Medical education reforms, vaping ban highlights of health ministry in 2019

The enactment of two key legislations, one aimed at ushering in mega reforms in the medical education sector and the other banning e-cigarettes were the major highlights of the Health Ministry in the outgoing year.

In a huge step towards boosting the availability of human resources for the health sector, the ministry in 2019 initiated the process of converting 75 district hospitals into medical colleges by 2021-22 in under-served districts of the country that do not have any medical colleges.

Once completed, it would lead to the creation of 15,700 more MBBS seats in India.

The National Medical Commission Act substituted the nearly 63-year-old Indian Medical Council Act to replace the existing scam-tainted apex medical education regulator Medical Council of India (MCI) with a new body to bring in probity, quality education and bring down costs of medical education. It received the assent of the President on August 8 and was published the same day.

Once the NMC comes into being, the Medical Council of India will automatically get abolished. The President dissolved the MCI in 2018 and a Board of Governors was appointed to perform its functions.

The Prohibition of Electronic Cigarettes Act, 2019 was notified on December 6 making the production, import, export, transport, sale or advertisements of such "alternative" smoking devices a cognisable offence attracting jail term and fine.

On the flip side, the ministry could not bring in the much-sought central legislation to check assault on doctors and other medical professionals with the home ministry opposing it holding there cannot be a separate law to protect members of a particular profession.

However, the health ministry decided to pursue the proposed legislation in the backdrop of rising instances of attacks on medicos.

The year also saw the ministry launching the 'Intensified Mission Indradhanush 2.0' in October with a special focus on improving coverage in areas with "low" immunisation.

Also, the Rotavirus vaccine (RVV) introduced in India in March 2016 in 11 states (Andhra Pradesh, Haryana, Himachal Pradesh, Jharkhand, Odisha, Assam, Tripura, Rajasthan, Tamil Nadu, Madhya Pradesh and Uttar Pradesh), to reduce mortality and morbidity caused by Rotavirus diarrhoea was expanded to the remaining states and union territories, thus covering the entire nation.

The report of Sample Registration System (SRS) released in November by the Registrar General of India (RGI) showed that Maternal Mortality Ratio (MMR) of India declined from 130 in SRS 2014-16 to 122 per 100,000 live births in 2015-17.

Another highlight was the launch of the Surakshit Matritva Aashwasan (SUMAN) initiative on October 10. It is a comprehensive multi-pronged and coordinated policy approach with an aim to assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every women and newborn visiting public health facilities in order to end all preventable maternal and newborn deaths and morbidities and provide positive birthing experience.

In a major step towards providing affordable healthcare in India, the ministry in 2018 launched the Ayushman Bharat programme.

Till December 18, more than 69 lakh people have availed treatment across India under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) that aims to cover over 10 crore poor and vulnerable families (approx. 50 crore beneficiaries) providing coverage up to Rs 5 lakh per family per year for secondary and tertiary hospitalisation.

Also, under the Ayushman Bharat programme, nearly 1.5 lakh sub-centres and primary health centres will be transformed as health and wellness centres by 2022 to provide comprehensive and quality primary care close to the community while ensuring the principles of equity, affordability and universality.

Approvals for more than 60,000 Ayushman Bharat health and wellness centres have been accorded to the states/UTs (except Delhi) and 26,743 such centres are in operation till December 23.

Till September, more than 1.22 crores screened for oral cancer, more than 49.79 lakh women have been screened for cervical cancer and more than 82.45 lakh were screened for breast cancer.

Around 90,91,903 beneficiaries availed treatment for hypertension and 45,28,307 beneficiaries availed treatment for Diabetes at these AB-HWCs.

As on November 27, total of 3,65,420 Yoga sessions have been conducted in operational HWCs.

Govt puts Bill to ban e-cigarettes in public domain, invites comments

The Union Health Ministry has put the draft of the bill, that will replace the ordinance issued last month to ban e-cigarettes, in public domain for eliciting views of public.

The ministry intends to introduce the Bill in the forthcoming session of Parliament. The entire Bill has been shared on the ministry's website for public feedback.

"The Government of India promulgated an ordinance namely Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Bill, 2019 on September 18.

"The said Bill is placed in Public domain as part of pre-legislative consultations with a view to elicit the comments/views of public. The comments should be specific and focused in the provisions of the Bill," the ministry said in its note attached to the Bill.

When the government brings an ordinance, it has to replace it with a Bill in the next session of Parliament.

On September 18, the government had issued an ordinance to ban e-cigarettes, making the manufacturing, production, import, export, distribution, transport, sale, storage or advertisements of such alternative smoking devices a cognizable offence, attracting jail term and fine.

First time violators will face a jail term of up to one year and a fine of Rs 1 lakh. For subsequent offences, a jail term of up to three years or a fine of Rs 5 lakh or both according to the ordinance.

The storage of e-cigarettes shall now be punishable with imprisonment of up to six months or a fine of up to Rs 50,000 or both, it said.

Govt's e-cigarette ban faces first legal challenge in Kolkata court

The ban on electronic cigarettes has been challenged in a court in Kolkata, marking the start of the first legal battle against the anti-vaping decision.

The government banned the sale, import and manufacture of e-cigarettes this month and warned of an “epidemic” among young people. The move could dash the expansion plans of companies such as Juul Labs and Philip Morris International in the country. Two separate challenges have been filed to the high court in Kolkata, by e-cigarette importer Plume Vapour and another company named Woke Vapours, according to court listing records publicly available online.

A senior health ministry official in New Delhi said the government had been notified of the cases, which were heard by the court on Thursday and will next be heard on Monday. “We are confident of defending our decision,” the official added. Further details about the challenges were not immediately available.

More than 900,000 people die each year due to tobacco-related illnesses in India, home to about 1.3 billion people. The government argues the e-cigarette ban is essential to protect people, especially young people, saying vaping can lead to nicotine addiction and push users towards consuming tobacco. Pro-vaping groups, however, say vaping is less harmful than smoking tobacco. “The ban raises questions of constitutional law and is mindless, arbitrary and excessive,” said Abhishek Manu Singhvi, one of the most prominent lawyers, who is representing Plume Vapour.

Govt issues ordinance to ban e-cigarettes; jail term, fine for violations

The Government on Thursday issued an ordinance to ban e-cigarettes, making the production, import, export, transport, sale or advertisements of such "alternative" smoking devices a cognizable offence attracting jail term and fine.

First time violators will face a jail term of up to one year and a fine of Rs 1 lakh. For subsequent offences, a jail term of up to three years or a fine of Rs 5 lakh, or both according to the ordinance.

The storage of e-cigarettes shall now be punishable with imprisonment of up to six months or a fine of up to Rs 50,000 or both.

The Union Cabinet on Wednesday decided to ban production, import, distribution and sale of electronic cigarettes, Finance Minister Nirmala Sitharaman said.

Sitharaman, who had headed a Group of Ministers (GoM) on the issue, said the Cabinet decided to ban e-cigarettes and similar products as they pose health risk to people, especially the youth.

The ordinance also allows authorised officials to conduct searches in premises stating that where such searches are not permissible, authorities may attach properties, stocks of e-cigarettes or records maintained by the manufacturer, producer exporter, transporter, importer, stockist against whom a complaint has been made.

It also said that that the owner or occupier of the place which stock of e-cigarettes shall voluntarily prepare a list of such stock in his possession and without delay submit the stock to the nearest authorised officer.

However, e-cigarettes promoting trade bodies, users and other stakeholders slammed the government's move to ban "alternative" smoking device through the ordinance route, alleging it was a "draconian" step taken in haste to protect the conventional cigarette industry.

Association of Vapers India (AVI), an organisation representing e-cigarette users, also alleged that it is a black day for 11 crore smokers in India who have been deprived of safer options.

Asserting that the decision was taken, keeping in mind their impact on the youth of today, Sitharaman on Wednesday quoted data, which she claimed was largely derived from the US' experience, to highlight that there has been a 77.8 per cent increase in the use of e-cigarettes among school students and that surprisingly, use of such products by middle school students has also seen a rise of 48.5 per cent.

Many science-based journals have already said that nearly 3 million people in US are regular users of e-cigarettes and in a matter of four to five years, between 2011 and 2015-16, there has been over 900 per cent growth in e-cigarettes in US, she said.

Govt bans e-cigarettes amid global concern over health risks

India became the latest country to ban electronic cigarettes as concern grows worldwide over health risks associated with the smokeless nicotine devices popular with teenagers.

The government will ban the production and sales of e-cigarettes, it announced after a cabinet meeting Wednesday.

Originally touted as a safer alternative to wean people off cigarettes, the e-cigarettes have come under widespread attack in America, especially for its appeal among young people. India’s decision shows that the industry is coming under scrutiny in other countries too, after the recent outbreak of a mysterious lung disease linked to vaping that has killed six people in the U.S. and afflicted hundreds of others.

E-cigarettes allow users to satisfy their cravings by inhaling vaporized nicotine rather than tobacco smoke. Their popularity has soared in recent years driven by candy-like flavorings, sleek devices and savvy marketing. The U.S. Surgeon General called it an “epidemic,” after the government found as many as 5 million American kids said they’ve vaped this year.