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Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) pose a serious health risk. According to the World Health Organisation (WHO), the risk of developing TB is estimated to be between 26 and 31 times greater in people living with HIV (PLHIV). In 2015, there were an estimated 10.4 million new TB cases worldwide, of which PHLIV accounted for 1.2 million (11%) cases. TB caused 400,000 deaths among the PLHIV of the 1.4 million who died of TB in the same year.  The TB-HIV co-infection is potentially lethal combination.

When a person develops HIV, his/her immune system loses its ability to fight off infections, making him or her more vulnerable to other infections like TB. People living with HIV are especially vulnerable to tuberculosis in countries where TB is common. Roughly, 75% of PLHIV who contract TB live in sub-Saharan Africa. In some countries in this region, up to 80% of individuals with active TB disease are also HIV-positive.

TB-HIV increasingly poses a risk to people living in other regions. Roughly 30% of all people who become sick with tuberculosis live in Asia, where TB accounts for 40% of AIDS deaths. Eastern Europe has the fastest-growing HIV epidemic globally, making this region vulnerable to increasing TB-HIV co-infection as well, according to the WHO.

According to Dr Anthony D. Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union), a healthy person has a 5-15% life time risk of contracting TB whereas a person with HIV has an annual 5-15% risk of contracting TB.

“”Antiretroviral Therapy (ART) suppresses HIV replication and this leads to a gradual increase in CD4 cell counts. These increased CD4 cell counts protect against TB. Studies have shown that CD4 count of less than 100 can have a TB rate of 25.5 per 100 per year as against a CD4 count of more than 700 where this rate falls to 2.7. In the case of an individual who is not infected with HIV, the rate is less than 0.62 per 100 per year,’’ Dr Harries explains.

Isoniazid Preventive Therapy (IPT) also reduces the overall risk of TB by 33% in PLHIV, Dr Harries says while adding that synergizing IPT to ART would greatly benefit the patients as studies had shown a 37% reduction in TB among people living with HIV as compared to ART alone.

According to WHO, measures have been taken to integrate TB-HIV care in countries around the world, with increasing success. For example in 2014, 77% of people living with HIV who were also diagnosed with active TB, were placed on anti retroviral treatment (ART). Still, opportunities are being missed as only 47% people on ART were screened for TB, only 51% people diagnosed with TB were tested for HIV, and only half of the estimated number of people living with HIV who developed TB were diagnosed and provided with TB care.

The Union has committed to addressing this lethal co-epidemic through an integrated care approach known as Integrated HIV Care for Tuberculosis Patients Living with HIV/AIDS (IHC). This approach aims to strengthen collaboration and build capacity of affected countries’ general health systems to deliver high-quality HIV and TB care.

Between 2000-2014, WHO estimates that 8.4 million lives have been saved through integrated and collaborative TB-HIV activities. There are still many more lives to save and more needs to be done to achieve universal access and to eliminate HIV-associated TB deaths. To begin, WHO recommends that all patients with presumptive or diagnosed TB should be tested for HIV.

According to WHO, the funding required for a full response to the global TB epidemic in low- and middle-income countries was estimated at US$ 8 billion per year in 2015, excluding research and development. As much as US$ 6 Billion could be mobilized from domestic sources, leaving a balance of US$ 2 billion needed from international donors. This gap fuels not only the spread of TB but also has serious implications for the health and safety of those living with HIV. Ending TB is crucial to the survival of those with HIV.

People living with HIV also face the threat of drug-resistant TB. If diagnosis is delayed, people living with HIV are at high risk of death from multidrug-resistant and extensively drug-resistant TB (MDR & XDR-TB).Integrated care is very important for patients at risk of co-infection with drug-resistant TB and HIV.

People living with HIV are also more likely than people who are not infected with HIV to have extra pulmonary TB. Between 40-80% of HIV infected people with TB have extra pulmonary disease, compared with 10-20% of people without HIV.”

“

Ingenious are the ways of the bureaucracy all over the globe. It keeps itself busy with minders, reminders and rejoinders.

So the Indian bureaucracy can’t be expected to be any different. But the moot question does it need the authority of the Cabinet Secretary and Secretariat to send routine reminders to ministries and departments that report to the institution.

The Cabinet Secretary is the top most executive official and senior-most civil servant in the Government of India. The Cabinet Secretary is the ex-officio head of the Civil Services Board, the Cabinet Secretariat, the Indian Administrative Service (IAS) and head of all civil services under the rules of business of the Government of India.The Cabinet Secretary is under the direct charge of the Prime Minister. Though there is no fixed tenure, the average tenure of the Cabinet Secretary has been less than 3 years. His or her tenure however, can be extended.

The senior-most civil servant has at its disposal a Secretariat. The administrative head of the Secretariat is the Cabinet Secretary who is also the ex-officio Chairman of the Civil Services Board. In the Government of India (Allocation of Business) Rules, 1961 “”Cabinet Secretariat”” finds a place in the First Schedule to the Rules. The subjects allotted to this Secretariat are Secretarial assistance to Cabinet and Cabinet Committees and Rules of Business.

This case best illustrates the point. On November 10 the Secretariat sent a note to all the central government Ministries and Departments maintaining that it is mandatory for them to seek ex-facto approval of the Cabinet or the concerned Cabinet Committee even in the cases where the sanction of the Prime Minister is obtained.

An official memorandum by a director level officer in the Secretariat S.G.P. Verghese maintained that “”the note for seeking ex-post facto approval of the Cabinet o concerned Cabinet Committee should be forwarded to Cabinet Secretariat latest with n one month of the approval under Rule 12″”.

“Attention is also drawn to Cabinet Secre ary’s D.o letter no. 1/48/6/2015-Cab. dated 14.08.2015 which conveyed the directions of the Prime Minister that “”all MoUs that are signed by the Departments and are required o be brought before the Cabinet for post facto approval or information, under extant provisions, must be submitted within one month of the signing of the MoU. In case of any delay, the Note should detail the specific reason(s) and justification(s) in submitting the Note before the Cabinet after the prescribed time period”.

The memorandum complained that in spite of the clear instructions on the subject, instances of delayed submission of notes by Ministries/ Departments have been observed. In many cases, the Ministry/ Department have not detailed reason(s) and justification(s) for the de ay in submitting the note beyond the prescribed time period. “This has been viewed seriously.”

We shall wait and watch if indeed the reminder would be `viewed seriously’ by the ministries and departments addressed. The past gives no reason for any optimism. 

About the author: The author is a practicing hack, a cynic to core.”

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Expressing deep concern and shock over the verdict of the Delhi High Court, lifting the ban imposed on 344 Fixed Dose Combinations (FDCs) of drugs by the Government a few months back, the Jan Swasthya Abhiyan (JSA) has said it was a huge setback to efforts aimed at bringing a semblance of order into the absolute anarchy that exist in India’s pharmaceutical market.

All the 344 FDCs that were banned are irrational and there is no scientific rationale for their continued use. Most of them are being manufactured in gross violation of regulatory procedures and should not have been allowed to be marketed in the first place, a statement issued by JSA has said.

“”Medical students are not taught about their use as no text book of Medicine or Pharmacology recommends the use of these combinations. There is also a large volume of evidence from across the world that speaks to the necessity of discontinuing the use of these FDCs. In fact, the 344 FDCs banned constitute the proverbial tip of the iceberg, and there are thousands of other FDCs that also need to be banned. The use of FDCs is generally discouraged except in a handful of cases, none of which are addressed by the FDCs that were banned,”” the statement said.

The World Health Organization’s Model list of Essential Medicines includes only 24 FDCs (out of 358) and India’s National list of Essential Medicines includes only 16 FDCs (out of 348). Yet, an estimated 40% of the Indian market for drugs comprises of FDCs.

The challenge of the ban order by drug companies, including by some of the largest MNCs like Pfizer, Glaxosmithkline and Abbott, was a disingenuous attempt by them to preserve their profits and to profiteer at the expense of public health. Most of these FDCs are not even registered in countries with strong regulatory systems. Further, as these drugs have no therapeutic validity their sales are driven by unethical marketing practices of drug companies, such as financial and other inducements offered to prescribers, the JSA has said.

 Pointing out that the use of FDCs increases cost of medication, exposes populations to a larger array of adverse effects and limits the choice of therapy as they may combine drugs with different dosage schedules, the JSA has said expenses borne by patients account for more than 70% of all healthcare costs and within these, 70% is accounted for by expenses incurred in buying medicines. The continued use of FDCs contributes to a big drain on the finances of individual patients. Further, some of the cough syrups in the ban order are primarily being used as addictive substances and not as therapeutic agents. Criminal investigation agencies and the narcotics bureau have filed several cases on charges of smuggling of the addictive cough syrup Phensedyl (one of the drugs in the banned list).

Access to essential, rational and affordable medicines is a core component of right to health care. In several judgments the Supreme Court of India and High Courts have upheld the fundamental right to health as part of the right to life with dignity over technical procedural issues. However, the lifting of the ban seems to be predicated on perceived procedural issues which fundamentally abrogate the right to life and health care.  Besides, the Delhi High Court order does not appear to address the issues of rationality of the FDCs and the resultant adverse effect on public health. Drug companies should not see this order as a vindication of their stand that these FDCs are rational, the JSA said while calling upon the esteemed judiciary of the highest courts to support and uphold people’s fundamental right to access affordable and rational medicines over the interest of the profiteering corporations who might see the lifting of the ban as a renewed opportunity to inundate the market with irrational FDCs.

The JSA has also appealed to all individual physicians, associations of medical professionals and hospitals not to prescribe the FDCs concerned. It has strongly urges the Government to appeal against the order lifting the ban in the Supreme Court of India. It must also, where appropriate, plug legal and regulatory loopholes so that the ban order can be restored. It is of utmost importance that the government, as a custodian of public health, act decisively to defend it and strengthen regulatory mechanisms. Many of the FDCs covered by the earlier ban are sold over the counter and nothing short of a complete ban can address the threat to public health posed by these drugs. The JSA also appealed to the judiciary to take a broad and informed view of while adjudicating on issues where the private commercial interests of companies come in direct conflict with public health.”

“Coming down heavily on Pakistan for its support to terror groups operating from its soil including Lashkar-e-Tayyaba (LeT) and Jaish-e-Mohammad (JeM), the just concluded Heart of Asia Conference in Amritsar has demanded concerted regional and international cooperation to eliminate terrorism in all its forms and manifestations as well as dismantling of terrorist sanctuaries and safe havens in the region as also disrupting all financial, tactical and logistical support for terror networks.Specific mention of LeT and JeM and Haqqani network along with other groups indulging in heightened  violence in Afghanistan and the region is a boost for India considering that these Pakistan-based terror outfits were not named in the BRICKS Goa declaration. Some 40 countries including Pakistan, represented by Sartaj Aziz, advisor to Prime Minister Nawaz Sharif on foreign affairs participated in the two-day conference, which concluded on Sunday.Without naming Pakistan, Prime Minister Narendra Modi spoke strongly about the need to demonstrate strong collective will to defeat terrorism. He said that silence and inaction against terrorism in Afghanistan and the Southeast Asian region will only embolden terrorists and their masters.Resolute action must be taken not just against forces of terrorism but also against those who support, shelter and finance them, he said.Reflecting Modi’s assertion, Afghan President Ashraf Ghaniunambiguously named Pakistan for promoting terrorism and said no amount of financial assistance can help stabilise the war-ravaged nation if “”support to terrorists”” from the neighbouring country continued. Ghani referred to USD 500 million pledged by Pakistan for reconstruction of Afghanistan and bluntly told Aziz that this money can “very well be used for containing extremism because without peace, any amount of assistance will not meet the needs of our people.”Ghani also said military operations in Pakistan have brought about selective displacement of terrorists networks.Maintaining that state-sponsored sanctuaries exist in Pakistan, he, quoting a Taliban leader said, “ as Mr Kakazada (Mullah Rahmatullah Kakazada), one of the key figures in the Taliban movement, recently said, if they did not have sanctuary in Pakistan, they would not last a month.”He also said that about 30 terrorist groups, as named by the UN, are trying to establish their base in Afghanistan and there was a need to identify cross-border terrorism and a fund to combat the scourge.Describing terrorism as the biggest threat to peace, stability and cooperation in the region the conference in its declaration pressed for dismantling terrorist sanctuaries and safe havens in the Heart of Asia region.It called upon all states to take action against these terrorist entities in accordance with their respective national counter-terrorism policies and UN Global Counter Terrorism Strategy 2006.In his statement, India’s Finance Minister Arun Jaitley — who led the Indian delegation in the absence of ailing external affairs minister Sushma Swaraj — said, “For the first time, a Heart of Asia Declaration expressed concern at the violence caused in Afghanistan and the region by terrorist groups like Al Qaeda, Daesh, LeT and JeM, etc.” Observers feel the declaration is a clear message to Pakistan — without naming it — that it should dismantle the safe havens of terrorism on its soil.The Amritsar Declaration said, “We remain concerned by the gravity of the security situation in Afghanistan in particular and the region and the high level of violence caused by the Taliban, terrorist groups including ISIL/ DAESH and its affiliates, the Haqqani Network, Al Qaeda, Islamic Movement of Uzbekistan, East Turkistan Islamic Movement, LeT, JeM, TTP, Jamaat-ul-Ahrar, Jundullah and other foreign terrorist fighters. Acknowledging the support that terrorism derives in our region, we demand an immediate end to all forms of terrorism, as well as all support to it, including financing of terrorism. We recognise that terrorism is the biggest threat to peace, stability and cooperation in our region. We encourage the international community to continue to assist the Government of Afghanistan. We strongly call for concerted regional and international cooperation to ensure elimination of terrorism, in all its forms and manifestations, including dismantling of terrorist sanctuaries and safe havens in the Heart of Asia region, as well as disrupting all financial, tactical and logistical support for terrorism.”“We welcome and support Afghanistan’s initiative in taking the lead in exploring a regional counter-terror strategy, in accordance with the established principles of the UN charter, which we agreed was necessary when we last met in Islamabad in December 2015. We note the progress that has been made since the last Ministerial with an Ambassadorial meeting of the CT-CBM participating countries at which a draft framework strategy was shared by Afghanistan for further consideration and development. We call for convening an early meeting of experts to discuss the draft framework strategy with the view to its finalisation for consideration by senior security officials,” it said.Mr Jaitley said, the three big issues of the conference were—-Countering terrorism to create stability and security in Afghanistan, Providing Afghanistan connectivity to strengthen economic activities, and Development, which is essential for the progress of Afghanistan.The participating countries included——apart from Afghanistan and host India——Azerbaijan, China, Iran, Kazakhstan, Kyrgyz Republic, Pakistan, Russia, Saudi Arabia, Tajikistan, Turkey, Turkmenistan, the United Arab Emirates, and the United Nations. The Conference also saw the presence and participation of guest countries Austria, Bulgaria, Latvia and Uzbekistan. The other supporting countries and international and regional organisations included Australia, Canada, Denmark, Egypt, European Union, Finland, France, Germany, Iraq, Italy, Japan, Poland, Norway, Spain, Sweden, the United Kingdom, the United States, Aga Khan Development Network (AKDN), Asian Development Bank (ADB), Conference on Interaction and Confidence Building Measures in Asia (CICA), Collective Security Treaty Organisations (CSTO), Economic Cooperation Organisations (ECO), North Atlantic Treaty Organisation (NATO), Organisation of Islamic Cooperation (OIC), Organisation for Security and Cooperation in Europe (OSCE), Shanghai Cooperation Organisation (SCO), and South Asian Association for Regional Cooperation (SAARC).(The writer is a Delhi-based freelance journalist. He has had a long stint in various editorial capacities, including West Asia correspondent, for the PTI news agency.) “

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Latest estimates have revealed that there were 8.7 million deaths because of cancer in 2015 globally. There were 17.5 million cancer cases and 208.3 million disability-adjusted life-years (DALYs).

Between 2005 and 2015, incident cancer cases increased by 33%, of which 12.6% were due to population growth, 16.4% due to an aging population, and 4.1 % due to increasing age-specific incidence rates, according to the latest Global Burden of Diseases study published in the latest edition of Jama Oncology.

Cancer is the second leading cause of death worldwide. The study was done for 32 cancers in 195 countries and territories from 1990 to 2015.

 For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent, the study by Institute of Health Metrics and Evaluation (IHME).

In India also, breast cancer topped the list of cancers followed by lip and oral cancer, stomach and tracheal cancer. India also had the highest number of cancers in South Asia. However, it was tracheal cancer that claimed the most lives in India followed by stomach, eosophageal and colon cancers, the study said.

Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma. The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant, the study said.

As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet, the study said.”

“The world is facing a humanitarian crisis that will require a record USD 22.2 billion in funding for 2017 to support nearly 93 million of the most vulnerable and marginalized people, the UN Office for the Coordination of Humanitarian Affairs (OCHA) has said while launching a relief aid appeal.“The scale of humanitarian crises today is greater than at any time since the United Nations was founded,” said UN Emergency Relief Coordinator Stephen O’Brien, launching the Global Humanitarian Overview 2017 in Geneva, Switzerland, OCHA said in a statement.“Not in living memory have so many people needed our support and solidarity to survive and live in safety and dignity,” he said, noting that humanitarian response plans in 33 countries aim to reach 93 million people in need. Globally, more than 128 million people are affected by conflict, displacement, natural disasters and profound vulnerability.Conflicts in Syria, Yemen, South Sudan and Nigeria are among the greatest drivers of humanitarian needs, fuelling new displacement within countries and across borders.“Funding in support of the plans will translate into life-saving food assistance to people on the brink of starvation in the Lake Chad Basin and South Sudan; it will provide protection for the most vulnerable people in Syria, Iraq and Yemen,” said Mr. O’Brien, also the Under-Secretary-General for Humanitarian Affairs.Launching the appeal in Geneva, UN relief chief Stephen O’Brien told reporters that funding will be translated into “”concrete actions,”” including but not limited to food, medical and psychological support, according to UN News Centre.At the same time, the impact of El Niño-triggered droughts, floods and extreme weather is pushing vulnerable communities to the brink of survival. Responding to these protracted crises has prompted the humanitarian community to strive for better, faster and more effective delivery of aid, as highlighted during the transformational World Humanitarian Summit in May this year. Ã¢Â€ÂœFunding will enable education for children whose schooling is disrupted by El Niño,” he said. So far in 2016, international donors have generously provided $11.4 billion to the current global appeal which, over the year, has risen from $20.1 billion to $22.1 billion. However, this represents only 52 per cent of the requirements and humanitarian organizations approach the end of this year with a funding gap of a record $10.7 billion – the largest gap ever.“The lives of millions of women, girls, boys and men are in our hands,” Mr. O’Brien said. “By responding generously and delivering fully on this appeal we will prove to them that we will not let them down.” The humanitarian appeal 2017 is based on Humanitarian Response Plans in Afghanistan, Burundi, Cameroon, Central African Republic, Chad, Democratic Republic of Congo, Djibouti, Ethiopia, Haiti, Iraq, Libya, Mali, Myanmar, Niger, Nigeria, occupied Palestinian territory, Somalia, South Sudan, Sudan, Syria, Ukraine and Yemen. Other appeals cover Burkina Faso, Mauritania and Senegal.Burundi, Nigeria, South Sudan and Syria are crises that affect entire regions and their neighbouring countries are included in regional response plans, bringing the number of countries included to 33, OCHA said.(The writer is a Delhi-based freelance journalist. He has reported from India and abroad for the PTI news agency in various capacities.) “

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In the times of demonetization when the Modi Government is urging people to move towards electronic modes of payments, the factor that will matter most in making digital payments successful is uninterrupted internet access, particularly in rural areas where reliable mobile network are still a big issue.

While top mobile operators, including government-owned BSNL, is striving hard to ensure uninterrupted mobile network for better voice and uninterrupted data transfer, a Gurgaon-based telecom company – Vihaan Networks Ltd or VNL – has shown the way that could help realise Prime Minister Narendra Modi’s dream of “Digital India”.

Through its unique and ‘green’ mobile solutions, VNL has set up broadband networks in three villages in Rajasthan that provide seamless Wi-Fi coverage free of cost. These networks are literally maintenance-free that can be managed by any villager and are not dependent on government power supply as they are solar powered,

Though the villages of Karenda, Phalsa and Bahadari in Rajasthan are yet to get good roads and proper supply of water, what they can boast of is uninterrupted Wi-Fi network that delivers good broadband speed and is free of cost. Students here can be seen visiting various websites related to education and jobs though they sometimes do visit entertainment and sports website for recreation. VNL has also provided broadband services to government school and ‘panchayat ghars’ in these villages that helps school and gram panchayats to get their official work done.

“We have created high-speed wireless internet services solutions especially for rural areas. Our ‘Rural Broadband Solution’ is totally solar-powered and standalone wireless broadband solution that provides seamless Wi-Fi coverage anywhere. It needs no shelter, air conditioning, connection to power grid, generator or diesel fund, and is ready for business in days providing fully-functional broadband,” says VNL Chairman Rajiv Mehrotra.

Another interesting innovation from VNL is ‘Gurukul’, village internet kiosk solution that enables rural communities to access high speed broadband internet without the need for connection to power grid or diesel generators. “High speed broadband internet access enables children to take advantage of distance learning and other e-learning initiatives. Villagers can also access the internet for e-finance and e-governance related tasks. Our modern and ‘green’ broadband solutions will help the government in speedy realization of the ‘Digital India’ goals,” adds Mr. Mehrotra.

Being close to Delhi, these villages had access to mobile networks and broadband, but erratic mobile connectivity and power supply besides high data packages made it difficult for them to freely use internet. “But for almost two years VNL has been providing us uninterrupted broadband access. Villagers, particularly children, are happy that they can use internet for education and other purposes. It has also helped us to get crucial information related to agriculture and weather. With the government scrapping old Rs.1000 and Rs.500 notes, people are now learning internet banking and other modes of e-transaction, thanks to good broadband network,” says a village elder in Karenda (Alwar, Rajasthan).

VNL, which also has to its credit of supplying cost-efficient and reliable mobile network in Naxal-affected states, is planning to take its rural broadband solution to other remote areas of the country. “Our rural solution can bring broadband revolution across India, particularly in remote villages and far off places in states like Jammu and Kashmir, Himachal Pradesh, Uttarakhand, Northeast, Andaman and Nicobar Islands. These easy-to-maintain and cost-effective Wi-Fi solutions can provide uninterrupted internet access to people. It can also help in running administration as we have demonstrated in these villages,’ Mr. Mehrotra adds.

Government sources say the Telecom Department and the BSNL have taken VNL’s experiment very positively and is mulling over starting a pilot project by using the technology. “VNL’s low-cost, and maintenance-free broadband solution looks ideal for taking Prime Minister’s Narendra Modi’s ‘Digital India’ campaign to the next level. The Prime Minister is pushing for e-payments and e-transactions post scrapping of old currency, the challenge for the government is to see that every Indian gets uninterrupted internet access. And to make it possible, we need solutions like the one being provided by VNL,” a senior DoT official adds.”

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Mortal remains of Tamil Nadu Chief Minister and supremo of AIADMK party J. Jayalalithaa were laid to rest with full State honours alongside her mentor MGR’s memorial on Marina beach in Chennai on Tuesday. The last rites were performed by her long time associate Sasikala Natarajan in the presence of a galaxy of political leaders and several Chief Ministers as millions bid tearful adieu to their beloved leader who passed away on Monday night in Apollo Hospital. 

The 68-year old AIADMK Chief passed breathed her last on Monday night after suffering a massive cardiac arrest. She was under treatment in the hospital for the last 74 days for various ailments but could not come out of the heart attack and failed to respond to the treatment. Her body was taken to her Poes Garden residence before being taken to Rajaji Hall. Millions of people from all walks of life paid their last respects to the departed leader who had changed the course of Tamil Nadu politics and endeared herself as “”Amma””  not only to her party workers but also people in rural areas and towns alike. 
President Pranab Mukherjee and Prime Minister Narendra Modi today homage to Jayalalithaa by offering flowers at Rajaji Hall in Chennai.
Both Houses of Parliament were adjourned for the day on Tuesday as a mark of respect to J. Jayalalithaa. In her obituary reference, Lok Sabha Speaker Sumithra Mahajan described Jayalalithaa as a true leader of the masses and a multifaceted personality. She said, in her demise, the country has lost a highly popular and eminent public persona.

Rajya Sabha Chairman Mohd Hamid Ansari said the country has lost a prominent leader, a distinguished parliamentarian and an able administrator. He said, as Tamil Nadu Chief Minister, her contributions towards the economic development of the state and social welfare of the poorer segments will be remembered long and cherished. Mr Ansari said, her demise is an irreparable loss to the people of India. Members in both the Houses observed silence to pay homage to the memory of the departed leader.
Jayalalithaa was a member of the Rajya Sabha from 1984 to 1989.

Jayalalithaa served four times as Tamil Nadu chief minister and had to quit twice because of corruption allegations. Her loyalist and finance minister O Panneerservam stood in for her and he has also taken over the reins of the administration as chief minister after her demise.

Born on February 24, 1948 in Mysore  district in Karnataka, she became a popular film actress in the 60s and 70s and partnered with MGR another hugely popular hero of Tamil films who was also her mentor. They did 28 films together and she entered politics under his guidance in 1982. After MGR’s death, she withstood humiliation but came back with great following of the party and became chief minister in 1991. She had a cult like devotion and over the past few years showered the electorate with gifts like mixers, cookers, television sets, laptops, grinders. She also launched Amma Canteen, a hugely popular eating joint for people from lower segment of the society.

After Amma who in Tamil Nadu? This question is going to haunt the people and the political parties in the State for a long time. The AIADMK would need to put up a united front, if the party wants to rule the State and take forward her programmes and legacy further. Only time will tell, how successful the party emerges from these trying times.”

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As disruptions and protests in both Houses of Parliament threaten to totally wash out the ongoing winter session, President Pranab Mukherjee delivered a rebuke to parliamentarians, stressing on the need to avoid disruption of Parliamentary proceedings. 

He said that while three Ds are essential in a parliamentary system of democracy — Debate, Dissension and Decision the fourth D — Disruption is totally unacceptable.  

Mr. Mukherjee said the Parliament is expected to transact business on important issues such as those related to money and finance.

“”Whatever be the differences, members have the opportunity to speak their mind and discuss issues freely. Even if a member levels an allegation against someone, no court can prosecute him because he has said so on the floor of the House. This extent of freedom available to Members of Parliament should not be misused by causing disruptions. Disruptions amount to gagging the majority as it is only the minority which disrupts and the Chair has no choice but to adjourn the proceedings,” the President said while clearly voicing his displeasure over disruptions in Parliament. 

He made these observations while delivering the fourth Defence Estates Day Lecture on the topic ‘Electoral Reforms for a Stronger Democracy’ in the Capital on Thursday. A day earlier BJP patriarch L K Advani had expressed his anguish over  disruptions in the Lok Sabha, saying both the ruling coalition and the Opposition were to be blamed for disruptions and the deadlock in Parliament. An aggressive opposition has taken on the government on the issue of the ban of Rs. 1000 and Rs. 500 currency notes which was ordered on November 8. The President said that India adopted its Constitution in 1950 and the first General Elections were held in 1952.  In the initial years, many doubted that Parliamentary system of democracy in India would be successful.  However, regular elections held successfully have proved the skeptics wrong, he said. 

Many scholars later commented that we have entered a coalition era and the possibility of forming a single party government in a diverse country like India was unlikely.  However, this view was proved wrong in 1984 as well as in the last General Elections of 2014, when a decisive mandate was given in favour of a single political party.  The President said there are certain areas regarding holding of elections which require attention and there are aberrations which need to be corrected. This has necessitated electoral reforms which should be taken up seriously.

The President said holding of frequent elections is a strain on both administrative and financial resources.  We are ready to pay this price for democracy, but, it should not be at the cost of development. Administrative and development work is adversely affected during elections since no new development projects can be taken up.  During state elections, work related to Government of India in that state should not be affected.  The Election Commission, State and Central Governments and political parties should sit together and discuss this issue. 

The President said the Election Commission of India could consider compressing the time frame of announcement, notification and conduct of the elections. The period of elections tends to get very long as it is spread over phases.

 Another suggestion the President made was of having larger number of Lok Sabha seats for which a Constitutional amendment could be considered. India has over 800 million voters. The delimitation of Lok Sabha constituencies is on the basis of the 1971 census. Today, 543 Lok Sabha Constituencies represent 1.28 billion people. To give true expression to the will of the people, it is time that we seriously look at the legal provisions on the delimitation of the parliamentary constituencies with a view to increasing their number. 

The President said another aspect which was important was reservation of seats for women in Parliament and State Legislative Assemblies. Although the population of women in the country is almost fifty percent, their representation is abysmally low.  This is totally unacceptable. He concluded that he was proud of the Indian Parliamentary System but electoral reforms have now become necessary.”

“With the passing away of Tamil Nadu chief minister Jayaram Jayalalithaa, the ruling All India Anna Dravida Munetra Kazhagam (AIADMK) faces its biggest test of remaining united. As expected senior leader and a staunch loyalist of Jayalalithaa popularly known as “”Amma””, O Paneerselvam was administered the oath of office and secrecy at 01 AM on the night of December 5/6. The transition was smooth and orderly as he had served as acting chief minister on at least on two occasions in the past with Amma having to step down on the directions of the court. Having faced adversity all her life Jayalalithaa took up the challenge posed by her rivals resolutely overcoming them and becoming the chief minister of Tamil Nadu a record four times. She was the second woman to become the chief minister of the southern state after her mentor the late M G Ramachandran’s wife Janaki occupied that office for barely three weeks. However, Amma’s confidant for nearly three decades Sasikala Natarajan has ambitions of taking over the reins of the AIADMK as its all powerful general secretary. There is already speculation that Sasikala is arraigning to herself the role of being the power behind the throne. One does not really know if this is what the ailing Jayalalithaa had in mind. At the same time what cannot be lost sight of is that despite differences between Amma and Sasikala on several occasions, the former appears to have given up the bitterness. One wonders if Amma had changed her mind of her own volition or there were other compelling reasons. At the same time Sasikala remained steadfast in being by Jayalalithaa’s side during all the 74 days that she remained in Apollo hospital in Chennai till she breathed her last at 11.30 p m earlier in the week on December 5 night. Without wasting much time Jayalalithaa’s body was moved to the historic Rajaji Bhawan for the people to pay their last respects. In all this Sasikala held sway accepting condolences standing next to Jayalalithaa’s body.  The signs are ominous amid discernible unease in the rank and file of the AIADMK about Sasikala’s possible transition to holding the whiphand of the AIADMK as its general secretary. She has competition if at all in another senior leader Thambi Dorai, who is the Deputy Speaker of the Lok Sabha, being in the race for the all powerful general secretary’s job of the Dravidian party. Amma’s association with her confidant Sasikala has always been viewed as an extra-constitutional authority alienating sections of Jayalalithaa’s support base. She drove away allies that Jayalalithaa had struggled to win back following MGR’s passing away. Jayalalithaa’s propensity to drive away friends was more than matched by her ability to bring together foes. Jayalalithaa had remained the party supremo along with being the chief minister. Expectedly, the job of being the chief minister as well as the AIADMK’s general secretary is now sought to be split rather than being concentrated in the hands of one person as evidenced during Jayalalithaa’s reign.  Amma’s death has come as a shock to Prime Minister Narendra Modi who has lost a good friend ever since he was the chief minister of Gujarat. The significance of AIADMK’s support to the BJP led NDA government in New Delhi cannot be undermined or brushed aisde. This Dravidian party has muscle at the centre with its 50 seats spread in the Lok Sabha and the Rajya Sabha in Parliament. The BJP has an opportunity to increase its footprint in the South comprising Tamil Nadu, Kerala, Karnataka, Telengana and Andhra Pradesh and the lone union territory of Puducherry having a tally of more than 200 seats in the 534-member Lok Sabha. With four-and-a-half years to go for the present AIADMK regime in Tamil Nadu, Paneerselvam faces the challenge of not only keeping the party united but also of carrying Amma’s legacy forward coupled with reinventing the Dravidian party in the post-Jayalalithaa era.With Sasikala and her hushand Natarajan seeking to take over the AIADMK, the next three months is going to be crucial period for Paneerselvam’s survival as the chief minister. It is widely believed Sasikala had zeroed in on OPS to be the chief minister in Jayalalithaa’s absence. The question is does Paneerselvam have it in him to keep the disparate forces in the AIADMK in check and break the shackles of the past as a ruthless Jayalalithaa brooked no opposition to her. She ruled with an iron fist and lets also not forget that she was an Iyengar brahmin who earned the respect and awe of Dravidians.DMK patriarch M Karunanidhi has conceded that Jayalalithaa will be remembered for ever for uplifting the poor. At the same time it is widely believed that the self effacing Paneerselvam can break the shackles and emerge a leader in his own right. Or is it wishful thinking as the political intrigues have already begun.Without having the charisma of MGR or the political acumen of Jayalalithaa, it will be tough task for the new chief minister. Like the Prime Minister, Paneerselvam or OPS as he is widely known was also a “”chai wala”” before making his foray in politics. There is no one in the AIADMK at present who can match either MGR or Jayalalithaa both of whom held sway over the masses for four decades. In the medium to long term there might be a reconfiguration in Tamil Nadu’s politics with the BJP being the primary beneficiary. The Lotus party at the helm of affairs at the centre has to counter the strong reservation that the people of Tamil Nadu have for the Hindutva agenda. The Dravidian parties in Tamil Nadu follow the ideals of Periyar or E V Ramaswamy who propagated the principles of rationalism, self- respect, women’s rights and eradication of caste. He opposed the exploitation and marginalisation of non-Brahmins in South India. His work has greatly revolutionised Tamil society and significantly removed caste-based discrimination. The BJP needs to put on its thinking cap in allaying the apprehensions of the people of the southern state contributing a sizeable 39 seats to the Lok Sabha.( T R Ramachandran is a senior journalist and commentator. The views are personal)”