Ms. Melinda Gates calls on Health Minister Shri J P Nadda



Ms. Melinda Gates calls on Health Minister Shri J P Nadda 

Appreciates initiatives in Maternal Health, Family Planning and Health Systems Strengthening 


Ms. Melinda Gates, Co-Chair & Trustee, Bill and Melinda Gates Foundation called on the Union Minister for Health & Family Welfare, Shri J P Nadda, here today. They discussed various issues relating to the health sector in India. During the meeting, Ms. Gates expressed appreciation for the initiatives taken by the Ministry towards strengthening the health systems, particularly in the primary health care, in addition to the success of full immunization through Mission Indradhanush and the resolve and commitment to launch new vaccines to protect the children and India’s population from various diseases. 

The Health Minister, Shri J P Nadda, stated that the Government is committed to providing universal health coverage to all citizens through newly declared scheme on Health Insurance. He added that the Government understands the significance of improving the delivery of public health provisions including vaccination, family planning and maternal health outcomes, in promoting all-round growth and development of women and children, who are the bedrock of a healthy nation. 

The Health Minister appreciated the efforts of Gates Foundation in complimenting the efforts of the Government in the health sector, which has enhanced the capacity of the health workers for more effective implementation of the projects. 

The Health Minister elaborated on the new initiatives of the Government such as Mission Indradhanush aimed to cover all missed-out and left-out children with cover of full immunization and the successes within the nation-wide initiative. He also stated that Rotavirus will soon be introduced in select states in the first phase. 

Commending the health initiatives taken by the Government Ms. Gates stated that the advances made in the area of immunization, Family Planning, Kala Azar, Health Systems Strengthening are indeed appreciable. The measures taken to increase the basket of choices for contraceptives are a progressive move, she said. 

Also present in the meeting were, Dr. (Prof) Jagdish Prasad, DGHS, Shri C K Mishra, AS&MD, and other senior officers of the Health Ministry and representatives of Gates Foundation. 

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Medical Devices under Jan Aushdhi Scheme 

Medical devices, including surgical and consumable items, are defined as ‘drugs’ under the Drugs and Cosmetics Act, 1940. As per the information provided by Department of Pharmaceuticals, 165 surgical and consumable items are already being sold through Jan Aushadhi Stores. 

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

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Medical Research 

The facilities for research in Medical Colleges need to be strengthened. The Department of Health Research initiated a scheme titled Establishment of Multi-disciplinary Research Units in Medical Colleges across the country to build up infrastructure facilities for conducting research. This scheme has been approved to establish 80 Multidisciplinary Research Units (MRUs) in State Govt. Medical Colleges during 12th plan period. 

Objectives of the scheme are: 

i. Encourage and strengthen an environment of research in medical colleges. 

ii. Bridge the gap in the infrastructure which inhibits health research in the Medical Colleges by assisting them to establish multidisciplinary research facilities with a view to improve the health research and health services. 

iii. To ensure the geographical spread of health research infrastructure, in order to cover un-served and under-served Medical Colleges and other institutions 

iv. To improve the overall health status of the population by creating evidence-based application of diagnostic procedures/processes/methods. 

So far 52 number of MRUs have been sanctioned across the country. 

The papers published /research projects undertaken by the students of post-graduate courses/PhD are well above standard and many of the publications feature in the international journals. The Department of Health Research has taken steps to augment the research infrastructure and to promote quality research papers as per the above scheme titled Establishment of Multi- disciplinary Research Units. 

The Minister of State (Health & FW), ShriShripadYessoNaik stated this in a written reply in the LokSabha here today. 

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Mental Health Policy 

The National Mental Health Policy, announced in October, 2014, is based, inter-alia, on the values and principles of equity, justice, integrated and evidence based care, quality, participatoryand holistic approach to mental health. Its goals and objectives include the following: 

to reduce distress, disability, exclusion, morbidity and premature mortality associated with mental health problems across life-span of a person, 

to enhance understanding of mental health in the country, 

to provide universal access to mental health care, 

to increase access to mental health services for vulnerable groups, 

to reduce risk and incidence of suicide and attempted suicide, 

to ensure respect for rights and protection from harm of persons with mental health problems, and reduce stigma associated with mental health problems 

to enhance availability and distribution of skilled human resources for mental health. 

The Government has approved the continued implementation of the National Mental Health Programme during the 12th Five Year Plan period with additional components. The financial support for establishment of each Centre of Excellence in the field of mental health has been increased from Rs. 30 crores to Rs. 33.70 crores per Centre. 

With the objective to address the shortage of mental health professionals in the country, 15 Centres of Excellence in Mental Health and 35 PG training departments in mental health specialties to increase the PG training capacity in mental health as well as improving the tertiary care treatment facility have been funded. 

During the current Plan period, the District Mental Health Programme (DMHP) has been extended to 118 new districts in addition to the 123 districts of the 11th Five Year Plan period. Under DMHP, enhanced financial assistance is being provided to the districts for detection, management and treatment of mental disorders/ illness and additional components like suicide prevention services, work place stress management, life skills training and counselling in schools and colleges, etc. Financial support has been increased from Rs. 46.37 lakhs to Rs. 83.70 lakhs per district per year. 

Sufficient financial assistance is also provided to the three Central Institutions viz. National Institute of Mental Health And Neuro Sciences, Bangalore, LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur and Central Institute of Psychiatry, Ranchi. 

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

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Stem Cell Therapy 



There is no treatment regime using Stem Cells has been established yet, however, treatment using Stem Cell is only valid for diseases like Cancer. All India Institute of Medical Sciences (AIIMS), New Delhi, is providing treatment through Stem Cell Therapy to Cancer patients only.

The Indian Council of Medical Research (ICMR), in collaboration with the Department of Biotechnology, has prepared the National Guidelines for Stem Cell Research in the year 2013. These guidelines apply to all stakeholders including individual researchers, organizations, sponsors, oversight/regulatory committees and any others associated with both basic and clinical research on all types of human stem cells and their derivatives. The details are given below:



Salient features of the guidelines

National Guidelines for Stem Cell Research (2013) apply to all stakeholders including individual researchers, organizations, sponsors, oversight/regulatory committees and any others associated with both basic and clinical research on all types of human stem cells and their derivatives. As per the National Guidelines for Stem Cell Research (2013), an additional layer of oversight, besides the Institutional Ethics Committee (IEC), in the form of Institutional Committee for Stem Cell Research (IC-SCR) and National Apex Committee for Stem Cell Research and Therapy (NAC-SCRT) has been introduced to review and monitor stem cell research at the institutional as well as the national level. A National Apex Committee for Stem Cell Research and Therapy (NAC-SCRT) will monitor and oversee activates at national level and institutional Committee for Stem Cell Research(IC-SCR) at institutional level. These oversight committees shall ensure that review, approval and monitoring of all research projects in the field of stem cell research are done rigorously and effectively as per the National Guidelines. This mechanism of additional review has been accepted by the scientific community in the country and the NAC-SCRT has become operational after its notification by Department of Health Research (DHR) on 29th October 2012. Till date, 82 organizations/ institutes across the country have applied for registration of their IC-SCRs with NAC-SCRT. Out of which only 5 institute have fulfilled the criteria and have been granted registration. The status of registration of these organizations is available at NACSCRT website.

Clinical Research/Trial

Clinical trials using human stem cells should be in compliance with Schedule Y of Drugs and Cosmetics Act and GCP Guidelines of CDSCO                                                (www.cdsco.nic.in)as well as ICMR Ethical Guidelines for Biomedical Research involving Human Participants (http://www.icmr.nic.in/ethical guidelines.pdf). Clinical trial protocol shall be formulated as per the format given in Annexure-II. The clinical research on stem cells must be performed only by appropriately qualified medical practitioners and in medical institutions with adequate infrastructure licensed by appropriate authority as per existing regulations (Clause 7.1). Reagents used for the derivation of humans ES or iPS cell lines, or expansion/enrichment of SSCs, for purposes of clinical trials should be of clinical – grade. The patient information sheet and the informed consent form shall specifically address:

a)      Information regarding the present status of use of stem cells in the given condition, experimental nature of the proposed clinical study and its possible short and long term risks.
b)      Information stating irreversibility of the intervention.
c)      Information regarding source and characteristics of stem cells and degree of their ex-vivo manipulation, if any.
d)     Information on the established standard of care for a given condition
e)      Information on the sample size and duration of study
f)       The information sheet and the consent form should be approved by IEC and IC-SCR and the same should be clearly mentioned in these documents.


Regulatory Approvals:-

1.    All clinical trials using stem cells shall be registered with CTRI http://ctri.nic.in/Clinicaltrials/longin.php
2.    Clinical trial proposals using minimally manipulated autologous SSCs hall be approved by IC-SCR and IEC.

As per the Indian Council of Medical Research (ICMR) National Guidelines for Stem Cell Research (2013), there are no approved indications for Stem Cell Therapy other than the Hematopoietic Stem Cell Transplantation (HSCT) for hemological disorders.

The Minister of State (Health and FW), Shri Shripad Yesso Naik stated this in a written reply in the Lok Sabha here today.


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Registration Under Clinical Establishments Act 

The Indian Medical Association has, in its correspondence with the Department of Health and Family Welfare, stated that the objectives sought to be achieved by Clinical Establishment (Registration and Regulation) Act, 2010 (CEA), can also be achieved by accreditation of such establishments by National Accreditation Board for Hospitals (NABH). 

Accreditation is a voluntary process and cannot be the basis for regulation. Only very few health care facilities have voluntarily applied for NABH accreditation so far. NABH accreditation is however, not a substitute for registration and regulation under the CEA. In terms of CEA, no one can run a clinical establishment unless it is duly registered under the Act. Further, the CEA does not have any provision to exempt accredited hospitals from registration. 

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

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Spinal Injury Centre 

A Central Sector Scheme of setting of State Spinal Injury Centre is administered by the Ministry of Social Justice and Empowerment whose salient features, inter alia is as under: 

(i) The State Spinal Injuries Centres shall be mainly on the comprehensive management of Spinal Injured attached to the District Hospital of State capital/Union Territory with dedicated 12 beds. 

(ii) The Department of Orthopedics and Rehabilitation attached to the District Hospital where the Centre is to be set up shall look after the activity of the Centre. Two such centres are envisaged per year under the Scheme based on availability of funds. 

The Central Government shall bear the non-recurring expenditure up to Rs.2.33 crore on medical equipment, medical/surgical instruments (OT), rehabilitation equipment- (a) OT & PT (b) Orthotics and Prosthetics and (c) assistive technology and non-recurring expenditure cost up to Rs.56.00 Lakh for setting up of 12 beds Ward. Out of 12 beds, the Central Government shall reimburse the cost involved on management of 10 beds daily for treatment of poor patients on actual occupancy basis at a flat rate of Rs.1000/- per bed per day. In addition, Central Government shall bear training cost @ Rs.20 lakh per Centre of the orthopedic surgeons, nursing staff and rehabilitation staff. 

The State Govt./UT shall provide requite space for setting up the Centre and expenditure on infrastructure cost e.g. basic structure work, finishing work including interior and other engineering services and cost on engineering plant requirement, if required. The recurring cost on salaries of medical, paramedical and allied health staff required for running the Centre; drugs and consumables; maintenance of infrastructure and equipment shall be borne by the concerned State Govt./UT. In addition, the State Govt./UT shall also bear recurring expenditure on management of two beds and partially bear the cost involved on training/technical support/sensitization of the doctors and staff. 

A proposal for setting up of State Spinal Injury Centre at Sawai Man Singh Medical College, Jaipur was received from the State Government of Rajasthan which was approved. Based on availability of funds under the Scheme during 2015-16, grant-in-aid amounting to Rs.37.50 lakh has been released for the Centre. 

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

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Accreditation of Medical Colleges 

Permission for starting of a medical college/yearly renewal permission / recognition of degree is granted by the Central Government on the recommendation made by the Medical Council of India (MCI) after assessment of infrastructure and other facilities available as per regulations prescribing minimum requirements in terms of infrastructure, faculty and clinical material. The Medical Colleges which fail to meet the required standards are not given permission / renewal permission / recognition. 

The Government has taken the following steps to promote medical education in the country: 

I. The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry. 

II. DNB qualification has been recognized for appointment as faculty to take care of shortage of faculty. 

III. Enhancement of maximum intake capacity at MBBS level from 150 to 250. 

IV. Enhancement of age limit for appointment/extension/re-employment against posts of teachers/dean/principal/ director in medical colleges from 65-70 years. 

V. Relaxation in the norms for setting up of a medical college in terms of requirement for land, faculty, staff, bed/ bed strength and other infrastructure. 

VI. Strengthening/upgradation of State Government Medical Colleges for starting new PG courses/Increase of PG seats with fund sharing between the Central and State Government. 

VII. Establishment of New Medical Colleges attached with district/referral hospitals in underserved districts of the country with fund sharing between the Central Government and States. 

VIII. Strengthening/ upgradation of existing State Government/Central Government Medical Colleges to increase MBBS seats with fund sharing between the Central Government and States. 

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

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Steps Being Taken for Combatting Infant Mortality 

The steps being taken by the government to combat infant mortality and increase vaccine coverage under the national Health mission are as under:

       I.            Promotion of Institutional deliveries through cash incentive under JananiSurakshaYojana (JSY) and JananiShishuSurakshaKaryakaram (JSSK) which entitles all pregnant women delivering in public health institutions to absolutely free and no expense ante-natal check-ups, delivery including Caesarean section, post-natal care and treatment of sick infants till one year of age.
    II.            Strengthening of delivery points for providing comprehensive and quality Reproductive, maternal, newborn, Child and Adolescent Health (RMNCH+A) Services,  ensuring essential newborn care at all delivery points, establishment of Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.

 III.            Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted in convergence with Ministry of Women and Child Development. Village Health and Nutrition Days (VHNDs) are observed for provision of maternal and child health services and creating awareness on maternal and child care including health and nutrition education.

 IV.            Universal Immunization Programme (UIP) is being supported to provide vaccination to children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Pentavalent vaccine has been introduced all across the country and “Mission Indradhanush” has been launched to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunization for various reasons.

    V.            Name based tracking of mothers and children till two years of age (Mother and Child Tracking System) is done to ensure complete antenatal, intranatal, postnatal care and complete immunization as per schedule.

 VI.            RashtriyaBalSwasthyaKaryakram (RBSK) for health screening, early detection of birth defects, diseases, deficiencies, development delays including disability and early intervention services has been operationalized to provide comprehensive care to all the children in the age group of 0-18 years in the community.

VII.            Some other important interventions are Iron and folic acid (IFA) supplementation for the prevention of anaemia among the vulnerable age groups, annual deworming on National Deworming Day (NDD), home visitation by ASHAs to promote exclusive breast feeding and early detection and referral of sick newborns and promote use of ORS and Zinc for management of diarrhoea in children.

VIII.            To sharpen the focus on the low performing districts, 184 High Priority Districts (HPDs) have been prioritized for Reproductive Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.


As per the Indian Council of Medical Research (ICMR) National Guidelines for Stem Cell Research (2013), there are no approved indications for Stem Cell Therapy other than the Hematopoietic Stem Cell Transplantation (HSCT) for hemological disorders.

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


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Health Service Delivery 

One of the responsibilities of the Department of Health Research (DHR) is to ensure that health-related policies are formulated on informed decisions derived from sound evidence. The Department of Health Research through its research arm of the Indian Research Council of Medical Research (ICMR), continuously develops and implements the research leads which have the potential of being developed into health technologies. A translational research division is already functional in ICMR for utilisation of knowledge network service delivery, medical education and research. 

The Minister of State (Health & FW), Shri Shripad Yesso Naik stated this in a written reply in the Lok Sabha here today. 

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Health Protection Scheme 

The Hon’ble Finance Minister, in his Budget Speech for 2016-17 on 29.02.2016, announced that “Government will launch a new health protection scheme which will provide health cover up to Rs. One Lakh per family, for poor and economically weaker families. For Senior Citizens of age 60 years and above, belonging to this category, an additional top-up package up to Rs. 30,000 will be provided.” 

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

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Citizen-Centric IT-Based Health Services 

Government has launched the following new IT-based initiatives on Citizen Centric Health Services:

·      Kilkari– It delivers free, weekly, time-appropriate audio messages about pregnancy, child birth and child care delivery to families’ mobile phones.



·      National Health Portal (NHP)-A citizen portal for health to provide authentic  information on various health issues to public. It has a toll-free number for citizens to access reliable, easy to understand and multilingual health information.



·      Online Blood stock availability on National Health Portal and Mobile App- It is a mobile app to locate hospitals and blood banks in nearby location and provides easy access to public for searching blood/blood products availability in all licensed Blood Banks across India.



·      Tobacco Cessation Programme – It is a mHealth Initiative in collaboration with WHO for Tobacco Cessation.



·      Online registration System (ORS)-For online registration, payment of fees and online appointment, online diagnostic reports, enquiring availability of blood online etc.



·   Missed Call Centre for reaching unreached TB patients – A dedicated toll free number with a call centre that is currently available in the States of Punjab, Haryana, Chandigarh and Delhi.

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


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Availing of Benefits of CGHS Wellness Centres 

CGHS beneficiaries including senior citizens can avail of specialist consultation from any government institution of the Central Government, State Government or local bodies. However, to avail of a procedure/investigation from a private empanelled hospital, a referral from the concerned CGHS Wellness Centre is necessary. 

Following efforts have been made to provide better services to the senior citizens/pensioners: 

1. There is a separate queue for senior citizens/ pensioners at registration counter and pharmacy counter in the CGHS Wellness Centres. 

2. Senior citizens / pensioners can consult CMO i/c without standing in queue. 

3. In case of emergency, CGHS beneficiaries including Senior citizens / pensioners can visit any hospital, empanelled or non-empanelled and avail medical treatment without any referral. 

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

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