Public health challenges (The Indian Express: 20181101)

Cure In Progress

https://indianexpress.com/article/opinion/columns/cure-in-progress-munga-who-public-health-tuberculosis-aids-5428013/

Deliberations at UN show resolve to address public health challenges at highest level.

Written by Poonam Khetrapal Singh | Updated: November 1, 2018 6:21:46 am

The high-level meetings at the UN headquarters provided the South East Asia regionsignificant scope to consolidate these gains, accelerate progress, and promote game-changinginnovations in each of these areas.

The high-level meetings at the UN headquarters provided the South East Asia region significantscope to consolidate these gains, accelerate progress, and promote game-changing innovationsin each of these areas.

On September 26, the UN General Assembly (UNGA) deliberated on how best to address aserious public health challenge — tuberculosis (TB). A day later, the world’s most esteemedpolitical forum deliberated on combating non-communicable diseases (NCDs). For severalyears, WHO South East Asia and its member states have been ground zero in the battle againstTB and NCDs. The numbers show why: The region accounts for 50 per cent of TB-associatedmortality, with the disease being the region’s leading cause of death and lost productive yearsin the crucial 15-49 years old age group. TB/HIV co-infection is meanwhile responsible for 25per cent of AIDS-related deaths.

On NCDs, though, the region accounts for a bit over a quarter of the world’s population, it ishome to around 29 per cent of NCD-related premature mortality. Every year, 8.9 million peoplein the region die of NCDs, accounting for 64 per cent of all deaths. Many of these deaths arepreventable. To their credit, the member states are making strong gains. In recent years, eachone of them has shown unprecedented political commitment to tackle TB, as expressed in the2017 “Delhi Call for Action” and the 2018 “Statement of Action” — a bold and very publicvow to accelerate sustainable progress to end TB by 2030. That commitment continues to be

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day

Thursday 20181101

reflected in on-the-ground action, including initiatives aimed at scaling up active case-finding,increasing nutritional assistance for TB sufferers, addressing latent TB and enhancinginvestments in research and development.

Political resolve to tackle NCDs has also been robust. As per the Colombo Declaration of 2016,each country in the region is committed to integrating NCD services at the primary level, whilecountry-specific multi-sectoral action plans to counter the problem have been developed androlled out region-wide. These include a range of ground-breaking initiatives, from nutrientlabelling systems that enhance health literacy to promoting physical activity through theprovision of outdoor gyms.

The high-level meetings at the UN headquarters provided the region significant scope toconsolidate these gains, accelerate progress, and promote game-changing innovations in eachof these areas. The meetings provided the member states an open — and global — platform tohighlight the problem’s significance and present a detailed outline of how they are addressingit. It gave them an opportunity to underscore the dramatic increase high-burden countries havemade in domestic funding. It also offered them a chance to emphasise that an increasedallocation of resources from the global community could generate momentum in combatingthe disease. Much emphasis was placed on harnessing greater investment in research anddevelopment — particularly for developing low-cost, affordable diagnostics and drugs to treatthe disease.

The stakes were similarly high with respect to the NCDs. The meeting provided member statesthe opportunity to highlight progress since the first high-level UNGA meeting was held in2011, as well as reiterate political momentum and resolve as they reach the half-way mark inthe quest to reduce premature deaths caused by NCDs, by a quarter by 2025. It gave them anopportunity to highlight the areas which require more spending and how governments can bebetter supported in implementing their country-specific plans. That includes emphasising thesignificance of preventive measures that are among the most cost-effective (thoughunderfunded) ways to deal with the problem.

The meetings showed that the member states are well prepared to deal with the public healthchallenges. In recent months WHO South-East Asia worked to support them on technical andprocedural matters associated with the meetings, and to secure several speaking roles — aswell as positions on stakeholder panels — that are crucial to amplifying the region’s voice.That support is part of WHO South-East Asia’s ongoing effort to work to ensure that eachmember country’s voice is fully leveraged.

Even as member states make strong inroads in tackling TB and NCDs, gains must beconsolidated, sustainable progress accelerated, and innovation promoted and pursued as amatter of priority. The UNGA’s High-Level meetings offered them an opportunity to make thathappen.

Natural Prescription (The Asian Age: 20181101)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11816681

Vegan diet

Vegan diet linked to reduced Type-2 diabetes risk (The Tribune: 20181101)

https://www.tribuneindia.com/news/health/vegan-diet-linked-to-reduced-type-2-diabetes-risk/676710.html

A vegan diet rich in fruits, vegetables, nuts, legumes and seeds, with few animal products, islinked to a significantly lower risk of developing Type-2 diabetes.

The study explored that vegan diet is associated with improved psychological well-being inaddition to reduction in the risk factors for Type-2 diabetes, and heart diseases.

For the study, researchers from the University of London, examined 433 people aged mid-50s,on average.

Results of the study, published in the journal BMJ, showed that while quality of life — bothphysical and emotional — improved significantly, depressive symptoms and nerve pain(neuropathic pain) also improved in people on plant-based diet.

In addition to a sharp fall of blood glucose levels in those who cut out or ate very few animalproducts, these participants also lost nearly twice as much weight.

The fall in blood fats — a risk factor for cardiovascular disease — was also greater in those onplant-based diets.

Those following a vegan diet were able to discontinue the drugs they were taking for theirdiabetes or high blood pressure.

"Furthermore, plant-based diets could potentially improve diabetic neuropathic pain and thelevels of total cholesterol, cholesterol and triglycerides in Type-2 diabetes," the team said. —IANS

Gender inequality

Gender inequality driving deaths of girls under five globally (The Tribune:20181101)

https://www.tribuneindia.com/news/health/gender-inequality-driving-deaths-of-girls-under-five-globally/676704.html

Gender inequality across the world is associated with disproportionate death rates among girlsunder five years old, according to an analysis of data from 195 countries, including India.

The study, published in the journal BMJ Global Health, suggests that the unequal treatment offemales in society could be interfering with the natural biological advantage they have overmales for survival.

Explaining some of the reasons behind the disproportionate death rates among girls, theresearchers draw on examples, such as India, where girls have lower odds than boys ofreceiving certain types of health care, including vaccinations, and are vulnerable to femaleinfanticide.

"The more unequal a society, the more girls are penalised in terms of their survival chances,particularly in lower-middle income countries," said Valentina Gallo from Queen MaryUniversity of London in the UK.

"Gender inequality then perpetuates itself through the generations via these unfair odds ofsurvival," Gallo said.

She said because of a sexist ideology which values boys over girls, young girls are often atgreater risk of mortality through diminished access to health resources, as well as throughheightened exposure to health risks.

"These girls are also further exposed to this risk via their mothers, who may themselves bepenalised and valued less than mothers of sons, and less able to provide for their daughters,"said Gallo.

In 2015, a total of 5.9 million children under the age of five years died.

More than half of these early deaths were preventable and the result of socio-economic factorsand barriers to healthcare.

Children are at a greater risk of dying before the age of five if they are born in rural areas,within poor households, or to a mother denied basic education, researchers said.

Previous studies have shown that greater gender inequality is associated with higher infantmortality, but up until now, it was not known whether boys or girls were more affected.

The study compared countries' sex-specific under-five mortality rates from the UNICEFdatabase, with their Gender Inequality Index (GII).

GII is a measure of gender inequality that takes into account reproductive health,empowerment, and economic status, which varies from a minimum of 0.040 in Switzerland toa maximum of 0.767 in Yemen.

Overall, boys have a slightly higher mortality than girls worldwide, which is thought to be dueto a relative biological advantage of girls over boys, researchers said.

However, the higher the gender inequality in a country, the more girls would die compared toboys, counteracting the girls' innate biological advantage, they said.

The researchers argue that global policy should extend its focus beyond economicdevelopment, and work to reduce gender inequality across a variety of domains including

reproductive health, political empowerment, educational attainment, and participation in thework force. — PTI

Vitamin E

How to make your skin glow with Vitamin E (The Tribune: 20181101)

https://www.tribuneindia.com/news/health/how-to-make-your-skin-glow-with-vitamin-e/676670.html

Autumn has just set in and with this change in season our skin also begins to change andtransform. To rescue our skin from the ever so changing weather and hydration drenchedcondition, Vitamin E acts as a super powerful hydration and anti-oxidant range so make sureyou are adding this as part of skin nutrient.

Shikhee Agrawal, Head Training at The Body Shop India and Shahnaz Husain, FounderChairperson and Managing Director of The Shahnaz Husain Group, list some benefits ofVitamin E.

* The day begins with preparing and activating the skin by exfoliating the dead and flaky skinoff from the face. You may choose from a variety of face cleanser in skin friendly formats ofcream cleanser and gentle facial wash. To give cleansing the final touch, a toner rich in VitaminE removes excess traces of cleanser, dirt and make-up without over-drying the skin dab.

* Before we step out for the day's exposure to pollution and harsh UV rays, get your skin superhydrated and nourished using a Vitamin E rich day moisture and hyaluronic acid with abalanced mix of SPF and UV Index which ensures the skin is well protected from externalaggressor UV rays which not only invites premature ageing but also damages the skin.

* To remove tan and reduce dark patches, mix Vitamin E oil from 2 to 3 capsules with papayapulp and half teaspoon honey. Apply on the face and wash it off after half an hour. The vitaminE capsules also help in removing acne scars.

* Eight hours of beauty sleep has been the key ingredient for a happy skin. Wrap your skinwith an intense night mask rich in Vitamin E sourced from Wheatgerm oil and the much neededmoisture magnet hyaluronic acid which is 100 per cent organic and sustainable. This is moreso for normal to dry skin and mature skin. Apply the cream at night, massaging it on the facewith outward and slightly upward movements. Wipe off excess cream with moist cotton woolbefore bedtime.

* Sunflower oil is rich in Vitamin E. It can be used to apply and massage on the body before abath. — IANS

Exercise

Exercise may prevent fall risk for older adults with Alzheimer’s (TheTribune: 20181101)

https://www.tribuneindia.com/news/health/exercise-may-prevent-fall-risk-for-older-adults-with-alzheimer-s/676104.html

A new study has suggested that exercise may decrease the risk of falling for older adults whohave Alzheimer's disease and mental health challenges.

The study appeared in the American Journal of American Geriatrics Society.

Alzheimer's disease (AD) is a brain disease that causes changes that kill brain cells. AD is atype of dementia, which causes memory loss and problems with thinking and making decisions.People with AD and other forms of dementia have difficulties performing the daily activitiesothers might consider routine.

Dementia takes a toll on those who live with it and it also places a burden on caregivers. Alongwith problems connected to memory, language, and decision-making, dementia can causeneuropsychiatric symptoms, such as depression, anxiety, changes in mood, increasedirritability, and changes in personality and behaviour.

People who have AD/dementia also have twice the risk of falls compared to people withoutdementia. About 60 per cent of older adults with dementia fall each year. Researcherssuggested that having neuropsychiatric symptoms might predict whether an older person withAD/dementia is more likely to have a fall.

It is already known that exercise can reduce the number of falls in older adults with dementia.

However, it is not known that about how neuropsychiatric symptoms may increase the risk offalls, and even less is known about how exercise may reduce the risk of falls for people withdementia and neuropsychiatric symptoms.

A research team decided to explore whether exercise could reduce the risk of falling amongcommunity-dwelling people with AD who also had neuropsychiatric symptoms.

To learn more, the researchers reviewed a study that investigated the effects of an exerciseprogram for older adults with AD (the FINALEX trial).

The study included a range of people living with different stages of AD/dementia and withneuropsychiatric symptoms.

The original FINALEX study examined and compared older adults who had home- or group-based exercise training with people who didn't exercise but who received regular care.

The researchers learned that the people who exercised had a lower risk of falls than those whodidn't exercise. There was also a higher risk for falls among those who had lower scores onpsychological tests and who didn't exercise.

This study revealed that people with AD/dementia and neuropsychiatric symptoms such asdepression and anxiety have a higher risk of falls. Exercise can reduce the risk of falling forolder adults with these symptoms. — AN

Novel vaccine

Novel vaccine may reduce post-stroke blood clot risk(The Tribune:20181101)

https://www.tribuneindia.com/news/health/novel-vaccine-may-reduce-post-stroke-blood-clot-risk/676103.html

Researchers have tested a vaccine, S100A9, that may be able to replace oral blood thinners toreduce the risk of secondary strokes caused by blood clots, without increasing the risk ofserious bleeding or triggering an autoimmune response, according to a new research.

Oral blood thinners are medicines that help blood flow smoothly through your veins andarteries.

According to the study, people who have had a stroke caused by a blood clot often need to takemedications that make their blood less likely to clot, which helps prevent another stroke.

"Many stroke patients do not take their blood thinning drugs as prescribed, which makes itmore likely they will have another stroke. This vaccine might one day help solve this issuesince it would only need to be injected periodically," said Hironori Nakagami, Professor atOsaka University in Japan.

The findings, published in the journal Hypertension, revealed that the vaccine prevents bloodclot formation and protected the arteries of treated mice from forming new clots for more thantwo months.

The vaccine in mice provided protection against blood clots for more than two months withoutincreasing the risk of bleeding or causing an autoimmune response.

In addition, it worked as well as the clopidogrel (oral blood thinner) in a major artery.

Developing a vaccine to replace and/or complement daily, oral medications might save manylives and help prevent both secondary strokes and possibly heart attacks, according toNakagami.

"...there are differences between mice and humans in how the vaccine will be recognized bythe immune system. We should be able to overcome such problems and believe this vaccineprovides a very promising strategy in secondary prevention of stroke," he noted. — IANS

Dengue, malaria cases

Dengue, malaria cases underreported in Delhi, says report (The Indian Express: 20181101)

https://indianexpress.com/article/cities/delhi/dengue-malaria-cases-underreported-in-delhi-says-report-5428117/

The weekly report released by the South Delhi Municipal Corporation (SDMC) on Mondayclaimed 290 fresh cases of dengue reported in this week, taking the total confirmed cases to1,310.

Written by Astha Saxena | New Delhi | Published: November 1, 2018 2:32:10 am

The weekly report released by the South Delhi Municipal Corporation (SDMC) on Mondayclaimed 290 fresh cases of dengue reported in this week. (Representational Image)

The weekly report released by the South Delhi Municipal Corporation (SDMC) on Mondayclaimed 290 fresh cases of dengue reported in this week. (Representational Image)

A report released on ‘The State of Health in Delhi’ hints at gross under-reporting of dengueand malaria cases in the capital. The report has suggested that actual cases of the vector-bornedisease is 20 times more than what the civic bodies have currently reported.

“The information received under the RTI Act from various government institutions shows thatdengue and malaria cases in Delhi were 7,153 and 4,205 respectively between April 2017 andMarch 2018. Our survey data across 12 zones of Delhi showed that the cases of dengue wereas high as 1,06,456 and of malaria were 1,26,334,” the report released by Praja Foundationstated. The report further stated that the civil line zone is the most affected, with 1,097 casesof dengue.

The weekly report released by the South Delhi Municipal Corporation (SDMC) on Mondayclaimed 290 fresh cases of dengue reported in this week, taking the total confirmed cases to1,310. “There is an urgent need to overhaul the entire system of confirming the cases of vector-borne diseases,” said Milind Mhaske, director, Praja Foundation.

According to the official process, once a hospital receives a suspected case of dengue, thepatient is required to get an NS1 antigen test. If the test comes out to be positive, the report issent to the municipal corporation that adds the details in its records. The record is furthermaintained to carry out the treatment of the patient.

“There are many loopholes in the reporting process of municipal corporation. There are manyprivate practitioners and nursing clinics which are still not reporting cases and no one is keepinga check on them. Many a times, the MCD local inspectors try to suppress the cases and tell thehospitals not to report the cases. Clearly, the cases which are reported by the civic authoritiesgive a false impression of the actual situation,” said Dr VK Monga, former chairman of MCD’shealth department. Monga headed the department from 2007-2012.

Hypertension

Delhi: Cases of hypertension rising in the capital (The Indian Express:20181101)

https://indianexpress.com/article/cities/delhi/delhi-cases-of-hypertension-rising-in-the-capital-5428118/

Multiple factors like stress, lack of sleep, easy availability of junk food and excessiveconsumption of alcohol and tobacco are pushing young people towards this disease.

By: Express News Service | New Delhi | Published: November 1, 2018 2:36:25 am

hypertension, obesity and diabetes in middle aged people, health issues in middle- aged people,hypertension, obesity, diabetes, heart problems, The Indian Express, Indian Express news

According to experts, hypertension and diabetes are on the rise and fast becoming a publichealth issue. (Source: Thinkstock Images)

With each passing year, the number of people diagnosed with hypertension in the capital isincreasing, a report prepared by NGO Praja Foundation has suggested. The report, releasedWednesday, also states that in 2017-18, diarrhoea had the highest occurrence, with 5,01,484cases, followed by hypertension with 3,67,833 cases.

The data was collected by the foundation in a series of RTIs filed between April 2014 andMarch 2018. The cases were reported from Delhi government hospitals, MCD hospitals anddispensaries.

Long-term hypertension or high blood pressure is a major risk factor for coronary arterydisease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic

kidney disease and dementia. According to experts, hypertension and diabetes are on the riseand fast becoming a public health issue.

“People at a younger age are nowadays suffering from hypertension, which is worrying trend.Earlier, people in their 40s used to complain about high blood pressure, but those in their 20sare suffering with this lifestyle disease,” said Dr JPS Sawhney, chairman, department ofcardiology, Sir Ganga Ram Hospital. Dr Sawhney recently saw a 13-year-old boy having ablood pressure of 180/140.

Multiple factors like stress, lack of sleep, easy availability of junk food and excessiveconsumption of alcohol and tobacco are pushing young people towards this disease. “I wassurprised to see the blood pressure of this young boy. He has been discharged after we gavemedicines to control his blood pressure. We have not been able to identify any other reason forthe high blood pressure,” he said.

Pollution chokes

Pollution chokes, kills you silently: Experts (Hindustan Times: 20181101)

http://paper.hindustantimes.com/epaper/viewer.aspx

Viral fever, infections with symptoms of cough, lung infection and fevers that usually end inSeptember have persisted and steadily risen through October this year. The number of peoplecomplaining of throat and airway infections, in fact, have gone up by 20% in the past one week.

People with asthma and chronic bronchitis are having increasing trouble breathing over thepast three weeks, with doctors estimating the numbers to go up by 30-40% of the normal afterDiwali.

While short-term exposure causes airway and lung infections and aggravates breathingdisorders, chronic exposure can lead to several life-threatening diseases. “Pollution kills. Everyyear thousands die of pollutionrelated ailments in Delhi and NCR during the winters when theair is extremely foul. Pollution is a silent killer; it does not directly kill anyone but aggravatesexisting diseases,” said Randeep Guleria, director of AIIMS.

This year, there has been no respite from infections. “There is usually a rise in the number ofpeople with upper respiratory tract infections in the end of August, when the rains stops and itstarts getting colder. The next spike happens in October, when the temperature dips and thecrop burning starts. There is a sharp increase after Diwali that continues to February of nextyear,” said Vikas Maurya, head of department of pulmonology at Fortis hospital, ShalimarBagh.

The rains this year persisted for a fortnight longer and the end of the monsoon was quicklyfollowed by farm fires that polluted the air. “This year, the rains lasted well into Septemberbecause of which the season-end infections occurred late. These then sort of bunched togetherwith infections and conditions associated with pollution, leading to more than the usual numberof infections,” said Nevin Kishore, head of bronchology, Max Super speciality hospital, Saket.

FIRECRACKERS MORE HARMFUL

A single snake tablet can produce 64,500 µg/m3 of PM 2.5 within three minutes and a garland(ladi) of 1,000 crackers produces 38,540 µg/m3 of PM 2.5 within six minutes, according to astudy conducted by the Chest Research Foundation, Pune. The permitted annual mean ofPM2.5 is 40 µg/ m3, according to the National Ambient Air Quality Standards. But, it is notjust the PM levels. “Pollution from fireworks is more harmful than that from vehicularemissions or crop burning. This is because the chemicals used in the crackers release harmfulheavy metals into the atmosphere,” said Raj Kumar, director, Vallabhbhai Patel Chest Institutein Delhi.

“Increased particulate matter from burning fireworks mainly comprises fine and ultrafinespherical particles. Elevated levels of trace metals, ions and various forms of carbon are presentin the particulate matter. Unique physical and chemical properties of ambient particulate matter

during short-term firework burning can lead to substantial health damage,” states a study fromNational University of Kaohsiung, Taiwan.

The recent Supreme Court judgement has set a two-hour window period for bursting ‘green’firecrackers, which will produce less pollution. The Petroleum and Explosives SafetyOrganisation (PESO) has to ensure that only fireworks with permitted chemical content areproduced, sold, purchased and used.

As per PESO specifications, the highest allowed content is 20% for sulphur, 57% for nitratesand 24% for aluminium. Lithium, mercury, arsenic, lead and antimony containing crackers arebanned, so are potassium chlorate-based crackers.

With Delhi’s air quality hovering between 300 and 400 on most days through the wintermonths, the long-term consequences of pollution cannot be ignored.

“Pollution increases the risk of cardiovascular diseases like heart attacks and strokes,” saidGuleria.

“It can also result in stunted growth of the lungs in children and cause respiratory problemslater in life,” he said.

Long-term exposure also leads to people developing asthma and chronic obstructive pulmonarydisease (COPD). In India, 50% of all COPD is caused by ambient and household air pollution,a recent state-level burden of disease published in Lancet stated. Globally, 80% of COPD iscaused by smoking.

Poverty reduction

What has driven India’s poverty reduction? (Hindustan Times: 20181101)

https://www.hindustantimes.com/india-news/what-has-driven-india-s-poverty-reduction/story-s83YduiFxOfFyQGIqdLW5L.html

55 % Indians were classified as poor by the MPI methodology in 2005-06. India halved itspoverty rate in the next 10 years. In absolute terms, the number of poor fell from 630 millionto 360 million during this period.

Improved nutrition, better sanitation and increased asset ownership have halved India’s povertyrate between 2005-06 and 2015-16, according to a study by the Oxford University.

In the 10-year period, 270 million Indians were pulled out of poverty in what is perhaps one ofthe most significant wins of the Indian economic story. In this period, per capita GDP grewfrom Rs 38,750 to Rs 88,746, and India became a lower middle-income economy.

Poverty statistics are notoriously controversial. It is very difficult to evolve a consensus aroundthem. Poverty ratio varies significantly, depending on what the cut-off is for classifying thepoor from non-poor. They also come with a significant time lag. India’s official povertyestimates are not available after 2011-12. There are credible alternatives to track absolute andrelative, vis-à-vis other countries, progress in India’s battle against poverty.

One such measure has been developed by the Oxford University-based Oxford Poverty andHuman Development Initiative (OPHI), which release something called Multi-DimensionalPoverty Index (MPI) for 105 nations.

The MPI is a more holistic measure because it considers dimensions of health, education andliving standards and its India results are based on the findings of the National Family and HealthSurvey (NFHS).

People are designated poor according to the MPI, if they are deprived in at least one of the 10indicators across the dimensions of education, health and living standards.

Fifty-five% Indians were classified as poor by the MPI methodology in 2005-06. India halvedits poverty rate in the next 10 years. In absolute terms, the number of poor fell from 630 millionto 360 million during this period. The decrease in poverty headcount has been driven mostlyby an improvement in living standards, through better availability of material goods such ascooking fuel, sanitation facilities, and household assets.

Air pollution

What Indian states must do to curb air pollution? (Hindustan Times:20181101)

http://paper.hindustantimes.com/epaper/viewer.aspx

One way to address local sources of air pollution is to conduct source apportionment studiesfor hotspots

STATE GOVERNMENTS CAN USE SATELLITE MEASUREMENTS AND A DENSENETWORK OF GROUND MONITORING STATIONS TO CHECK HOW THEIRSTRATEGY IS AFFECTING POLLUTION LEVELS

The World Health Organization’s (WHO) air pollution and child health report released onMonday adds to evidence that air pollution is causing health damage and deaths worldwide.Instead of spending time questioning the evidence, India must establish timebound strategiesto deal with the crisis. The Centre is yet to release the National Clean Air Programme (NCAP)with a goal to meet the annual air quality safe standard at all locations within a specified period.The draft released in April did not set a time frame for reaching the target. The ministry sincethen has said that the draft has been revised and finalised with timebound targets. One of thetargets being considered is to reduce PM 2.5 concentrations by 35% in the first five years ofNCAP implementation, in more than a 100 cities, which have not met the safe standard. About80 city air pollution action plans under NCAP have been finalised by the ministry; 36 othersare being considered.

The Central Pollution Control Board (CPCB) has commissioned some local health studies tounderstand health impacts of air pollution but perhaps there is no time to waste. Large scalecohort studies will help India document the health burden but doctors and scientists are alreadyraising alarm bells on pollution levels.

The NCAP has to have a clear implementation strategy to be able to verify if cities are on trackto meet targets. Only a handful of cities have source apportionment studies that clearly lay outwhich are the major pollution sources in the region. A couple of such studies have beenconducted for Delhi. IIT Kanpur is currently conducting source apportionment studies forKanpur and Agra. One way to address local sources of air pollution is to immediately conductsource apportionment studies for major pollution hotspots and then devise plans to reduceemissions from major sources. State governments can use satellite measurements and a densenetwork of ground monitoring stations to check how their strategy is affecting pollution levels.

State governments can make it legally mandatory for the city or district administration to meettargets. Not doing so within a stipulated time could be linked to disbursal of development funds,for example. Covering rural areas that have a high burden of household air pollution will becrucial in reducing morbidity and mortality from air pollution, by verifying if they have LPGcoverage and transparently releasing industrial emissions data.

It is also important to have strategies for villages and towns in the vicinity of pollutingindustries like thermal power plants, coal mines, industries releasing hazardous waste whichcause extremely high air pollution exposure but are invisible in government policies becausethere is little or no pollution monitoring here.

China’s Air Pollution Prevention and Control Action Plan (APPCAP) (2013-2017) has alreadystarted showing results. A recent study by Peking University School of Public Health has foundthat the annual average concentration of PM 2.5 decreased by 33.3% in 74 key cities where theplan was implemented in the past five years. This reduction may have led to 44,240 fewer airpollution-linked deaths in 74 Chinese cities, according to the study. China’s success story canbe studied to refine the NCAP.

There is another global example of legal remediation. The European Commission took the UK,France, Germany, Hungary, Italy and Romania to the European Court of Justice earlier thisyear for not meeting nitrogen dioxide standards. Even as India waits for the NCAP to benotified, the focus doesn’t need to be limited to Delhi-NCR alone, which already has an airquality monitoring network of 38 real-time stations and a graded response action plan for highair pollution days and a comprehensive action plan with medium and long-term strategies.Environmental lawyers say there is no dearth of legal remedies for air pollution which includessections in the Air Act, the Environment Protection Act and section 133 of the Code of CriminalProcedure. The CPCB’s notification dated April 11, 1994, also mandates that national airquality standards should be met on 98% of days, which is violated in almost all cities. Article21 of the Constitution guarantees every Indian the right to live in a clean and healthyenvironment. Communities affected by air pollution can always use it to demand clean air.

Health scheme

Our health scheme better than Ayushman Bharat, says Naveen(The Hindu:20181101)

https://www.thehindu.com/news/national/other-states/our-health-scheme-better-than-ayushman-bharat-says-naveen/article25383990.ece

Odisha CM brushes aside Union Minister Dharmendra Pradhan’s criticism

Odisha Chief Minister Naveen Patnaik on Wednesday claimed that the State’s health insurancescheme was much better than the Pradhan Mantri Ayushman Bharat programme, brushingaside criticism from Union Minister Dharmendra Pradhan.

Odisha has adopted its own health health insurance scheme — the Biju Swasthya KalyanYojana, named after legendary leader Biju Patnaik — in place of the Central programme whichwas launched by Prime Minister Narendra Modi on September 23. The BSKY was launchedon August 15.

Mr. Patnaik’s assertions came a day after Mr. Pradhan had termed as “misleading” the ChiefMinister’s claim that one crore cases were registered under the BSKY within 60 days of itslaunch.

“The Biju Swasthya Kalyan Yojana is a historic step since both the BPL [Below Poverty Line]and APL [Above Poverty Line] people will get health benefits under the scheme. It is waybetter than Ayushman Bharat,” the Chief Minister said while addressing a function to mark theruling Biju Janata Dal’s “Padayatra” here.

The BJD had launched the “Jansampark Padayatra” on October 2 across the State.

After a review of the BSKY, Mr. Patnaik had on Saturday said the scheme had benefitted overone crore people within 60 days of its launch.

Misleading, says Minister

Mr. Pradhan, the Union Petroleum Minister, had challenged the Chief Minister’s claim onTuesday. “How come one crore cases were registered under the BSKY within 60 days whenthe total number of people visiting government hospitals in a year is much less than one crore?”he had said.

Odisha’s adoption of a different health insurance scheme has triggered a war of words betweenthe BJD and the BJP ahead of the 2019 Lok Sabha election, which would coincide with theState Assembly polls.

Talking about the BSKY, Mr. Patnaik said people irrespective of their economic status will bebenefitted under the scheme.

Ridiculing the Centre’s Ayushman Bharat programme, he said, “Does any disease see poor orrich before affecting a person? Those not in the BPL category will also get benefits underBSKY.”

“The State government is there for those in the BPL as well as in the APL category,” Mr.Patnaik added.

Free Health Care Scheme (Navbharat Times: 20181101)

http://epaper.navbharattimes.com/paper/16-13@13-01@11@2018-1001.html

Pollution (Dainik Gagaran: 20181101)

https://epaper.jagran.com/ePaperArticle/01-nov-2018-edition-Delhi-City-page_8-83-10495-4.html

Pollution

नौिनहाल�के िलए खतरनाक है धुंध क�यह चादर(Hindustan: 20181101)

http://epaper.livehindustan.com/textview_291206_65183740_4__14_01-11-2018_1_0.html#

Vegetarian ((Dainik Gagaran: 20181101)

https://epaper.jagran.com/ePaperArticle/01-nov-2018-edition-Delhi-City-page_24-57-5605-4.html