Hepatitis B and C major killers, but few know it

In News:

On the World Hepatitis Day, the Union health minister pledged to join a campaign initiated by the Institute of Liver and Biliary Sciences (ILBS) to create awareness about the disease.

Context of the topic:

In India, more people are dying of Hepatitis B and C than HIV, malaria and dengue combined and yet the awareness about the disease remains low.

In Focus: Hepatitis

What is Hepatitis?

Hepatitis is an inflammation of the liver.

The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer.

Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.

Note: Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E.

A different virus is responsible for each type of virally transmitted hepatitis.

These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread.

In particular, types B and C are the most common cause of liver cirrhosis and cancer.

Causes:

Hepatitis A and E are typically caused by ingestion of contaminated food or water.

Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids.

Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Hepatitis A:-Hepatitis A infections are in many cases mild, with most people making a full recovery and remaining immune from further Hepatitis A Virus (HAV) infections. However, HAV infections can also be severe and life threatening.

Most people in areas of the world with poor sanitation have been infected with this virus.

Transmission of the Virus:

Through consumption of contaminated water or food.

Certain sex practices can also spread Hepatitis A Virus (HAV).

Vaccination availability:

Safe and effective vaccines are available to prevent HAV.

Hepatitis B:

Hepatitis B is a viral infection caused by Hepatitis B Virus (HBV) that attacks the liver and can cause both acute and chronic disease.

According to WHO, in 2015, 257 million people suffered from Hepatitis B infection (defined as Hepatitis B surface antigen positive).

Infections in India: India harbours 10-15% of the entire pool of Hepatitis B virus carriers in the world and 15-25% of these patients are likely to suffer from cirrhosis, scarring of the liver and liver cancer and likely to die prematurely.

Transmission of the Virus:

Exposure to infective blood, semen, and other body fluids.

From infected mother to infant at the time of birth or from family member to infant in early childhood.

Vaccination availability:

Safe and effective vaccines are available to prevent HBV.

All infants should get a shot as soon as possible after birth, preferably within 24 hours. It, however, can be taken at any age.

Hepatitis B is a viral infection caused by Hepatitis B Virus (HBV) that attacks the liver and can cause both acute and chronic disease.

According to WHO, in 2015, 257 million people suffered from Hepatitis B infection (defined as Hepatitis B surface antigen positive).

Infections in India: India harbours 10-15% of the entire pool of Hepatitis B virus carriers in the world and 15-25% of these patients are likely to suffer from cirrhosis, scarring of the liver and liver cancer and likely to die prematurely.

All infants should get a shot as soon as possible after birth, preferably within 24 hours. It, however, can be taken at any age.About National Viral Hepatitis Control Program

The National Viral Hepatitis Control Program has been launched by Ministry of Health and Family Welfare, on the occasion of the World Hepatitis Day, 28th July 2018.

It is an integrated initiative for the prevention and control of viral hepatitis in India to achieve Sustainable Development Goal (SDG) 3.3 which aims to ending viral hepatitis by 2030.

This is a comprehensive plan covering the entire gamut from Hepatitis A, B, C, D & E, and the whole range from prevention, detection and treatment to mapping treatment outcomes.

Aim:

Combat hepatitis and achieve country wide elimination of Hepatitis C by 2030.

Achieve significant reduction in the infected population, morbidity and mortality associated with Hepatitis B and C i.e. Cirrhosis and Hepato-cellular carcinoma (liver cancer).

Reduce the risk, morbidity and mortality due to Hepatitis A and E.

Key Objectives:

Enhance community awareness on hepatitis and lay stress on preventive measures among general population especially high-risk groups and in hotspots.Provide early diagnosis and management of viral hepatitis at all levels of healthcare.

Develop standard diagnostic and treatment protocols for management of viral hepatitis and its complications.

Strengthen the existing infrastructure facilities, capacity building of existing human resources and raise additional human resources, where required, for providing comprehensive services for management of viral hepatitis and its complications in all districts of the country.

Develop linkages with the existing National programs towards awareness, prevention, diagnosis and treatment for viral hepatitis.

Develop a web-based “Viral Hepatitis Information and Management System” to maintain a registry of persons affected with viral hepatitis and its sequelae.

Components:

Preventive component:

Awareness generation & behaviour change communication

Immunization of Hepatitis B (birth dose, high risk groups, health care workers)

Safety of blood and blood products

Injection safety, safe socio-cultural practices

Safe drinking water, hygiene and sanitary toilets

Diagnosis and TreatmentMonitoring and Evaluation, Surveillance and Research

Training and Capacity Building

Way ahead:

To make the programme successful and to ensure all persons suffering from Hepatitis B and C get treatment, there is need of more funds.

However, with the recent reductions in the costs of diagnosing and treating viral hepatitis, countries can scale up investments in eliminating the disease.

Also, mass campaigns are needed to create awareness about its vaccination.

China, Russia, France share satellite data on Assam floods

In News:

The above-average rainfall has led to floods in Assam, Bihar and Uttar Pradesh, with Assam being the hardest hit.

Details:

India has acquired satellite imagery related to floods from eight international space agencies, due to its membership of the International Charter Space and Major Disasters.

Note: There is apprehension about further floods, after Bhutan released excess water from Kuricchu Hydropower reservoirs which could lead to rise in water level in seven districts in Assam.

UN-SPIDER

United Nations Platform for Space-based Information for Disaster Management and Emergency Response (UN-SPIDER) was established in 2006 under the United Nations Office for Outer Space Affairs (UNOOSA), which is the United Nations office responsible for international cooperation in the peaceful use of outer space.

It develops solution to address the limited access developing countries have to specialized technologies that can be essential in the management of disasters and the reducing of disaster risks.

It facilitates the use of space based disaster management and emergency response technologies. The International Charter Space and Major Disasters has been set up under the UN-SPIDER.

International Charter Space and Major Disasters

The International Charter Space and Major Disasters is a non-binding charter which provides for the charitable and humanitarian retasked acquisition of and transmission of space satellite data to relief organizations in the event of major disasters.

It was initiated by the European Space Agency and the French space agency CNES after the UNISPACE III conference held in Vienna, Austria in 1999 and it officially came into operation in 2000.

Since 2000, when the Charter came into operation there have been about 600 activations and data from 61 satellites have helped with disaster operations in 125 countries.

Every member agency has committed certain resources to support the provisions of the Charter and is therefore helping to mitigate the effects of disaster on human life and property.

How the Charter works?

Whenever there is a natural disaster, any of the member countries can send a ‘request’ to activate the Charter.

The Charter seeks the information pertaining to disaster- hit area available with all the 33 member space agencies

By combining earth observation assets from different space agencies, the charter allows resources and expertise to be coordinated for rapid response to major disaster situations

ISRO has also provided information to other Space Agencies in response to requests under the charter.

National Remote Sensing Center (NRSC)

The National Remote Sensing Center (NRSC) represents the Indian Space Research Organisation (ISRO) as a member of the charter..

Due to the heavy floods in India, the Charter was activated on July 17 by NRSC.

Under the Charter, so far data has been received from 8 countries, including USGS, CNES, ESA, ROSCOSMOS, Chinese National Space Agency (CNSA) and 3 others.

ISRO’s CARTOSAT satellites too got the Indian space agency its own images.

Note: In 2018 also, India had activated the Charter after Kerala was inundated by floods.

Use satellites for Disaster Management

The data from earth observation and meteorological satellites in conjunction with ground based information, and services derived from communication & navigation satellites are being used towards Disaster Management Support.

Data Obtained:

From meteorological satellites: For cyclone tracking, intensity & landfall predictions and forecasting of extreme weather events

From earth observation satellites: For monitoring disaster events and  assessing the damages

The communication satellites: Help to establish emergency communication in remote and inaccessible areas

Navigation satellites: For providing location based services

CARTOSAT:

The Cartosat satellites are a series of Indian earth observation satellites built and operated by the ISRO, as part of Indian Remote Sensing Program.

The Cartosat-2 series satellites, placed in a sun synchronous orbit, provide high resolution images of earth’s surface.

The images obtained from these satellites are useful in variety of applications requiring high resolution images, which include cartography, infrastructure planning, natural resources management, disaster management.The National Remote Sensing Centre (NRSC) of ISRO has the mandate to develop the technologies for effective use of remote sensing and GIS based information services for disaster mitigation, relief and management at local/state/central level.

RCEP

RCEP is proposed between the ten member states of the Association of Southeast Asian Nations (ASEAN) (Brunei, Burma (Myanmar), Cambodia, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand, Vietnam) and the six states with which ASEAN has existing FTAs (Australia, China, India, Japan, South Korea and New Zealand).

RCEP negotiations were formally launched in November 2012 at the ASEAN Summit in Cambodia.

Aim: RCEP aims to boost goods trade by eliminating most tariff and non-tariff barriers — a move that is expected to provide the region’s consumers greater choice of quality products at affordable rates. It also seeks to liberalise investment norms and do away with services trade restrictions.

Why has it assumed so much significance in recent times?

When inked, it would become the world’s biggest free trade pact. This is because the 16 nations account for a total GDP of about $50 trillion and house close to 3.5 billion people. India (GDP-PPP worth $9.5 trillion and population of 1.3 billion) and China (GDP-PPP of $23.2 trillion and population of 1.4 billion) together comprise the RCEP’s biggest component in terms of market size.

Why is India concerned?

Greater access to Chinese goods may have impact on the Indian manufacturing sector. India has got massive trade deficit with China. Under these circumstances, India proposed differential market access strategy for China.

There are demands by other RCEP countries for lowering customs duties on a number of products and greater access to the market than India has been willing to provide.

Why India should not miss RCEP?

If India is out of the RCEP, it would make its exports price uncompetitive with other RCEP members’ exports in each RCEP market, and the ensuing export-losses contributing to foreign exchange shortages and the subsequent extent of depreciation of the rupee can only be left to imagination. Some of the sectors that have been identified as potential sources of India’s export growth impulses under RCEP to the tune of approximately $200 billion.

There are more compelling trade and economic reasons for RCEP to become India-led in future, than otherwise. India would get greater market access in other countries not only in terms of goods, but in services and investments also.

H1N1

In News:

In a trend that has become a cause for concern for health authorities in Maharashtra, nearly 82% of deaths.

About H1N1:

• Swine flu, also known as the H1N1 virus, is a relatively new strain of an influenza virus that causes symptoms similar to the regular flu.
• The H1N1 infection was originally transmitted through contact with pigs, but now it can be spread from person to person.
• Its symptoms, which include fever, coughing, a sore throat, and body ache, are similar to the regular flu.
• But if not treated, the H1N1 infection can lead to more serious conditions, including pneumonia and lung infections.
• The risks are especially high for children under the age of five and the elderly.

What was the measure taken by the government in the past?

• The quadrivalent vaccine for active immunisation of adults of age 18 to 64 years was approved in May 2018 by the Drug Controller General of India (DCGI).
• For years, flu vaccines were designed to protect against three different flu viruses (trivalent vaccines).
• Trivalent vaccines include an influenza A (H1N1) virus, an influenza A (H3N2) virus and one influenza B virus.
• However, the quadrivalent flu vaccine will contain four influenza virus strains (two influenza A subtypes and two influenza B subtypes — H1N1 and H3N2, and Victoria and Yamagata respectively).
• The viruses used in the vaccine are killed and this eliminates the possibility of the virus in the vaccine itself causing infection.
• However, most public health programmes are not prepared for a mass adoption of this vaccine.
• There are also reports of non-availability of sufficient doses of quadrivalent vaccine.

Traditional Knowledge Digital Library (TKDL)

India possesses a rich traditional knowledge which is generally being passed down by word of mouth from one generation to another. Most part of this traditional knowledge is inaccessible to common since it is described in ancient classical and other literature. There is also a threat of misuse of such knowledge through obtaining patents on non-original innovations which is a great loss to the country. TKDL addresses these issues.

What is TKDL?

• TKDL is an initiative to provide the information on traditional knowledge existing in the country, in languages and format understandable by patent examiners at International Patent Offices (IPOs), so as to prevent the grant of wrong patents.
• TKDL is a collaborative project of the Council of Scientific and Industrial Research (CSIR) and the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, is situated in Ghaziabad, U.P.
• TKDL acts as a bridge between the traditional knowledge information existing in local languages and the patent examiners at IPOs.

How is it evolved?

• TKDL uses the tools of information technology and a novel classification system to make available traditional medical knowledge in digital form.
• Vinod Kumar Gupta, who set up TKDL, devised a modern classification based on the structure of International Patent Classification (IPC) for India’s traditional systems: Ayurveda, Unani, Siddha & Yoga.
• The India’s traditional knowledge is found in Sanskrit, Tamil, Malayalam, Kannada, Arabic, Persian and Urdu texts. This is inaccessible and incomprehensible to patent examiners overseas. The focus of TKDL was on breaking the language and format barriers by scientifically converting and structuring the available TK in IPC.
• The Traditional Knowledge Resource Classification (TKRC) has resulted in a fundamental reform of IPC by enhancing the TK segment from one sub-group to 207 sub-groups, thus enabling effective search and examination process.

How does it work?

• The knowledge obtained from ancient Indian texts is stored in 34 million A4 size pages and translated into five foreign languages – in Japanese, English, Spanish, German and French.
• It is not a transliteration; rather it is a knowledge-based conversion, where data abstracted once is converted into several languages by using Unicode, Metadata methodology.
• TKDL has signed access and non-disclosure agreements with the Indian and seven other global patent offices. This ensures near-foolproof security for our invaluable bioresources against piracy.
• All of this required not just high-end technology but also skills of a high technical order. And there were people with knowledge of ancient texts, modern medicine and technical terms of foreign languages.
• This was a tremendous exercise of global proportions and the price for this unique propriety system was Rs. 16 crore.

What are the benefits?

• TKDL has identified 1,000 cases of biopiracy of India’s TK in the last 3 years. In 105 cases, patent claims were withdrawn or cancelled by the patent offices. This is done at no cost to India and it takes very less time. All that is required is an e-mail to the relevant patent office.
• There is necessity to spend huge legal fees and time in fighting biopiracy. For example, the Agricultural and Processed Food Products Export Development Authority (APEDA) spent 7 years and Rs 7.62 crore in legal fees to fight the intellectual property rights battle for basmati rice.
• There has been as much as a 44% decline in patent claims filed on Indian systems of medicine.
• Now TKDL also includes videos of the most common yoga postures. This is avoids grating wrong patents for Yoga exercise in the west which is an increasing trend.