Back as Union Health Minister, Nadda has his task cut out for him: Climate-induced health threats, restoring NEET credibility, achieving Universal Health Coverage with reduced Out-of-Pocket Expenses for the poor, and harnessing tech to extend healthcare access to remote areas among others, experts tell ARCHANA JYOTI

Cancer, and blood disorder patients need a healing touch

By Dr  Nita Radhakrishnan Associate Professor and HOD of pediatric haematology-oncology at Child PGI, Noida, UP

• All cancer patients and all aplastic anemia patients should be eligible for PMJAY scheme
• Patients with thalassemia should have access to NAT-tested safe blood
• Patients with hemophilia should have access to long-acting factors and non-factor replacement treatment that offers the advantage of prevention of bleeds
• Bone marrow transplantation (Allogeneic) should be covered under the Ayushman Bharat scheme.
• Weight-based packages should be made available under the Ayushman Bharat scheme for cancers and blood diseases

Enhanced access and quality healthcare a key

By Padmashiri Awardee Dr Mahipal S Sachdev, Chairman and Medical Director, Centre for Sight Group of Hospitals

• Strengthen Primary Healthcare: Expand and utilize Health and Wellness Centres (HWCs) for comprehensive primary care, early disease detection, and preventive healthcare.
• Enhance Healthcare Access and Affordability: Refine the Ayushmanarat scheme for broader coverage and address service delivery gaps to maximize impact.
• Improve Immunization Coverage: Continue Mission Indradhanush to maintain high immunization rates, especially in low-coverage regions, and include new vaccines.
• Boost Eye Care Services:: Strengthen the National Programme for Control of Blindness (NPCB) to improve screening, treatment, and outreach in rural areas.
• Promote Public Health and Sanitation: Expand Swachh Bharat Abhiyan to enhance sanitation and hygiene.
• Address NCDs: Develop strategies to manage diabetes, hypertension, and cardiovascular diseases, promoting healthy lifestyles and accessible treatments.
• Enhance Mental Health Services: Integrate mental health into primary healthcare, ensuring accessible and affordable mental health care for all.
• Ensure Health Workforce Development: Invest in training and capacity building for healthcare professionals, strengthening medical education and continuous professional development.
• Foster Innovation and Research: Support healthcare innovation through research and development, leveraging technology to improve healthcare delivery and outcomes.
• Expand Public-Private Partnerships: Utilize under-utilized private healthcare capacity through schemes like Ayushman Bharat, especially in underserved areas.
• Improve Government Healthcare Facilities: Focus on enhancing existing government healthcare infrastructure and service provision.
• Rationalize Service Charges: Streamline reimbursement processes for private hospitals under schemes like CGHS, ensuring good quality care for beneficiaries.
• Simplify Compliance Processes: Simplify statutory compliance for hospitals, particularly for smaller setups, and develop frameworks recognizing daycare and short-stay treatment services.
• Restore NEET Credibility: Ensure the credibility of NEET to maintain trust in the medical college entrance process and the quality of medical education.

Prioritise prevention, support for cancer survivors, strengthen healthcare infrastructure

By DS Negi, Chief Executive Officer, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), Delhi

*Only 1% of female cancer patients in India undergo cervical cancer screening, highlighting a significant gap in preventive healthcare. Comprehensive nationwide screening initiatives are necessary to raise awareness and accessibility. Hence, educating women about the importance of regular screenings and ensuring healthcare facilities is the need of the hour.

*Early Diagnosis and Treatment Advancements: Early diagnosis has led to an increase in cancer survivors. Emphasizing "prevention is better than cure" is crucial, advocating for regular health check-ups and awareness of available screening tests to detect cancers early when treatment outcomes are better.

*Support Systems for Cancer Survivors: There's a need for comprehensive support systems post-treatment. This includes access to quality healthcare services such as rehabilitation, mental health support, and survivorship programs. Enhancing the overall well-being and quality of life for cancer survivors requires sustained government support and healthcare infrastructure.

*Healthcare Coverage under Ayushman Bharat: Extending coverage to everyone above 70 years and potentially increasing coverage limits for critical illnesses like cancer is required. The current Rs. 5 lakh coverage is not adequate for extensive cancer treatments, which can cost significantly more. This adjustment would alleviate financial burdens on patients and their families during critical healthcare episodes.

*Expansion of Healthcare Infrastructure: The healthcare sector needs substantial government support to expand primary healthcare facilities, incentivize private sector participation, and increase the availability of healthcare professionals. This includes policies to boost healthcare expenditure to 2.5% of GDP, aligning with global healthcare standards and enhancing overall healthcare access and quality

Surging AMR demands urgent action

By Dr Sangeeta Sharma, Professor & Head, Neuropsychopharmacology, IHBAS & President, DSPRUD, Delhi.

The silent pandemic of antimicrobial resistance (AMR) is an urgent health priority, posing a significant threat to public health, food security, the environment, and the global economy. AMR arises from the excessive and irresponsible use of antibiotics, compounded by poor sanitation, inadequate diagnostics, and lack of regulation on over-the-counter antimicrobial availability.

The National Action Plan to Combat AMR (NAPAMR), initiated in 2017, is currently under revision, with NAPAMR 2.0 in progress. The updated plan emphasizes a 'One Health' approach, integrating human, animal, and environmental health to provide a comprehensive response. However, effective implementation demands robust efforts at both state and healthcare facility levels. Despite only five states having developed their State Action Plans (SAPs), there is an urgent need for nationwide enforcement.

NAPAMR 2.0 must address the gaps identified in the initial plan, incorporating a triple shield strategy focused on Infection Prevention and Control (IPC), Diagnostic Stewardship (DS), and Antimicrobial Stewardship (AMS). IPC aims to reduce the spread of infections through stringent hygiene protocols, while DS ensures accurate and timely diagnosis to avoid unnecessary antibiotic use. AMS promotes the responsible use of antibiotics, reducing the development of resistance and ensuring the effectiveness of treatments.

As heatwaves sweep through a large number of pockets in India, the urgency of addressing AMR becomes even more pronounced. High temperatures can exacerbate health conditions, including those linked to AMR, highlighting the need for robust, climate-resilient healthcare strategies.To mitigate the impact of AMR, it is crucial to enhance policy frameworks, strengthen healthcare infrastructure, and promote education and awareness. Immediate and coordinated action is essential to combat this silent pandemic, safeguarding the health and ensuring the sustainability of our antimicrobial resources for future generations.

Integrate Oral health into National Health Policy

By Dr Mahesh Verma, Padmashri Awardee, Vice-Chancellor, Guru Gobind Singh Indraprastha University (GGSIPU), Delhi

Oral health has been significantly overlooked in India's National Health Policy (2017) and the Ayushmaan Bharat scheme, which currently only covers severe inpatient dental cases. This omission neglects a crucial component of overall health, as highlighted by the WHO in 2022, urging all countries to integrate oral health into their health policies. Oral diseases are more prevalent than mental disorders, cardiovascular diseases, diabetes, and cancers combined. These cost approximately USD 710 billion annually in treatment and productivity losses. Poor oral health also increases risks for NCDs Hence, incorporate comprehensive oral health care Policy in the National Health Policy, making it an essential part of health services and Ayushmaan Bharat scheme to cover preventive and routine dental care. Because dental care is not covered under Ayushmaan Bharat, people avoid going to doctors until they become life-threatening. Integrate oral health into the government's 100-day programme, with clear, actionable steps.

Invest funds in collaborative upstream discovery

By Dr  Kavita Singh, Director, Drugs for Neglected Diseases initiative, South Asia

The Covid-19 pandemic has highlighted the critical role of drug development. Many drugs were quickly developed globally but were not readily available to developing countries, including India. This underscores the necessity of investing in our drug development capabilities to prepare for future viral pandemics. Drugs are the first line of treatment for saving lives before vaccines can be widely administered.

A crucial aspect of preparedness includes supporting upstream R&D, such as discovery research to identify promising novel antivirals. This is vital for building a pipeline for future viral pandemics. There is an urgent need to invest sustained funds into collaborative upstream discovery through our existing academia, research institutes, and their partners.

 This allows pooling of shared resources, experience, and expertise, accelerating innovation in drug development. Policies encouraging innovative pooled financing mechanisms, engagement with multilateral development banks, funds under CSR, and contributions from the pharma/biotech industries are important for this risky venture.

To effectively mentor drug discovery groups, a call from the government encouraging experts to contribute would significantly enhance our capabilities and ensure the success of these initiatives.

Finally, prioritizing R&D through collaborative efforts is needed.

Volunteer docs for better healthcare

By Dr Rahul Bhargava Principal Director & Chief of BMT, Fortis Memorial Research Institute, Gurugram

Anemia is a significant public health challenge in India. Hence we would suggest the new Minister to announce a National Anemia Day. This will ensure that all efforts are concentrated on eradicating anemia and improving public health outcomes across India.

Also, addressing thalassemia effectively requires making it a notifiable disease so that by raising awareness, identifying hotspots, and promoting early detection and prevention, we can significantly reduce the prevalence of thalassemia in India. Our goal is to ensure that by 2030, India moves towards being free of thalassemia, improving the quality of life for future generations. At least one BMT Centre should be set up in the government hospital in each state. Here I would also suggest the new Minister to consider inviting volunteer doctors from the private sector for government healthcare projects which can have numerous benefits. Many rural and underserved areas in India lack access to specialist care. Volunteer doctors can fill this gap by providing essential medical services, including surgeries, consultations, and diagnostic care, which may otherwise be unavailable.

Experienced volunteer doctors can train and mentor local healthcare staff, enhancing their skills and knowledge. This can lead to long-term improvements in healthcare quality and patient outcomes

Enhance med edu, access, and ethics

By Dr DS Rana Nephrologist, Chairman-Sir Ganga Ram Trust Society, Sir Ganga Ram Hospital, Delhi

Medical education standards and the quality of doctors must be prioritized. Among these, it's crucial to emphasize the significance of medical educators finding their profession attractive and fulfilling. However, when selecting individuals for teaching positions, there should be no compromises. Only the most competent and dedicated educators should be chosen, as the quality of teachers directly influences the caliber of students they produce.

*Doctors from both private and public sectors should provide medical assistance in rural areas. This can enhance healthcare access and quality, ensuring that comprehensive medical expertise reaches underserved communities, including quick emergency response and ambulance availability, is crucial, even in rural areas.

*The medical framework operates on an undeniable foundation. Despite the perception that all patients seeking medical care are being taken advantage of, only 5 percent encounter such exploitation. Whereas, The majority of doctors strive to save and improve patient health

Advanced healthcare tech enhances access, efficiency

By Mylswamy Annadurai, Former Director of ISRO also known as ‘Moon Man of India’

Healthcare advancements developed for space missions have significantly influenced the medical field on Earth, particularly in enhancing accessibility, efficiency, and quality of care. Space-derived technologies, including robotic surgery and artificial intelligence, have helped transform healthcare, in remote and underserved areas in India, where access to specialized healthcare is limited. By bridging the gap between rural areas and urban medical facilities, these tech ensure that patients in distant locations receive timely and expert care from specialists located in metropolitan cities.

Further, AI has a huge role in enhancing medical diagnostics and procedures. As AI can assist in real-time image analysis, anomaly detection, and decision support during surgery, integrating AI with medical expertise can lead to more accurate and timely interventions, even in the most remote parts of the country. Also, India's reliance on imported medical equipment poses challenges, including higher costs and supply chain vulnerabilities. To address this, there is a need for closer collaboration between Indian medical practitioners and technologists to develop cost-effective, indigenous medical solutions.

By focusing on research and development within the country, India can produce affordable and innovative medical equipment tailored to its specific needs, reducing dependence on imports.

Challenges in med education, healthcare, and emergencies

By Dr Ajay Swaroop, ENT, Chairman- Sir Ganga Ram Hospital, Delhi

There seems to be concern and legal challenges around a significant medical exam that young doctors must take. This is causing distress among students and parents alike. Resolving this issue promptly is crucial to alleviate anxiety and ensure fairness in the medical education system.

There is an overwhelming presence of the private sector in healthcare (accounting for over 75%). Hence there is a need for stronger collaboration between the government and private entities. This partnership could improve healthcare access and quality, especially in underserved areas.

There's criticism that the government healthcare infrastructure is not up to the mark, leading to the dominance of private healthcare providers. Auditing government expenditures on healthcare to set fair pricing benchmarks for the private sector, could promote transparency and affordability.

It is time that we are prepared for Covid-19 like health emergencies. This includes adequate infrastructure (such as oxygen supply and hospital beds) and healthcare personnel to handle crises effectively. Issues such as overcrowding and communication gaps between doctors and patients in government hospitals and private hospitals need to be addressed to curb growing violence among patients/medicos. There should be high-level committees or experts to propose policies to ensure equitable healthcare delivery

Restore the credibility of NEET, act against the culprits

By Dr Rohan Krishnan Orthopedic Surgeon, MAMC, Delhi and Co-founder, Federation of All India Medical Association (FAIMA)

The piousness and transparency of the NEET (National Eligibility cum Entrance Test) examination, a critical gateway for medical aspirants in India, has come under the shadow. It is facing numerous issues, including allegations of paper leaks and irregularities in results with so many toppers announced. This has led to a loss of trust among students and stakeholders. We want confidence in the examination process is restored, fairness, and accountability of those responsible for the mishandling of the examination.  One important thing is that there should be an unbiased committee that examines where the fault has occurred. NTA should be held responsible for the catastrophe it has caused in the NEET UG exams. Their clarification in each aspect is not doing justice to the dreams of 24 lakh aspirants. Either they have yet not discovered their error which is sad, or they are trying to hide something sad and pathetic. It is high time that DG of NTA resigned and took moral responsibility for the mayhem and chaos. We are talking about 1500 students who will be given the chance to re-appear in the examinations, but not all those students who want to take re-exam and who believe that there has been some fault. We can give a chance to everyone who wants to re-appear and the best of the two marks will be considered for merit.