Global action plan on antimicrobial resistance- WHO

At the Sixty-eight World Health Assembly in May 2015, the World Health Assembly endorsed a global action plan to tackle antimicrobial resistance - including antibiotic resistance, the most urgent drug resistance trend.

Antimicrobial resistance is occurring everywhere in the world, compromising our ability to treat infectious diseases, as well as undermining many other advances in health and medicine. The goal of the draft global action plan is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.

To achieve this goal, the global action plan sets out five strategic objectives:

• to improve awareness and understanding of antimicrobial resistance;
• to strengthen knowledge through surveillance and research;
• to reduce the incidence of infection;
• to optimize the use of antimicrobial agents; and
• develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

Development of this plan was guided by the advice of countries and key stakeholders, based on several multistakeholder consultations at different global and regional forums.

Heat Waves

All India mean temperature has risen nearly around 0.6⁰ C over the last 110 years in line with the rising temperature across the globe. In a statement in reply to a question in the Lok Sabha today, the Union Minister for Science & Technology and Ministry of Earth Sciences Dr. Harsh Vardhan, said that the latest Intergovernmental Panel on Climate Change (IPCC) report (2014) highlights that mean surface temperature of the globe has risen by 0.85⁰ ± 0.18⁰ C.  ,.

 Every year India experiences severe heat waves in summer, but in 2015, casualties were abnormally high the Minister. Most of the deaths were concentrated in Andhra Pradesh, Telangana, Odisha, Punjab, Uttar Pradesh, and Bihar. Details of the Heat Wave/Sun Stroke related deaths are given below:

State	Number of deaths
Andhra Pradesh	1,369
Telangana	541
Odisha	67
Uttar Pradesh	22
West Bengal	13
Gujarat	10
Madhya Pradesh	10
Delhi	5

Using daily maximum temperature data of 103 stations uniformly distributed over the country for the period 1961-2010  from Indian main land during the hot weather season (March to July), it was observed that many areas of the country (north, northwest, central and northeast Peninsula) have experienced more than eight (8) Heat Wave days  on an average per season. He said the recent decade 2001-2010 happens to be the warmest decade for the country as well as for the globe.

Upon prediction of the heat wave conditions by the ESSO-IMD, various State Governments have a system of giving wide publicity of Dos and Don’ts through advertisements in Print and audio-visual media and opening up of drinking water camps at identified places in rural and urban areas to mitigate the impact of heat waves. The schedule of National Rural Employment Guarantee Scheme workers is adjusted to avoid exposure to extreme hot weather duration periods.

Health Minister directs officials to gear up for monsoon: Review meeting held on preparedness of States

Shri J P Nadda, Minister for Health and Family Welfare, has given topmost priority to advance preparedness of states affected by dengue, in order to prevent the disease and effectively manage it. He has been personally monitoring the situation and the preparedness of the states. The Minister has directed the officials in the Ministry to gear up to meet the possible incidence of Dengue during monsoon. “We are coordinating with states concerned and are ready to provide all necessary support,” said Shri Nadda. Under his direction, Shri B P Sharma, Secretary (Health and Family Welfare) chaired a high-level meeting to review the dengue situation in four northern states viz. Haryana, Rajasthan, Uttar Pradesh and National Capital Territory of Delhi, here yesterday. Dr. (Prof) Jagdish Prasad, DGHS, Shri C K Mishra, Additional Secretary and Mission Director (NHM), and Health Secretaries and representatives from the states participated in the meeting.

Reviewing the preparedness of the states in view of the ensuing transmission season, the states were advised that as no vaccine is available for prevention and as there is no specific drug for treatment of the disease, source reduction activity to eliminate the mosquito vector breeding needs to be the top priority to reduce the risk of transmission.

The states were asked to strengthen and work towards focussed IEC activities in coordination with Swachha Bharat Campaign to maintain a mosquito free environment. The Health Secretary pointed out that community awareness campaign plays a crucial role to create awareness and prevent panic in case of dengue positivity. The states have been advised to launch public awareness campaigns to disseminate information on the DO’s and DON’Ts of Dengue to enable and educate communities for prevention of Dengue.

The Health Secretary also stressed on inter-sectoral coordination for prevention of mosquitogenic condition. The states were advised to give priority to training of doctors based on the recent National Guidelines on Dengue case management. The states were also asked to ensure availability of dengue diagnostic kits (ELISA based NS1 and IgM) in all the Sentinel Surveillance Hospitals. Provision of implementation of legislation for the construction sites and residential areas was identified as one of the thrust areas during the meeting. 

The Health Minister was briefed about the proceedings and the preparedness of the states. He directed the concerned officers to continuously monitor the situation and to keep him apprised. 

maggi controversy- PIB

Press Note 

Pursuant to the adverse results received after sampling and testing of M/s Nestle India Private Limited’s “Maggi Instant Noodles with Tastemaker” in U.P., the Food Safety & Standards Authority of India (FSSAI) had advised Commissioners of Food Safety in various States to draw samples and get the same tested from authorized laboratories.

Analysis of the reports received, and the record of the case, revealed the following 3 violations in the product:

(i)          Presence of lead in excess of the permissible level of 2.5 ppm

(ii)        Misleading label of “No added MSG- Monosodium Glutamate”

(iii)       Release of “Maggi Oats Masala Noodles with Tastemaker” without risk assessment and grant of product approval.

The Company representatives were given a hearing on 4.6.2015 by the Chairman and CEO of FSSAI to seek their response in the matter.  The Company contended that testing protocols had not been complied with; that the “No added MSG” label was fixed on account of lack of clarity and in accordance with industry practices; and that the Oat Noodles had been launched at a time when the advisory dated 11.5.2013 (on the subject of product approvals) had been stayed by the Court. 

The above response was considered by FSSAI and not found to be satisfactory.  The violations of the law have been held to be established. 

Accordingly, vide Order dated 5.6.2015, FSSAI has directed the Company as follows:

(i)           Withdraw and recall all the 9 approved variants of Maggi Instant Noodle from the market; and stop further production, processing, import, distribution and sale thereof.

(ii)         Comply with the labeling regulations and remove the label of “No added MSG”.

(iii)        Withdraw and recall the food product “Maggi Oats Masala Noodles with Tastemaker” and any other product for which risk assessment has not been undertaken and product approval granted.

(iv)      Take appropriate action to re-ascertain the safety of its products in compliance of the obligation contained in Section 26 of the Food Safety Standards Act, 2006.

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Addressing Anaemia among Pregnant Women

Under the National Health Mission (NHM), the management of nutritional anemia among pregnant and lactating women is an important intervention. The steps taken to tackle anaemia are given below:

·        Universal screening of pregnant women for anaemia is an integral part of ante-natal care, through the existing network of sub-centers and primary health centres and other health facilities as well as through outreach activities at Village Health & Nutrition Days (VHNDs).

·        Every pregnant woman during ANC is given iron and folic acid (IFA) tablets for six months and six months post-partum. Pregnant women, who are found to be clinically anemic, are given double dose.

·        Health and nutrition education to promote dietary diversification, inclusion of iron folate rich food as well as food items that promote iron absorption.  

·        To tackle the problem of anaemia due to malaria particularly in pregnant women and children, Long Lasting Insecticide Nets (LLINs) and Insecticide Treated Bed Nets (ITBNs) are being distributed in endemic areas.

·        To reduce the prevalence of anemia in adolescent girls, both in and out of school, Government of India has launched a scheme of Weekly Iron and Folic Acid Supplementation (WIFS) all over the country.

·        Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.

·        Non –Pregnant and Non Lactating women are given Weekly Iron and Folic Acid Supplementation

·        Engagement of 8.8 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.

·        Janani Shishu Suraksha Karyakaram (JSSK) has been launched on 1st June, 2011, which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section.  The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick newborns accessing public health institutions for treatment till one year after birth.

Success Stories

nutrition eggs and MDM

Union Agriculture Minister Shri Radha Mohan Singh, requested the Chief Ministers of Bihar, Tamil Nadu and Rajasthan to encourage free milk to school children. Union Minister write that Karnataka and Madhya Pradesh States have already implemented the availability of free milk products schemes to raise the nutritional level of school children through encouraging cooperatives milks in the Mid- Day Meal schemes. Minister also write that in the review meeting it was found that the State Milk Federation have surplus stocks of skimmed milk powder and in the interest of farmers and the country's milk producers, cooperatives purchase of milk has continued.

            The text of letter written to States Chief Ministers is as followed:

“You may be aware of School Milk Programme running successfully across the developed world which encourages children to consume dairy products and maintain a balanced diet regime. Milk, Yoghurt, cheese, buttermilk and other milk products that are important from the point of view of good nutrition and balanced diet, are provided to school children under the programme.

2.         The Department of Animal Husbandry, Dairying & Fisheries in a meeting held on 15^th June 2015, reviewed the situation in respect of procurement and sale of milk in the country. In the meeting, it was observed that there are surplus stock of skimmed milk powder with the State Milk Federation. The higher stocks of milk products with the cooperatives have resulted in reducing the working capital. In the interest of farmers and milk producers’ of the country, the cooperatives have continued procuring milk but they are working under severe constraint of working capital.

3.         Government of Karnataka’s project titled “Ksheerabhagya” scheme during the year 2012-13 aimed at supplying milk to schools thereby ensuring clean and hygienic food to children. The scheme continues to progress and give good results. Even the Government of Madhya Pradesh had recently launched a similar scheme in the State in which milk will be provided to schools and anganwadis.

4.         You may be aware that Milk contributes close to a third of the gross income of rural households and in the case of those without land it contributes, it estimates nearly half of their gross income. Further, 90% of farmers have a herd size of 2 or less and 69% of the dairy farmers are small & marginal. Introducing school milk scheme would help farmers and milk cooperatives owned by farmers a ready and steady market for their produce.

 I would appreciate if your Government launches a similar milk programme in the Mid Day Meal scheme, addressing the issue of child malnutrition in the country by utilizing milk powder from the cooperatives which will help in enhancing nutrition of school children as well as improving their retention.”