Promoting Usage of Generic Medicines



Promoting Usage of Generic Medicines 
A number of steps have been taken by the Government to promote use of generic medicines. Circulars/ instructions have been issued from time to time to all Central Government hospitals, CGHS dispensaries and State Governments for encouraging prescription of generic medicines. Besides, the Code of Medical Ethics under Indian Medical Council Regulations, 2002 also mandates prescription of drugs with generic names. Further, vide Gazette Notification No.570 (E) dated 07.08.2014, the application for grant of licence for a drug formulation containing single active ingredient can be made only in the proper name and the existing licencees manufacturing single active ingredient drug formulation also have to apply for grant of licence for a drug formulation containing single active ingredient in proper name within one year of the commencement of these rules. Apart from this, the Government has initiated a Jan Jagriti Abhiyan to encourage use of generic medicines to increase their availability. 


The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today. 
*****
Measures for Detection of Early Stage Cancer 
The Central Government supplements the efforts of the State Governments for improving healthcare including prevention, diagnosis and treatment of Cancer. At present, the objectives of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) being implemented under National Health Mission (NHM) for interventions up to the district level include awareness generation for Cancer prevention, screening, early detection and referral to an appropriate level institution for treatment. The focus is on three sites namely breast, cervical and oral Cancer. Screening guidelines have been provided to State Governments for implementation. Suspected cases are to be referred for confirmatory diagnosis by various tests including histopathological biopsy.

Cancer detection and treatment facilities are also available in Central Government Hospitals such as All India Institute of Medical Sciences, Safdurjung Hospital, Dr Ram Manohar Lohia Hospital, PGIMER Chandigarh, JIPMER Puducherry, CNCI, Kolkata etc.

Oncology in its various aspects has focus in case of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY). Setting up of 2nd campus of CNCI, Kolkata has also been approved.

Under Tertiary Care Cancer Centre (TCCC) Scheme under NPCDCS, the Central Government will assist to establish State Cancer Institute (SCI) and Tertiary Care Cancer Centres which will mentor all Cancer related activities including prevention and screening in their respective areas.

The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today. 
*****
Proper Monitoring of Dengue Control Initiative 
Health being the state subject, the primary responsibility for collecting data on Dengue cases and deaths lies with the National Capital Territory (NCT) of Delhi. The South Delhi Municipal Corporation (SDMC) has been notified as the nodal agency for Dengue Control in NCT of Delhi.

The SDMC coordinates with other implementing agencies, various Hospitals (Govt. and Private) and collects data regarding dengue cases and deaths in Delhi and submits the weekly & monthly reports to the Dte. of National Vector Borne Disease Control Programme, Government of India.

A Control Room for Dengue Outbreak was established at Nirman Bhawan, Dte. General of Health Services, Emergency Medical Relief on 17.9.2015, as per the direction of Secretary (Health), Government of India to monitor the dengue situation in Delhi. The Control Room has been collecting the data about dengue cases and deaths from the 33 Sentinel Surveillance Hospitals (SSHs) and 1 Apex Referral Laboratory in Delhi on daily basis.

The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today. 
*****
Increased Surveillance on Adulterated Food items 

Milk and other food articles have been included in the Surveillance Plan for states prepared by a Working Group of Food Safety Commissioners taking into account various parameters including consumption pattern. Food Safety Commissioners of States are sensitized about enforcement of standards and use of the aforesaid plan to effectively curb adulteration. The State is also at liberty to modify the surveillance plan to suit local requirements.   
While separate data on cases relating to adulteration/misleading information on packaged food items is not maintained by FSSAI, based on information made available by the States/UTs, details of food samples received, analysed, found adulterated/misbranded, and action taken during 2014-15, are as under :-


No. of samples received
83265
No. of Samples Analyzed
74010
No. of Samples found adulterated and Misbranded
14599
No. of Cases Launched
Criminal
2676
Civil
7860
No. of Convictions/ Penalties
Convictions
1402
Penalties/
Amount raised in Rupees
2795/ Rs.10,93,87,214

The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today.

Regularisation of E-Pharmacies 
The sale and distribution of drugs in the country is regulated as per the provisions under the Drugs & Cosmetics Act, 1940 and the Drugs and Cosmetics Rules, 1945 made thereunder. As per said Rules, Drugs specified in Schedule H, H1 or Schedule X can’t be sold except on and in accordance with the prescription of a Registered Medical Practitioner. The supply of prescription drugs can be effected only by or under the personal supervision of a registered pharmacist from a licensed premises. A number of representations have been received from chemists and druggist associations against the online sale of prescription drugs. Similarly, a number of representations have also been received to permit such sales. The representations received were discussed in detail in the 48th meeting of the Drugs Consultative Committee (DCC), held on 24th July, 2015. The DCC has constituted a seven member Sub-Committee to examine the issue of sale of drugs on the internet, while taking care of the risks and concerns related to such sales.

The Government always follows the normal process of inviting objections and suggestions from the stakeholders before making any rules.

The Health Minister, Shri J P Nadda stated this in a written reply in the RajyaSabha here today. 
*****

Funds Allocated under Malaria and Polio Control Programme 
Under the National Health Mission (NHM) which encompasses the National Rural Health Mission (NRHM) and the National Urban Health Mission(NUHM) as its twosub-missions, support is provided to States/UTs as per their resource envelope for strengthening their health care systems based on requirements posed by the States/UTs in their Programme Implementation Plan (PIPs). The details of the amount allocated and spent by the States/UTs during the last 3 years under vector borne diseases (including malaria) and polio control programmeare given below respectively.


State-wise Fund allocation & released under VBD including Malaria
(Rs. In Lakhs)
S.  No.
States/UTs
2015-16 (prov. Upto 30.09.2015)
Allocation
Release
Expdt.
1
Andhra Pradesh.
858.00
403.88
83.63
2
Arunachal Pradesh
1273.00
989.34
338.06
3
Assam
2592.00
1426.71
379.75
4
Bihar
4085.00
4972.64
1345.61
5
Chhattisgarh
2545.00
311.70
174.11
6
Goa
98.00
47.50
44.62
7
Gujarat
1148.00
857.81
312.01
8
Haryana
255.00
191.25
0
9
Himachal Pradesh
104.00
0.00
12.17
10
Jammu and Kashmir
92.00
44.50
3.13
11
Jharkhand
5537.00
3053.37
264.88
12
Karnataka
1954.00
163.02
470.11
13
Kerala
726.00
544.50
79.11
14
Madhya Pradesh.
2442.00
1703.77
459.35
15
Maharashtra
639.00
490.31
93.59
16
Manipur
917.00
645.00
29.69
17
Meghalaya
966.00
549.32
193.01
18
Mizoram
1220.00
757.65
355.32
19
Nagaland
1203.00
616.12
250.89
20
Orissa
3888.00
2583.75
482.38
21
Punjab
398.00
178.90
0.98
22
Rajasthan
2614.00
1454.93
385.29
23
Sikkim
53.00
31.73
0
24
Tamil Nadu
1619.00
1195.50
374.80
25
Telangana
487.00
423.76
123.59
26
Tripura
1400.00
652.03
441.26
27
Uttar Pradesh
4335.00
1704.26
41.78
28
Uttarakhand
205.00
122.78
0
29
West Bengal
1800.00
287.92
708.85
30
Delhi
170.00
0.00
1.33
31
Pondicherry
49.00
36.33
5.58
32
A&N Islands
352.00
242.62
4.03
33
Chandigarh
80.00
59.90
21.7
34
D and N Haveli
95.00
132.54
20.37
35
Daman and Diu
68.00
74.49
0
36
Lakshadweep
46.00
40.05
0
Total
46313.00
26989.88
7500.98
S.N.
States
2014-15
2015-16
Allocation
Release
Exp
Allocation
Release
Exp
1
Andaman & Nicobar Islands
0.24
0.24
0.23
0.24
0.18
2
Andhra Pradesh
11.69
7.82
15.38
11.59
1.51
3
Arunachal Pradesh
0.91
0.68
0.64
0.91
0.68
4
Assam
9.46
7.10
7.28
9.46
7.1
0.05
5
Bihar
29.12
28.87
56.87
29.12
21.84
3.76
6
Chandigarh
0.25
0.19
0.27
0.25
0.25
7
Chhattisgarh
4.94
3.71
4.95
4.94
3.71
0.12
8
Dadra and Nagar Haveli
0.06
0.05
0.00
0.06
0.05
9
Daman and Diu
0.04
0.04
0.04
0.04
0.03
10
Delhi
5.99
4.49
9.87
5.99
4.49
2.78
11
Goa
0.19
0.14
0.19
0.19
0.14
12
Gujarat
12.29
9.22
11.15
12.29
9.23
0.59
13
Haryana
7.67
5.75
10.50
7.67
5.75
3.36
14
Himachal Pradesh
1.98
1.98
2.09
1.98
1.49
0.12
15
Jammu and Kashmir
3.98
2.99
2.23
3.98
2.99
0.02
16
Jharkhand
8.32
6.24
8.62
8.32
6.24
17
Karnataka
10.36
7.77
9.69
10.36
7.77
0.26
18
Kerala
3.71
2.78
4.06
3.71
1.85
0.25
19
Lakshadweep
0.04
0.03
0.00
0.04
0.03
20
Madhya Pradesh
15.72
11.79
11.38
15.72
7.86
1.34
21
Maharashtra
28.65
21.49
23.27
28.65
21.49
1.20
22
Manipur
1.30
0.98
1.10
1.3
0.98
23
Meghalaya
1.76
1.32
1.22
1.76
1.33
0.06
24
Mizoram
0.49
0.37
0.50
0.49
0.37
25
Nagaland
0.90
0.68
0.82
0.9
0.68
26
Orissa
6.38
4.79
5.72
6.38
4.79
0.18
27
Pondicherry
0.15
0.11
0.15
0.15
0.11
28
Punjab
5.82
4.37
6.07
5.82
4.37
2.09
29
Rajasthan
16.23
16.23
14.04
16.23
12.17
1.61
30
Sikkim
0.22
0.22
0.19
0.22
0.17
32
Tamil Nadu
9.85
7.39
8.03
9.85
7.39
0.51
33
Tripura
1.46
1.10
0.01
1.46
1.1
0.03
34
Uttar Pradesh
85.80
64.35
94.18
85.8
64.35
24.07
35
Uttarakhand
5.99
4.49
6.98
5.99
4.49
2.30
36
West Bengal
27.78
20.84
31.14
27.78
20.84
9.12
37
Telangana
8.36
6.27
6.19
8.36
4.18
1.17

GRAND TOTAL
328.10
256.83
355.04
328.00
230.49
56.50
38
Others
1.90
1.80

GRAND TOTAL
330.00
258.63
355.04
328.00
230.49
56.50










































The Health Minister, Shri J P Nadda stated this in a written reply in the RajyaSabha here today.

                                                       *****
Report of FSSAI on Seized Items 
As per information made available by the States/Union Territories to the Food Safety and Standards Authority of India, 74010 food samples were analyzed during 2014-15. Out of these, 14599 food samples were found to be adulterated or misbranded.
Details of action taken by the State Government concerned are as under:-
No. of Cases Launched
No. of Convictions/ Penalties
Criminal
Civil
Convictions
Penalties/ Amount raised in Rupees
2676
7860
1402
2795/ Rs.10,93,87,214




The data regarding cancellation of licences by States/UTs and arrests made are not maintained centrally by the food Safety and Standards Authority of India or the Department of Health and Family Welfare.
The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today.

                                                       *****
Funding for Improving Services in Hospitals 
Approved and utilized amount under the flagship scheme of National Health Mission (NHM) under the head of Hospital Strengthening and New Constructions/ Renovation and Setting up in various states during the last two years and in the current year is given below:-


SPIP- State Programme Implementation Plan.
Above mentioned utilization figures are as reported by States/UTs up to 30.09.2015.
Utilization is inclusive of previous year unspent balance.

Under the above heads, following activities are supported:-
(i)  Hospital Strengthening:-
·         Up gradation of Dist. Hospitals,  Sub-Divisional Hospitals(SDHs), Community Health Centres(CHCs), Primary Health Centres(PHCs), Health Sub Centres(HSCs) and other health institutions .
·         Rent and Contingencies of Health Sub centres

(ii)  New Constructions/ Renovation and Setting up:-
·         New Constructions/ Renovation of Community Health Centres (CHCs), Primary Health Centres (PHCs), Health Sub Centres (HSCs) and Govt. Dispensaries/ others renovations,
·         Setting up Infrastructure wing for Civil works,
·         Construction of Basic Emergency Obstetric Care (BEmOC) and Comprehensive Emergency Obstetric Care (CemOC) centres,
·         Construction of Sick Newborn Care Units  (SNCUs) / New Born Stabilisation unit (NBSUs) / Newborn Care Corner (NBCCs),
·         Carry forward / spill over from previous year's sanction for Sick Newborn Care Units  (SNCUs), New Born Stabilisation unit (NBSUs) and Newborn Care Corner (NBCCs),
·         Major civil works for operationalization of First Referral Units and  24 hour services at Primary Health Centres s
·         Civil Works for Operationalising Infection Management & Environment Plan at health facilities and
·         Other civil works.

Apart from above, Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) is a central scheme and it envisages two components i.e.
(i)                 Setting up of AIIMS-like institutions and
(ii)               Up-gradation of existing State Government Medical College/Institutions (SGMC).

PMSSY Accounts Statement (Phase-I), Rs. in crores
Statement showing funds released in last two years and current F.Y. to Other Institutions
Name of Site
2013-14
2014-15
2015-16
BMC, Bangalore
Civil HLL
-
-
-
M&E HLL
2.76
-
-
M&E Institute
-
-
-
Consultancy (Civil)
0.02
-
1.00
Total
2.78
-
1.00
TMC, Trivandrum
Civil HLL
-
-
-
M&E HLL
-
-
-
M&E Institute
-
-
-
Consultancy
0.02
-
-
Total
0.02
-
-
SMC, Salem
Civil HLL
-
-
-
M&E HLL
-
-
-
Consultancy
-
-
-
Total
-
-
-
SVIMS, Tirupati
M&E Institute
-
-
-
M&E HLL
14.69
-
-
Consultancy
0.19
-
-
Total
14.88
-
-
KMC, Kolkata
Civil (HSCC)
2.07
-
-
M&E HSCC
-
-
-
M&E HLL
-
-
-
Consultancy
-
-
-
Total
2.07
-
-
SGPGI, Lucknow
Civil (HSCC)
-
-
-
M&E HLL
-
-
-
M&E Institute
-
9.76
-
Consultancy (Civil)
-
-
-
Total
-
9.76
-
NIIMS, Hyderabad
Civil (HSCC)
-
-
-
M&E Institute
7.68
-
-
Consultancy
-
-
-
Total
7.68
-
-
GMC, Mumbai
M&E HLL
2.53
-
-
M&E Institute
-
-
-
Consultancy
0.18
-
-
Total
2.71
-
-
BJMC, Ahmedabad
Civil (HSCC)
-
-
-
M&E HLL
1.02
1.79
-
M&E Institute
-
-
-
M&E HSCC
-
-
-
Consultancy
0.10
-
-
Total
1.12
1.79
-
JMC, Jammu
Civil
1.16
-
-
M&E HLL
0.12
1.45
-
M&E CPWD
-
-
-
Consultancy
0.19
-
-
Total
1.47
1.45
-
Srinagar Medical College, Srinagar
Civil
10.14
-
-
M&E CPWD
0.80
0.48
-
M&E HLL
-
-
-
Consultancy
0.08
-
-
Total
11.02
0.48
-
IMS, Varanasi
Civil
1.66
-
-
M&E Institute
-
6.38
-
M&E HLL
1.53
-
-
Consultancy
0.05
-
-
Total
3.24
6.38
-
RIMS, Ranchi
Civil
-
-
-
M&E HLL
3.63
-
-
M&E Institute
-
-
-
Consultancy
0.03
-
-
Total
3.66
-
-



PMSSY Accounts Statement (Phase-II),

Rs. in crores
Statement showing funds released in F.Y.s 2013-14 to 2015-16  to Other Institutions
Name of College
 2013-14
 2014-15
 2015-16
AMU, Aligarh




Civil (HLL)
          -  
       8.06
      9.05

M&E (HLL)
      3.50
           -  
          -  

Consultancy
      4.64
       0.09
      0.01

Total
      8.14
       8.15
      9.06

State Govt. Share
          -  
           -  
          -  

G. Total
      8.14
       8.15
      9.06
GMC, Amritsar




Civil (HSCC)
      5.00
       2.00
      1.47

M&E (Institute)
          -  
           -  
          -  

M&E (HLL)
    15.19
           -  
          -  

Consultancy
      0.11
       0.04
          -  

Total
    20.30
       2.04
      1.47

State Govt. Share
          -  
           -  
          -  

G. Total
    20.30
       2.04
      1.47
R.P. Medical College, Tanda




Civil (HSCC)
      8.70
           -  
          -  

Hostels/Lecture theatre Institute
    10.00
           -  
          -  

M&E (Institute)
          -  
           -  
          -  

M&E (HLL)
      2.00
           -  
          -  

Gas Pipe Line (HSCC)
          -  
     15.00
          -  

Consultancy
      0.52
       0.03
          -  

Total
    21.22
     15.03
          -  

State Govt. Share
          -  
           -  
          -  

G. Total
    21.22
     15.03
          -  
GMC, Nagpur




Civil (State Govt.)




M&E (Institute)
    37.81
           -  
          -  

Consultancy
          -  
           -  
          -  

Total
    37.81
           -  
          -  

State Govt. Share
          -  
           -  
          -  

G. Total
    37.81
           -  
          -  
Rothak Medical College




Civil HLL
      5.00
       8.00
    10.00

M&E (Institute)
          -  
           -  
          -  

Consultancy
      0.25
       0.24
          -  

Total
      5.25
       8.24
    10.00

State Govt. Share
          -  
           -  
          -  

G. Total
      5.25
       8.24
    10.00
Madurai Medical




Civil HLL
      8.10
     10.00
          -  

M&E (HLL)
          -  
           -  
          -  

Consultancy
      1.45
           -  
      1.82

Total
      9.55
     10.00
      1.82

State Govt. Share
          -  
           -  
          -  


























































The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today.

                                                                                                                        *****
Expansion of Healthcare Services 

Public health being a State subject, the primary responsibility of providing health care services to the population including women and children in rural areas is that of respect State/UT Government. Under National Health Mission (NHM) support is being provided to States/ UTs to supplement the efforts of the States/UTs to strengthen their health care system for provision of accessible and affordable health care to all those who access public health facilities.
Some of the special measures taken under NHM for the expansion of health services after May, 2014 are given below:-
New initiatives for expansion of health services
1)      Launch of India Newborn Action Plan (INAP): INAP was launched in September 2014,  for accelerating the reduction of preventable newborn deaths and stillbirths in the country - with the goal of attaining ‘Single Digit Neo-natal Mortality Rate (NMR) by 2030’ and ‘Single Digit Still Birth Rate (SBR) by 2030’. Currently, there are estimated 7.47 lakh neonatal deaths annually.The neo-natal deaths are expected to reduce to below 2.28 lakh annually by 2030, once the goal is achieved.
2)      Intensified Diarrhoea Control Fortnight was observed in July- August 2014 and 2015 focusing on ORS and Zinc distribution for management of diarrhoea and improved feeding practices.
3)      Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest infant mortality (UP, MP, Bihar and Rajasthan).
4)      National Deworming day was observed in eleven States/UTs, namely- Assam, Bihar, Chhattisgarh, Dadra & Nagar Haveli, Haryana, Karnataka, Maharashtra, Madhya Pradesh, Rajasthan, Tamil Nadu and Tripura.
5)      Launch of Mission Indradhanush: Mission Indradhanush was launched in December 2014 to reach 90 Lakh unimmunized/partially immunized children by 2020. It has been implemented in 201 districts in 1st Phase, 297 additional Districts are to be covered in 2nd Phase.  About 20 lakh children received full immunization during the Phase-1 of Mission Indradhanush.
6)      New vaccines: launch of new vaccines has been announced of which Inactivated Polio Vaccine (IPV) has already been launched on 30th November, 2015 and Rotavirus vaccine is planned to be launched on first quarter of 2016. In addition, NVBDCP has recently identified 21 adult JE vaccination districts in Assam, Uttar Pradesh and West Bengal. Adult JE vaccination campaign has been completed in three districts of Assam, selected blocks of three districts of West Bengal and ongoing in selected blocks of six districts of Uttar Pradesh.
7)      Launch of Nationwide Anti-TB drug resistance survey: Drug resistant survey for 13 TB drugs was launched to provide a better estimate on the burden of Multi-Drug Resistant Tuberculosis in the community. This is the biggest ever survey in the world with a sample size of 5214 patients. Results are expected by 2016.
8)      Kala Azar Elimination Plan : Kala-Azar elimination Plan was rolled out to reduce the annual incidence of Kala-Azar to less than one per 10,000 population at block PHC level by the end of 2015,  which inter-alia includes,
·                  New thrust areas launched for UP, Bihar, West Bengal and Jharkhand.
·                  New Action Plan to include active search, new drug regimen, coordinated Indoor Residual Spray (IRS) etc.
·                  New non-invasive Diagnostic kit launched.

9)       Kayakalp –Award to Public Health facilities has been launched on 15th May 2015, as a national initiative to promote cleanliness, hygiene and infection control practices in public health facilities. Under this initiative public healthcare facilities shall be appraised and such public healthcare facilities that show exemplary performance meeting standards of protocols of cleanliness, hygiene and infection control will receive awards and commendation.
10)  Operational Guidelines have been  issued under NHM on :
(i)                 NHM Free Drugs Service Initiative
(ii)               NHM Free Diagnostic Services Initiative
(iii)             Mobile Medical Units
(iv)             Swachhta Guidelines for public Health Facilities
11)  New Guidelines:  The following new guidelines to strengthen capacities of States to effectively treat women in rural and urban areas of the country have been prepared:
(i)                 National  Guidelines for deworming in pregnancy
(ii)               Engaging General Surgeons for performing C-Sections and Managing Obstetric complications
(iii)             Maternal Near Miss Review Operational Guidelines
(iv)             National Guidelines for Diagnosis and Management of Gestational Diabetes
(v)               National Guidelines  for calcium supplementation during pregnancy and lactation
(vi)             National Guidelines for screening of hypothyroidism during pregnancy
(vii)           Screening for Syphilis during pregnancy
(viii)         DAKSHATA – A strategic initiative to strengthen quality of  intra and immediate postpartum care empowering providers for improved MNH care during institutional deliveries
(ix)             Daksh Skills Lab for RMNCH+A services (training manual for facilitators)
(x)               Daksh Skills Lab for RMNCH+A services (training manual for participants)
The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today.

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