Indian Vaccine maker Bharat Biotech's intranasal vaccine for Covid-19, the first in the world, is scheduled to be introduced in the country as a booster dose shortly. The vaccine, iNCOVACC (BBV154), is now available on CoWin, and priced at Rs 800 for private markets and Rs 325 for supplies to the Centre and state governments, the Hyderabad-based company said.
Recently, Bharat Biotech received approval from the Central Drugs Standard Control Organization (CDSCO) for the use of heterologous booster doses of iNCOVACC. It is a recombinant replication-deficient adenovirus vectored vaccine with a pre-fusion-stabilised SARS-CoV-2 spike protein.
This intranasal vaccine candidate was evaluated in phases I, II III clinical trials with successful results, the company said. iNCOVACC has been specifically formulated to allow intranasal delivery through nasal drops. The nasal delivery system has been designed and developed to be cost-effective in low- and middle-income countries, it added.
Digital influence and technological intervention are breaking barriers in the Indian healthcare industry, leading to a dynamic transformation. While the telemedicine sector witnessed a 30 per cent spike during the pandemic, the online consultation market is projected to grow at 72 per cent CAGR to reach over 800 million dollars by FY2024, as per the report by Praxis Global Alliance.
Artificial intelligence is geared up to dominate the Indian healthcare industry by increasing the market value from $1.1 billion to $5 billion at a 39 per cent CAGR. Tech trends like nanomedicine, virtual and augmented reality and robot-assisted surgery are also acquiring large space in the Indian healthcare industry.
While adopting disruptive technologies, the Indian healthcare industry is evolving from improved accessibility and affordability to quality of life in the rural areas, as well, through technological advancements. In India, the doctor-patient ratio is 1:1456 compared to the standard ratio of 1:1000 as per the WHO. Since the doctor-patient ratio in India lacks the standard WHO ratio, digital healthcare becomes more imperative in remote rural areas where doctors can reach via technology.
Artificial intelligence is the game changer in the global healthcare industry. Currently, the global market of AI stands at $15 billion and is estimated to expand at a CAGR of 37 per cent by 2030. The high-focus areas of AI in Indian healthcare are triaging, detection and diagnostics. AI plays a vital role in identifying the underlying causes of diseases and managing their treatment plans. The government of India is also proactively boosting several initiatives, policies and schemes like National eHealth Authority (2015), the Biotechnology Ignition Grant Scheme (2012, Health Data Privacy & Security Act (2016).
A few decades back, consulting doctors via video conference must have looked like a far-off dream. Virtual healthcare has become the potential tech health segment in India and is targeting to reach $5.4 billion at a CAGR of 31 per cent.
Nanomedicine is another emerging tech-enabled trend that uses nanotechnology for highly-specific medical interventions for the diagnosis, treatment and prevention of diseases effectively. The global nanomedicine market size is expected to grow at a CAGR of 9.2 per cent by 2030.
Nanomedicines refer to a more diminutive and accurate delivery system that allows doctors to deliver chemotherapy directly to targeted tumours instead of poisoning an entire body. They slowly release medicine from a single nanoparticle, reducing the frequency of drug injections. Robot-assisted surgeries are the new-edge technology enabling doctors and specialists to perform delicate procedures and complex surgeries more accurately. The surgical tools consist of a camera and mechanical arms, controlled by a surgeon through a computer system, giving them a high-definition (HD) and magnified view of the surgical site. The advantages of this most commonly used system include enhanced precision, flexibility and control, less pain and blood loss and quicker recovery. Since it is minimally invasive, it results in fewer scars and complications than conventional surgeries. Virtual reality in healthcare caters to a broad spectrum of healthcare services. VR technology provides simulators that help healthcare professionals to practice surgeries and procedures in virtual reality, enhancing the quality of operations in real situations. It is also instrumental in physical and mental health treatments. While immersing in the virtual world lowers pain and anxiety, it also helps tackle traumatic experiences by recreating the situation.
Technology facilitates real-time diagnosis, improves the chances of successful treatments, lowers healthcare costs and reduces hospital stays. The growing potential of technology in healthcare indicates that Indian health infrastructure will be fortified.
(Rajib Banerjee:The author is Founder & CEO MasMedi)
Among ancient India’s biggest gifts to the world, we must embrace it emphatically first
Union Minister of State for Tourism Shripad Naik has rightly advocated the need for giving benefits of ‘Ayurveda’ to the world. The 9th World Ayurveda Congress is being organised by the World Ayurveda Foundation with support of the Union Ministry of AYUSH and Government of Goa. Prime Minister Narendra Modi will address the valedictory session on December 11. “It (Ayurveda) is not just medicine, it’s our tradition. We need to give benefits of it to the world,” he said. “Ayurveda has been facilitated by the setting up of a separate Ministry of AYUSH, credit of which goes to Modi” Naik added. He also said that the Modi government took Yoga to the world. And that is perhaps where he was off the mark. Indeed the AYUSH ministry was formed to give fillip to the alternative medicines especially Ayurveda but has it achieved its objective is rather questionable. More than 5,000 delegates and 200 delegates from 30 countries are attending the congress. Though conclaves like this do help, the minister and the government at large should understand that it takes more than just words to make a system popular. Equating it to Yoga would be wrong as Yoga was already popular in the west and the credit for that certainly does not go to the government.
The Ministry of AYUSH is responsible for developing education, research and propagation of traditional medicine systems in India. The Department of Indian Systems of Medicine and Homeopathy (ISM&H) was made into a ministry by the Modi Government in 2014. But in its eight years there is hardly anything that AYUSH can be proud of. It started with much fanfare but has delivered nothing. It promised 100 AYUSH hospitals across the country were proposed, an Institute of Naturopathy in Pune at the cost of Rs 1,000 crore and posting 4,000 AYUSH practitioners across the country. Perhaps the AYUSH ministry can throw some light on the progress made. Somewhere the ministry lost its sense of direction and got embroiled in unnecessary controversies with its advisories which were not backed by scientific research. It failed to provide an infrastructure for alternative medicine and create awareness about the alternative medicines. The minister would do well to come up with a viable plan to provide facilities for the alternative medicines. Before that happens it would be just lip service to a great cause by the union ministers, nothing more.
'Miracles of Face Yoga' book written by Mansi Gulati Appreciated by President of India Smt Droupadi Murmu ji at Rashtrapati Bhavan Delhi
President Madame appreciated the work by saying that Face Yoga’ has come out at an appropriate time when the world is anxiously looking up for solutions to improve immunity and evolve a holistic lifestyle. The book ‘Face Yoga’ is a comprehensive work on face yoga written in lucid simple language which can be easily understood by beginners and practitioners alike. Photographs and illustrations have further enhanced comprehension, assimilation, and understanding of the book by the reader.
Most of us are aware of the concept of gut health and understand its importance to our overall wellbeing, but what exactly does having a healthy gut mean? Our gut is home to millions of microorganisms, with about 1,000 distinct species, including various types of viruses, bacteria, yeast and other fungal bodies. Some of these microorganisms are harmful to our health and the others are very beneficial and important for a healthy body. Studies on people who have lived to be 100 years old in Blue Zones around the world have also shown that the structure and function of the gut microbiome determine whether or not a person will live to be 100 years old in good health. These people also appear to have high populations of good bacteria.
A healthy gut is said to be when there is a good balance between the good as well as the bad bacteria and viruses. In other words, if your gut health is poor, your immune system, hormones, and general health will suffer as a result. Some of the research has also indicated that having a variety of bacteria in your gut may lower the risk of diseases, including psoriatic arthritis, inflammatory bowel disease, and diabetes.
According to studies, the secret to healthy aging may lie in maintaining a healthy gut. Everything starts with our gut. It facilitates the breakdown of the food we eat, takes in nutrients, and utilizes them to energize and sustain our body. It is, therefore, more difficult to maintain good health and healthy aging if our gut is out of balance and our immune system isn’t functioning properly. Our body eliminates metabolic waste and pollutants in our gut.
However, our body will find it difficult to eliminate those toxins if we have a poor digestive system. People, therefore, encounter symptoms, including brain fog, constipation, joint discomfort, etc. Some of the tips to improve gut health and boost immunity and aging recommend consuming a variety of fruits, vegetables, and legumes (fruits and vegetables are the best sources of nourishment for a healthy microbiome since they are high in fiber). Fiber may be broken down by certain bacteria in our stomach, which encourages the growth of those bacteria. Legumes and beans both contain a lot of fiber.
Bifidobacteria, for instance, are beneficial bacteria because they may lessen intestinal inflammation and enhance gut health. It has been proven that eating foods including apples, artichokes, blueberries, almonds, and pistachios increases a person’s Bifidobacteria levels.
The majority of the bacteria in our guts have a symbiotic connection with our bodies, which means that both of our systems contribute to the health and growth of these microorganisms as well as their support of bodily functions. They generate vitamins, fatty acids, and amino acids that are necessary for a variety of processes, including immune system health, digestion, mood management, and more. Exercise on a regular basis quickens the process, increasing the variety of microbial species in the stomach and promoting the growth of bacteria.
Microbiome may also be badly impacted by excessive drinking. Recurrent alcohol consumption is connected to gastritis, an inflammation of the gut that causes discomfort. Heartburn, ongoing pain, ulcers, and bacterial infections can all result from such inflammation. Additionally, excessive drinking is linked to intestinal inflammation, which is an indication of a bad gut. According to research, this form of inflammation can upset the microbiota’s balance and change how well it functions.
Probiotics may improve or prevent gut inflammation as well as other intestinal or systemic disease phenotypes by reestablishing the balance of the gut microbiome and introducing beneficial functionalities to gut microbiome. Probiotics may be very useful for elderly people, notably in terms of infection prevention and potentially also in the prevention of a number of age-related disorders.
It is important to make sure that the body has adequate levels of vitamins, minerals, enzymes, and even microorganisms to make sure we perform and function at our peak. Different supplements like Glutathione, Magnesium complex, NAD+ booster, Alpha KetoGlutarate, Probiotics, Colostrum and Omegas constantly help our body manage this network of metabolism and make sure that no processes in our body are short-circuited because of lack of an important molecule.
Modern diets are heavy in fatty, salty, or sugary processed foods, which may impair the aging gut, whereas higher fiber foods like fruits, vegetables, seeds, beans, and nuts, together with regular exercise, may assist maintain a healthy gut microbial balance as we age. As a result, it may serve as a warning sign for a variety of chronic illnesses.
(The author is Chief Scientific Officer, Decode Age)
The Roe vs. Wade decision, which declared abortion to be a constitutional right, was overturned by the Supreme Court of the United States by a 6-3 decision. With its most recent ruling, the pro-life vs. pro-choice argument has been brought up not just in the United States but also across the globe. Joe Biden, the president of the United States, has also publicly denounced the Supreme Court's decision. Now, some could argue that Joe Biden's comments were just a little bit motivated by politics. as Donald Trump appointed the Supreme Court justices who made the decision. However, the folks' rage is genuine.
History of Abortion Rights in the US
Abortion-related social and legal regulations may be traced back to the colonial era. Before "quickening," or the time when a pregnant woman feels the foetus move, usually at about four or five months, abortion was permitted in the British colonies. State laws banning abortion did not first arise until the 1820s, and the earliest versions of these laws were unclear and not properly implemented. In order to stop the selling of chemical mixtures intended to cause abortions, several regulations were created as poison control measures. Slaves were under the control of their masters, who often desired their subjugated captives to reproduce as many children as possible. As a result, the history of abortion regulation is entwined with racism. Black women and other women of color still today.
Despite the movement's opposition to abortion, the demand for birth control was regarded as a challenge to male domination, and efforts to regulate and limit women to the traditional childbearing role included banning abortion. Additionally, it was a method for males in the newly formed medical profession to usurp midwives, whom they detested for executing abortions and taking over the very lucrative industry of birthing. Attacks against the right to an abortion were also motivated by racism and white supremacy. The eugenics movement fueled worries about the disappearance of the white identity. Attempts to outlaw abortion were driven in the late 1800s by rising immigration, particularly that of Catholic immigrants, and the dropping birthrate among white Protestant women born in the United States. Black midwives were frequently the object of specific censure from White doctors.
Roe vs. Wade: A landmark judgment
In its historic Roe vs. Wade ruling on January 22, 1973, the U.S. Supreme Court declared all current criminal abortion prohibitions unconstitutional. According to the Court, every individual has a basic "right to privacy" that is "based on the concept of personal liberty" as stated in the Fourteenth Amendment. The Court evaluated the right to privacy of a pregnant person against the interests of the state in promoting mother health and foetal survival. The Supreme Court ruled that the decision to have an abortion must be made by the person who is pregnant during the first trimester, in consultation with their doctor; that the state may regulate abortion in the second trimester in ways that are reasonably related to maternal health; and that the state may regulate or prohibit abortion in the third trimester, except where necessary to preserve the person's life or health.
Dobbs v. Jackson Women’s Health Organization
The United States Supreme Court eliminated constitutional safeguards for the right to an abortion on June 24, 2022. The landmark decisions in Roe vs. Wade (1973) and Planned Parenthood v. Casey (1986) were reversed by the wide ruling in Dobbs v. Jackson Women's Health Organization (1992). A basic constitutional privilege was curtailed for the first time in Supreme Court and American history.
History of Abortion Rights in India. Abortion was not permitted in India until 1971; in fact, it was illegal under section 312 of the IPC. However, the Indian Constitution gave women the right to an abortion in 1971.
MTP Act: Medical Termination of Pregnancy (1971)
The Shah Committee, which was established by the Indian government in 1964, carried out research on the sociocultural, medical, and legal aspects of abortion. The group advocated for legalising abortion and cited several field research. The Constitution was amended to incorporate the Medical Termination of Pregnancy Act in 1971. It implied that women up to 20 weeks of pregnancy had the right to an abortion under the following circumstances:
1. If the pregnancy offers a serious risk to the woman's life and is likely to harm her physically and mentally.
2. If the unborn child would be physically or intellectually disadvantaged or pose a threat to their lives.
3. If a rape led to the pregnancy.
4. If a failed method of birth control leads to pregnancy.
A few cases of abortions performed after 20 weeks have also requested Supreme Court approval. The highest court has this authority under Article 142.
MTP Amendment Act (2021)
In March 2020, the MTP Amendment Bill was approved by both Houses of Parliament. One of the final laws approved before the lockdown was enacted was this one. This act is an improved and liberalised version of the prior act, which it embodied in its core.
It raised the threshold for pregnant women to have an abortion from 20 weeks to 24 weeks. This law also permitted unmarried women to end a pregnancy if contraception had failed. Women now have the privilege of having their own privacy. Only the designated individual may get information on abortion from the medical institute. This new law extends more protection to rape survivors, incest victims, people with disabilities, juveniles, etc. Prior to this change, a licenced medical professional may terminate a foetus for up to twelve weeks. Additionally, the advice of two doctors was required for periods of time longer than 12 weeks and less than 20 weeks. One doctor is now required for abortions performed within 20 weeks and two physicians are required for those performed between 20 and 24 weeks. A medical board is responsible for making the decision if any woman requests an abortion post 24 weeks by evaluating the seriousness of the necessity.
Lacunae in MTP laws
The absence of formal policy on appropriate clinical practice and research is a significant flaw in Indian abortion legislation. Published national technical requirements fall short of ensuring excellent clinical practice even at institutions that perform legal abortions and do not follow WHO's worldwide recommendations. As a result, 8–15% of reported abortion clinics continue to employ general anesthesia, and 39–79% of physicians continue to perform sharp curettage. Simply put, India has not been able to find a mechanism to guarantee the use of enhanced and safer abortion techniques brought about by research and continually advancing reproductive technology.
Similar to much of India's health care, abortion treatment is still not given enough attention, particularly in the public sector. A lack of effective law (or its inability to be implemented) combined with subpar treatment and a weak work ethic in the public health care sector has led to an unchecked expansion of the private sector's services, many of which are exploitative in character. Despite the fact that India's abortion policy and legislation are progressive, erroneous and unneeded practices frequently make it difficult for these policies and laws to really increase access to safe abortion treatment.
The bill gives state governments the authority to control abortion providers. Despite the fact that states have modified these laws and regulations, there are differences in how they are interpreted and applied.
The way ahead
Despite not being particularly innovative, recent legislation and policy changes nonetheless mark a positive development in the fight to protect women's access to safe abortion treatment. Goals and objectives from the Action Plan of India's National Population Policy, 2000 that might be used:
1. Expanding access to the availability of safe abortion services.
2. Establishing additional facilities and professionals with the necessary qualifications, particularly in remote regions.
3. The decoupling of clinic and provider accreditation.
4. The tying of policy to technology, research, and excellent clinical practice.
5. The use of uniform standards in both the public and commercial sectors.
These policies require political will and commitment in the form of proper financial allocation, training, and infrastructural support, together with social inputs based on women's needs, in order to be implemented effectively. The National Population Policy, 2000's operational methods for abortion must be implemented through advocacy and legislation at the federal and state levels.
(Rushil Gupta writes articles on contemporary topics)
On the occasion of Population Day, UP chief minister Yogi Adityanath made a statement regarding population control. Yogi said that the population control program should proceed successfully but the situation of demographic imbalance should not arise. He said that it should not happen that the population of the original denizen decreases and on the other hand the population of any one section keeps on increasing. He expressed concern over an adverse fallout of disparity in the religious demography of India.
In any country, when the population reaches an explosive state, it starts growing disproportionately with the resources, so it is necessary to bring stability to it. The resource is a very important component. The population growth rate is higher than the rate of development in India. This creates a regional imbalance within the country. For example, in the Southern states of India the total fertility rate is about 1.8, which is considered a stable rate, but in contrast, North India, which has states like Bihar, Uttar Pradesh, Jharkhand, have about 3.0 total fertility rates. When development is low and the population is high, people migrate from such places to other places in search of employment and livelihood. The limitation of resources and excess population creates conflict; gives birth to fights among people of different states based on ethnic group, region, and language.
English scholar Thomas Robert Malthus has explained population growth and its effects in An Essay on the Principle of Population. According to Malthus, the population grows in a geometrical fashion, while resources increase in an arithmetic progression. Therefore the population doubles every 25 years. Although the views of Malthus cannot acquiesce literally; it is veritable that the rate of growth of population is greater than the rate of growth of resources. On the coordination of population and resources, David Ricardo, the father of the land tax theory; Thomas Sadler; and Herbert Spencer have also expressed serious views on population growth.
India will overtake China by 2025
According to the latest edition of World Population Prospects 2022 released by the United Nations, India is projected to surpass China as the world’s most populous country in 2023. According to the report, India’s population stands at 1.412 billion in 2022, compared to China’s 1.426 billion. India is projected to have a population of 1.668 billion in 2050, way ahead of China’s 1.317 billion people by the middle of the century.
China is now ahead of us in population, so it is also very big in the area. India accounts for a meager 2.4 percent of the world's surface area yet it supports and sustains a whopping 17.7 percent of the world population. However, India’s population is expected to stabilize after 2050 and may virtually stop growing by the end of this century, due in large part to falling fertility rates. Institute for Health Metrics and Evaluation (IHME) projects a total fertility rate (TFR) of 1.29 births per woman in 2100 instead of 1.69 in the United Nations medium scenario for India, resulting in a population that is 433 million smaller than according to the United Nations projections at the end of the century.
Understanding ‘total fertility rate’
Total fertility rate refers to the average number of children that a hypothetical cohort of women would bear over the course of their reproductive life if they were subject to the age-specific fertility rates (usually referring to women aged 15 to 49 years) estimated over a given period and were not subject to mortality. It is expressed as children per woman. A TFR level above 5 children per woman is considered high fertility whereas below 1.3 children per woman is very low fertility. TFR levels of about 2.1 children per woman are replacement-level fertility. According to the United Nations, “if replacement level fertility is sustained over a sufficiently long period, each generation will exactly replace itself in the absence of migration.”
The National Family Health Survey (NFHS-5) 2019-21 found that India’s total fertility rate is 2.0 children per woman, which declined from 2.2 children in 2015-16 and is currently below the replacement level of fertility of 2.1 children per woman. This means that the population of India achieved the replacement level. At least the official figures tell the same. In most of the states/union territories the total fertility rate is well below replacement level. Bihar (3.0), Uttar Pradesh (2.35), Jharkhand (2.3), and some northeastern states such as Meghalaya (2.9) were present as exceptions.
Economic Survey 2018-19: A different approach
The Economic Survey 2018-19 states that the rate of population growth in the country has been hindered over the past few decades. During the year 1971-81 the annual growth rate was 2.5 percent, which has come down to 1.3 percent in the year 2011-16. Referring to the demographic trends in the survey, it has been highlighted that states like Bihar, Haryana, Rajasthan, and Uttar Pradesh, which have historically had high population growth rates, have also shown a drop in the population growth rate. The states of South India and West Bengal, Odisha, Assam, Punjab, Maharashtra, and Himachal Pradesh have annual growth rates of less than 1 percent. According to the survey, the population growth rate in India is expected to decline sharply in the coming two decades, with some states beginning to move towards the status of an aging society by 2030. The Economic Survey not only upholds an optimistic view of population control but advocates that the focus of policymaking in the country should be on the increasing number of elderly people in the future.
Demographic dividend or demographic curse
The population of youth and working population in a country and the economic benefits from it are seen in the form of demographic dividends. India currently has the largest population of youth in the world, if this population is used to accelerate India's economy, then it will provide a demographic dividend to India. But if education is not of quality, employment opportunities are limited, and means of health and economic security are not available, then a large working population can take the form of a curse. Therefore, different countries emphasize population growth in proportion to their resources. In the present situation in India, the young and working population is large but only limited employment opportunities are available for them. In such a situation, unless the population growth is regulated, the situation can become catastrophic.
Key challenges of a growing population
First, to provide citizens with a minimum quality of life, investments have to be made in the development of education and health systems, maximum production of food grains, providing affordable houses, clean drinking water supply, and work on strengthening infrastructures such as roads, transport, and power generation and distribution. Second, to take advantage of the growing population, India has to build a strong base of human capital so that it can contribute significantly to the country’s economy. However, India’s low literacy rate (about 74 percent) can be the biggest obstacle in this path. Third, the country’s urban population will double by the year 2050; due to which there will be a challenge to improve urban facilities and provide housing to all, as well as it will be necessary to save the environment. Additionally, unequal distribution of income and increasing inequality among people may result in negative consequences of overpopulation.
Poverty and population growth
Family health, child survival, and the number of children are closely related to the health and level of education of the parents (especially the mother). Thus the poorer a couple is, the more children they tend to give birth to. This trend is concerned with the opportunities, options, and services available to the people. Poor people tend to give birth to more children because child survival is low in this class, the desire to have a son has always been high, and children help in economic activities and thus meet the economic and emotional needs of the family.
According to the National Family Health Survey (NFHS-5) 2019-21, women in the lowest wealth quintile have an average of 1.0 more children than women in the highest wealth quintile. Thus moving from the richest to the poorest, the fertility rate is found to be 2.6 instead of 1.6. Similarly, the number of children per woman decreases with the increase in the level of schooling of women. The TFR was 2.82 for women who did not attend school compared to 1.8 for women who had been schooled for 12 years or more. This reveals that health, education, and inequality are closely related to fertility rates, and people with less access to health and education remain trapped in the vicious circle of poverty and give birth to more and more children.
Political demand for population control law
From time to time, there has been a demand from political parties to make laws to stop population growth. Such demand has increased significantly after the Modi government came to power in 2014. On 15 August 2019, Prime Minister Narendra Modi, while giving a speech from the Red Fort, said that the population explosion that is happening in India will create many troubles for the coming generation. He also recognized that a conscious section of the country, understanding the problems caused by rising population growth, keeps its family confined. These people display patriotism in a way, he held. Last year, RSS chief Mohan Bhagwat also advised policy formulation regarding population control. Many Bharatiya Janata Party (BJP) leaders keep raising this issue time and again. Rakesh Sinha, Rajya Sabha Member of Parliament of BJP, introduced the Population Regulation Bill as a private bill in July 2019. Even before Sinha introduced the bill, in May same year, Delhi BJP leader and advocate Ashwini Kumar Upadhyay had filed a PIL in the Delhi High Court, demanding a stringent law for population control. The Delhi High Court had disposed off the case. Now the matter is with the Supreme Court. In 2018, around 125 lawmakers urged the President to implement the two-child policy in India. In 2016, BJP MP Prahlad Singh Patel also introduced a private member's bill on population control. However, like most private bills, it did not reach the voting stage. Since independence, about 36 such bills have been introduced by MPs of different parties, out of which 15 have been introduced by Congress MPs.
Many states have already implemented penal provisions to control the population or encourage small households. Soon after Prime Minister Modi’s speech, the BJP-led Assam government decided to implement the Assam Population and Women Empowerment Policy, which was passed in September 2017. Under this policy, no person with more than two children shall be eligible for government jobs in Assam from January 2021 onwards. Similar provisions are in place in about a dozen states that impose eligibility and entitlement restrictions if the conditions of the two-child policy are not met. These restrictions also include barring people from contesting elections to Panchayati Raj institutions in some states.
Population growth and the M-factor
Once again Muslims are in the thick of a hysterical debate in India. While some groups are successful in creating a common belief among the people in the country that Muslims produce more children, on the other hand, allegations are being made that the government is trying to bring population control law by conspiring against the Muslim population. What’s the truth? Are Muslims growing faster than other religions or is it a population myth? According to Census 2011 data, the population growth rate of various religions has come down from 2001 to 2011. Hindu population growth rate slowed down to 16.76% in 2011 from the previous decade's figure of 19.92% in 2001 while Muslim witness a fall in growth rate to 24.6% in 2011 from the previous decade's figure of 29.52% in 2001. Similarly, the TFR among women in Hindus has declined from 2.8 children in 1998-99 to 1.9 children in 2019-21 while Muslims witnessed a fall in TFR to 2.4 children (2019-21) from the previous figure of 3.6 children (1999-99).
Although these numbers look comfortable, people who have been pointing out these numbers as an indication of the ceasing of the religious imbalance are wrong. A study of religion data from Census 2011 by the Centre for Policy Studies (cpsindia.org) reveals that at the national aggregate level there was an increase in the share of Muslims in the population of India from 13.43 percent in 2001 to 14.23 percent in 2011, which means there was an addition of 0.8 percentage points to their share in the population. This level of increase was significant as it was the third decade in a row when their share had increased by or above 0.8 percentage points. Another important aspect is that the share of Muslims has been rising every decade since independence. During 1951-61, the decadal increase in the growth of the Muslim population was 0.24 percent and it has jumped to almost four times at 0.80 percent in 2001-11. Studying the growth of the Muslim population in absolute numbers, it can be seen Muslim population in India has grown to 172.2 million in 2011 compared to 37.7 million in 1951, implying a multiplication factor of 4.6. The population of others in the same period has multiplied only 3.2 times. Given the upward, most demographers agree that within two or three decades India will be home to the largest Muslim population in the world.
A report by Pew Research Center backs these concerns about the changing religious demography of India. According to the study India is expected to have the largest population of Muslims in the world (11% of the global total) in 2050. In 2050 the Muslim population in India will be 31.10 million, an increase of 76 percent compared to 2021. At the same time, the population of Hindus is projected at 1.3 billion, an increase of 33 percent. The youngest median age and highest fertility rates among major religious groups are the reasons Indian Muslims are expected to grow faster than Hindus. The median age of Indian Muslims was 22 in 2010, compared with 26 for Hindus. Likewise, Muslim women have an average of 3.2 children per woman, compared with 2.5 for Hindus. Due to these factors, India’s Muslim community will expand faster than its Hindu population, rising from 14.4% in 2010 to 18.4% in 2050.
Lessons from the past
With 350 million people India was one of the most populous countries even during its independence. This was the reason the world’s first state campaign for population control was started in the year 1951 in India. But this did not lead to success. During the Emergency of 1975, efforts were made to control the population on a large scale. Many inhuman measures were used in these efforts. Not only did this program fail, but there was an atmosphere of fear among the people about the program and its execution, which hindered the efforts of population control for many years. After the disastrous experience of forced family planning during the Emergency, the term was rarely used by politicians. Population control remained politically untouched since then.
Population support instead of population control
India has not seen the population in terms of a problem and control over it, but as a thriving resource that is the life force of a growing economy. Seeing it in the terms of problem and control and acting from this point of view may not be a favorable step for the nation. This approach may stifle progress so far and set the ground for a weaker and worse health delivery system.
Despite supporting the population policy, experts are against making it a law and strictly implementing it. Many believe that the states should focus on the already existing system. At present, the work of family planning in rural areas is done by ASHA, Anganwadi, and ANM health workers. Their effort and work on the ground in the family planning program, specifically in rural India, are commendable. Modern contraceptive use by currently married women in the country has increased from 48 percent to 56 percent between 2015-16 and 2019-21. The TFR among women in rural areas has declined from 3.7 children in 1992-93 to 2.1 children in 2019-21; it was 2.4 in 2015-16. Presently, the fertility rate in 23 states and union territories (including all the states of South India) has already reached below the replacement level of 2.1 children per woman. Thus a policy of support rather than control would be more effective.
Finally, do we need a law?
Although population growth has given rise to many challenges, a legal course of action cannot be considered a suitable step to control it. India’s position is different from China and unlike China, India is a democratic country where everyone has the right to decide about their personal life. In my view, instead of resorting to law, efforts should be made for population control by taking measures like awareness campaigns, raising the level of education, and eradicating poverty. Financial incentives should be given to the families associated with family planning and such families who have not adopted family planning should be motivated for the same through various programs.
While I agree that the population growth rate of various religions has come down during past years, the fact that India’s Muslim community will expand faster than its Hindu population and the country is going to have the largest population of Muslims in the world cannot be repudiated. And this reality will continue to preoccupy a large section of the Hindu community and its leaders in this country.
Most of those who went through psychological distress like anxiety, depression, worry, and perceived stress before Covid-19 struck them, happened to develop Long Covid, a study published in The JMMA Psychiatry said, suggesting that physical health conditions like smoking, asthma, and other health behaviours were not only the main reasons for Covid-19.
The study by researchers at Harvard TH Chan School of Public Health reinforces the need to increase public awareness of the importance of mental health and to get mental health care for people who need it, including increasing the supply of mental health clinicians and improving access to care.
“We were surprised by how strongly psychological distress before a Covid-19 infection was associated with an increased risk of long Covid,” said Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School who led the study.
“Distress was more strongly associated with developing long Covid than physical health risk factors such as obesity, asthma, and hypertension.”
To determine the effects of psychological distress before Covid-19 infection on developing long Covid, Wang and her colleagues enrolled more than 54,000 people in April 2020.
At the beginning of the study, the researchers asked the participants about their psychological distress. Over the following year, more than 3,000 participants contracted COVID-19, and the researchers asked participants about their Covid-19 symptoms and symptom duration.
After analyzing the responses and comparing those who developed long Covid to those who did not, the researchers determined that distress before Covid-19 infection, including depression, anxiety, worry, perceived stress, and loneliness, was associated with a 32per cent-46per cent increased risk of long Covid. These types of psychological distress were also associated with 15per cent–51per cent greater risk of daily life impairment due to long Covid.
According to the U.S. Centers for Disease Control, about 20per cent of American adults who have had Covid-19 have developed long Covid, which is defined as experiencing Covid-19-related symptoms, such as fatigue, brain fog, or respiratory, heart, neurological, or digestive symptoms, for longer than four weeks after infection. Severe Covid-19 illness increases the risk of long Covid, although people with milder Covid-19 cases can also develop long Covid. Symptoms, which can be debilitating, could last months or years, and little is known about which traits are linked to developing long Covid.
Mental health is known to affect the outcomes of some diseases. Depression and other mental illnesses have been associated with greater risk of more severe Covid-19 including the risk of hospitalization, which is a risk factor for long Covid.
In other acute respiratory tract infections, such as flu or the common cold, mental health conditions are associated with greater severity and longer duration of symptoms.
Previous studies have also suggested that distress is associated with chronic symptoms following Lyme disease and in chronic fatigue syndrome and fibromyalgia, which have symptoms similar to those of long Covid.
Karnataka Health Minister K. Sudhakar on Friday inaugurated a Brain Health Clinic under the Karnataka Brain Health Initiative (KaBHI) here at Jayanagar Government Hospital.
KaBHI aims to promote brain health from Primary Health Centres (PHCs) to secondary level district hospitals and the National Institute of Mental Health and Neurosciences (NIMHANS) at the tertiary level
The main focus of the KaBHI initiative is to train PHC doctors to diagnose and provide primary care for brain and mental health issues including Stroke, Epilepsy, Parkinson's, Brain Tumor and Dementia.
Further, the initiative focuses on training ASHA workers to screen people for such mental health issues which greatly increases the speed of diagnosis and treatment potentially offering a complete cure to some of these diseases.
Minister Sudhakar spoke at the World Brain Day-2022 event organised at NIMHANS and stated that treatment for mental health will be available at the 243 Namma Clinics which will be started in Bengaluru.
"Doctors working in most rural PHCs are MBBS doctors and lack skills and knowledge to diagnose Mental Health issues. With the help of NIMHANS, we have trained 100 such PHC doctors to make mental health treatment more accessible at primary and secondary levels.
Sudhakar also spoke about the taboo and stigma associated with mental health. "Many people have wrong opinions, taboos and stigma about Mental health.
"If one is seen going to a counsellor or a psychiatrist, people think that there is something wrong with the person's brain or that they are mad. Many don't get to go because of this," he said.
The initiative was launched in January 2022 by Karnataka Chief Minister Basavaraj Bommai on a pilot basis for Chikkaballapur, Kolar and Bengaluru South districts and will soon be extended across the state.
Indian cricketer Robin Uthappa, who is also a Kanandiga, has been made the ambassador for the initiative and Minister Sudhakar appreciated him during the event for readily agreeing to be the ambassador without expecting any remuneration.
Abortion clinics across the US have begun to shut after the Supreme Court overturned its 50-year-old Roe v. Wade decision which granted women constitutional right to abortion.
In the wake of the 5-4 order on Friday, about half of states are expected to introduce new restrictions or bans, out of which 13 have outlawed abortion effective immediately, reports the BBC.
Trigger laws, which allow an instant ban, have already been applied in Kentucky, Louisiana, Arkansas, South Dakota, Missouri, Oklahoma and Alabama.
Meanwhile, bans in Mississippi and North Dakota will come into effect after their Attorney Generals approve it.
While Wyoming's ban will take effect in five days, Utah's ban must be certified by a legislative council
Bans in Idaho, Tennessee and Texas will be applied in 30 days.
At an abortion clinic in Little Rock, Arkansas, the doors to the patient area shut as soon as the court's opinion was posted online on Friday afternoon.
Staff made calls to tell women that their appointments were cancelled.
"No matter how hard we prepare for bad news, when it finally hits, it hits hard. Having to call these patients and tell them Roe v. Wade was overturned is heartbreaking," a nurse at the clinic told the BBC.
In New Orleans, Louisiana, the Women's Health Care Centre, one of only three abortion providers in the state, was also closed.
Due to the Supreme Court ruling, about 36 million women of reproductive age will lose access to abortion, the BBC quoted research from Planned Parenthood, a healthcare organisation that provides abortions, as saying.
Meanwhile, the decision was met with elation by anti-abortion campaigners outside the court in Washington, but protests against the ruling were due to be held in more than 50 cities across the US.
The ruling has led to widespread criticism.
President Joe Biden said the Supreme Court's move will put women's health and lives at risk.
"It's a realisation of an extreme ideology and a tragic error by the Supreme Court," he said.
Slamming the verdict, Nancy Pelosi, the Democratic Speaker of the House of Representatives, said the "Republican-controlled Supreme Court has achieved the GOP's dark and extreme goal of ripping away women's right to make their own reproductive health decisions".
"American women today have less freedom than their mothers... This cruel ruling is outrageous and heart-wrenching. But make no mistake: the rights of women and all Americans are on the ballot this November."
The Governors of California, Washington and Oregon have vowed to protect patients travelling from other states for an abortion.
The landmark 1973 Roe v Wade case saw the Supreme Court rule by a vote of seven to two that a woman's right to terminate her pregnancy was protected by the US constitution.
The ruling gave American women an absolute right to an abortion in the first three months (trimester) of pregnancy, but allowed for restrictions in the second trimester and for prohibitions in the third.
The US is expected to start Covid-19 vaccination this week for children as young as six months old.
The plan came after the US Centers for Disease Control and Prevention (CDC) signed off on the shots for an additional 19 million children across the US, Xinhua news agency reported.
The CDC's advisory panel on Saturday unanimously recommended the Pfizer-BioNTech vaccine for children aged 6 months through four years, as well as the Moderna vaccine for children aged 6 months through five years.
"We know millions of parents and caregivers are eager to get their young children vaccinated, and with today's decision, they can," said CDC Director Rochelle Walensky in a statement.
The CDC's move came a day after the US Food and Drug Administration amended emergency use authorisations for the two vaccines to include the youngest age group.
This was the last age group in the US without access to a Covid-19 vaccine.
Since the pandemic began, more than 13.5 million US children have tested positive for the coronavirus, according to the latest report of the American Academy of Pediatrics and the Children's Hospital Association.
Although Covid-19 is normally less severe in children than adults, the virus can be life threatening for some children. Covid-19 is the fifth leading cause of death for children aged 1 to 4 years from March 1, 2020, to April 30, 2022, according to CDC data released on Friday.
The White House said vaccinations for children aged below 5 years would begin on Tuesday after the Juneteenth federal holiday.
The Joe Biden administration has procured a significant supply of vaccines for this age group, with 10 million doses available initially and millions more available in the coming weeks, according to a plan released by the White House.
Parents will be able to get their youngest children vaccinated at their pediatricians' offices, as well as at pop-up clinics at children's museums, libraries and child-care sites, according to the plan.
Appointment availability might be limited initially but every parent who wants to get their child vaccinated should be able to do so in the next few weeks, said Ashish Jha, who oversees the Biden administration's Covid-19 response.
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