While smart pills have emerged as the new digital health tool that help patients and doctors track drug regimen compliance as well as increase patient adherence, its ethical issues such as patient privacy, consent and data sharing must be addressed, researchers argue.

Smart pills, or digital pills, are prescription medications equipped with edible electronic sensors that send wireless messages to devices, like patches and smartphones or tablets, outside the body when they are ingested. 

Health care providers and policymakers need to exercise caution in allowing this technology in patient care settings as it can also dump down the doctor-patient relationship, the researchers warned.

“Smart pills are a dangerous reduction of the provider-patient relationship and there is no shortcut to improving patient adherence, which happens in a larger framework of home, work and clinical environments, not to mention perceptions and emotions,” said Eric Swirsky, clinical Associate Professor at the University of Illinois at Chicago (UIC). 

Swirsky said that there is simply no evidence yet to suggest smart pills benefit patients as much as traditional medical care.

“It is naive to think that this type of surveilled compliance with provider-recommended drug treatments will function like a magic pill. 

“More likely, it will just challenge the ingenuity of patients. 

“This technology dumbs down an issue that is often very complex in the hopes of quickly solving an expensive medical challenge,” Swirsky said. 

The study, published in the American Journal of Bioethics, warned that smart pills should be evaluated based on their clinical efficacy against the standard of care drugs, like any other intervention, not based only on compliance or cost savings.

Use of data-based technology should also not outpace public policy and legislation in properly regulating how this data is shared, used or purchased by companies, said Andrew Boyd, Associate Professor at the UIC.

“Health information technology functions best when implemented in conjunction with doctors and patients in a collaborative manner,” the researchers said. 

“With no magic pill to cure the ills of the modern doctor-patient relationship, patients would be better served by providers who seek a comprehensive understanding of adherence than those who employ technology they do not understand.”

India has nearly halved its number of multidimensional poverty between 2005-6 and 2015-16 by climbing down to 27.5 percent from 54.7 percent, according to estimates from the 2018 global Multidimensional Poverty Index (MPI) released by the United Nations Development Programme (UNDP) and the Oxford Poverty and Human Development Initiative (OPHI).

But while there is much to be done, there are promising signs that such poverty can be – and is being – tackled. In India, the first country for which progress over time has been estimated, 271 million people moved out of poverty between 2005/06 and 2015/16. The poverty rate here has nearly halved, falling from around 55 percent to around 28 percent over the 10-year period.

Among South Asian countries, only Maldives has a lower headcount ratio than India at 1.9 percent, with Nepal (35.3 percent), Bangladesh (41.1 percent), and Pakistan (43.9) having higher incidences of multidimensional poverty. Though the traditionally disadvantaged groups – across states, castes, religions, and ages-are still the poorest, they have also experienced the biggest reductions in MPI through the decade, showing that they have been “catching up”. This is in line with global trends, where deeper progress among the poorest groups is reflected in the global MPI being cut by half.

Despite the massive gains made in reducing multidimensional poverty, 364 million Indians continue to experience acute deprivations in health, nutrition, schooling and sanitation. Just over one in four multidimensionally poor people in India are under ten years of age.

Pockets of poverty are found across India, but multidimensional poverty is particularly acute – and significant – in the four states of Bihar, Jharkhand, Uttar Pradesh and Madhya Pradesh. These accounted for 196 million MPI poor people – more than half of all MPI poor in India.

But there was also progress. Jharkhand made the biggest strides among all states in reducing multidimensional poverty, with Arunachal Pradesh, Bihar, Chhattisgarh, and Nagaland only slightly behind.

Delhi, Kerala and Goa have the lowest incidence of multidimensional poverty.

Across nearly every state, poor nutrition is the largest contributor to multidimensional poverty. Not having a household member with at least six years of education is the second largest contributor. Insufficient access to clean water and child mortality contribute least. Relatively fewer people living in poverty experience deprivations in school attendance, the report says.

The MPI looks beyond income to understand how people experience poverty in multiple and simultaneous ways. It identifies how people are being left behind across three key dimensions: health, education and living standards, and 10 indicators – nutrition, child mortality, years of schooling, school attendance, sanitation, cooking fuel, drinking water, electricity, housing and assets. Those who are deprived in at least a third of the MPI’s components are defined as multidimensionally poor, the report said.

The 2018 report, which is now closely aligned with the Sustainable Development Goals, cover almost three-quarters of the world’s population. The 2015-16 district-level calculations of the incidences of multidimensional poverty for India has been sourced from the National Family Health Survey IV. The data for 2005-06 is from the National Family Health Survey III.

In 104 primarily low and middle-income countries, 662 million children are considered multidimensionally poor. In 35 countries half of all children are poor. 

The latest figures paint a stark picture of just how many are still left behind by development, but they also demonstrate that progress can happen quickly with the right approach.

 Globally, some 1.3 billion people live in multidimensional poverty, which is almost a quarter of the population of the 104 countries for which the 2018 MPI is calculated. Of these 1.3 billion, almost half – 46 percent – are thought to be living in severe poverty and are deprived in at least half of the dimensions covered in the MPI.

“Although the level of poverty – particularly in children – is staggering so is the progress that can be made in tackling it. In India alone some 271 million have escaped multidimensional poverty in just 10 years,” said Achim Steiner, UNDP Administrator. “The Multidimensional Poverty Index gives insights that are vital for understanding the many ways in which people experience poverty, and it provides a new perspective on the scale and nature of global poverty while reminding us that eliminating it in all its forms is far from impossible.”

Although similar comparisons over time have not yet been calculated for other countries, the latest information from UNDP’s Human Development Index shows significant development progress in all regions, including India. Since 1990, life expectancy increased by almost 4 years in South Asia (almost 11 years in India). This bodes well for improvements in multidimensional poverty.

 Â“The MPI demonstrates the tremendous strides India has made, and continues to make, in reducing poverty. It is especially encouraging that traditionally disadvantaged groups are catching up the fastest. Not only is this in line with the core philosophy of the Sustainable Development Goals to reach the farthest first, it is also reflected in Prime Minister Narendra Modi’s development pledge of Sabka Saath, Sabka Vikas,” said Francine Pickup, UNDP India Country Director.

 The 2018 MPI is available for 1,101 subnational regions showing within-country variations in multidimensional poverty levels for 87 countries.

Traditional poverty measures – often calculated by numbers of people who earn less than $1.90 a day – shed light on how little people earn but not on whether or how they experience poverty in their day-to-day lives. The MPI provides a complementary picture of poverty and how it impacts people across the world.

“The Sustainable Development Goals call to eradicate poverty in all its forms everywhere. The Multidimensional Poverty Index helps answer that call, providing immensely valuable information for all those seeking to understand what poverty looks like for a particular place or group of people, and for those working on the policies to help people escape poverty now and into the future.”, said Selim Jahan, Director of the Human Development Report Office at UNDP.

While the MPI’s core data look at those who are poor, and the subset who are severely poor, the numbers also look at those very close to becoming poor. These people, while not quite multidimensionally poor, are living precariously and struggling to remain above the poverty line.

The data show that in addition to the 1.3 billion classed as poor, an additional 879 million are at risk of falling into multidimensional poverty, which could happen quickly if they suffer setbacks from conflict, sickness, drought, unemployment and more.

At least 90 rural activists, who work under the National Rural Health Mission (NRHM), called on Prime Minister Narendra Modi here on Thursday to thank him for the increase in their incentives, an official statement said.

Under the NRHM, the government provides villages with a trained female Accredited Social Health Activist or ASHA. 

According to the release, the Prime Minister recalled his interaction with the ASHA and Anganwadi workers across the country via video conference and appreciated them for sharing their experiences and personal accounts. 

“Today , ASHA activists shared some more accounts of how they had been instrumental in saving lives of poor mothers and children through timely intervention,” it said.

The Prime Minister appreciated ASHA workers for their skill and dedication and recalled that even Bill and Melinda Gates Foundation had praised their efforts towards eradication of diseases such as Kala Azar, a severe parasitic disease.

The Cabinet Committee on Economic Affairs (CCEA) on Wednesday gave its approval to the benefit package with effect from October 2018 (to be paid in November 2018). The package covers the expenditure till 2020.

The size of the Indian economy will double to $5 trillion by 2022 with manufacturing and agriculture contributing $1 trillion each, and the various states are competing with each other to help achieve this goal, Prime Minister Narendra Modi said on Thursday.

In his address at the foundation laying ceremony of the India International Convention and Expo Centre here, Modi said that towards achieving this target, the government is making all efforts to increase the share of exports to 40 per cent of the country’s GDP.

“The country’s macroeconomic fundamentals are strong, and all efforts are being made by various agencies to increase the share of exports to 40 per cent of the GDP,” he said.

“We plan to increase our GDP to $5 trillion by 2022 in which manufacturing and agriculture would contribute $1 trillion each.

“The states are also together in this endeavour and are competing with each other on the ease of doing business rankings,” he said. 

The high rate of India’s GDP growth in recent years had resulted in a massive employment generation, particularly in the IT, retail and tourism sectors, he added 

Referring to government’s proposal made on Tuesday of the merger of Dena Bank, Vijaya Bank and Bank of Baroda to create the country’s third largest banking entity, the Prime Minister said that his administration had brought in bank consolidation which was being debated over a long time.

“The need for having dozens of government-run banks was being debated for a long time but we have acted on it. This government will not shy away from taking tough decisions in the national interest,” he said, citing the rollout of the Goods and Services Tax (GST) among such measures taken by the government.

In a first, the government on Thursday came out with a National Database on Sexual Offenders (NDSO), containing a list of 4.5 lakh convicts with photos of about 3.5 lakh of them available.

The offenders face charges of rape, gangrape and eve-teasing.

The database, which was rolled out by the Ministry of Home Affairs (MHA) along with Women and Child Development Ministry (WCD) here, will be maintained by the National Crime Records Bureau (NCRB).

The NDSO which is accessible only to law enforcement agencies will assist in effectively tracking and investigating cases of sexual offences and employee verification.

The registry which was approved by the Cabinet in April 2018 makes India the ninth country in the world to set up and maintain a national database of sexual offenders.

According to MHA, the state police have been requested to regularly update the database from 2005 onwards. The database includes name, address, photograph and fingerprint details for each entry. However, the database will not compromise any individual’s privacy.

MHA has already released a grant of Rs. 94.5 crore to states/UTs for establishing cyber forensic-cum-training laboratories to strengthen cybercrime investigation and conduct training programmes to enhance capabilities of police officers, public prosecutors and judicial officers.

According to the WCD ministry, the sex offenders listed in the database will be classified on the basis of criminal history to ascertain if they pose a serious danger to the community. 

“It is a matter of great pride and joy as two initiatives that my Ministry (WCD) and I had been pursuing for three years have been executed. The launch of National Registry of Sexual Offenders and Cybercrime Reporting Portal is one more step taken by our government for the safety of our women and children,” Union WCD Minister Maneka Gandhi said.

Another web portal, “Cyber Crime Prevention Against Women and Children (CCPWC)”, an initiative under the Nirbhaya Fund was also launched which will enable complainants in reporting cases without disclosing their identity. 

“Government has taken several measures to check crime against Women and Children, including provision of stringent punishment and creation of modern forensics facilities to improve investigation, creation of the Women’s Safety Division in the MHA and launching of Safe City projects for Women’s Safety,” Union MHA minister Rajnath Singh said.

The complaints registered through this portal will be handled by police authorities of respective State/UTs and complainants can also upload the objectionable content and URL to assist in the investigation by the state police.

The NCRB will proactively identify such objectionable content and take up with intermediaries for its removal. For this NCRB has already been notified as the Government of India agency to issue notices under the IT Act.

“A positive aspect of this portal is the provision for anonymous reporting, which will encourage more people to come forward with such complaints. This portal comes as a relief by providing time-bound solutions to a huge number of women and children who are being exploited in cyber space,” Gandhi added.

 Indian Institute of Technology Madras is collaborating with Oil and Natural Gas Corporation Limited (ONGC) to enhance the operational life cycle of existing platforms and reduce running and operating cost by optimum use of offshore survey requirements.

IIT Madras is going to develop a Database Management System for all the 280-plus platforms of ONGC and develop software for Structural Integrity Management System (SIMS) as well.

Prof. Ravindra Gettu, Dean (Industrial Consultancy and Sponsored Research), IIT Madras, and Mr. Dinesh Kumar, Executive Director, Head of Institute of Engineering and Ocean Technology (IEOT), ONGC, Panvel, signed the agreement for the Collaborative R&D project titled ‘Development of Structural Integrity Management System (SIMS) For Offshore Platforms of ONGC’.

Speaking on the occasion of signing the agreement, Mr. Dinesh Kumar said, 

“This kind of collaboration will go a long way in benefiting the country. This is part of a concerted effort to further industry-academic collaboration and a good start has been made between IIT Madras and ONGC. ”

The existing offshore platforms in Mumbai High have been operational for more than three decades. Though the design life has exceeded in some cases, oil and gas production still continues as their reservoirs are producing. Hence, considerable effort has been spent on maintaining the structural stability and strength of these platforms for the last 10 to 15 years by both ONGC and IEOT in terms of mitigation measures such as underwater strengthening of members, removal of marine growth and many other activities including load shedding in some cases.

The project is being spearheaded from IIT Madras by Dr. S. Nallayarasu, Professor in the Department of Ocean Engineering who has over 25 years of experience in Oil and Gas industry, research and teaching. Prior to joining IITM, his industry experience includes offshore structures and field development, structural auditing and verification, port and harbor development, marine terminals for oil and gas, FSRU-LNG facilities and FPSO’s.

Speaking about the challenges involved in this project, Dr. Nallayarasu, said, “The IEOT and Department of Ocean Engineering, IIT Madras, has been working on several collaborative projects such as non-linear ultimate strength of offshore platforms and structural integrity assessment in the past. The synergy between IEOT and IITM will be continued to develop a technology based tool for monitoring, assessment, inspection and maintenance of structural integrity of existing platforms to fulfill operational and regulatory requirements for prolonged production of oil & gas.”

Another notable feature of this project is to develop the location based design criteria specific to the platforms operated by ONGC in this region. This will become a starting point for development of codes and standards for offshore platforms in India which does not exist as of now. SIMS software is being developed in line with Government of India’s ‘Make in India’ policy under the umbrella of ONGC-PAN IIT program.

The World Animal Protection, along with the Department of Animal Husbandry of Kerala and Indian Red Cross Society – Kerala, are partnering on the recovery and reconstruction for animals affected by the recent floods. The Department of Animal Husbandry has said that 46,016 livestock and 2,500,000 poultry succumbed to the floods and continuous heavy rains.

“The impact on animals cannot be overstated. In some areas, virtually all animals were killed or suffered in the days following the deluge. We are in Kerala to provide relief to as many animals as possible and to see how this tragedy can be prevented from recurring in the future. Together with the Department of Animal Husbandry and the Indian Red Cross Society we are ensuring that animal welfare needs are met concurrent with the humanitarian effort,” said Gajender K Sharma, India Country Director at World Animal Protection.

Working across 12 locations in five districts – Alappuzha, Pathnamthitta, Kottayam, Ernakulam and Thrissur districts, our disaster response teams are addressing the persistent needs of livestock left stranded in evacuation camps following the record floods that began in July. Following intensive support from the government and humanitarian agencies the situation for affected people is slowly improving.

However, animals are facing prolonged hardships and suffering, working animals will be pushed to make up for all the loses in agriculture, and will need feed and mineral supplements, which World Animal Protection is providing to the most vulnerable of them.

“The Kerala floods remind us that disaster preparedness for animals is critically important. Many of these animals could have been saved if a disaster plan were in place that included their needs. We are engaging the Kerala government to ensure they develop a plan for protecting animals during disasters and to offer our technical support in developing the plan. Animals are often the forgotten victims of disasters. We are here to be a voice for the voiceless,” said Hansen Thambi Prem, Disasters Projects Manager India at World Animal Protection. 

India has led the way in many respects on animal protection. Following years of efforts, the National Disaster Management Authority (NDMA) in 2013 instructed all the States and Union Territories to integrate animals in their respective disaster management plans and programmes. Kerala has not yet done so, but we are closely working with State and district officials to enable them to launch plans and policies that will protect animals and the livelihoods of people who depend on them in future disasters. 

World Animal Protection has over 50 years of experience in protecting animals during disasters. In India, World Animal Protection works with the National Disaster Management Authority, and has also provided training to the National Disaster Response Force to manage animals during disasters throughout the subcontinent. 

The Union Cabinet has approved an ordinance making `triple talaq’ an offence. The ordinance was approved after making amendments to the draft Muslim Women (Protection of Rights on Marriage) Bill, 2017.

There were three contentious issues that had stalled the passage of the Bill in the Rajya Sabha though it was passed by the Lok Sabha in the last session of Parliament. The ordinance has to be passed in the next session of Parliament.

Briefing media after the Cabinet meeting, Union Law Minister Ravi Shankar Prasad said there was a “compelling necessity” to bring the measure as instances of ‘talaq-e-biddat’ continued unabated despite the Supreme Court striking it down.

The first change allows only a woman, or a close relative, to file a police case against her husband for instant triple talaq, the Islamic practice that allows men to divorce their wives immediately by uttering the word “talaq” (divorce) thrice.

The second amendment allows her to drop the case if the husband comes around later and they arrive at a compromise while the third amendment makes provision of bail for the erring husband, though by a magistrate.

The practice of triple talaq had been declared illegal and unconstitutional by the Supreme Court last August, prompting the government to bring a law.  

However, there were some dissenting voices on the move. “This ordinance is against the Muslim women. This ordinance will not provide justice to the Muslim women. In Islam, marriage is a civil contract and bringing penal provisions in it is wrong,” said Asaduddin Owaisi, MP and AIMIM chief.

“Modi government not making this an issue for justice for Muslim women, but making this into a political issue,” says Congress leader Randeep Surjewala.

The All India Muslim Personal Law Board has hinted that it would challenge the ordinance in the Supreme Court.

The World Health Organisation (WHO) has commended India for its concerted efforts to reduce child deaths, which have resulted in under-five mortality estimates to have fallen below the one million mark.

As outlined in a report released by the UN Inter-agency Group for Child Mortality Estimation, India’s share of global child deaths has been reduced from 22% in 2012 to 18% in 2017 ­– a rate that outpaces the global decline.

India’s remarkable achievement was made possible via a series of initiatives the Ministry of Health and Family Welfare has taken in recent years, including to vaccinate each and every child with life-saving vaccines under Mission Indradhanush and to expand the reach of diarrhoea and pneumonia management across the country, with a focus on vulnerable and hard-to-reach populations, a statement issued by WHO has said.

Given recent reductions, the global percentage of under-five deaths that occur in India is commensurate with the percentage of global births the country accounts for (18%), and represents a dramatic breakthrough for India, the WHO South-East Asia Region and the world. 

Notably, India’s gender gap in child survival is now almost four times less than what it was five years ago, reflecting substantial advances in gender equity that the country can continue to build on, precisely as it has built on its successes in a range of other areas.

As India’s progress continues – including by concentrating on reducing neonatal deaths, which now account for 62% of under-five deaths — there is immense potential to go beyond ensuring children simply survive but can also thrive and enjoy their right to the highest attainable standard of health and wellbeing.

As outlined in the Global Strategy for Women’s, Children’s and Adolescents’ Health, among other priorities that means ensuring access to adequate nutrition and early childhood development services, at the same time as continuing to increase vaccination coverage for all. Ending preventable newborn and child deaths has been one of the WHO South-East Asia Region’s Flagship Priorities since 2014.

WHO is committed to supporting India and the Region consolidate the significant gains made in recent years, to accelerate further progress, and to ensure healthy lives and promote wellbeing for all at all ages, the statement said.

Scientists have developed a novel approach using skin cell-based gene therapy to stifle the desire for cocaine and to protect against an overdose.

The study, successfully tested on mice, involved removing a small patch of skin and introducing genes that produce cocaine-degrading enzymes. Finally, grafting it back onto the patient.

“Our results show promise of cutaneous gene therapy as a safe and cost-effective therapeutic option for cocaine abuse in the future,” said researchers led by Ming Xu, Professor at the University of Chicago. 

For cocaine addicts or those prone to cocaine abuse, this approach could reduce drug-seeking and protect against cocaine overdose, potentially making them “immune” to further cocaine abuse. 

This skin cell-based approach can potentially be used to treat alcohol, nicotine and opioid abuse and co-abuse, the researchers said.

In the study, the team collected primary epidermal basal progenitor/stem cells from newborn mice and used CRISPR to deliver engineered human butyrylcholinesterase (BChE) — enzymes that can degrade cocaine — to the cells.

Then they prepared skin organdies and transplanted them back to the donor animals, where they acted as a depot for robust expression and secretion of hBChE into the blood stream. 

This efficiently protected the mice from cocaine-seeking and cocaine-induced relapse. It even prevented the death of mice exposed to uniformly lethal doses of cocaine, the researchers noted.

Mice who received the skin grafts were able to remove cocaine from the bloodstream much faster than normal mice.

They were able to withstand cocaine overdoses that would be lethal to 100 per cent of unprotected mice and were less likely than untreated mice to enter environments previously associated with cocaine use. 

However, mice exposed to alcohol retained a learned fondness for that drug.

“Our study demonstrates that transplantation of genome-edited skin stem cells can be used to deliver an active cocaine hydrolase long term in vivo,” the researchers said, in the paper published in the journal Nature Biomedical Engineering. 

The study showed that epidermal stem cells “can be successfully employed for ex vivo gene therapy, as efficient genetic manipulation is possible with minimal risk.”