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1. Developing Standard Treatment Workflows—way to universal healthcare in India

Author

Ashoo Grover, Balram Bhargava, Saumya Srivastava, Lokesh Kumar Sharma, Jerin Jose Cherian, Nikhil Tandon, Sudha Chandershekhar, Roderico H. Ofrin, Henk Bekedam, Deepika Pandhi, Aparna Mukherjee, Rupinder Singh Dhaliwal, Manjula Singh, Kavitha Rajshekhar, Sudipto Roy, Reeta Rasaily, Deepika Saraf, Dhiraj Kumar, Neeraj Parmar, Sushil Kumar Kabra, Dhruva Chaudhry, Ashok Deorari, Radhika Tandon, Rajdeep Singh, Binod Khaitan, Sandeep Agrawala, Sudeep Gupta, Satish Chandra Goel, Anil Bhansali, Usha Dutta, Tulika Seth, Neeta Singh, Shally Awasthi, Amlesh Seth, Jeyaraj Pandian, Vivekanand Jha, Sudhanshu Kumar Dwivedi, Reva Tripathi, Alok Thakar, Surinder Jindal, Banglore Nanjudaiah Gangadhar, Anjali Bajaj, Mohan Kant, and Aniket Chatterjee

Subjects
Standard Treatment Workflows (STWs), universal health coverage (UHC), quality health care (QHC), public health, disease, Public aspects of medicine, RA1-1270
Abstract

Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC.

Published
2023
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2. India's road to independence in manufacturing active pharmaceutical ingredients: Focus on essential medicines

Author

Jerin Jose Cherian, Manju Rahi, Navdeep Rinwa, Shubhra Singh, Sanapareddy Eswara Reddy, Yogendra Kumar Gupta, Vishwa Mohan Katoch, Vijay Kumar, Sakthivel Selvaraj, Payal Das, Raman Raghunathrao Gangakhedkar, Amit Kumar Dinda, Swarup Sarkar, Puroshottambhai Devshibhai Vaghela, and Balram Bhargava

Subjects
media_common.quotation_subject, Economics, Econometrics and Finance (miscellaneous), pharmaceutical policy, Psychological intervention, India, 030209 endocrinology & metabolism, essential medicines, Development, Essential medicines, 03 medical and health sciences, domestic manufacturing, 0302 clinical medicine, import dependence, ddc:330, 030212 general & internal medicine, Marketing, HB71-74, Pharmaceutical policy, media_common, Active ingredient, Focus (computing), Government, public health, Independence, Economics as a science, active pharmaceutical industry, Business, Dependency (project management)
Abstract

Background: Active Pharmaceutical Ingredient (API) manufacturing is an important segment of the Indian pharma industry. India ranks third in terms of volume of medicines produced, and is a major global supplier of generic medicines. However, India depends heavily on the import of several raw materials used to produce some of these medicines. Main Body: This paper highlights how the situation emerged, as well as the various steps taken by the government to reduce import dependency and promote domestic manufacturing of APIs. Through various consultations with government officials, policy analysts and academicians, and interactions with key industry experts, the paper also highlights the public health perspectives of such dependence, especially regarding the secure access to essential medicines. India needs a conducive ecosystem to capitalize on the full potential of its API manufacturing capabilities, which may require some short-term and some mid/long-term interventions. Conclusions: It concludes by providing certain short-, medium- and long-term recommendations in the policy, fiscal and technology domains, to promote API independence. It also summarizes the various steps taken by the government in moving towards domestic manufacturing of APIs.

Published
2021

3. Exploring links between vitamin D deficiency and COVID-19

Author

Amit Sharma, Jerin Jose Cherian, and Mradul Mohan

Subjects
Viral Diseases, Critical Care and Emergency Medicine, Pulmonology, Physiology, Organic chemistry, Pearls, Medical Conditions, Immune Physiology, Pandemic, Medicine and Health Sciences, Biology (General), Vitamin D, Immune Response, Acute Respiratory Distress Syndrome, Respiratory Distress Syndrome, 0303 health sciences, Innate Immune System, 030302 biochemistry & molecular biology, Nutritional Deficiencies, Vitamins, Physical sciences, Chemistry, Infectious Diseases, Micronutrient Deficiencies, Cytokines, Coronavirus Infections, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), QH301-705.5, Pneumonia, Viral, Immunology, Microbiology, Virus, vitamin D deficiency, Betacoronavirus, 03 medical and health sciences, Chemical compounds, Respiratory Disorders, Immune system, Respiratory Failure, Virology, Organic compounds, Genetics, medicine, Vitamin D and neurology, Humans, Pandemics, Molecular Biology, 030304 developmental biology, Nutrition, Vitamin D deficiency, Biology and life sciences, SARS-CoV-2, business.industry, Public health, COVID-19, Covid 19, RC581-607, Molecular Development, medicine.disease, Immune System, Dietary Supplements, Respiratory Infections, Parasitology, Immunologic diseases. Allergy, business, Hormone, Developmental Biology
Abstract

Coronavirus Disease 2019 (COVID-19) pandemic remains a major public health threat in most countries. The causative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can lead to acute respiratory distress syndrome and result in mortality in COVID-19 patients. Vitamin D is an immunomodulator hormone with established effectiveness against various upper respiratory infections. Vitamin D can stall hyper-inflammatory responses and expedite healing process of the affected areas, primarily in the lung tissue. Thus, there are ecological and mechanistic reasons to promote exploration of vitamin D action in COVID-19 patients. As no curative drugs are available currently for COVID-19, we feel that the potential of vitamin D to alter the course of disease severity needs to be investigated. Clinical studies may be undertaken to address the value of vitamin D supplementation in deficient, high-risk COVID-19 patients.

Published
2020

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