OPINION56 Allotting OBC Quota in Medical Seems a Commendable Step

YOUNGSTERS RESOLVE TO ENSURE OPTIMISTIC WORLD AFTER PANDEMIC

Youngsters across the globe often stay optimistic that an inclusive and, resilient recovery from the COVID-19 pandemic is possible. They are assisting in developing solutions to ensure communities free from the pandemic stronger than before. The deadly Coronavirus may have taken the most serious physical toll on older people, but it’s the younger generations that have faced the burden of the pandemic worldwide. The WHO Director General, Dr Tedros Adhanom Ghebreyesus, said that the younger generations were less at risk of severe disease and death from COVID-19 but would be the most affected by the long-term consequences of the pandemic. It would shape the world they lived and worked in for decades to come, he added.

The social distancing and stay-at-home policies have interrupted youth education, made it difficult to hold or find employment, and led to growth in mental health conditions. A large chunk of children are not progressing in school, with 101 million falling behind on reading proficiency in 2020, intimidating an educational gain of almost 20 years. In the same year, global adult employment reduced by 3.7 per cent, while youth employment refused by 8.7 per cent. The unemployment figures for young women are even bleaker, and they face additional, unique challenges, including increased vulnerability to domestic violence and child marriage.

In spite of these problematic trends, youngsters have also been an energetic force at the forefront of growing creative solutions to an inclusive, sustainable pandemic recovery. Noticing these efforts, the WHO started working on putting together younger generations into its work and policies. The Director-General’s Senior Adviser on Gender and Youth, Diah Saminarsih is leading this program. Since 2018, she has been answerable for exploring the way WHO can better serve young people, and how they, in turn, can contribute to the mission of the Organization. She says, “I would like the youngsters to have a role in every possible element that exists: advocacy, policymaking, research and science, sexual and reproductive health, gender — across every possible angle”.

Saminarsih points out that youth initiatives are often narrowly focused on a homogeneous definition of the demographic or on single issues such as unemployment. She would like the approach of WHO to be more holistic and inclusive, positioning young people as equal partners to better enable a ‘transfer of wisdom’ within the Organization. During the pandemic, she and her team began putting this vision to the test by developing and launching the WHO Youth Council. Various departments of WHO have youth-focused plans, the Council serves as an umbrella in a view to house them all. It brings together young people from both health and nonhealth backgrounds to provide guidance to the Director-General on issues that affect and matter to them. Members of the Council will meet several times a year, with their work culminating in a WHO Youth Engagement Strategy.

She emphasized that the pandemic had shown them that young people were much resilient.

On the other hands, with the launch of the Youth Council, the WHO announced creation of Global Youth Mobilization (GYM), a step to invest in and replicate youth solutions to the COVID-19 pandemic. In partnership with the UN Foundation and the Big 6 Youth Organizations — which alone engage more than 250 million young people — and with support from the COVID-19 Solidarity Response Fund, the movement convened a Global Youth Summit in April 2021 to reflect on the pandemic from a youth lens.

Dr Tedros said, “Joining forces with the Big 6 and the UNF provides WHO and the world a unique opportunity to learn from hundreds of millions of young people and be guided by their sustainable solutions to help communities build back better from the pandemic”. The three-day event brought together young people as well as policymakers from over 150 countries to discuss their experiences and proposed solutions to multiple issues, among them disrupted formal and informal education, the glaring inequalities that the pandemic has exposed, physical and mental well-being, and how to enter a changing labor market.

For Global Youth Mobilization board member Tharindra Arumapperuma, what made the conversations and solutions at the summit stand out was that they were specific to local contexts.

FRESH ENTRANTS PRESSED FOR SOLIDARITY CLINICAL TRIAL BY WHO

While pronouncing the next phase in its Solidarity trial, the World Health Organization (WHO) has said that Solidarity PLUS will enroll hospitalized patients to test three new drugs in hospitalized COVID-19 patients. These therapies - artesunate, imatinib and infliximab – were selected by an independent expert panel for their potential in minimizing the risk of death in hospitalized COVID-19 patients. They are already used for other indications: artesunate is used for severe malaria, imatinib for certain cancers, and infliximab for diseases of the immune system such as Crohn’s Disease and rheumatoid arthritis.

These drugs were donated for the trial by their manufacturers. The WHO DirectorGeneral, Dr Tedros Adhanom Ghebreyesus, said, “Getting more efficient and reachable therapeutics for COVID-19 patients’ remains a serious requirement and WHO is proud to lead this global effort. I would like to thank the participating governments, pharmaceutical companies, hospitals, clinicians and patients, who have come together to do this in true global solidarity”. The Solidarity PLUS trial is a platform trial that represents the largest global collaboration among WHO Member States. It involves thousands of researchers in over 600 hospitals in 52 countries, 16 more countries than the first phase of trials. This allows the trial to assess multiple treatments at the same time using a single protocol, recruiting thousands of patients to generate robust estimates on the effect a drug may have on mortality--even moderate effects. It also allows new treatments to be added and ineffective treatments to be dropped throughout the course of the trial. Earlier, four drugs were evaluated by the trial.

The results showed that remdesivir, hydroxychloroquine, lopinavir and interferon had little or no effect on hospitalized patients with COVID-19. Through the Solidarity PLUS trial, researchers across the world have an opportunity to use their expertise and resources to contribute to global COVID-19 research. Produced by Ipca, is used to treat malaria. In the trial, it will be administered intravenously for 7 days, using the standard dose recommended for the treatment of severe malaria. Artesunate is a derivative of artemisinin, an antimalarial drug extracted from the herb Artemisia annua. Artemisinin and its derivatives have been extensively used in the treatment of malaria and other parasitic diseases for over 30 years, and are regarded as being very safe.

The WHO COVID-19 Therapeutics Advisory Group recommended evaluating the anti-inflammatory properties of artesunate. Produced by Novartis, is used to treat certain cancers. In the trial, it will be administered orally, once daily, for 14 days. The dose used is the standard maintenance dose, which is at the lower end of the dose patients with haematological malignancies are given over extended periods. Imatinib is a small molecule tyrosine kinase inhibitor, formulated as an oral chemotherapy drug used to treat certain types of cancer. Experimental and early clinical data suggest that imatinib reverses pulmonary capillary leak. A randomized clinical trial performed in the Netherlands reported that imatinib might confer clinical benefit in hospitalized COVID-19 patients, in the absence of safety issues. Produced by Johnson and Johnson, is used to treat diseases of the immune system. In the trial, it will be administered intravenously as a single dose. The dose used is the standard dose that patients with Crohn’s Disease are given over extended periods. Infliximab is a TNF alpha inhibitor, a chimeric monoclonal antibody that recognizes human TNF alpha. Anti-TNF biologics have been approved for treatment of certain autoimmune inflammatory conditions for more than 20 years, demonstrating favourable efficacy and safety in restricting broad spectrum inflammation, including in elderly populations who are most clinically vulnerable to COVID-19.

The results showed that remdesivir, hydroxychloroquine, lopinavir and interferon had little or no effect on hospitalized patients with COVID-19.

LAND OF AYURVEDA MUST MAINTAIN ITS DIGNITY

India’s medical science has wide history in the world. The country is often termed as the land of Ayurveda. This is the ancient system of natural, personalized and holistic medicine. Our country is the home to two of the most famous medical treatises ever written. Both the Charakasamhita by the physician Charaka, and Sushruta-samhita, authored by the father of plastic surgery, Sushruta, dating back to 800 BCE to 1000 CE, has their origin in Ayurveda. The 3,000-year-old science has gained immense popularity worldwide for its holistic approach to health and well-being. The modern medicine - still a nascent science in the country, has contributed immensely to patient care and public health. The average life expectancy of infant mortality rate (IMR), and maternal mortality rate (MMR) in the country have all improved significantly. We have stemmed the rampant growth of TB, Hepatitis, HIV, and other deadly diseases, while providing timely intervention care in curing others such as Cancer.

India’s Universal Immunization Program is renowned as one of the largest public health interventions in the world, successfully bringing under control many communicable diseases including small-pox and polio. The modern medical fraternity in India has consistently raised the bar on research and innovation, aided by technological advancements in the last two decades.

Multi-specialty hospitals across the country are offering the very best in diagnosis, advanced intervention facilities and care options. With our skilled doctor base and low-cost treatment availability, India is fast emerging as a global health and wellness tourism destination, accounting for nearly 18 per cent of the global medical tourism market. India’s healthcare industry is projected to grow into a USD 9 billion market over the course of the next year. In recent decades, the growing popularity of Ayurveda has provided an impetus to the wellness tourism sector in India, attracting a large global population. Ayurveda is projected to be a INR 30,000 crore industry in India. In fact, earlier this month, the WHO announced that it will set up a Global Centre for Traditional Medicine in India. It poses many unanswered questions and unforeseen threats to both streams of medicine. Let’s Most Allopathic medicines are chemicals or organic compounds produced in the laboratory and some are biologically engineered to help cure and prevent diseases and provide symptomatic relief – going against the very essence of Ayurveda. The foundational principles of diagnosis, treatment planning and execution in Ayurveda are diametrically different from that of modern medicine. The strength of Ayurveda lies in its ability to customize preventative, naturally aided, holistic wellness methods to the unique constitution of every individual, based on their energy type. This has proven extremely impactful in the treatment of chronic ailments. Modern medicine, on the other hand, has provided great relief in acute, immediate care. Ayurvedic experts and post-graduate students can and must perform surgeries, considering the very origin of surgical procedures can be traced back to Ayurveda. But the approach must include rigorous exposure to surgical procedures based purely on ayurvedic principles and philosophies. Towards this goal, the government must further research in Ayurveda across physiology, pathology, pharmacology and pharmaceuticals and elevate its status further to an evidence backed science, encouraging empirical validation of Ayurvedic concepts.

Both Ayurveda and Allopathy have their unique strengths and advantages. The proposed move will greatly dilute the foundational essence and true curative capabilities both streams of medicine can offer to mankind. In fact, it may completely erode the significance of Ayurvedic philosophy in the long run while also undermining the effort of Allopathic students and professionals in advancing patient care. Not to speak of the economic consequences on healthcare and tourism. The need of the hour is to invest deeper and faster into research and development, technology, and facilities in both streams of medicine. In order encourage independent progress and retain the authenticity of both approaches to medical care, while facilitating sharing of knowledge, empirical evidence, diagnostic learnings, research information and even infrastructure facilities between the two streams for mutual growth and advancement. Towards this end, the authorities can consider introducing super specialization programs that will certify medical professionals to offer an integrated, holistic approach to healthcare. India has the ubiquitous distinction of nurturing and furthering two parallel, extremely rich, expansive, and highly evolved streams of medicine.

India’s Universal Immunization Program is renowned as one of the largest public health interventions in the world, successfully bringing under control many communicable diseases including small-pox and polio. The modern medical fraternity in India has consistently raised the bar on research and innovation, aided by technological advancements in the last two decades