Global Measles Mortality: India Accounts for 47 Percent of Worldwide Deaths

Measles is a highly infectious and potentially dangerous illness which spreads very easily. Whether you stay in the United Kingdom or travel abroad it is crucial that individuals who may be at risk are fully immunized.

Reports of measles go back to at least 600 BC. In 1954, the virus causing the disease was isolated, and licensed vaccines to prevent the disease became available in 1963. Humans are the only known natural hosts of measles.

In the 1990s, experts thought they were close to eliminating measles for good. But now the World Health Organization (WHO) has put back its target date for getting rid of the disease to 2015. But even that seems unlikely.

The reason? A measles outbreak which is spreading across Europe, affecting France, Belgium, Germany and Romania - and now the United Kingdom.

According to the WHO, other significant outbreaks are taking place in Serbia, Spain, Macedonia and Turkey. Over the last few months, the Health Protection Agency has seen an increase in measles cases in children and young adults in England and Wales. Their figures show that between January and April, 275 laboratory-confirmed cases of measles were reported, compared to 33 cases for the same period the previous year.

Africa and India accounted for a combined total 79 per cent of all deaths from measles between 2000 and 2010. Anthony Lake - the executive director of the United Nations children's organization UNICEF, which is also part of the Measles and Rubella Initiative - said there were still 382 deaths from measles every day.

India Faces Alarming Situation

Delayed implementation of accelerated disease control in India has led the country to account for 47 per cent of estimated measles mortality in 2010. At 36 per cent, even the WHO African region accounted for lesser mortality than India. Although India achieved 26 per cent reduction in measles mortality between 2000 and 2010, its contribution to the percentage of global measles deaths increased from 16 per cent in 2000 to 26 per cent in 2010.

Except for the Southeast Asia WHO region, all the other WHO regions recorded a reduction in mortality by more than three-quarters during 2000-2010. Even in the case of WHO Southeast Asia region, except for India, the other countries in the region had reported a reduction.

Africa is a study in contrast. The mortality reduction during the same period, 2000-2010, was 85 per cent. The effect of this decline gets reflected in the continent's contribution to the global measles deaths — 63 per cent in 2000 to 36 per cent in 2010.

According to the Federal Health Ministry, India has introduced the second dose of measles vaccine in 2010. "India started giving a second dose of vaccine to children through routine immunization in 21 better performing states where coverage for measles vaccination was more than 80 per cent. In the remaining 14 high-risk states, we are carrying out the campaign in a phased manner. These 14 states also include second dose of measles vaccination under the routine immunization program, six months from completion of the campaign.”

New WHO Findings

The WHO study states that measles mortality has been reduced by more than three-quarters in all regions of the world except in south-east Asia. Anti-measles efforts had suffered from inadequate funding and lack of political commitment since 2008.

In 2007, investigators reported that the global goal to reduce measles deaths by 50 per cent by 2005, compared with 1999, had been achieved. Later, WHO member states decided on a more ambitious target of 90 per cent reduction between 2000 and 2010.

Situation in Southeast Asia

Southeast Asia, excluding India, had 79 per cent vaccine coverage in 2010. The global coverage for measles vaccination overall was 85 per cent. Over 1 billion doses of measles vaccine were delivered through supplementary mass vaccination campaigns in the past decade, and were the main driver behind the huge fall in mortality.

Measles eradication is biologically feasible and while no formal eradication goal has yet been set, progress on the mortality reduction goal will lead to consideration for an eradication goal.

Millennium Development Goals that aims to reduce child mortality by two-thirds by 2015 will be missed if measles outbreaks continue to spread. The challenges, however, include competing public health priorities, weak immunization systems, sustaining high routine vaccination coverage and plugging the $298 million funding gap for global anti-measles efforts. Measles virus is spread by airborne droplets through coughing and sneezing. It begins with fever and is followed by cough, running nose, conjunctivitis, and body rashes.

Global Efforts

Global efforts to cut the number of deaths from measles have fallen short of World Health Organization (WHO) targets.

An analysis published in the Lancet said deaths had fallen by 74 per cent between 2000 and 2010, but the target was 90 per cent.

Outbreaks in Africa and delays in vaccination programs in India have stalled progress. A new campaign to tackle the disease has been launched, which will combine measles and rubella jabs.

In 2000, there were 535,300 deaths from measles. This fell to 139,300 deaths in 2010.


Warning to Europe

European countries need to act now to tackle measles outbreaks, the WHO warns. The WHO report states that there were over 26,000 measles cases in 36 European countries from January to October 2011. Western European countries reported 83 percent of those cases, with 14,000 in France alone.

In England and Wales, there were just under 1,000 confirmed measles cases in that period - compared with just 374 in the whole of 2010. Altogether, measles outbreaks in Europe have caused nine deaths, including six in France, and 7,288 hospitalizations.

France has now launched a nationwide campaign to raise awareness about the need for MMR vaccination.

France can simply not afford to have deaths, painful and costly hospitalizations, disruptions to work and school from a completely vaccine-preventable disease.

Ninety per cent of European cases were amongst adolescents and adults who had not been vaccinated or people where it was not known if they had been vaccinated or not. And measles from Europe has been linked to outbreaks in several other countries including Brazil, Canada and Australia.


Points To Remember

* A highly infectious viral illness

* Causes a fever, coughing and distinctive red-brown spots on the skin

* Contracted by breathing in tiny droplets created when an infected person coughs or sneezes

* Possible complications include pneumonia, ear and eye infections, and croup

* Serious complications include inflammation of the brain (encephalitis), which can be fatal

* Infection during pregnancy can cause miscarriage, premature labor or low birth weights

Polio Eradication in India: Big Challenge for Government

Additional Secretary, Health Anuradha Gupta has said that India is inching closer to the goal of polio eradication and hopes to be free of the deadly viral infection by 2014. She was pointing to the fact that over 90 per cent environmental samples taken from sewage disposal sites across migration hubs of India to determine the presence of the virus in the air had been found to be negative since November 2010.
She added that India’s success will arguably be its greatest public health achievement and will provided a global opportunity to push for the end of polio.
With oral vaccines, India appears to have achieved what was once thought a Herculean task — decisively breaking the circulation of wild polio viruses that paralyzed countless children. But the use of oral vaccines, which contain live but weakened strains of the virus, can be a bit like riding a tiger. Discontinuing them, without risking a resurgence of polio that would undo all that has been achieved, is going to be a tricky exercise.
The Outbreak
The outbreak response actions were carried out jointly by the Center, State, the World Health Organization’s (WHO)-National Polio Surveillance Project, UNICEF and Rotary along with some stakeholders who identified 36 high risk blocs/municipalities and 222 high risk Gram Panchayats/wards to focus activities on. This was followed by enhanced by coordination by the local administration at all levels and 25 experienced additional Surveillance Medical Officers were deployed at each district for intensive monitoring. The vaccinators and supervisors were imparted training to improve skills trainings to improve skills & performance of vaccinators and supervisors. Approximately 9,096,609 children were vaccinated in January of 2011 which was followed by special immunization rounds on February 6 (990,586), February 13 (1,422,549), February 27 (8,996,193) and the figure remained upwards of 4,100,100 in the subsequent months.
Government’s Initiatives
The federal government is likely to step up surveillance at airports to rule out chances of cases coming in from Pakistan, Afghanistan and Nigeria, where polio is endemic. Thus far, such surveillance is happening only in case of children entering India via rail or road.
Strategies to combat the virus will be discussed at the two-day Polio Summit to be held this weekend. Prime Minister Manmohan Singh will open the summit, which will be attended by health ministers of Pakistan and Nigeria.
For India, the challenge is to prevent new polio cases and block imported ones. “We already have surveillance points along borders with Pakistan. These are at Wagah, Attari and in Rajasthan. But we have to create similar surveillance points at airports. Polio can also be imported via air route. We further want to strengthen polio surveillance across borders,” Additional Secretary, Health, Anuradha Gupta said today while briefing reporters about the Polio Summit.
The India Polio Advisory Group, which advises the government on strategy, is meeting on March 16 to flag new challenges.
The summit will celebrate India’s huge polio success - of reduced infection cases, from two lakh annually in 1988 to zero last year. The last child who got wild polio virus 1 was Rukhsar from Howrah. Today, she is a motivator for the United Nations Children’s Fund (UNICEF), going door to door, asking parents to get children for polio drops. Rukhsar, infected on January 13, 2011, had never received polio drops.
So far as India’s hopes of eradication go (For WHO’s eradication status, nations must be able to remain polio-free for three consecutive years), they are real.
There has been a new case since Rukhsar’s and results of all environmental samplings have been negative since November 2010.
Environmental samples have been taken from sewage disposal sites in four migration hubs of India — Delhi, Mumbai, Kolkata and Patna. This has been done to gauge presence of virus in the air.
In 2009, most Mumbai samples tested positive. But in 2011, all samples across four sites were negative. This means the virus is not circulating in the environment.
In 2009, India had reported 741 cases, half of the global burden of polio. But now, it appears on track to be rid of polio.
For the 12th Plan, the Ministry has sought Rs 4,400 crore as against Rs 5,500 crore sought in the previous plan. This because of lesser burden, Gupta explained.
Globally, however, Rotary International projects a deficit of $520 million for the polio eradication initiative.
Facts About Polio
* Last wild polio virus 1 case: January 13, 2011 (Howrah, West Bengal)* Last wild polio virus-3 case: October 22, 2010 (Pakur, Jharkhand)
*Last wild polio virus 2 case: October 1999 (Aligarh, Uttar Pradesh)
*Last polio-positive case came to surface after environmental sampling in November 2010
*Polio drops given to 17.4 crore children in one round.

Health, Development and Human Rights in India

The improvement in the indices of health and development for India has been incredible. Yet for millions hunger is routine and the loss of their livelihoods not newsworthy. While medical services impact the health of individuals, the factors associated with longevity of populations are social and economic.
Education and sponsorship which determine access to work contribute to occupational inequality, which, in turn, leads to socioeconomic outcomes. These sequences operate as a cycle of relative socioeconomic privilege and deprivation transmitting inequalities from one generation to the text.
In fact, health and economic development are dynamically interlinked. Low-income countries have poor healthcare facilities. On the other hand, a high proportion of the population with ill health breeds poverty as these societies lack the basic tools such as medicine, fertilizer, credit, etc., to move out of deprivation through development.
However, the relationship between economic development and income inequality takes the form of an inverted U-turn. Income inequality increases during the early phase of development when the main mechanism of growth is the increase in physical capitals and the fact that resources are allocated to those who save and invest. During later stages of development, this inequality reduces on account of mass education, rural-to-urban and agriculture-to-industry migration and also due to social policies of Governments of mature economies which invest in human capital. The income inequality during the early phase, in fact, exacerbates poverty.
However, rising inequality will eventually put pressure on the Government to rectify the situation using the high incomes attained in the later stages of development. The disparities, as is currently happening in India, tend to split society.
Vulnerability to Ill-Health
The World Health Organization (WHO) has argued that health and human rights are inextricably linked. Violation of human rights can have serious health consequences. Vulnerability to ill-health can be reduced by taking steps to protect such rights (rights to healthy education, housing and freedom from discrimination). It argues that we need to apply a human rights-based approach to health care.
Nevertheless, human rights largely remain the concern of specialist lawyers in the country. In recent years, however, there is increased recognition in the public health community that human rights provide a useful framework for ensuring the conditions in which people can be healthy.
Improvement in health care has been an important part in the overall strategy for socioeconomic development over the planning period. Significant demographic changes and epidemiology shifts have occurred but the health scenario in India is still at crossroads with a wide gap between demand and supply of health services. Some measures of success have been achieved on the communities diseases especially in the case of tuberculosis and leprosy in the case of vector borne diseases, concerted efforts are being made both the Central and State Government under the program while under AIDS, the major strategy has been to build up infrastructure and go in for targeted interventions.
As far as development is concerned, the vibrant economy is a reflection of success of India’s middle and upper classes. They form the engine which is driving the country’s development and evoke the image of a shining India. The hope is that the growth of the economy will also uplift the poor, albeit in a trickle-down effect. While poverty based on headcount has reduced, deprivation, defined as the disparity between base and mean consumption, is increasing in the country.

Model for Human Rights
In the present situation, human rights have attained a new meaning—an accepted phenomenon now. But the irony is that everything encompassed by the motion of human rights is subject of controversy.
India is a signatory to the Universal Declaration of Human Rights adopted by the UN in 1948, just a year after the country attained Independence. It signified the new republic’s resolve to follow the path of democracy, which would ensure human rights to its citizens, despite doubts expressed by leading statesmen of developed democracies about the success of such an experiment in India.
India’s venture was unique in many respects. Democracy was adopted in many countries after completing the phase of industrialization with the launching of the first Five-Year Plan in 1951, and soon after held a general election, on the basis of adult franchise.
Many advanced western nations introduced women suffrage and voting rights to all citizens much after the India did. India has the most diversity in the world—religious, linguistic and racial—united under a democratic set-up.
Yet, threats to individual freedom are formidable. Religious intolerance, caste tensions, regional chauvinism, terror threats, detentions without trial, poverty amidst plenty, crime against women, custodial deaths, corruption in public life and attendant evils constantly violate human rights.
The promise that India had initially showed in the field of human rights and the type of democratic institutions it has evolved, has won it international recognition. For these reasons, it was elected a member of the Human Rights Council of the United Nations, which had replaced the Commission on Human Rights in June 2006 by securing 173 out of 191 votes of the UN General Assembly, the maximum number of votes.
The rights of the poor can never compete against the might of the rich. The huge toll on the underprivileged during the initial stages of development needs to be factored into the country’s economic planning. Macroeconomic policies which protect sectors of the economy which are not able to face the sudden opening up of markets and a phased and carefully planned changeover.
The promotion of the healthcare, social and economic right of the poor is the most important human rights struggle of our times. We should think about human rights in the context of India’s public health. It needs to be realized that a higher standard of human rights is in the best national interest. India need not search for a model elsewhere. It should aspire to be a model for others.

Is US on Decline?

The incident of burning Muslim holy book, the Qoran, in the United States is highly regrettable, shameful, and condemnable act. Although it is an incident of isolated nature, it has exposed the mentality and culture of a world power. The protest that should have been expressed against the incident in the United States has not been seen. This incident indicates that the United States is on the decline. The Muslim world should take a strict notice of this incident and pressure the US Administration to take action against the fake and cruel pastor to satisfy the sentiments of Muslims across the world and ensure that no one could even think of desecrating any holy book in future.

Basic Amenities

According to Organization of Economic Cooperation and Development (OECD), a 15-year-old US student is at 25th place in global ranking of mathematics and at 17th place in the ranking of science. After occupying first place as for number of graduates in a country, the United States is now at 12th place on this count in the developed world. As for high school enrolment (preceding word in English), the United States is at 79th place. As far as basic amenities are concerned, the United States comes at 23rd place in the world. All developed countries are far ahead of the United States in this regard.

According to health figures released by the OECD and World Health Organization (WHO), the situation in the United States is quite surprising and alarming. The United States is at 27th places on account of average age, 18th on account of diabetes, and first in obesity. The US performance has been good in these departments in the past, but not today.

The United States is still at first place in a few matters. For example, it has the highest number of private homes in the world. The highest crime rate in developed countries is in the United States. Moreover, the United States is also the most indebted country of the world. If the United States is facing difficulties today, it does not mean that the United States has committed some blunder. But the reality is that other countries are showing well. Japan has been giving a tough time to the United States for the past three decades. Tokyo has been the world's second biggest economy during these three decades. Rather, it is still the third biggest world economy.

It was said in 1980s that Japan would emerge as the most powerful country in the world. But it did not happen and the United States emerged the most powerful state. Japan is a very small country vis-à-vis area and population. Japan can pose a real danger to any developed country, but has no capability to become a superpower. As far as per capita income in concerned, Japan is much behind other countries. If China is to take over the United States in economic field, it will have to enhance per capita income to one-fourth of the United States, as it will be sufficient for the Chinese people.

Impact on Economy

In his latest book the Civilization: West And The Rest, Harvard University researcher Niall Ferguson writes that what the United States did during the past 500 years has been playing an important role in its development. Mancur Olson had written a book entitled The Rise and Decline of Nations several decades ago, which said that Germany and Japan, who suffered massive destruction during the Second World War, made exemplary development after the war, but the economy of Britain, which was declared victorious in the war, continued to grow weaker and it also lost the status of a superpower. Giving its reasons, the writer said after the victory, the people in Britain became satisfied. They were assured that they are the number one in the world. As a result, the British gave up competition with other nations. The British Government also abandoned the desire of overtaking the others.

However, Germany and Japan, which were completely destroyed in the war, decided to work hard and show to the world their superiority. Both these countries learned a lot from their defeat and destruction. The worst defeat made the Germans to do extraordinary in other fields. Therefore, the Germans rose up and regained their lost status just in four decades through great hard work. The defeat made the Germans to do soul-searching. They analyzed their mistakes and rebuilt all major industrial organizations afresh. They brought a revolution in the education sector and became the world's third big economy.

Changing Times

The United States not prepared to learn anything more. It thinks that whatever it has is enough to keep it on top. It is happy and satisfied with its position. It is not ready to change with the time. It must be remembered that only that nation progresses, which changes itself with changing times. Olson's research says that successful societies gradually start rotting. According to him, its solution is that no society should remain stagnant. Rather it should be flexible so that the changing times could be better negotiated with. It is government's job to make the best preparations for the future. It is also government's responsibility to make considerable investment in fundamental infrastructure and prepare young generation to look after new industries in keeping with changing times.

There is no doubt that the United States faces numerous difficulties. Its problems are also increasing. Analyzing the situation the United States faces today, experts emphasize two aspects. On one hand, is decline in social values and structure. The education system is weak and new generation lacks the spirit of working with full devotion. The political system in the United States has become ineffective. On the other, is there physical structure. Americans have made very little investment in the United States. Debt burden is on the increase and the infrastructure of basic amenities has become quite weak.

Ground Realities

If one sees these things coupled with many other small signs, he will come to know that the United States is fast declining. The US attempts to capture the world are continuously meeting with failures. Its dreams have shattered right from Vietnam to Afghanistan. These wars have inflicted irreparable loss on the US economy. And the US Administration is perhaps unable to realize this loss.

However, China is making a continued progress because of its wisdom and better strategy. If China got a conducive environment in coming 10 years and imperialist forces did not subject it to conspiracies, it will emerge as the world's biggest economic power. The US society is breaking from within as well. The ground realities in the United States are not coming to light. The crimes in the United States have increased to an alarming extent. If the United States did not change its policy of capturing the world, no one will be able to save it from declining.

China, India, Pakistan Top List of Kidney Suppliers

Recently, the entire world celebrated World Kidney Day under the title of "Kidneys Can Be Saved by Controlling Diabetes". China, India and Pakistan are on the top of the list of the countries where kidneys are sold; while, the United States, the United Kingdom and France are the major buyers. In some villages of the countries, 40 to 50 percent of the people are living on one kidney.

Blood Pressure-Related Diseases
According to the statistics obtained from a source, more than five percent of the adult population (about 400 million) is suffering from kidney diseases while more than 1 billion people are suffering from diseases relating to blood pressure. After diabetes, blood pressure is the second major cause of failure of kidneys.

Some 20.25 million people are suffering from kidney diseases in our country; while, some15,000 to 20,000 are falling prey to these diseases every year. On an average, there is one kidney specialist for a population of 2 million. As a result, most of the patients are deprived of diagnosis. In rural areas, in particular, the lack of doctors is resulting in increase in the disease.

WHO Report
According to World Health Organization (WHO) report, Pakistan is one of the countries where kidneys are sold. Pakistan is number three in the world in this regard, with China being number one and India, number two. On an average, a person sells one of his kidneys for only $1,000. Circumstances sometimes force people to sell their kidney for just a few hundred dollars. The broker, on the other hand, receives $2500 for their kidney. According to WHO report, as a result of this situation, in some of the villages in our country, 40 to 50 percent people are living on one kidney.

The United States is on top of the list of buyers of kidneys; while, the United Kingdom is second and France, third. Despite the ban on kidney trade at international level, kidneys are bought and sold. According to WHO, five percent of the 70,000 kidneys transplanted every years are obtained illegally.

Major Cause of Failure
According to medical experts, kidneys purify the blood. Even if the kidneys are performing 25 percent of their function, a man can live; however, if the kidneys fail, one has to resort to dialysis and transplant. With the help of dialysis, a man can survive for seven years; while, with the help of transplant, he can survive for 14 years.

The kidney diseases generally attack at the age of 30 to 40 years. However, because of a rise in diabetes and blood pressure-related diseases, even children and aged ones have now started to catch this disease.

Women, too, are prone to failure of kidneys because of shortage of blood during delivery. According to experts, different pain-killers are also a cause of kidney diseases. During the last few years, diabetes has been the major cause of failure of kidneys. Some 246 million people of the world are victim to diabetes. If this disease is not controlled, by 2025, the number of victims of this disease is likely to rise to more than 380 million.

Fighting With Tuberculosis

Looking at the massive challenge that tuberculosis in India poses, every effort to get rid of this disease appears to be providing relief. Here, scientists of International Center for Genetic Engineering and Biology, in cooperation with All India Institute of Medical Science, have claimed on the basis of a research that they have solved the mystery of how tuberculosis (TB) bacteria flourish inside human body.

Eliminating Proteins
According to the team of scientists, for the first time in the world, they have been successful in finding those 44 proteins in human body that provide food to tuberculosis bacteria. This team says that if the production of these proteins could be stopped somehow, we could fight tuberculosis quite effectively.

Although the research has not revealed the role these 44 proteins play in the functioning of our body and what harm their absence could cause us, it would be better if these proteins don't prove to be essential for us, so that we could root out tuberculosis by eliminating these proteins.
Tuberculosis, which was once considered to be a disease under control, like small pox and plague, has once again growing fast in India in recent years.

Strain of Tuberculosis
According to the organizations TBC India and the World Health Organization (WHO), more than 300000 persons are dying of tuberculosis in India every year at an average of 1000 persons per day.

Four years ago, WHO and Center for Disease Control of the United States had issued a warning that India is far ahead in the list of countries where a new and almost incurable strain of tuberculosis is spreading. This new strain of tuberculosis has been named as 'Extreme Drug Resistant', or XDR-TB, in short.

Immunity Against Antibiotic Drugs
The most important problem in the treatment of tuberculosis is the development of immunity against antibiotic drugs. If this disease, which is proving to be a difficult challenge for medical science, can be cured with the elimination of certain proteins, it would be a matter of big relief.

We should make arrangement for complete eradication of tuberculosis from the country by taking this research forward and finding a solution to the obstacles in the way.