the UK Health Security Agency. Source: Healthworld

May 28,2024 New Delhi: A five-member expert committee will examine if manufacturing of nutraceuticals should be allowed within drug manufacturing facilities. India’s drug regulator had said earlier that action will be taken against those flouting norms by manufacturing supplements and drugs in the same facility. However, following objections raised by various pharma lobbies, the drug regulator has formed a committee that will give its recommendations within three weeks on the issue. The committee comprises senior officials from the regulatory authority, experts from the National Institute of Pharmaceutical Education and Research (NIPER) and an industry expert. “It has been decided to constitute a committee to examine the request of the industry associations to consider permitting manufacturing nutraceuticals in drug manufacturing facility,” said the notice dated May 27. “The committee shall submit the report within the time period of three weeks,” the notice said. ET had earlier reported that the government may “reconsider” its decision to act against pharmaceutical companies manufacturing nutraceuticals, health supplements and drugs in the same facility following objections raised by industry bodies. Federation of Pharma Entrepreneurs (Fope), a pharma lobby that works with micro, small and medium enterprises (MSMEs), had said any clampdown in this regard will affect not only exports but also the domestic market. Under the revised Schedule M of Drugs and Cosmetics Act 1940, a manufacturing facility approved for drugs cannot be used for manufacturing other products. Executives of Fope had also met the health secretary and the Drug Controller General of India (DCGI) seeking an exception to select units as was given earlier. An exception was earlier provided to the units established prior to December 2001, he said. “Subsequently, this concession was extended to all manufacturing establishments by the DCGI under his letter dated March 1, 2007, based on the decision of the Drugs Consultative Committee in its 37th meeting,” an industry expert said. Source: Pharma

May 25,2024 To facilitate the empanelment of public and private Ayush hospitals for insurance coverage, the Ministry of Ayush is meeting with heads of general insurance companies and Ayush hospital owners starting next week. The sensitisation outreach is also aimed at providing affordable Ayush healthcare to all citizens to be covered under public and private insurance and develop a networking relationship with all State/union territory government and private hospital associations linked with delivering Ayush health care. With an increase in demand for Ayush treatment, the Insurance Regulatory and Development Authority of India (IRDAI) has recently advised all insurers for providing Ayush coverage, which inter alia, shall include their approach towards placing Ayush treatment at par with other treatments for the purpose of health insurance so as to provide an option for the policyholders to choose treatment at their choice. “Empanelment of Ayush hospitals is the important aspect in ensuring Ayush insurance coverage. This will increase the visibility of Ayush hospitals in the health insurance sector,’’ said a senior official from the Ministry. He added that this sensitisation programme would serve as a platform for insightful discussions, knowledge exchange, and networking opportunities between representatives from the insurance sector and key stakeholders from the Ayush sector. The programme will have interactive sessions designed to elucidate the benefits and intricacies of integrating Ayush treatments into insurance coverage. The presentation is scheduled to cover issues including — Standard Treatment Guidelines (STG) & ICD Codes for insurance sector, Ayush in insurance sector (regulator’s perspective, penetration of Ayush) etc. Heads of general insurance companies and Ayush hospital owners, officials of IRDAI, General Insurance Council, Insurance Information Bureau of India, National Health Authority, national institutes of Ministry of Ayush, national commissions of Ministry of Ayush are expected to be part of this programme. Source: The Hindu

May 24,2024 New Delhi: About 7.5 lakh deaths associated with antimicrobial resistance (AMR) could be prevented every year in low-and middle-income countries (LMICs) by improving measures that prevent infections, according to an analysis, part of a four-paper series published in The Lancet journal. These measures included hand hygiene, regular cleaning and sterilisation of equipment in healthcare facilities, along with providing access to safe drinking water, effective sanitation and paediatric vaccines, researchers said. The international team of researchers estimated that each year, one in every eight deaths globally is caused by bacterial infections- about 77 lakh deaths in total, of which 50 lakh are associated with bacteria that have become resistant to antibiotics. The authors called for support in providing sustainable access to antibiotics to be central to ambitious and actionable targets for tackling AMR. “Access to effective antibiotics is essential to patients worldwide. A failure to provide these antibiotics puts us at risk for not meeting the UN sustainable development goals on child survival and health ageing,” said series co-author, Iruka Okeke of the University of Ibadan, Nigeria. Okeke said that effective antibiotics prolong lives, reduce disabilities, limit healthcare costs and enable other life-saving medical actions such as surgery. “However, antimicrobial resistance is on the rise – accelerated by inappropriate use of antibiotics during the COVID-19 pandemic – threatening the backbone of modern medicine and already leading to deaths and disease which would have once been prevented,” said Okeke. Existing infection prevention methods can prevent AMR-associated deaths, according to modelling analysis undertaken for putting together the series of papers. Up to 3.37 lakh deaths a year could be saved by improving infection prevention and control in healthcare facilities including better hand hygiene and regular cleaning and sterilisation of equipment, the authors found. Around 2.5 lakh deaths could be avoided yearly by providing universal access to safe drinking water and effective sanitation in community settings, they found. Further, 1.82 lakh deaths a year could be saved by expanding the rollout of some paediatric vaccines, such as pneumococcal vaccines which help protect against pneumonia and meningitis, along with introducing new ones, such as RSV vaccines for pregnant women, the researchers found. “Our findings highlight how public health actions to prevent infections in the first place should be prioritised as a strategy to tackle AMR as these methods have the potential to drastically reduce the number of deaths from AMR-associated infections,” said co-author Yewande Alimi of Africa Centres for Disease Control and Prevention (CDC). Source: Healthworld

May 23,2024 New Delhi: India will highlight its universal coverage through Ayushman Bharat, public health emergency preparedness and digital health transformations in the country at the World Health Assembly to be held in Geneva from May 27, official sources said on Wednesday. It will also showcase the Arogya Maitri Disaster Management Cube — an indigenous portable hospital — equipped with several innovative tools designed to enhance disaster response and medical support at the annual event organised by the World Health Organisation (WHO). The 77th session of the World Health Assembly (WHA) will be held in Geneva from May 27 to June 1. Indian delegation from the Ministry of Health and Family Welfare is being led by Union Health Secretary Apurva Chandra. Representatives from 194 countries will participate in the event to structure the global health ecosystem. The theme for this year’s WHA is “All for Health, Health for All”. The WHA comprises sessions in three main committees — Plenary, Committee A and Committee B. The plenary session will open the Health Assembly and will be attended by health ministers/heads of delegation of 194 nations, sources said. Committee A will be chaired by India and facilitate discussion on topics covering universal health coverage, public health emergency preparedness and response, anti-microbial resistance, climate change, sustainable financing for WHO etc, an official source said. Committee B mainly focuses on internal and external audit, budget and financing matters and the WHO secretariat. At least 14 side events and multiple strategic roundtables are being organised on the sidelines of WHA focusing on diverse health topics where the participant will share their thoughts on the way forward for the global health architecture. India is leading and supporting the Regional One Voice for the Southeast Asia region, advocating for well-being and health promotion, social determinants of health, maternal, infant and young child nutrition and economics and health for all. Source: Healthworld

May 22,2024 New Delhi: With the Indian Council for Medical Research (ICMR) and the National Institute of Nutrition (NIN) releasing new Dietary Guidelines for Indians, FSSAI’s plea that it is hampered in regulating ultra-processed food (UPF) and foods high in fat, sugars and salt (HFSS) because the terms “have not been defined” may no longer be valid. The guidelines released last week have detailed definitions of UPF and HFSS foods put together by a scientific body. The guidelines also spell out the harm caused by consumption of UPF. “Lack of fibre and poor micronutrients makes them unhealthy. Also, UPFs contribute to high calorie (energy) intake as they are often high in fat. UPFs are consumed in larger quantities by a large population since these have unique taste, high palatability and low cost as well as are easily available even in remote areas. …UPF consumption is associated with overweight/obesity and higher risks of coronary heart disease (heart attack), cerebrovascular diseases (stroke) and diabetes. UPFs also hasten the process of ageing,” stated the guidelines. On February 5, Nutrition Advocacy in Public Interest-India (NAPi), a national think tank on nutrition consisting of independent experts in epidemiology, nutrition, and paediatrics, wrote to the health ministry seeking regulations for labelling and marketing of UPF and HFSS foods “to halt their rising consumption”. Responding to the letter on April 15, FSSAI stated that “it is informed that the terms ultra-processed food and junk foods have not been defined in any of the Food Safety and Standards Regulations” and that comments and suggestions received from stakeholders on the Food Safety and Standards (Labelling & Display) Amendment Regulations , 2022 notified by the FSSAI “are under examination”. It included a list of initiatives taken by FSSAI to reduce consumption of UPFs such as Eat Right India, the social media campaign “Aaj se thoda kam” urging dietary modifications to reduce diet-related non-communicable diseases and a ban on sale/marketing of HFSS foods in schools or in areas within 50 metres from the school gate in any direction. “Why does it take FSSAI so long to examine the comments given in 2022? It has been working on regulation of front-of-pack labeling for a decade now,” said Dr Arun Gupta of NAPi. Front-of-pack labelling was proposed in 2014 by an expert committee constituted by the FSSAI on the order of the Delhi High Court on a public interest petition seeking labelling and a ban on sale of junk food in schools. On May 10, NAPi wrote to the health ministry urging the use of the NIN dietary guidelines, which are “science-based practicable guidelines”, “for developing regulations that could meaningfully prohibit advertising of HFSS and UPFs”. The guidelines also provide guidance on which food products could be regulated for front-of-pack labelling and prohibition of advertisements, stated the letter. Source: Healthworld

May 23,2024 New Delhi: The Delhi High Court on Tuesday reserved its order on a plea by several doctors’ associations against yoga exponent Ramdev over his alleged “unsubstantiated” claim about ‘Coronil’ being a “cure” for COVID-19 and not just an immunity booster. The plea forms part of a 2021 lawsuit by doctors’ associations against the yoga guru, his aide Acharya Balkrishna as well as Patanjali Ayurveda founded by Ramdev, and seeks an interim relief of removal of statements from various media platforms with respect to the claim. According to the lawsuit, Ramdev made unsubstantiated claims about ‘Coronil’ being a cure for COVID-19, contrary to the licence granted to the drug for merely being an “immuno-booster”. The senior counsel appearing for the plaintiffs also sought a direction to restrain the defendants from making further similar statements. Ramdev’s senior lawyer said he was bound by the undertaking given in the Supreme Court in the case concerning advertisements of Patanjali products, adding that he was willing to make a similar statement in the high court as well. The plaintiffs’ senior lawyer, however, urged the court to pass an order on the interim application stating that the undertaking before the apex court was with regard to not making “causal statements” that are not in compliance with the law. Justice Anup Jairam Bhambhani said the matter before him concerned “specific instances” and reserved the order. Three Resident Doctors’ Association of the All India Institute of Medical Sciences at Rishikesh, Patna and Bhubaneswar as well as Association of Resident Doctors, Post Graduate Institute of Medical Education & Research, Chandigarh; Union of Resident Doctors of Punjab (URDP); Resident Doctors’ Association, Lala Lajpat Rai Memorial Medical College, Meerut, and Telangana Junior Doctors’ Association, Hyderabad had moved the high court in 2021 against Ramdev and others. In their lawsuit filed through advocate Harshavardhan Kotla, the associations have submitted that the yoga guru, who is a highly influential person, was sowing doubts in the minds of the general public about the safety and efficacy of not only allopathic treatments but also COVID-19 vaccines. They alleged that the “misinformation” campaign was nothing but an advertisement and marketing strategy to further the sales of the product sold by Ramdev, including ‘Coronil’, which he claimed to be an alternative treatment for COVID-19. On October 27, 2021, the high court had issued summons to Ramdev and others on the lawsuit, saying it was not a frivolous matter and a case was “definitely” made out for its institution. Source: Healthworld

May 23,2024 New Delhi: Spices play a key role in making the Indian culinary experiences a worthy one. But, the recent buzz about contamination of spice mixes by MDH and Everest with cancer-causing chemical called Ethylene oxide has raised eyebrows and concerns in the national and international market. Keeping the same in view, the Food Safety and Standards Authority of India (FSSAI) recently collected samples from across India and released the report. FSSAI recently announced that it did not find ethylene oxide (ETO), a food contaminant flagged by foreign countries, in MDH and Everest product samples. As per a report by ANI, FSSAI made the announcement after testing of the samples of spices sold by the two companies. It is reported that FSSAI collected 34 samples of Everest and MDH spices for testing, 9 from Everest’s facilities in Maharashtra and Gujarat, and 25 from those of MDH’s in Delhi, Haryana and Rajasthan. According to the same ANI report, the tests also included several parameters including moisture content, insect and rodent contamination, heavy metals, aflatoxins, and pesticide residues. The samples were tested for ethylene oxide at NABL-accredited laboratories as well. The FSSAI received around 28 lab reports so far and the chemical was found absent in them. However, the body awaits the results from 6 more samples. If reports are to be believed, the Food Standards Agency (FSA) said that it had already been issuing early warning alerts for ETO in various spices from India since before January 2023. Source: Healthworld