News from here and there

On 27 November 2016, Union Minister for Health and Family Welfare Shri J.P. Nadda, along with officers, staff members, doctors, nurses and other paramedical staff of all Central government hospitals of New Delhi pledged to donate their organs. Also present on the occasion were participants of the walkathon that took place that morning at India Gate to create and increase awareness regarding organ donation.

Terming organ donation as selfless, egalitarian and ethical, the health minister wanted it to become a national movement. By donating organs, he said that the end of life can become a new beginning. Organs are a national resource and not even one should be wasted. He added that we can show the world that even in death we care for our fellow citizens and humanity at large.

The Union health ministry has implemented the National Organ Transplant Programme (NOTP) through the National Organ and Tissue Transplant Organization (NOTTO). NOTTO has two divisions, namely the National Human Organ and Tissue Removal and Storage Network, and the National Biomaterial Centre.

The National Human Organ and Tissue Removal and Storage Network was created as per the Transplantation of Human Organs (Amendment) Act, 2011. It functions as the apex centre for coordinating and networking for the procurement and distribution of organs and tissues and as a registry for organ and tissue donation and transplantation in India.

Various activities are undertaken to enable organ transplantation in the safest way in the shortest possible time. The organs that can be donated include the liver, kidneys, pancreas, heart, lungs and intestines. The tissues that can be donated include cornea, bone, skin, heart valves, blood vessels, nerves and tendons.

NOTP has been implemented to promote organ donation from cadavers and thus increase the number of organs available for transplantation. Various activities have commenced and state governments have been alerted to have systems in place to improve awareness about organ donation.

r Sumana Navin, Course Director, MOHAN Foundation told this Journal, ‘The Prime Minister in his “Mann Ki Baat” broadcast to the nation observed that there could be no greater donation than organ donation. This has made organ donation an issue of national importance. The key to public support is that transplants need to be accessible to poor patients in government hospitals. NOTTO can play an important role in capacity building and initiating transplant programmes in public sector hospitals. Individual states are responsible for creating robust criteria for organ-sharing and implementing the organ donation and transplantation programme as per the legal framework. Improved data collection from the states on deceased organ donation and transplant outcomes help in building trust in the entire process. Non-governmental organizations bring transparency, expertise and credibility to this effort.’

P.M. Nischal, Bengaluru, Karnataka

Medical research in India bypasses major diseases in favour of cancer research

The Vidhi Centre for Legal Policy released their briefing book Law in numbers: Evidence based approach to legal reform on 2 December 2016. The book, which aims to influence policymakers to reform existing laws, collected empirical data of contemporary and legally relevant topics as statistical evidence. Themes included the judiciary, the financial sector, crime and society, the legislature and environmental and human capabilities.

As per the data published, only 11.3% of all pharmaceutical clinical trials and 12.3% of all new marketing approvals were dedicated to the top seven diseases in the country, even though these diseases amounted for almost half of all deaths in India in 2012. An overwhelming majority of clinical trials and research grants were focused on cancer, which incidentally does not figure in the top ten causes of mortality in India.

The top seven diseases causing mortality in India include diarrhoea (which ranks as the highest infectious killing condition in the country), tuberculosis (the second most lethal infectious disease in the India), cardiovascular and pulmonary diseases. No new drugs were approved for TB in India from 2009 to 2016 despite the growing menace of multidrug resistance to existing antitubercular regimens.

With a paucity of indigenous research aimed at locally relevant diseases, India is often placed as one of many centres in global multicentric trials for drugs that are relevant to other countries’ markets. Cancer, which has a huge local and global presence, is often the primary condition whose treatment is evaluated with research. This research is sometimes oriented towards trials for minor improvements to existing drugs and for types of cancers that affect few people in India. These trials are often conducted with market authorization for the trials obtained specifically for the USA and for the European Union, but no separate approval is sought in India.

The situation is aggravated by clinical research still being largely funded by private companies in India and a tendency of the Indian pharmaceutical industries to create cheap drugs by reverse engineering patented drugs while not allotting sufficient funds or human resources to innovative indigenous locally oriented research.

Maharra Hussain, Dubai, United Arab Emirates