Health Ministry launches a new ‘Test and Treat Policy for HIV’ for India

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The Union Minister for Health & Family Welfare, Shri JP Nadda launched the ‘Test and Treat Policy for HIV’ yesterday.

As per the policy, “as soon as a person is tested and found to be positive, he will be provided with anti-retroviral therapy (ART) irrespective of his CD count or clinical stage. This will be for all men, women, adolescents and children who have been diagnosed as a HIV + case. This will improve longevity, improve quality of life of those infected and will save them from many opportunistic infections, especially TB,” said the Health Minister.

A National Strategic Plan for HIV for next seven years is under way. The Health Minister emphasized on the need to address stigma & discrimination towards HIV to enable persons infected and affected with HIV access health services. The long pending HIV/AIDS Act has been passed very recently to facilitate this. “Very few countries globally have such a law to protect rights of people infected with HIV,” Shri Nadda elaborated. The key provisions of HIV/AIDS Bill are prohibition of discrimination, informed consent, non-disclosure of HIV status, anti-retroviral therapy & opportunistic infection management, protection of property of affected children, safe working environment and appointment of ombudsman in every State.

The Health Ministry has intensified its efforts to find all those that are estimated to be infected with HIV. “Out of 21 lakh estimated with HIV, we know only 14 lakh. To detect remaining we have revised national HIV testing guidelines and are aiming to reach out to people in community and test them where they are, of course with proper counseling and consent,” Shri Nadda mentioned.

Shri Nadda further said that all those who are positive should get treatment and for that the Health Ministry is constantly expanding treatment delivery sites. “We have nearly 1600 ART and Link ART sites where treatment is provided across the country and recently we crossed the 1 million people on ART, second country in world to have such large numbers on free lifelong treatment. We have been able to avert 1.5 lakh deaths due to ART and we will be able to avert 4.5 lakh more deaths by expanding provision of ART,” Shri Nadda informed.

Shri Nadda stated that the 90:90:90 strategy that the Ministry has adopted will help to identify 90% of those infected, place 90% of these on treatment and ensure 90% have their virus under control. “This strategy will offer us an opportunity to work towards our commitment during HLM and WHA on “ending AIDS by 2030” as a part of the Sustainable Development Goal (SDG).”

(Source: Press Information Bureau, Ministry of Health and Family Welfare, April 28, 2017)

Dr KK Aggarwal
National President IMA & HCFI

Waist circumference a better indicator of health than BMI

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A new study says that the waist circumference, and not body mass index (BMI), is a better indicator of increased risk of death from cardiovascular causes or any cause.
In the study, normal weight individuals who had central obesity i.e. higher waist-to-hip ratio were at a 22% higher risk of death from any cause and a 25% higher risk for death from cardiovascular causes compared to these who are obese according to BMI but did not have central fat accumulation. The study jointly conducted by researchers from the University of Sydney in Australia and Loughborough University in England has been published April 26, 2017 in the Annals of Internal Medicine.

The body mass index is the most commonly used measure of obesity, which is based on height and weight of a person. It is calculated as weight (in kg) divided by the height squared (in cm). But, it does not measure body fat. The correct method to measure obesity is to measure body fat, especially the fat around the abdomen. A high waist-to-hip ratio indicates high amounts of abdominal fat.
A person can be obese even if the body weight is within the normal range. This is called normal weight obesity, where the BMI is normal as per the age and height, but the body fat percentage is high. Typically, such individuals have a potbelly but otherwise look normal.

Abdominal obesity is more dangerous than generalized obesity. Abdominal girth or waist circumference of more than 90 cm in men and 80 cm in women indicates that the person is at a higher risk of future heart attacks, type 2 diabetes, hypertension, abnormal cholesterol (high TGs and low HDL or ‘good’ cholesterol) and metabolic syndrome. Lifestyle changes should be instituted immediately to ward off these chronic but potentially life-threatening diseases.

Any weight gain after puberty is invariably due to fat as most organs also stop growing, once the height stops increasing. One should not gain weight of more than 5 kg after the age of 20 years in males and 18 years in females. And, after the age of 50, the weight should reduce and not increase.
Potbelly obesity is linked to eating refined carbohydrates and not animal fats. General obesity is linked to eating animal fats. Refined carbohydrate includes white rice, white maida and white sugar. Brown sugar is better than white sugar.

Some tips to reduce obesity

• Skip carbohydrates once in a week.
• Combine a sweet food with bitter food.
• Include more green bitter items in foods.
• Do not eat trans fats.
• Do not consume more than 80 ml of soft drink in a day.
• Do not consume sweets with more than 30% sugar.
• Avoid maida, rice and white sugar.
• Eat in moderation.
• Walk, walk and walk…

Remember, longer the waist line… shorter the lifeline…

(Source: University of Sydney News, April 26, 2017)

Dr KK Aggarwal
National President IMA & HCFI

IMA-FOMA DELHI RESOLUTIONS

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From the desk of Dr KK Aggarwal, National Presidemt, IMA and Dr R N Tandon, HSG, IMA

An emergency Action group meeting of IMA followed by an emergency meeting of Indian Medical Association – Federation of Medical Associations of India were held in IMA Headquarters Delhi from 11 am to 2 pm on Wednesday 26/04/2017 to discuss the emergent situation on generic drugs.

(IMA- Federation of Medical Associations of India)

Prescription of Generic Name of the Drugs by Medical Professionals

IMA-FOMA appreciates Hon’ble Prime Minister, Shri Narendra Modi’s concern about the availability, accessibility and affordability of quality economical drugs to the society.

1. The judgement to choose a rational drug and its format vests only with the Registered Medical Practitioners. This right of the medical profession is sacrosanct.
2. IMA – FOMA also wants the Government to strengthen Quality control mechanisms to ensure adherence to Good Manufacturing Practices (GMP) for patient safety.
3. For a rational prescription, doctors should choose drugs generic-generic or generic – brand based on quality, efficacy and economy and write legibly and preferably in capital letters.
4. IMA-FOMA recommends that Government should ban differential pricing of a drug under different brand names (generic-generic, generic- trade or generic- brand) by one company. (one chemical drug, one company, one prise)
5. IMA FOMA will be meeting the President of MCI, Union Health Minister and Prime Minister of India about the views of the medical fraternity on this issue. All the constituent members of IMA-FOMA shall communicate these IMA-FOMA Delhi Resolutions to its members.

Reference

MCI Ethics Regulations Clause No. 1.5 states ” All physicians SHOULD prescribe medicines with generic names, legibly and preferably in capital letters and he or she SHALL ensure rational prescription and use of drugs”

List of Associations which attended the FOMA meeting

Indian Medical Association, All India Ophthalmological Society, Urological Society of India, Geriatric Society of India, Indian Radiology & Imaging Association, Indian Academy of Echocardiography, Heart Care Foundation of India, Cardiological Society of India, Association of Surgeons of India, Indian Psychiatric Society, Delhi Psychiatrist Society, Indian Orthopaedic Association, The Federation of Obstetric & Gynaecological Societies of India, Indian Association of Dermatologists, Venereologists and Leprologists, Association of Physicians of India, Indian Academy of Echocardiography, FFPAIA,

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