Breaking the TB chain
WHO data shows that since 2015, India has made good progress in tackling TB. There has been a 17 per cent drop in the number of reported cases and a 20 per cent drop in the number of deaths. More than 85 per cent of those detected with the infection have received treatment and efforts to contain multi-drug-resistant TB are yielding results. It is evident that the TB problem is not intractable, but given India's massive disease burden, accounting for 27 per cent of the global cases, there is no room for complacency. The challenge is compounded by the problem of subclinical TB, where infected individuals do not yet present symptoms like persistent coughing. A study published in The International Journal of Tuberculosis and Lung Disease in 2024 found that 39 per cent of TB cases in India are subclinical, and therefore more likely to escape detection and continue spreading. This is why the attempt to tackle TB as early as possible matters. The ICMR's update, making molecular TB testing available at the level of the community health centre (CHC) —with sub-centres and primary healthcare centres (PHCs) also sending samples to be tested — could be crucial to providing timely treatment and breaking the chain of transmission.
Despite making significant progress, India is unlikely to meet its target of eliminating TB by the end of the year. The government has made the expansion of primary healthcare a key pillar of its policy, with the aim of bringing a broad spectrum of services closer to the people through the network of over 1.7 lakh centres around the country. The broadening of the TB diagnostics must be factored in, equipping SHCs and PHCs to identify and treat infected individuals as early as possible, even as initiatives to reduce the financial burden of treatment and improve access to nutrition are strengthened.
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Mint
11 minutes ago
- Mint
Two-thirds of Indian adolescents swayed by food ads; higher taxes on sugary, fatty foods may help curb rising obesity
New Delhi: An overwhelming 67.57% of adolescents in India are influenced by ads when making their food choices, a large nationwide survey has found, amid a focus on child obesity as a major lifestyle-related health concern. The survey of 143,000 adolescent respondents was conducted in 2022 as part of the Let's Fix Our Food initiative, a public-private partnership between the Public Health Foundation of India, the Indian Council of Medical Research, National Institute of Nutrition, and UNICEF. The findings are currently undergoing peer review for publication in a scientific journal. Unhealthy food advertising, often using celebrity endorsements and games, heavily influences young people's food choices, contributing to rising obesity and related diseases. The policy brief stated that in India, 90% of ads for children and youth on TV are for High Fat, Sugar, and Salt (HFSS) foods. Studies show such ads increase consumption; for example, children watching cartoon food ads ate 45% more. It said that current Indian advertising rules, especially the 2022 guidelines, are weak, lacking clear definitions for "junk foods" or child-targeted ads. India must strengthen these rules with clear definitions and wider scope to protect everyone, not just children. Countries like Chile and South Korea prove strong, mandatory ad restrictions work. With projections from the World Obesity Atlas 2022 indicating that over 27 million Indian children and adolescents could be affected by obesity by 2030, the survey highlighted that unhealthy eating habits and insufficient physical activity are key drivers of overweight and obesity among young people. The survey found that nearly half (49.46%) of respondents receive most of their nutrition information from schools. However, economic barriers play a significant role, with 30.7% of adolescents citing high prices as an obstacle to healthy foods. While a large majority (72.58%) of adolescents said they do read nutrition information on food products, over half (62.81%) said this information should be simplified. Additionally, around 43.88% of adolescents believe that providing more information about unhealthy food items could deter them from consumption. The outcomes of the LFOF initiative, including a detailed policy brief, were recently discussed at a high-level stakeholder consultation in the presence of Dr V.K. Paul, member, NITI Aayog, and D Rajiv Bahl, director general, ICMR. To combat this growing crisis, the initiative urges the government to tighten regulations on advertisements for unhealthy food products targeting children. Other crucial recommendations include introducing health taxes on high fat, sugar, and salt (HFSS) foods and ensuring clear, simplified nutrition information on food packaging. 'Develop guidelines for clear front-of-pack nutrition information on packaged foods and regulate HFSS food consumption. Introduce health taxes on HFSS foods. Enforce the ban on HFSS foods in and around educational institutions, as per FSSAI guidelines. Implement programs to make healthy foods more affordable and accessible and Avoid partnerships with corporations promoting HFSS foods among adolescents," the policy brief said. Prof. Monika Arora, Vice President, Research and Health Promotion, Public Health Foundation of India (PHFI), stated, 'The recommendations such as the introduction of health taxes on HFSS foods and clearer front-of-pack nutrition labelling are presently under discussion. They have been shared with relevant stakeholders. These discussions are part of a growing national and global movement towards creating healthier food environments for children and adolescents." Addressing HFSS Food Marketing On the taxation front, the document said that health taxes are crucial in India to combat obesity and related diseases driven by unhealthy foods like sugary drinks. It said that the WHO endorses taxation as a cost-effective solution, already adopted by over 70 countries. A modelling study on fiscal policies in India found that a 20% tax on sugar-sweetened beverages (SSBs) could reduce overweight and obesity by 3% and type 2 diabetes by 1.6% with the largest relative effect expected among young rural men. 'Extending similar strategies to unhealthy foods especially those aggressively marketed to children could play a critical role in safeguarding public health," Prof Arora said. Dr Soumya Swaminathan, former WHO Chief Scientist and ICMR Director General, welcomed the crucial findings of the survey, reiterating that the rising trends of obesity and non-communicable diseases (NCDs) in India are directly linked to the significant impact of advertising on adolescents' food choices. This, coupled with poor diet and lack of physical activity, predisposes them to NCDs, making immediate action essential to reverse the trend. She emphasized the need for strict advertising regulations to prevent unsubstantiated claims, especially for products targeting children with appealing characters or gifts, which are often high in fat and sugar. She also called for effective front-of-pack labeling, suggesting a clear A, B (healthy) and C, D (unhealthy) system based on fat, sugar, and salt content, rather than the proposed star labeling by FSSAI. Furthermore, she advocated for health taxes on tobacco, sweets, and high-fat/sugar foods, similar to those in countries like Thailand. While acknowledging that such taxes in India currently contribute to the general treasury, she stressed that ideally, these funds should directly benefit public health schemes and educational campaigns to deter unhealthy consumption. Echoing these concerns, Dr. Suranjeet Chatterjee, Senior Consultant at the Internal Medicine Department, Apollo Hospitals Indraprastha in Delhi, emphasized the critical need for strict regulation of advertisements in India. He highlighted that endorsements by film stars and other prominent figures significantly impact not only children but also adults. Dr Chatterjee stressed that food labeling must clearly indicate the amounts of fat, sugar, salt, and calories. He noted a concerning shift in food consumption patterns, leading to a rise in heart disease, blood pressure, and diabetes at much younger ages. "Earlier, very rarely would patients in the age group of 30-35 years come with problems of heart disease, but now, the percentage has increased in the age group of 25-35 years," he stated, underlining the urgency of addressing these lifestyle-related health issues. 'The findings of the report indicate that 68% of adolescents are influenced by food advertisements, and nearly 31% reported that high food prices prevent them from eating healthy. These insights highlight the urgent need to improve affordability and accessibility of nutritious foods for young people. Addressing childhood obesity must remain a national priority, with stronger policies on food environment, nutrition education, physical activity, and front of pack nutrition labeling and its skill-based literacy, supported by community engagement and cross-sectoral collaboration, said Preetu Mishra, Nutrition Specialist, UNICEF. The findings reinforce the need for system-level policy interventions to reshape the food environment. Among the key recommendations is the introduction of health taxes on HFSS foods (Food high in fat, salt and sugar), which is supported by global and regional evidence showing their impact on reducing consumption of unhealthy foods and incentivizing better industry practices. WHO recommends taxation as one of the most cost-effective tools. An increasing number of countries have taken steps to implement fiscal policies that promote healthy diets, with 115 countries taxing sugar-sweetened beverages nationally as of February 2024. An additional 41 countries have applied national taxation on a variety of unhealthy food categories, Mishra added.
The Hindu
2 hours ago
- The Hindu
Move on HPV vaccine rollout to adolescent girls raises other vaccination priorities for Kerala: epidemiologists
Kerala's decision to introduce HPV vaccination targeting adolescent girls, to protect them from cervical cancer is generally hailed as a positive public health measure. However, health experts have pointed out that the State has other pressing public health concerns, where also vaccination strategies must be prioritised. Going by the current data from the population-based and hospital-based cancer registries in Kerala, the incidence of cervical cancer has been on a steady decline in the State over the past several years and it no longer figures among the top five cancers affecting women in Kerala, according to epidemiologists. This is consistent with improvements in women's health and hygiene, better sexual practices, education and healthcare access in Kerala. Even though the World Health Organization (WHO) has recommended HPV vaccination for adolescent girls, in Kerala cervical cancer incidence is only eight per lakh population, even when at the national level, cervical cancer remained the second highest of all cancers reported amongst women as in 2022. 'Only if there is an uptick' The committee headed by Dr. B. Ekbal, which submitted the State's Vaccine Policy recommendations in November 2022, had noted that HPV vaccination should be considered in Kerala only if there is an increasing trend in the incidence of cervical cancer from the current baseline. It said that given the fact that the cost of vaccinating 13 lakh adolescent girls would be over ₹200 crore, HPV vaccination was not indicated, nor was it cost effective. Dr. Ekbal says that this picture has changed given that Serum Institute of India is now producing HPV vaccines at much competitive rates. While HPV vaccine manufactured by pharma majors are available in the range of ₹2,000-₹4,000/dose (there is also the HPV vaccine which protects against nine strains of HPV, costing around ₹10,850/dose), Cervavac produced by Serum Institute of India is available at ₹2,000/dose. 'HPV vaccine cost has come down and as far as dosage is concerned, there is some emerging evidence, (as per the WHO), that even a single dose delivers solid protection against HPV. That changes the picture completely. From a gender perspective, I am happy about the State's decision to protect adolescent girls against HPV,' Dr. Ekbal said. Current public health concerns However, the State should not forget its current public health concerns, which included protecting children from rabies through anti-rabies pre-exposure prophylaxis vaccine and from mumps, through an additional dose of MMR vaccine, he said. Rabies is emerging as a serious public health issue in the State, with children being a major casualty, he reminded. 'The mortality and morbidity due to influenza and pneumococcal infections is high in the elderly, the immunocompromised and those with co-morbidities. The State should prioritise annual flu vaccine and pneumococcal vaccine to protect elderly against pneumonia and meningitis,' Dr. Ekbal pointed out. He said that the Health department should recommend these vaccines so that there is more uptake for the same, which can bring down the cost of vaccines. Time to push for elimination 'Introducing HPV for adolescent girls is a policy decision that the Government had taken much earlier. Questions whether HPV vaccination is a priority now can be controversial. It is true that cervical cancer incidence is going down steadily and thus this would be the right time to push through elimination strategies. HPV vaccination is being introduced as part of the State's efforts to eliminate cervical cancer and the operational details are being worked out,' PK Jameela, member, State Planning Board, said.
The Hindu
3 hours ago
- The Hindu
Tezpur University team develops low-cost device to detect tuberculosis
GUWAHATI A team of researchers from central Assam's Tezpur University has developed an affordable and portable device to detect tuberculosis (TB). The researchers said the device, using the autofluorescence or natural glow of the TB bacteria for detection instead of any chemical or dye, has been specially designed for use in rural and remote areas where advanced medical facilities are not easily available. Pabitra Nath of the university's Department of Physics and the team leader, said the device has a built-in heating system to improve test accuracy and can be operated using a smartphone. 'It costs under ₹25,000 and weighs less than 300 grams, making it a perfect fit for places with limited healthcare infrastructure,' he said. The other members of the team are Biprav Chetry and Chunuranjan Dutta, research scholars from Tezpur University's Department of Physics; J.P. Saikia and Santanu Goswami from the Department of Molecular Biology and Biotechnology; and Abhijit Gogoi from Labdig Innovations and Systems Private Limited. Early and accurate diagnosis is crucial in stopping the spread of TB, a major public health issue in India. The World Health Organization (WHO) and India's National TB Elimination Programme currently recommend LED fluorescence microscopy as the gold standard for TB screening. However, the standard testing method recommended by the WHO needs expensive machines and trained technicians, which are not available in many rural areas. The new device can solve this problem by making TB testing simpler and more accessible, the researchers said. 'While LED-FM offers higher sensitivity than conventional optical microscopy, it has several drawbacks. It depends on costly equipment, chemical staining agents like auramine-O, and trained personnel for sample preparation and interpretation. Furthermore, its reliance on laboratory infrastructure makes it impractical in many rural settings,' Professor Nath said. The device developed by the Tezpur University researchers leverages the principle of autofluorescence, a natural property of certain microbial cells, including Mycobacterium tuberculosis (mTB) cells, that emit a fluorescence signal when excited by a specific wavelength of light. 'The team's key innovation lies in the integration of a heating element within the sensor system. By raising the temperature of the bacterial sample, the system enhances the natural fluorescence signal from mTB cells, enabling trace-level detection without the use of stains or dyes,' Prof. Nath explained. The team has filed a patent for the device, and their study was published in Biosensors and Bioelectronics, an international journal.
