Tailor-made influenza prevention programmes needed across the world

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New influenza strains emerge each year in India

New Delhi, 13 March 2019: The World Health Organization (WHO) recently launched a strategy to protect people worldwide over the next decade against the threat of influenza, warning that new pandemics are ‘inevitable’. WHO’s new strategy, for 2019 through 2030, aims to prevent seasonal influenza, control the virus’s spread from animals to humans and prepare for the next pandemic, WHO said.

Influenza epidemics, largely seasonal, affect around one billion people and kill hundreds of thousands annually, according to WHO, which describes it as one of the world’s greatest public health challenges. The new strategy called for every country to strengthen routine health programmes and to develop tailor-made influenza programmes that strengthen disease surveillance, response, prevention, control, and preparedness.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Influenza A is an archetypal shape shifter and causes most human outbreaks. The flu germ exists in dozens of sub-types of which two, H1N1 and H3N2, currently circulate in humans. Each of these further have many different strains, with new ones emerging all the time — each needing its own vaccine. The virus that causes flu has evolved manifold to avoid this detection by antibodies. Called, antigenic drift, minute genetic changes happen as the virus replicates, which make it different every season. Another change is called the antigenic shift in which genetic material is exchanged between Influenza A subtypes to create a brand-new strain to which few people, if any, have immunity.”

The WHO recommends annual flu vaccines as the most effective way to prevent the spread of the disease, especially for healthcare workers and people at higher risk of influenza complications. It also called for the development of more effective and more accessible vaccines and antiviral treatments.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “As viruses adapt and change, so do those contained within the vaccines – what is included in them is based on international surveillance and scientists’ calculations about which virus types and strains will circulate in a given year. Flu is primarily treated with rest and fluid intake to allow the body to fight the infection on its own. Paracetamol may help cure the symptoms but NSAIDs should be avoided. An annual vaccine can help prevent the flu and limit its complications.”

Some tips from HCFI

  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  • If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.
  • Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
  • Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
  • Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
  • Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Will the government consider comprehensive insurance for doctors?

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Secretary Legal Affairs to head a committee on Comprehensive Insurance Scheme for Advocates: This should have been explored for doctors first

My colleague Ira, an advocate brought to my attention a recent PIB release (dated 8th March, 2019), which stated that the Government has set-up a five-member committee to examine the issues related to framing of a proper, structured scheme for providing of medical insurance cover to the advocates and also suggest modalities for the implementation of such scheme.

The Union Minister for Law set-up the committer under the chairmanship of Secretary Legal Affairs with members including a senior representative from the Department of Financial Services, representative of Department of legal affairs and one representative each from Bar Council of India and State Bar Councils.

The committee shall, within three months, recommend a comprehensive insurance scheme for the welfare of the advocates all over India to address concerns relating to untimely death and medical insurance.

The scheme may include assistance from central and state governments as also involvement of State Bar Councils and in the representatives operating lawyer’s welfare fund.

In 2001, the Central government had enacted the Advocates Welfare Fund Act, 2001 to provide for the Constitution of a Welfare Fund for the benefits of advocates across the country. This act came into force on 14th September, 2001

All practicing lawyers are entitled to membership of the Fund under Section 18 (1) of the Act (as below) at an annual subscription of Rs 50/- to be paid before 31st March. Senior advocates are required to pay an annual subscription of Rs 100/-, as per Section 18 (5)

“18. Membership in Fund

(1) Every advocate practising, before the commencement of this Act, in any court, tribunal or other authority in a State and being a member of a State Bar Association or a State Advocates’ Association in that State, shall apply, within six months of the commencement of this Act, to the Trustee Committee for admission as a member of the Fund, in such form as may be prescribed.

(2) Every person,—

(a) admitted as an advocate on the roll of a State Bar Council, after the commencement of this Act;

(b) practising in any court, tribunal or other authority in a State and being a member of a State Bar Association or a State Advocates’ Association in that State,

shall apply, within six months of his enrolment as an advocate, to the Trustee Committee, for admission as a member of the Fund in such form as may be prescribed.”

Some of the provisions of the Act are as under:

  • The Trustee Committee on an application made to it by a member of the Fund, and after being satisfied about the genuineness of the claim, may allow ex gratia grant from the Fund in case of hospitalisation or major surgical operation or if he is suffering from TB, leprosy, paralysis, cancer, unsoundness of mind or from such other serious disease or disability (Section 19).
  • Every advocate who has been the member of the fund for a period not less than five years shall, shall on the cession of his practice, be paid an amount at the rate specified in Schedule I. If the member dies before receiving such amount payable to him, his nominee or legal heir shall be entitled to receive the amount payable to the deceased member (Section 21).
  • The interest of any member in the Fund, or the right of a member of the Fund or his nominee or legal heir to receive any amount from the Fund, shall not be assigned, alienated, or charged and shall not be liable to attachment under any decree or order of any court, tribunal or other authority. Also, no creditor shall be entitled to proceed against the Fund or the interest therein of any member of the Fund or his nominee or legal heir (Section 22)
  • All income, profits or gains accrued to the Fund shall be exempt from income-tax (Section 23).
  • The Trustee Committee may, for the welfare of the members of the Fund obtain, from the Life Insurance Corporation of India or any other insurer, policies of Group Insurance on the life of the members of the Fund; or provide, in such manner as may be prescribed, for medical and educational facilities for the members of the Fund and their dependants; or provide monies to the members of the Fund for purchase of books; or provide monies to construct or maintain common facilities for the members of the Fund or provide funds for any other purpose which the Trustee Committee may specify; or provide for such other benefits as may be prescribed (Section 24).
  • Senior advocates, or those receiving pension from the Central/State Government are not eligible for ex gratia grant or other benefits under the various provisions of the Act (Section 28).

I personally feel the medical profession too should have been accorded equal priority.

Medical profession is a high-risk profession. Doctors on an average die a decade earlier than non-doctor professionals. They are exposed to various antibiotic resistant infections, contagious and infectious diseases and are at a higher risk of work fatigue, mental problems, heart attacks, paralysis and cancers.

A similar comprehensive insurance for doctors will be an added incentive to stay happy in the profession. Till this is done all doctors may be considered for Central Health Government Scheme (CGHS).

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA