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Presenting the first Union Budget combined with Railways budget for 2017-18 in the Lok Sabha on Wednesday, Finance Minister Arun Jaitley said the agenda of the NDA government for the next year is to Transform, Energise and Clean India- TEC India. He said TEC India seeks to transform the quality of the governance and quality of life of people, energise various sections of the society and clean the country from the evils of corruption, black money and non-transparent political funding.
In order to foster this agenda, the Finance Minister presented budget under 10 themes on doubling farmers income, rural employment and infrastructure, energising youth, care for poor and underprivileged, infrastructure, stable financial sector, digital economy, effective public service and prudent fiscal management and tax administration.
Mr. Jaitley said, the overall approach of the budget has been to spend more in rural areas, infrastructure and poverty elevation and yet maintain fiscal prudence. He announced major hike in allocations for ministries of agriculture, drinking water and sanitation, health and family welfare, new and renewable energy, rural development, skill development and Water resources for their various schemes.Prime Minister Narendra Modi said the General Budget will accelerate development and it has addressed the aspirations of all. He said Finance Minister has presented an excellent budget devoted to well-being of the villages, farmers, poor and the youth. Mr Modi said the aim of the Government is to double the income of farmers. He said special emphasis has been given on women empowerment and added that the Housing sector will immensely gain from the Budget. He also said the merger of the Railway Budget with the general budget will give an impetus to the transport sector’s growth. In his reaction to the Budget, Congress Vice President Rahul Gandhi said the Budget lacks vision and there is nothing in it for farmers. Mr Gandhi said his party support moves for curbing corruption in political funding.Railway Minister Suresh Prabhu hailed the budget as path breaking, saying that a new era has begun.Congress leader Mallikarjun Kharge claimed that the Budget is pro rich and pro corporates. On political funding limit in the Budget, Mr Kharge said his party believes in transparency. BJD leader B Mahtab said the rosy picture portrayed by the government may not be achieved due to lack of growth and the manner in which manufacturing sector growth is coming down. NCP leader Tariq Anwar said there is nothing new in the General Budget and it is not as per expectations.”

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Under fire from the National Human Rights Commission (NHRC) for its dismal track record of human rights in the Naxal-affected Bastar region, the Chhattisgarh government has announced setting up of a district-level Human Rights Protection Committee to be headed by the Collector.

This decision comes just a day after the government asked the DIG (Baster Range) S.P.Kalluri to proceed on medical leave following large scale allegations against him of “harassing and threatening’’ journalists, human rights activists and academics.

The Chhattisgarh government has come up with an Action Plan for the protection of human rights, including those of journalists and academics.

The Commission, taking suo motu cognizance of the reported allegations, had observed on the 16th November, 2016 that it was deeply disturbed by the state of affairs in Chhattisgarh over last one year or more. In response, the Chhattisgarh government informed the Commission that they had prepared a six point Action Plan to ensure that human rights are adequately protected in Bastar. As an urgent measure, the State Government has given standing instructions to the Special DGP/Additional DGP (Naxal Operations) to immediately recommend action to the Additional DGP (CID) in a case of gross violation of human rights wherein the action is found to be slow, lacking or inadequate at lower levels. 

The other measures include organizing training and orientation of the police force posted in Bastar Division to sensitizes them on the human rights issues and to ensure that human rights are not violated in the course of their duties;All police officers will ensure that human rights are not violated in the course of their work, be it in Naxal affected areas or elsewhere. Human rights violations will invite consequences. They would also be responsible for ensuring compliance among other police personnel under their command.There will be a clear, separate entry in the Annual Performance Assessment of All Indian Police Services and State Police Service Officers about their performance on human rights issues; and a district level Human Rights Protection Committee headed by a District Magistrate/Collector has been constituted in each of the seven Naxal affected districts of Bastar to receive complaints on human rights issues and to make suggestions to the State Government for taking necessary action. This committee comprises six district level administrative, police, law officers and two- three eminent citizens;A State Human Rights Protection Committee has been constituted under Secretary, General Administration Department. This will consider only those cases which has been not been disposed off at the district level or where the complainant is not satisfy with the action by the Districts Committee. This committee comprises seven senior level administrative, police, law officers and two-three eminent citizens/NGO representatives”

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Even though Union Finance minsiter Arun Jaitley presented a futuristic budget on February 1 by focussing on the poor, farmers and the middle class, it has failed to enthuse BJP activists. This is particularly so with regard to the most crucial poll bound state of Uttar Pradesh where voting will be held in seven phases. The disappointment pertains to the budget not having anything to enthuse the voters.

The Election Commission of India had specifically urged the BJP led NDA government of Prime Minister Narendra Modi not to announce any concessions for the five states going to the polls from today, the fourth of February. Apart from UP the other states where assembly elections are being held are Punjab, Uttarakhand, Manipur and Goa. The results will be announced on March 11. 

Lotus party leaders believe the budget exercise was aimed at ensuring Modi gets elected for a second term two years hence in the 2019 general elections. It is apparent they are jittery about the prospects of the BJP in UP in the light of the chief minister Akhilesh Yadav’s SP having reached an agreement with the Congress which has managed a good deal of 105 seats for itself. The remaining 298 in the 403-member state assembly will be contested by the SP.

The patriarch of the regional party Mulayam Singh Yadav has said he will not be campaigning for the SP as he was not in favour of having a truck with the Congress. Simultaneously, Shivpal Singh Yadav, the sulking brother of ‘Netaji’ as Mulyam Singh is known is trying to create confusion by talking about floating his own party after the assembly elections are over.

At the same time SP sources are categoric that there is no rift between father and son despite the bitter feud and upheaval in the SP to take control of the party. Now that Akhilesh has been backed by a significant majority of the legislators as well by the youthful supporters in the state, his pre-eminence as the chief ministerial candidate for a second term in Lucknow has been established. He has subsequently been anointed the national president of the SP.

Given these fast paced developments in UP, the BJP has to once again bank on the charisma of Modi to pull the chestnuts out of the fire in Uttar Pradesh. Whether Modi retains that magic evidenced in the 2014 elections remains to be seen though he has a busy schedule ahead criss crossing UP addressing rallies.

A Prime Minister’s honeymoon ususally lasts 30 to 36 months and Modi has already completed 32 months. People have borne with fortitude the multitude problems arising from the bold November eighth demonetisation. However, their patience is now running thin having been tested for far too long.

The nervousness in the BJP ranks in UP is palpable. This is reflected with the names of three of its sidelined leaders — Murli Manohar Joshi, Varun Gandhi and Vinay Katiyar — being included in the list of campaigners for the second and third phases. The party has suddenly woken up to Joshi being a prominent Brahmin leader and wants to exploit his impact on the community.

Varun has kept himself away from campaigning in UP. Sources said he wanted to be projected as the chief ministerial nominee and now party strategists want to minimise the damage he can cause the party. Katiyar a backward class leader in the forefront of the Ram Temple movement has been ignored for many years. 

Winning UP is critical for the saffron brigade as that will set the stage for the 2019 general elections. The BJP is still smarting from its defeat in the Bihar assembly elections in 2015 considered a battleground state in the Hindi heartland. Meanwhile, Punjab, an important state bordering Pakistan, and Goa are having a one-day poll on February 4. The campaign ended in both the states on Thursday. 

The stakes are indeed high in Punjab for the SAD-BJP combine, the Congress as well as the Aam Aadmi party which appears to have regained lost ground in the last few months. One wonders if political pundits, psephologists and others are able to grasp the mood of the electorate this time. The last time in 2012 everyone fell flat on their face. A three cornered contest is unusual in Punjab. While the Congress has old war horse in Capt Amarinder Singh spearheading its campaign, chief minister Parkash Singh Badal remains the chief ministerial face of the Akalis for the sixth time. Its a high stakes battle which can go to the wire despite the angst against the SAD.”

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How ironical it is to be caught up in the vicious circle of growing, cultivating and harvesting of crops and to find the only escape from this in suicide. Giving life to a seed in fields at times culminates with taking your own life. The India shining story with much urbanization and smart cities often leaves out the story of dirty muddy fragmented fields far behind. To bring out this story we shall present the case of innumerable farmers of India who live (or choose not to) in ever mounting debts. The story of distressed farmers who find answers to their debt-related problems in suicide.

In two decades up to year 2014 there were over 3 lakh farmer suicides in India. In 2014, the country recorded 12,360 farmer suicides. In 2015, that number went up to 12,602. To break it down for a better understanding it means on an average over 1000 farmer suicides per month. That is, around 35 farmers committing suicide every day. At least one farmer ending his life every hour in this country. Appalled? Wait, that’s just the official data we are talking about. The real numbers are higher. There are many more farmer suicides unreported or misreported in the earnest effort from the government to keep the numbers low. To hush up the issue and to make believe that it isn’t all that bad at the ground-level.

However, it is that bad. Or in fact worse. Denial of the magnitude of the problem is dismissal. Persistent farmer suicides has become a growing problem. A problem that is not getting its due attention in the past several budgets. The numbers are rising but so is the awareness now. The government’s dismissal is out in the open and thus in the past several years there have been many columns, journals, articles and books written about farmer suicides. With the incoming Budget of 2017-18 the same is expected now.Though, clearly that’s not quite enough. Still, there seems no respite. And no real relief for farmers through the way of budgetary allocations. The crisis is deepening and the suicide numbers alarming. Through this story we aim to bring out the reasons for farmer suicides, the steps taken by the government so far and the days ahead for farmers in India.

Reasons for Suicides by Farmers

The most well-known and often spoken about reason for farmer suicides is crop failure due to lack of monsoon rains. For instance, years 2014 and 2015 were drought years. According to a study titled ‘Relative contribution of monsoon precipitation and pumping to changes in groundwater storage India’, which was published in the journal Nature Geoscience last month groundwater withdrawals in the country have increased over tenfold in six decades. “The monsoons in North India, from June to September, have declined in intensity and duration since 1950, leading to more frequent and intense droughts.” The severe drought experienced by farmers result in farming woes and much lesser crop produce. While, this is definitely an important reason it is not the only significant one. There have been years with good monsoon rains and excellent crop produce witnessing suicides.

Farmers have been killing themselves in years of excellent crop produce just as in years of crop failure. Clearly, there is more to it than just monsoon.

The rising input costs, ever since the green revolution happened, have adversely affected the cultivators. A 100 to 500 per cent increase in prices of agricultural inputs like high-yield variety seeds, fertilizers, fungicides, pesticides and labor costs have made it almost impossible for farmers to make ends meet. The water-use patterns, hyper-commercialization, and severe price shocks and price volatility break the farmers.

Growing crops year after year on the same piece of land without the use of fertilizers and pesticides has become difficult. The yield per hectare has gone down. And the added costs have been forcing farmers to take credit. With limited institutional avenues to take credit from, farmers end up in the clutches of moneylenders and sahukars who lend at exorbitant rates of interest. In some cases the interest rates are as high as 45%.

The steps taken

To bring relief to farmers there is not much the government has done in terms of execution. The schemes like Pradhan Mantri FasalBimaYojana, Pradhan Mantri Krishi SinchayeeYojana, organic farming, self-sufficiency in pulses and oilseeds, national agriculture market (eNAM), mobile app, and disaster relief are all there aiming to double the income of farmers in the next five years. But they work best on paper alone. When put to practice each one of them fail to bring relief to the farmer. The middlemen and commission agents end up profiting from the government sanctioned credit schemes and compensations instead.

However, the Agricultural Debt Waiver and Debt Relief (ADWDR) scheme of 2008-09 did its bit to acknowledge the crisis. It provided for full waiver on all ‘eligible loans’ overdue on December 31, 2007, for marginal (holding up to one hectare) and small (holding between one to two hectares) farmers, and a one-time settlement scheme for farmers holding more than two hectares of land under which a rebate of 25% was given against the payment of the balance 75% of the loan before June 30, 2009. This deadline was extended by a year because of the failed monsoon season in 2009-10. A total of Rs 52,500crores were released for the scheme, with about 192.59 lakh farmers reported to have benefitted from it.

These and some other measures like soil health cards, direct benefit transfer scheme, etc. have tried to address the farmer’s issues. But, the fact remains that much more needs to be done.

In the Time to Come

To put the best foot forward the government needs to start acknowledging the intensity of agrarian crisis. The fact that so many farmers take the extreme step cannot be concealed. Some research and analysis of past several years reveal a certain trend. It brings out that farmers growing cash crops are the most affected. That is the growers of cotton, sugar cane, groundnut, vanilla, coffee, pepper and others.  Fewer suicides occur amongst growers of paddy or wheat. Similarly, farmers coming from seven states namely Maharashtra, Karnataka, Telangana, Madhya Pradesh, Chhattisgarh, Andhra Pradesh, and Tamil Nadu are more prone to take the extreme step in comparison to farmers hailing from other states.

Also, marginal and small farmers comprise of over 72% of the total farm suicides. And then, there is another category of ‘agricultural laborers’ with no landholding that is committing suicide. In states like Chhattisgarh, Jharkhand, Uttarakhand, West Bengal which in the past reported ‘zero’ farm suicides have actually left out the agricultural labourers and women farmers who work in the fields. This brings us to the point wherein we should be able to define a farmer. Also, better and timely compensation from the government if provided will go a long way in helping the farmer. A bigger and wider coverage for provisioning of loans through institutional mechanisms like NABARD will also bring relief. However, focus shouldn’t be on credit and loan rather steps should be taken to increase the income, productivity and prosperity of farmers. The putting in check of the middlemen and private moneylenders should be emphasized upon and the policies should be executed in letter and spirit. The push for reforms in agriculture marketing and more funds for irrigation and insurance schemes announced in this year’s budget will only help if it all reaches down to the lowest level. If not, the irony of farmers committing suicides will continue to haunt this nation.”

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Goa registered a record voter turnout of 83 percent in Saturday’s assembly polls. The coastal state had recorded 81.8 percent polling in last assembly elections. At a media briefing in New Delhi, Deputy Election Commissioner Umesh Sinha said that no case of paid news was reported from the state. He said the polling passed off peacefully.

In the Northern plains, Punjab recorded 70 percent polling till 5 PM. The voter turnout in last assembly polls in 2012 was a little over 78 percent. Deputy Election Commissioner Sandeep Saxena said that 59 cases of paid news were reported. Voting in Punjab was by and large peaceful. 

The two states went to polls in a single phase on Saturday. The final figures may go up as reports are yet to come from some polling booths. There were also some reports of EVMs developing technical snags which were replaced.

In Saturday’s assembly elections, Delhi Chief Minister Arvind Kejriwal’s Aam Aadmi Party (AAP) is making its debut in Goa as well as Punjab. Assembly elections will run through March in the most crucial State of Uttar Pradesh, hilly Northern State of Uttarakhand and the North-Eastern State of Manipur. Taken together, the five State assembly polls are also seen as a referendum on the Modi government’s demonetisation decision as well as its test in the electoral arena before the country goes to general polls in 2019. While BJP rules in Goa and is in power along with Shiromani Akali Dal in Punjab, its traditional rival Congress and the newbie AAP are making strong efforts to grab power in Punjab where 117 assembly seats went to polls. Deputy Election Commissioner Sandeep Saxena said that Rs 58 crore cash, 12.43 lakh litre liquor worth Rs 13.34 crore, 2,598 kg of drugs and narcotics were seized in Punjab. 

In Goa, which has 40 assembly seats, the BJP hopes to retain power though it has broken its alliance from Maharashtrawadi Gomantak Party (MGP).”

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Latest cancer data released by the World Health Organisation (WHO) suggests that 8.8 million people die from cancer, mostly in low and middle-income countries. One thing common in these deaths is that they are diagnosed too late when their chances of survival are slim. Even in countries with optimal health systems and services, many cancer cases are diagnosed at an advanced stage, when they are harder to treat successfully.

This year on World Cancer Day – observed every year on February 4, the WHO released new guidelines which aim to improve the chances of survival for people   living with cancer by ensuring that health services can focus on diagnosing and treating the disease earlier.
 Ã¢Â€ÂœDiagnosing cancer in late stages, and the inability to provide treatment, condemns many people to unnecessary suffering and early death,” says Dr Etienne Krug, Director of WHO’s Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention.
“By taking the steps to implement WHO’s new guidance, healthcare planners can improve early diagnosis of cancer and ensure prompt treatment, especially for breast, cervical and colorectal cancers. This will result in more people surviving cancer. It will also be less expensive to treat and cure cancer patients.”
All countries can take steps to improve early diagnosis of cancer, according to WHO’s new Guide to cancer early diagnosis. The three early steps to early diagnosis are improving awareness of different cancer symptoms and encouraging people to seek care when these arise; invest in strengthening and equipping health services and training health workers so that they can conduct accurate and timely diagnosis; and ensuring people living with cancer can access safe and effective treatment, including pain relief, without incurring prohibitive personal or financial hardships.
Challenges are clearly greater in low and middle-income countries, which have lower abilities to provide access to effective diagnostic services, including imaging, laboratory tests and pathology – all key to helping detect cancers and plan treatment. Countries also currently have different capacities to refer cancer patients to the appropriate level of care.  
Detecting cancer early also greatly reduces cancer’s financial impact: not only is the cost of treatment much less in cancer’s early stages, but people can also continue to work and support their families if they can access effective treatment in time. In 2010, the total annual economic cost of cancer through healthcare expenditure and loss of productivity was estimated at US$ 1.16 trillion.
Strategies to improve early diagnosis can be readily built into health systems at a low cost. In turn, effective early diagnosis can help detect cancer in patients at an earlier stage, enabling treatment that is generally more effective, less complex and less expensive. For example, studies in high-income countries have shown that treatment for cancer patients who have been diagnosed early are two to four times less expensive compared to treating people diagnosed with cancer at more advanced stages.  
 
Sustainable Development Goal (SDG) 3 aims to ensure healthy lives and promote well-being for all at all ages. Countries have agreed to a target of reducing premature deaths from cancers and other noncommunicable diseases (NCDs) by one-third by 2030. They also agreed to achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. At the same time, efforts to meet other SDG targets, such as improving environmental health and reducing social inequalities can also help reduce the cancer burden.
 
Cancer is now responsible for almost one in six deaths globally. More than 14 million people develop cancer every year, and this figure is projected to rise to over 21 million by 2030. Progress on strengthening early cancer diagnosis and providing basic treatment for all can help countries meet national targets tied to the SDGs.
 
Most people diagnosed with cancer live in low- and middle-income countries, where two thirds of cancer deaths occur. Less than 30% of low-income countries have generally accessible diagnosis and treatment services, and referral systems for suspected cancer are often unavailable resulting in delayed and fragmented care. The situation for pathology services was even more challenging: in 2015, approximately 35% of low-income countries reported that pathology services were generally available in the public sector, compared to more than 95% of high-income countries.
Comprehensive cancer control consists of prevention, early diagnosis and screening, treatment, palliative care, and survivorship care. All should be part of strong national cancer control plans. WHO has produced comprehensive cancer control guidance to help governments develop and implement such plans to protect people from the onset of cancer and to treat those needing care.
Cancers, along with diabetes, cardiovascular and chronic lung diseases, are also known as NCDs, which were responsible for 40 million (70%) of the world’s 56 million deaths in 2015. More than 40% of the people who died from a NCD were under 70 years of age.

Tobacco control is the cost-effective and evidence-based cancer prevention strategy. Over 20% cancer deaths are caused by tobacco use. Tobacco not only dangerously elevates lung cancer but also impacts 14 kinds of cancers and passive smoking kills 600,000 people annually. Tobacco is a leading common risk factor for major non-communicable diseases that will kill 38 million people annually with most deaths in low and middle income countries, says Anne Jones, senior tobacco control expert with the International Union Against TB and Lung Disease (The Union).

Figures compiled by Central Bureau of Health Intelligence suggest India had 11.48 lakh cases of cancer in 2016. This figure has shown a steady increase since 2012 when it was 10.57 lakh.

According to Dr. Navneet Singh, secretary of Indian Society for the Study of Lung Cancer, and Associate Professor at the Department of Pulmonary Medicine, PGIMER nearly 85% of lung cancer patients present themselves in Stage 3B and $ of the disease at the time of diagnosis. Cure at that point of time is not possible. He says lung cancer in developing countries is either declining or has plateaued but in India it is increasing with indoor pollution, and passive smoking being major reasons, particularly among women.”

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Inspired by US President Donald Trump’s decision to bar immigration from Muslim countries harbouring terrorists, Hindu youths have formed ‘Trump Sena’ to stop migration of Hindus from western Uttar Pradesh. ‘Trump Sena’ has also decided to support BJP in the state. To begin with, it started with a show of strength at BJP President Amit Shah’ rally on Friday today at Pilkhuwa, a town which falls under Dhaulana assembly seat in Hapur district from where BJP has fielded its four-time MP, Dr. Ramesh Chand Tomar. Hapur is barely 40 kms from the national Capital of Delhi. 

Incidentally, in his speech Amit Shah called as a strong President who has decided to fight directly all those supporting and harbouring terrorists mentioned. He said Prime Minister Narendra Modi was also a strong leader and he will take all steps to safeguard Hindus. He said this while raising the issue of migration of Hindus from western Uttar Pradesh.

Dhaulana seat has been in the news after BJP MP and firebrand Hindutva leader Yogi Adityanath said in his rally in the constituency a few days back that Hindus are being forced to migrate from western Uttar Pradesh which is likely to convert west UP into second Kashmir. Same day Election Commission ordered FIR against Dr. Ramesh Chand Tomar for allegedly inciting communal tensions after he said that “he will not let Dhaulana assembly seat turn into Maulana assembly seat”.

According to ‘Trump Sena’ volunteers: “Trump Sena has been formed to end atrocities being committed on Hindus in western UP. Hindus are being forced to leave their properties behind and migrate. We are inspired by what US President Donald Trump is doing. We also support Yogi Adityanath for giving a call to end migration of Hindus from western UP. We understand Dr. Ramesh Chand Tomar’s concerns how demography of assembly segments in western UP is being systematically changed to suppress Hindu community. Therefore Trump Sena has been formed to stop all this.”

“Trump Sena volunteers will pan out in entire state starting from western UP and assure Hindus that we are with them. Anyone getting threats from anyone to migrate can contact us. We will stand behind them and given them full protection. A lot of youths are joining us every day and soon we will become a formidable force and not let atrocities committed on Hindus. We will mobilize youths and also start campaign against ‘love jihad’,” volunteers said.

Trump Sena volunteers, in their justification, also said when Maulanas can issue fatwas to support Muslim candidates, we also can ask people to support BJP and Hindu candidates. When Hindus are being threatened, we have all the right to stand for them. Only BJP can come out in support of Hindus and therefore we are supporting its candidates. We will travel to all parts of Uttar Pradesh and seek votes for BJP, volunteers added.”

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India has revised its target for eliminating Kala-azar from 2015 to 2017. Elimination would mean bringing down the number of cases so that it no longer poses a threat to public health and keeping it low. The target is to eliminate Kala azar from all the blocks by the end of this year. India accounts for about 50% of the global Kala-azar burden with 4,632 cases reported till August last year. Bihar is home to over 77% of the national burden of Kala-azar, reporting 3,563 cases until August 2016. Bihar and Jharkhand together account for over 90% of Kala-azar cases in the country.

Visceral Leishmaniasis (VL) or Kala-azar (KA) as it is called in South Asia, is a relatively rare communicable disease, usually affecting the poorest, that is characterized by prolonged fever and debility, and that usually kills unless treated.

Other than the Indian subcontinent, it is also found in Brazil in South America, Ethiopia, Somalia, Sudan and South Sudan in Africa in sizeable numbers.  It is considered one of the neglected tropical diseases (NTDs), in the sense that for a long time, there was little attention paid to the disease, and it remained poorly understood and addressed. Ever since a global effort began to eliminate it since 2005, it is receiving more attention.

Kalaazar is caused by a tiny, one-celled parasite called Leishmaniadonovani- examples of similar parasites are malarial parasite and ameba. The parasite multiplies in the spleen, liver and bones of the affected person to large numbers and causes a steady deterioration in the health of the person. The parasite enters the body when a sand fly containing the parasite comes looking for a blood meal and bites a person.

The sand fly picks up the parasite from a person suffering from Kala azar, the parasite grows and multiplies inside the sand fly for more than a week, and then the parasites get accidentally injected into the blood of the next person who gets bitten. If left untreated, it usually kills the infected person. Even before killing, the disease causes    severe debility, loss of ability to work and malnutrition. It spreads slowly but silently from person to person, and even after years of efforts to control it, thousands of cases still occur every year in India. Since it is rare, people take a long time to realize that they may have Kala azar, and in the meanwhile they themselves suffer, and continue to spread the disease

The disease is regularly found in the Indian subcontinent in 54 districts in India, 11 districts (Zila) in Bangladesh and 16 districts in Nepal. In India 33 districts in Bihar, 4 districts in Jharkhand, 11districts in West Bengal, and 6 districts in Uttar Pradesh are consistently affected. Additionally, Bhutan has sporadic cases, and occasional cases turn up in different states of India, usually in people traveling out of the affected areas.

Kala azar symptoms include fever that does not respond to usual treatment for malaria, typhoid, viral infections for two weeks or more, enlargement of the abdomen due to the spleen and liver becoming large. It is associated with tiredness, loss of appetite and loss of weight; and darkening of the skin. The disease is seen more among people living in villages in kutcha homes, sleeping on the floor and living close to cattle. These often belong to the economically weaker and vulnerable sections of society.

The sandfly is often found in places that have heavy annual rainfall, a mean humidity of above70%, a temperature range of 15-38°C, abundant vegetation, high subsoil water and alluvial soil. It is found in dark, damp places. Treatment of Kala azar is free of cost in government facilities and Accredited Social Health Activists are given an incentive for identifying a patient, bringing him/her to the health facility and ensuring that the patient completes the course. This is important since there have been reports of patients developing resistance to Kala azar medicines which is becoming a serious. 

In addition to free treatment in Bihar, patients are given a compensation of Rs.6,600 to make up for the loss of wages they may have suffered because of their illness and associated expenses. This is provided from the Chief Minister’s Relief Fund.

The Government of India provides Rs 500 to every patient of Kala azar and Rs 2000 to every patient of Post Kala-azar Dermal Leishmaniasis (PKDL). This is a complication of the disease which primarily affects the skin that develops lesions—mostly small, pale lesions that do not itch or lose sensation. This results in cosmetic disfigurement. Though curable, it takes several years.

Certain kinds of skin lesions of PKDL contain a large number of parasites, and thus these cases are likely to be source of spread of the disease.

Researchers Piero L. Olliaro, Tushar A.K.M. Shamsuzzaman, Baburam Marasini, A.C.Dhariwal and others in a latest scientific paper “Investments in Research and Surveillance Are Needed to Go Beyond Elimination and Stop Transmission of Leishmania in the Indian Subcontinent,’’  have said that to maintain this target and stop transmission, it is necessary to re-evaluate whether the appropriate interventions are in place for surveillance, diagnosis, treatment, and vector control. In particular, it is important to decide whether current approaches should be reconsidered and whether new or modified interventions are required.

“”The current strategy in the Indian subcontinent is built around the early detection of symptomatic cases so that morbidity and mortality can be reduced and the source of infection is removed from the community,”” the paper points out.

Regardless of what treatments are available now and in the future, the paper says, perhaps the most important consideration is to ensure that treatments and diagnostic tests are available at all of the Primary Health Centres in endemic communities. This will require a greater number of PHCs with sufficient expertise to deliver the first-line treatment. Access to treatment locally, combined with increased knowledge in the community, will reduce the time from symptoms to treatment and, consequently, reduce the rate of transmission. This can be achieved immediately with the necessary commitment.

Finally, a vaccine to stop transmission would represent the best intervention. People who are cured of visceral leishmaniasis following treatment are immune against re-infection for life, which implies that a vaccine for leishmaniasis is possible. Due to the relatively low numbers of cases and high population, it would be necessary in the first instance to combine a vaccination programme with the elimination programme to deploy the vaccine in highly endemic areas and areas with new outbreaks during the maintenance phase. Any vaccine would need to be effective on both immunologically naive people and asymptomatic infected people if it is to be deployed in highly endemic areas, the paper says.”

“Former Chief Minister J. Jayalalithaa’s confident and `soul sister’, V K Sasikala was unanimously elected by the AIADMK MLAs as the legislature party leader, clearing her way to take over as new Chief Minister of Tamil Nadu. After Janaki Ramachandran and J Jayalalithaa, Sasikala would be third woman Chief Minister of Tamil Nadu which has been ruled for the past several years alternatively by AIADMK and DMK.Sasikala’s name to head the AIADMK legislature party was proposed by the Chief Minister O. Panneerselvam. She is likely to take over on February 9. Mr. Panneerselvam could become the number two as deputy chief minister in the Sasikala cabinet, reports emanating from Chennai said. The AIADMK legislature party’s official communication has to be handed over to Raj Bhavan as well as the resignation letter of Panneerselvam who earlier also remained a stop-gap chief minister when Jayalalithaa had been lodged in a prison in a corruption case. Sasikala took over the party as the General Secretary on December 29 last following her unanimous selection in the party general body meeting. Many AIADMK leaders had been urging Sasikala to become chief minister as well. Sasikala had been constant companion of former chief minister Jayalalithaa since mid-80s barring a brief period when she had fallen out.  It was Sasikala who remained with Jayalalithaa when she was hospitalised last year and till she died on December 5 last year. She performed her last rites as well. The main opposition leader in the state Assembly and arch rival DMK working president MK Stalin said the elevation of Sasikala will not gel with the people as she does not represent the popular choice. Sasikala, 61, is not an elected member of the assembly and had never held any post in the party. She is fondly called Chinamma (mother’s younger sister) by AIADMK supporters.”

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The World Health Organization (WHO) has congratulated India for launching one of the world’s largest vaccination campaign against measles, a major childhood killer disease, and congenital rubella syndrome (CRS), responsible for irreversible birth defects. The campaign launched today to vaccinate more than 35 million children in the age group of nine months to 15 years with MR (measles and rubella) vaccine, once again demonstrates India’s commitment to improve health and well-being of its people by protecting children against vaccine preventable diseases, a statement issued here said. The first phase of the campaign is significant as it is expected to accelerate the country’s efforts to eliminate measles which affects an estimated 2.5 million children every year, killing nearly 49 000 of them. The campaign also marks the introduction of rubella vaccine in India’s childhood immunization programme to address CRS which causes birth defects such as irreversible deafness and blindness in nearly 40 000 children every year. India has made important efforts and gains against measles in recent years. Measles deaths have declined by 51% from an estimated 100 000 in the year 2000 to 49 000 in 2015.

This has been possible by significantly increasing the reach of the first dose of measles vaccine, given at the age of nine months under routine immunization programme, from 56% in 2000 to 87% in 2015. In 2010 India introduced the second dose of measles-containing vaccine in routine immunization programme to close the immunity gap and accelerate measles elimination. Nearly 118 million children aged nine months to 10 years were vaccinated during mass measles vaccination campaigns between 2010 and 2013 in select states of India. Simultaneously, India continues to further strengthen surveillance for measles and rubella, an important learning from India’s polio eradication programme that helped to identify infected and vulnerable areas and populations and enabled the programme adopt appropriate strategies to eradicate the disease.

India has already beaten smallpox, polio, maternal and neonatal tetanus and, very recently, yaws. Further gains in the battle against measles will help achieve a number of other public health priorities, the statement added.The campaign was formally launched at a function in Bengaluru and will extend to Karnataka, Tamil Nadu, Puducherry, Goa and Lakshadweep covering 35 million children. Following the campaign, MRV will be introduced in routine immunization, replacing the currently given two doses of measles vaccines, at 9-12 months and 16-24 months.The MR campaign targets 410 million children across the country, the largest ever in any country , covering all children aged between 9 months and less than 15 years of age with a single shot of MR vaccination irrespective of their previous measles/rubella status.The vaccine will be provided free of cost across the States from session at schools as well as health facilities and outreach session sites. Measles vaccine is currently provided under Universal Immunisation Programme (UIP). However, rubella vaccine will be a new addition. Measles is a deadly disease and one of the important causes of death in children.

It is highly contagious and spreads through coughing and sneezing of an infected person. Measles can make a child vulnerable of life threatening complications such as pneumonia, diarrhea and brain infection. Globally in 2015, measleas killed 1.34 lakh children mostly under-five years, killing 49,000. Rubella is generally a mild infection, but has serious consequences if infection occurs in pregnant women, causing congential rubella syndrome (CRS) which is a cause of public health concern. The CRS is characterized by congential anomalies in the foetus and newborns affecting the eyes, ears, brain and heart defects, causing a huge socio-economic burden on the families in particular and society in general.”