Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                             Dated:10th August,2019

Key medical devices for primary health care
The Pan American Health Organization (PAHO) has published the updated version of theList of Priority Medical Devices for the first level of care. This aims to help countries in the Region of the Americas prioritize critical devices and respond effectively to the main health issues faced by their population. Thedevices range fromclothing and personal protective equipment for health workers, to instruments, supplies, solutions, reagents, medical gasses and furniture. It also includes medical equipment such as infant scales, stethoscopes and vital signs monitors.

The list, which was updated in July, now includes supplementary lists for dental care, laboratory practices and diagnostic imaging, according to the various treatments offered by primary health care centers and depending on the organization of services in each country. The total number of medical devices on the list now reaches 337, of which 208 belong to the core list, 69 in the module for dental care, 30 in the module for diagnostic imaging and 30 for the laboratory practices module.

“This list serves as a reference for country health authorities to select devices according to the needs of their populations,” said Analía Porrás. Head of the Medicines and Health Technologies Unit at PAHO/WHO. “The list also aims to promote the rational use of these technologies in order to ensure the efficient use of resources,” she added.

The list can be accessed at:https://www.paho.org/hq/index.php?option=com_docman&view=download&slug=list-of-priority-medical-devices-for-the-first-level-of-care-main-list-paho-july-2019&Itemid=270&lang=en… (PAHO, Aug. 6, 2019)

With NMC taking over it may be time to revise MCI Code of Ethics(Part 1)
The President has given his assent to the NMC Bill and with this the stage is set for formation of a National Medical Commission (NMC) to replace the Medical Council of India (MCI).

With NMC now taking over, it may be time to revise the MCI Code of Ethics Regulations.

Here are American Medical Association Principles of Medical Ethics (1957) .

These principles are intended to aid physicians individually and collectively in maintaining a high level of ethical conduct. They are not laws but standards by which a physician may determine the propriety of his conduct in his relationship with patients, with colleagues, with members of allied professions, and with the public.....read more

FAQs on National Medical Commission (NMC) Bill 2019 (Part 3)
NMC to ensure due weightage to theoretical and clinical skill sets

“Clause 15: NEXT Exam

Medical Education (ME) is a specialized area with high focus on technical skill sets. A common final year undergraduate examination (NEXT) with common standards of knowledge and skills for Doctors on a Nation-wide basis.

An enabling provision has been made to ensure common standards. Regulations for operationalizing the NEXT would be made in due course keeping in mind importance of both theoretical as well as clinical skill sets required at the level of UG....read more

Healthcare News Monitor

Bombay HC strikes down plea against online drug sales
ET Healthworld- Rupali Mukherjee

The Bombay high court has struck down a public interest litigation (PIL) challenging online sale of medicines. The PIL was filed against the Union government and e-pharmacies. The HC noted that guidelines to regulate such entities would be announced soon and, hence, they would “comply with substantive laws”. The petition had said certain categories of drugs (schedules H and X) cannot be sold without a prescription, that is, only through physical stores. In other words, the case challenged e-pharmacies where these critical medicines can be ordered online even without prescription in certain towns and cities. (Schedule H drugs include key antibiotics, and schedule X drugs are related to opioid and psychotropic substances — both categories cannot be sold without the prescription of a registered medical practitioner). This comes after a similar petition against e-pharmacies was withdrawn in the Calcutta high court in March, while the Patna high court in July questioned the government on delay in finalising guidelines for e-pharma companies. The deadline for amendments to the Drugs and Cosmetics Rules, 1945, which would regulate e-pharmacies, was July 31. With the government yet to notify the guidelines, e-pharma companies continue to face an uncertain regulatory climate, and mounting court cases. In its reply, the government said the final notification on e-pharmacies is likely to be issued within four months. Retail trade channels under All-India Organisation of Chemists and Druggists have been opposing e-pharmacies because of discounting as a standard practice by online players. On an average, most e-pharmacies offer a 15-20% discount on each order, while there is no such fixed practice among chemists and stockists, or they may offer up to 10% off on orders of a certain amount.

Ministry of Health's public consultation on National Digital Health Blueprint: Legal issues around telemedicine, consent, and 'egosystems' in healthcare
Medianama - Trisha Jalan

“The patient should be centric to every intervention,” declared Preeti Sudan, special secretary at the Ministry of Health, at the ministry’s public consultation on the National Digital Health Blueprint 2019, held at the Constitution Club of India in New Delhi on August 6. The venue was packed with representatives from the government, major hospitals chains, health start-ups, associations, and civil society organisations. The blueprint — which is an evolved document of the National Health Stack 2018 (NHS) — was put in the public domain on July 15, and comments were closed on August 4. After holding consultation on the NHS, the ministry formed a committee under the chairmanship of former UIDAI head and former MeitY secretary J. Satyanarayana to create an implementation document for the NHS. Health is a complex and interwoven subject, and deals with people’s lives, said Sudan. “The patient should be centric to every intervention,” she said. Clearly stated during the discussion was that private sector participation is important and necessary. Sudan opened the consultation by mentioning that the ministry is in the process of forming the e-pharmacy rules, “we’ve had extensive consultations on it”.

Not Withholding Payments To Patients Who Want More, Johnson And Johnson Tells High Court

Johnson and Johnson on Thursday told the Delhi High Court that it was not withholding payment to those patients who underwent revision surgeries for alleged faulty hip implants made by the company and want more than the interim compensation of Rs. 25 lakh. The submission by the company came in response to a query by Justice Vibhu Bakhru as to what was it doing in cases where patients want more than the Rs. 25 lakh. "We are paying everyone," Johnson and Johnson told the court. However, the central government told the court that the company till date has paid the interim compensation to only 67 patients out of the over 4,700 persons who received the faulty articular surface replacements (ASR) hip implants. The government's contention was opposed by the company which said it had paid more people than just 67 and told the court that it will provide a list of the patients who have been given the interim compensation. The government also claimed that the company appeared unwilling to track down the patients mentioned in the list of persons who received the ASR hip implants. The court had on May 30 asked the company to pay the interim compensation to 67 patients after the Johnson and Johnson said it has verified that they had undergone revision surgery and it was voluntarily paying them Rs. 25 lakh. The court was hearing the company's plea challenging a Health Ministry press release asking it to pay compensation to all the affected patients, as determined by the reports of the Committees formed to examine issues relating to its faulty hip implants.

Indian firm develops test to detect drug-resistant TB mutation
ET Healthworld- IANS

Genetic diagnostic and drug discovery research firm MedGeneome Labs on Thursday claimed to have developed the first whole genomic sequencing-based test to detect drug-resistant mutation in tuberculosis (TB) bacteria. "The breakthrough DNA test will enable a doctor to correctly prescribe the most effective drug to a TB patient without a time-consuming trial and error process," said the city-based clinical data-driven Labs. Announcing its foray into infectious disease testing in TB, central nervous system (CNS), systemic and eye infections, the company said India had the largest number of multi-drug resistant (MDR) TB cases. "India has the largest number of MDR-TB cases. Our spit sequence can be a boon for TB patients, clinicians and healthcare agencies to achieve the sustainable development goal of eliminating TB by 2025," Labs Chief Operating Officer V.L. Ramprasad told reporters here. "The test is based on the whole genome sequencing of mycobacterium tuberculosis (MTB), the TB causing bacteria, to assess the mutations in bacteria's genome and allows a clinician to determine which drug will work for a patient," he said.

Govt aims to set up NMC in six months to tackle graft, quackery
Mint - Neetu Chandra Sharma

The Centre will set up the National Medical Commission (NMC) within six months, Union minister of health and family welfare Harsh Vardhan said on Thursday. President Ram Nath Kovind gave assent to the NMC Bill 2019 on Thursday. The government said that the NMC Act 2019 is a progressive legislation, which will reduce the burden on students, ensure probity in medical education, bring down costs of medical education, simplify procedures, help enhance the number of medical seats in India, ensure quality education, and provide wider access to people for quality healthcare. “In a bid to deal with quacks in the country, the punishment for quackery under the Act has been enhanced by up to one year imprisonment and up to ?5 lakh fine. NMC will be an overarching body, which will frame policies and coordinate the activities of four autonomous boards. These boards will look after the work of undergraduate (UG) and postgraduate (PG) education, medical assessment and rating; and ethics and medical registration," said Harsh Vardhan. “One of the mandates of NMC is to look at the cost of medical education. It also provides for a common entrance test for MBBS (NEET), along with common counselling process for all medical institutions in the country. This provision will prevent seat blocking in parallel counselling processes and will eliminate the need for students to approach multiple colleges and take part in multiple counselling sessions for admission. This will save students and their families from unnecessary physical and financial trauma," he added.