Initiatives and Achievements: Health Ministry Review 2016

Written by savita thakur thakur Published On 2016-12-27T12:54:47+05:30 | Updated On 27 Dec 2016 12:54 PM IST

The Ministry of health and family welfare has set several of milestones in filed of Healthcare in the year of 2016. Here is the review of all the achievements and Initiatives:

The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)

Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is aimed at reducing maternal and infant mortality rates through safe pregnancies and safe deliveries. The national programme will provide special free antenatal care to about 3 crore pregnant women across the country in order to detect and prevent high risk pregnancies. The nationwide programme will provide fixed day assured, comprehensive and quality antenatal care to pregnant women on the 9th of every month. Pregnant women can now avail of a special antenatal check-up in their second or third trimesters at Government health facilities provided by gynecology specialists/ physicians with support from private sector doctors to supplement the efforts of the Government sector. These services including ultrasound, blood and urine tests will be provided in addition to the routine antenatal check-ups at the identified health facility/outreach in both rural and urban areas. One of the aims is to identify and follow-up on high risk pregnancies in order to reduce MMR and IMR.

MAA-Mother’s Absolute Affection

A nationwide programme launched in an attempt to bring undiluted focus on promotion of breastfeeding and provision of counselling services for supporting breastfeeding through health systems. The programme has been named ‘MAA’ to signify the support a lactating mother requires from family members and at health facilities to breastfeed successfully. The chief components of the MAA Programme are Community awareness generation, Strengthening inter personal communication through ASHA, Skilled support for breastfeeding at delivery points in public health facilities, and monitoring and award/recognition.

Introduction of new vaccines

Rota virus vaccine: In order to prevent the morbidity and mortality in children due to rotavirus, Rotavirus vaccine was introduced in Universal Immunization Programme in a four states initially i.e. Himachal Pradesh, Haryana, Odisha, Andhra Pradesh in April 2016 as recommended by the Expert Committee constituted for the same.

Adult JE vaccine: Japanese Encephalitis vaccination was expanded in adult population of districts with high disease burden of adult JE. Recently, 21 high burden districts from Assam, Uttar Pradesh and West Bengal have been identified for adult JE vaccination. Adult JE vaccination campaign activity has been completed in 3 districts of Assam (Darrang, Nagaon and Sonitpur) and selected blocks of 3 districts (Darjeeling and Jalpaiguri, Alipurduar) of West Bengal and campaign is ongoing in selected blocks of 6 districts of Uttar Pradesh.

Mission Indradhanush

Second phase of MI continued in Jan 2016 in 352 districts. Phase III was implemented from April to July 2016 in 216 districts of the country.

During all the three phases, (as on 1st August 2016, 2.08 crore children have been vaccinated of which 54.5 lakh children have been fully immunized. In addition, 55.4 lakh pregnant women were vaccinated against tetanus toxoid.

According to Integrated Child Health and Immunization Survey 2016, full immunization coverage has increased by about 5-7% after the launch of mission Indradhanush.

Family Planning

Expanding basket of choices: Three new methods have been introduced in the National Family Planning program:

Injectable Contraceptive DMPA (Antara) – a 3-monthly injection

Centchroman pill (Chhaya) – a non-hormonal once a week pill

Progesterone-only pills (POP) – for lactating mothers

Improved Contraceptive Packaging: The packaging for Condoms, Oral contraceptive pills (OCP) and Emergency Contraceptive Pills (ECP) has now been redesigned and improved so as to increase the demand for these commodities.

New Family Planning Media Campaign: A 360 degree holistic Family Planning campaign with a new logo has been launched with Shri Amitabh Bachchan as the brand ambassador.

Intensified Diarrhoea Control Fortnight (IDCF)

The Intensified Diarrhoea Control Fortnight (IDCF) was observed from 11th to 23rd July across the country. The importance of this activity is that ORS will be available in the household when needed at the time of diarrhea. ORS corners which were operational at health facilities continuously demonstrated the way to prepare the ORS mixture. These corners also administer ORS and Zinc to children who are in need of these during diarrhoea. With a sharpened focus on demand generation, an important component of the IDCF is IEC activities that shall not only create awareness but also generate demand. Intensified community awareness campaigns on hygiene and promotion of ORS and Zinc therapy were conducted at the state, district and village levels. There are about 10 crore children below five years of age across the country. During last year, due to the interventions carried out as part of IDCF, about 6.3 crore children were reached out to. This year in order to expand the cover of this fortnight; the target was to cover all the under-5 children. 21 lakh children could be prevented from hospitalisation and death due to Diarrhoea last year. More than 5 lakh schools participated in the IDCF campaign and more than 3.5 lakh ORS corners were set up in the country.

National Deworming Day (NDD)

The National Deworming Day, a flagship initiative of the Ministry of Health & Family Welfare, was observed on 10 February 2016. It is the largest ever single-day public health campaign in the world targeting approximately 27 crore children aged 1-19 year throughout the country at risk of parasitic worm infection, through the platform of schools and anganwadi centres. The target population includes 8 crore and 19 crore children in the age group of 1-5 and 6-19 years respectively across 561 districts of the country. Over 900,000 education and health workers administered Albendazole tablet to crores of children in schools and anganwadis across India yesterday. 137 districts in 14 States have been excluded from the deworming initiative this year as they have already covered during Mass Drug Administration in Lyphatic Filarsis program of the Health Ministry.

Longitudinal Ageing Study in India (LASI)

LASI is the largest study on older population in the country. The International Institute for Population Sciences (IIPS), Mumbai in collaboration with Harvard School of Public Health (HSPH) and University of Southern California (USC), USA is undertaking the “The Longitudinal Ageing Study in India” under the aegis of the Ministry of Union Health and Family Welfare. LASI is jointly funded by the Union Ministry of Health and Family Welfare, the United States’ National Institute on Ageing, and the United Nations Population Fund-India.

As no sufficiently broad nationally representative dataset on older population is currently available in India, comprehensive new scientific data are needed to conduct analyses of health, economic and social challenges based on population ageing and to formulate mid- and long-term policies and programmes to address these and other challenges presented by population ageing. LASI will contribute greatly to the newly launched the National Programme for Health Care for the Elderly (NPHCE) and the social and economic security programmes planned to be initiated by the Ministry of Social Justice and Empowerment (MoSJE). LASI will help in expanding the scope of health and social security policy and programmes for older population.

Pradhan Mantri National Dialysis Programme

Under the ‘Pradhan Mantri National Dialysis Programme’, support is being provided to all States for provision of free dialysis services for poor. Guidelines for dialysis services in District Hospitals in PPP mode have been shared with States/UTs on 27 April, 2016. The Guidelines contain model Request for Proposal (RFP). As per the guidelines, the private partner is envisaged to provide medical human resource, dialysis machines along 9 Schemes of Department of Health & Family Welfare with Reverse Osmosis (RO) water plant infrastructure, dialyzer and consumables, while the space, power, and water supply within District Hospitals would be provided by the State Government. All States/UTs were requested to incorporate proposals for roll out of National Dialysis Programme in Programme Implementation Plans (PIPs) for 2016-17. Approval has been accorded to all States for implementing the Pradhan Mantri National Dialysis Programme.

Centre for Integrative Medicine and Research (CIMR) at the All India Institute of Medical Sciences (AIIMS)

The Center for Integrative Medicine and Research is a pioneering initiative by AIIMS, New Delhi in the quest for convergence of contemporary medicine with India’s ancient and traditional medical practices. It has been envisioned as a “state of the art” research center where top experts from various disciplines of contemporary medicine will collaborate with Yoga and Ayurveda specialists, both for disease treatment, and for preventive healthcare. The Center will seek scientific validation of our ancient medicine systems with a focus on Yoga. It has been designed as a perfect platform for rigorous research to establish the efficacy of our traditional methods of healing, which in turn should pave the way for their greater international scientific acceptability.

I.T. Initiatives

a) Swasth Bharat Mobile application - “Swasth Bharat Mobile Application” to empower the citizens to find reliable and relevant health information. The application provides detailed information regarding healthy lifestyle, disease conditions (A-Z), symptoms, treatment options, first aid and public health alerts. The application “Swasth Bharat Mobile Application” is an Android based mobile application, which can be installed on any device with Android OS version 2.3 or above. The application will be launched soon for other popular platforms.

b) ANM Online application (ANMOL)-ANMOL is a tablet-based application that allows ANMs to enter and updated data for beneficiaries of their jurisdiction. This will ensure more prompt entry and updation of data as well as improve the data quality since the data will be entered “at source” by providers of health services themselves. Since the Application is Aadhaar-enabled, it will help in authentication of the records of field workers and beneficiaries.

c) E-RaktKosh initiative- It is an integrated Blood Bank Management Information System that has been conceptualized and developed after multiple consultations with all stakeholders. This web-based mechanism interconnects all the Blood Banks of the State into a single network. The Integrated Blood Bank MIS refers the acquisition, validation, storage and circulation of various live data and information electronically regarding blood donation and transfusion service. Such system is able to assemble heterogeneous data into legible reports to support decision making from effective donor screening to optimal blood dissemination in the field.

d) India Fights Dengue- Launched in 2016, this App empowers the community members how to contribute towards prevention of Dengue.

e) Kilkari, which means ‘a baby’s gurgle’, delivers free, weekly, time-appropriate 72 audio messages about pregnancy, child birth and child care directly to families’ mobile phones from the second trimester of pregnancy until the child is one year old. Kilkari has been launched in Jharkhand, Odisha, Uttar Pradesh, Uttarakhand and High Priority Districts (HPDs) of Madhya Pradesh and Rajasthan in the first phase.

f) Mobile Academy is a free audio training course designed to expand and refresh the knowledge base of Accredited Social Health Activists (ASHAs) and improve their communication skills. Mobile Academy offers ASHAs a training opportunity via their mobile phones which is both cost-effective and efficient. It reduces the need to travel – sometimes great distances – and provides them the flexibility they need to learn at their own pace and at times they find convenient. Mobile Academy is being launched in Jharkhand, Madhya Pradesh, Rajasthan and Uttarakhand.

g) M-Cessation aims at reaching out to those willing to quit tobacco use and support them towards successful quitting through text messages sent via mobile phones. When offered along with traditional services, M-Cessation has been found to be cost-effective in comparison to traditional options for cessation support. This is first time in the world that such a two way service is being provided as part of any mHealth initiative.

h) National Health Portal (NHP) was launched to provide healthcare related information to the citizens of India and to serve as a single point of access for consolidated health information.

i) Online Registration System (ORS): Online Registration System (ORS) is a framework to link various hospitals across the country for Aadhaar based online registration and appointment system, where counter based OPD registration and appointment system through Hospital Management Information System (HMIS) has been digitalized. The Portal facilitates online appointments with various departments of different hospitals using eKYC data of Aadhaar number, if patient's mobile number is registered with UIDAI.

j) National e-Health Authority (NeHA) will be an integrated health information system. It will help avoid problems arising out of uncoordinated induction of IT systems in hospitals and public health systems. It will also enforce the laws and regulations relating to the privacy and security of patients' health information and records. There would be a provision of Electronic Health Records (EHR) of patients.

k) M-Diabetes initiative was launched to harnesses the power and potential of the vast mobile telephony network. With a missed call to 011-22901701 the caller can get more information on Diabetes and how to prevent and manage it. One can also log on to mdiabetes.nhp.gov.in for more information.

Disease Control

Tuberculosis

500 Cartridge Based Nucleic Acid Amplification Test (CBNAAT) machines inducted in the TB programme. The CBNAAT is a revolutionary rapid molecular test which detects Mycobacterium tuberculosis and rifampicin drug resistance, simultaneously. This test is fully automated and provides results within two hours. It is a highly sensitive diagnostic tool and can be used in remote and rural areas without sophisticated infrastructure or specialized training. Until 2015, 121 CBNAAT sites are functional in the country largely providing decentralized testing for detection of DR TB. With the availability of these additional 500 machines, access to rapid quality assured diagnosis of DR TB and TB will be ensured in all the districts of India either directly or through a linkage by specimen transport mechanism. Additionally, the programme will be able to use this highly sensitive state-of-art technology for diagnosis of TB among key populations like children, PLHIV and extra pulmonary TB patients.

Bedaquiline was launched as part of the RNTCP. The drug is a new anti-TB drug for treatment of MDR-TB. This new class of drug is a diarylquinoline that specifically targets Mycobacterial ATP synthase, an enzyme essential for supply of energy to Mycobacterium tuberculosis and most other mycobacteria. This drug is indicated for use in the treatment of drug-resistant TB. Bedaquiline has been introduced at six identified tertiary care centres across India. These sites have advanced facilities for laboratory testing and intensive care for patients. Bedaquiline will be given to multi-drug resistant TB patients with resistance to either all fluoroquinolone and/or all second line injectables and extensive drug resistant TB.

HIV/AIDS control

Third line ART programme for People Living with HIV launched - The life-saving third line ART costs nearly Rs. 1.18 lakh per patient per year. Providing these free would not only safe lives but improve socioeconomic conditions of the patients. This initiative brings India’s ART programme at par with programmes in the developed countries.

Control of Communicable diseases (Malaria, Dengue, Chikungunya, Kala-Azar)

The National Framework for Malaria Elimination (NFME) was launched on 11^th February 2016. Preventive measures by source reduction, engineering methods, use of Long Lasting Insecticidal Nets (LLIN), Indoor Residual Spray (IRS), repellents, early case detection, complete treatment are part of the strategy.

The Ministry provided Technical Guidelines to the States for prevention and control including vector control and also uploaded these guidelines on National Vector Borne Disease Control Programme (NVBDCP) website www.nvbdcp.gov.in.

Focused IEC/BCC activities were carried out at National and State level with media mix strategies focusing on source reduction and personal protective measures. A user friendly Dengue App “India Fights Dengue” has been launched on 7th April, 2016.

‘National Dengue Day’ was observed on 16th May 2016 throughout the country. ‘Strategy and Plan of action for Effective Community Participation for Prevention and Control of Dengue’ has been shared with the States/UTs uploaded on the NVBDCP website.

Accredited Social Health Activists (ASHAs) were involved in source reduction activities (emptying containers to prevent breeding of vector mosquitoes) for Dengue prevention and control. The Ministry also provided funds to the States/UTs for prevention and control of Vector Borne Diseases including Dengue to implement the public health measures.

Also Kala-azar is targeted for elimination by 2017 and Lymphatic Filariasis by 2020 and as of now eliminated in 502 out of 625 endemic blocks (80%) in Bihar, Jharkhand, West Bengal and Uttar Pradesh.

Non-Communicable Diseases (NCDs)

The programme aims at providing early diagnosis and management of common NCDs, build capacity at various levels of health care facilities for prevention, diagnosis and treatment of common NCDs.

Under national programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS), 356 district NCD cells and 356 district NCD clinics have been established.

103 cardiac care units, 71 day care centres and 1871 CHC level NCD clinics have been setup.

The tertiary care cancer centers (TCCC) scheme, 20 state cancer institutes (SCI) and 50 TCCCS envisaged

So far five (10) TCCC and six (10) SCI have been supported with financial assistance under the scheme.

AYUSH facilities and methodologies and yoga integrated with NPCDCS services

Scientific study commissioned to document impact of yoga on diabetes (S-VYASA University and HLL).

Big Thrust to Hospitals

a) Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

The PMSSY envisages creation of tertiary healthcare capacity in medical education, research and clinical care, in the underserved areas of the country. It aims at correcting regional imbalances in the availability of affordable/reliable tertiary healthcare services and also augmenting facilities for quality medical education in the country.

DPR in r/o all the 39 GMCs under Phase –III have been approved. Standard Tender Document for civil work and Standard Contract Agreement for Project Management and Supervision Consultancy services, have been approved. MoU between Executing Agencies i.e HSCC (I) and HITES and MoHFW has been signed. MoU between CPWD and MoHFW has also been signed.

Tenders for 38 GMCs have since been floated by concerned Executing agencies.

Tender for civil work has been awarded in respect of 33 GMCs

Out of 19 State Governments, MoU with 12 State Governments have been signed by MoHFW.

Project Funds amounting to Rs 398.6695 crore for civil works have been released to Executing Agencies

Foundation stone has been laid by Hon’ble HFM in r/o Assam Medical College, Dibrugarh, Assam, Guwahati Medical College, Guwahati, Assam, Government TD Medical College, Alappuzha, Kerala, Gajra Raja Medical College, Gwalior, Madhya Pradesh, Shyam Shaha Medical College, Rewa, Baba Raghav das Medical College, Gorakhpur and Netaji Subhash Chandra Bose Medical College, Jabalpur. Foundation stone for LLRM Medical College, Meerut and MLB Medical College Jhansi and MLN Medical College Allahabad.

Work Committee to review the progress of execution of up-gradation work under Phase III has been constituted

Cabinet approved establishment of new AIIMS at Gorakhpur in Uttar Pradesh under Phase-IV of PMSSY

Cabinet approved establishment of new AIIMS at Bathinda in Punjab under Phase-V of PMSSY

Cabinet approved up-gradation of 13 Government Medical Colleges under Phase-IV of PMSSY

Medical Education

Grant-in-aid of Rs.400.00 crore has been released to 12 States under the Centrally Sponsored Scheme of ‘Establishment of New Medical Colleges attached with District/ Referral Hospitals’.

(b) Grant-in-aid of Rs.10.00 crore has been released to 4 States for 4 Government Medical Colleges under the Centrally Sponsored Scheme of ‘Central Assistance to Government Medical Colleges under the scheme for strengthening and up-gradation of State Government Medical Colleges for increase in PG seats’.

(c) Letter of Permission issued for the establishment of 07 new Medical colleges (total 1050 MBBS seats) for the academic session 2016-17.

(d) Letter of Permission issued to the 2 existing Medical Colleges for increasing of 100 MBBS seats for the academic session 2016-17.

(e) Renewal of permission issued to 07 existing Medical Colleges for the academic session 2016-17 (700 seats)

(f) Letter of Permission issued for the Recognition of 12 Medical Colleges.

(g) Time Schedule for completion of admission of BDS courses for the academic session 2016-17 has been extended up to 7th October, 2016-17, to facilitate filling up of BDS seats in the country.

(h) The orders for allocation of 236 MBBS and 38 BDS Central Pool seats for the year 2016-17 to various beneficiary States/UTs/Government Departments have been issued.

(i) 98 PG medical Courses were recognized under IMC Act, 1956.

(j) 9 MDS courses and 6 BDS degrees were recognised under the Dentist’s Act, 1948.

(k) Letter of Permission issued for establishment of 17 new Medical Colleges for the academic session 2016-17. Of these 12 are in the Government and 5 in the private sector. The intake capacity will increase by 2150 MBBS seats.

(l) Letter of Permission issued to 08 Medical Colleges for increase of 595 MBBS seats for the academic session 2016-17.

(m) Letter of Permission issued for increase of 40 Super-Speciality seats for the academic session 2016-17.

(n) In pursuance of Rule 6(i) of Rules and Regulations of the National Board of Examinations, Governing Body of National Board of Examinations has been constituted.

(o) Grant-in-aid of Rs.445.00 crore has been released to 17 States/UT under the Centrally Sponsored Scheme of ‘Establishment of New Medical Colleges attached with District/ Referral Hospitals’.

(p) Grant-in-aid of Rs.110.00 crore has been released to 8 States for 22 Government Medical Colleges under the Centrally Sponsored Scheme of “Upgradation of existing State Government/Central Government Medical College to increase MBBS seats in the country”.

Government of India has launched National Organ Transplant Programme for carrying out the activities as per Transplantation of Human Organs and Tissues Act, 1994 training of manpower and promotion of organ donation from deceased persons. Under the said programme, an apex level organization, National Organ and Tissue Transplant Organization (NOTTO) has been set-up at Safdarjung Hospital, New Delhi for National networking, National Registry, to provide an online system for procurement and distribution of Organs & Tissues and to promote Deceased Organ and Tissue Donation

Government has taken various steps to simplify organ donation law/rules and procedures such as Website of National Organ & Tissue Transplant Organisation (www.notto.nic.in) provides updated information and online facility for registering pledges for organ donation.

A 24x7 call centre with toll free helpline number (1800114770) has been established for providing information on organ donation and coordinating matters relating to retrieval and allocation of organs recovered from cadaver donors.

National Organ and Tissue Donation and Transplant Registry (NOTTR) have been launched. NOTTO has launched National Registry for maintaining National Waiting list of patients who require organs/ tissue.

The networking of transplant and/or retrieval hospitals has been started initially in Delhi and NCR. Five regional level organizations called Regional Organ and Tissue Transplant Organization (ROTTO) have been identified in the States of Tamil Nadu, Maharashtra, Assam, West Bengal and UT of Chandigarh for networking and coordinating procurement and distribution of organs. Operational Guidelines for National Organ transplant Programme has been released.

Policy and criteria for organ allocation in case of Kidney, Liver, Heart & Lung and Cornea have been approved. Standard Operating Procedures for various vital organs has been approved and uploaded on NOTTO website.

More than 1 lakh pledges for organ donation received.

(q) National Eligibility –Cum Entrance Test (NEET)

Hon’ble Supreme Court vide its orders dated 28th April, 2016 and 9th May, 2016 in Writ Petition No.261/2016 filed by Sankalp Charitable Trust and others, had directed that NEET [UG] shall come into effect immediately. Purpose of the Ordinances is to provide a firm constitutional status to the concept of Uniform Entrance Examination for all undergraduate and post graduate admissions in Medical/Dental Colleges while providing a relaxation to the State Governments in relation to only UG admissions for this year [2016-17] in view of their difficulties.

The National Eligibility cum Entrance test, NEET-UG for admissions to all medical and dental colleges in the country will be conducted in 6 regional languages besides Hindi and English next year. A direction to this effect was sent to CBSE on 8th December and preparations have already begun for holding the exam.

NEET-UG was organized efficiently by CBSE in 2016. Extensive preparations are being made by CBSE to conduct the examination in 2017 on the basis of parameters which have already been conveyed to them. Consultations with States/UTs would be undertaken again in future before NEET-UG is conducted in future years, i.e., 2018 onwards.

National Health Protection Scheme (NHPS)

The Government of India has proposed to launch a new improved health care Scheme viz. National Health Protection Scheme which is under finalization that envisages health cover of up to Rs. 1.0 lakh per family for poor and economically weak families. For senior citizens of aged 60 years and above in this category there is an additional top-up package up to Rs. 30,000. The senior citizen component has been implemented w.e.f. 01.04.2016.

Organ Transplant

Government has taken various steps to simplify organ donation law/rules and procedures such as Website of National Organ & Tissue Transplant Organisation (www.notto.nic.in) provides updated information and online facility for registering pledges for organ donation.

A 24x7 call centre with toll free helpline number (1800114770) has been established for providing information on organ donation and coordinating matters relating to retrieval and allocation of organs recovered from cadaver donors.

National Organ and Tissue Donation and Transplant Registry (NOTTR) have been launched. NOTTO has launched National Registry for maintaining National Waiting list of patients who require organs/ tissue.

The networking of transplant and/or retrieval hospitals has been started initially in Delhi and NCR. Five regional level organizations called Regional Organ and Tissue Transplant Organization (ROTTO) have been identified in the States of Tamil Nadu, Maharashtra, Assam, West Bengal and UT of Chandigarh for networking and coordinating procurement and distribution of organs. Operational Guidelines for National Organ transplant Programme has been released.

Policy and criteria for organ allocation in case of Kidney, Liver, Heart & Lung and Cornea have been approved. Standard Operating Procedures for various vital organs has been approved and uploaded on NOTTO website.

More than 1 lakh pledges for organ donation received.

Seventh Session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC)

India successfully organized the seventh session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control, in November 2016. During the conference, parties renewed their commitment to the Convention, both as a public health treaty and as a Goal under Agenda 2030 for Sustainable Development, particularly Goal 3, to ensure healthy lives and promote well-being for all at all ages. To promote better implementation of the Convention, they stressed the importance of continued research and study by WHO and other stakeholders into the social and economic determinants of tobacco use in all its forms and other products promoting tobacco use as well as the strategies for their control.

Shri C K Mishra, Health Secretary has been chosen as the President of the COP Bureau for the next two years.

6^th BRICS Health Ministers’ Meet

The BRICS countries, represented by the Ministers of Health of the Federative Republic of Brazil, the Russian Federation, Republic of India, People's Republic of China and Republic of South Africa, met in New Delhi on 16 December 2016 at the Sixth BRICS Health Ministers Meeting. The Ministers acknowledged the renewed commitment to health by the BRICS leaders as expressed in the Goa Declaration of October 2016, noted the progress made since the first BRICS Summit and resolved to continue cooperation in the sphere of health through the Technical Working Groups and the "BRICS Framework for Collaboration on Strategic Projects in Health".

The Ministers welcomed the recommendations made in the BRICS workshop on drugs and medical devices in Goa, India in November 2016, including the need for concluding a Memorandum of Understanding on regulatory collaboration with a view to improving the regulatory standards, certification and systems for medical products. They agreed to constitute a working group, to work on strengthening regulatory systems, sharing of information, appropriate regulatory approaches in case of international and national health emergencies and provide recommendations for the promotion of research and development of innovative medical products (drugs, vaccines and medical technologies). The Ministers adopted the BRICS TB Cooperation Plan and supported the recommendations made by the BRICS workshop on HIV and Tuberculosis, held in Ahmedabad, India in November 2016, including the need for the suggested political, technical and financial actions to address the public health challenges of TB and HIV among BRICS countries. They agreed to set up a BRICS network on TB Research and creation of a research and development consortium on TB, HIV and Malaria. The Ministers agreed to support the Global Ministerial Conference on the fight against TB to be held in Moscow in 2017 and the UN High-Level Meeting on TB at United Nations Headquarters in 2018.

Biomedical Equipment Management and Maintenance Program (BMMP)

A massive exercise to map the inventory of all bio-medical equipment was undertaken in the year 2016 including their functionality status. The mapping was successfully completed in 29 States resulting in 7,56,750 numbers of equipment in 29,115 health facilities costing approximately Rs 4564 cr being identified. Equipment in range of 13% to 34% was found to be dysfunctional across states. Cost of dysfunctional equipment is Rs. 1015.74 Cr. The Ministry also prepared comprehensive guidelines along with RFP on Biomedical Equipment Management and Maintenance Program (BMMP), linked with uptime of equipment. Under BMMP, support is being provided to the State governments to outsource medical equipment maintenance comprehensively for all the equipment across all the facilities. Subsequent to inventory mapping, RFPs/tenders were rolled out to award maintenance contract for the respective states.

As a result, eleven States namely Andhra Pradesh, Kerala, Rajasthan, Mizoram, Chandigarh, Maharashtra, Sikkim, Madhya Pradesh, Punjab, Jharkhand and Puducherry have outsourced the maintenance. Three states (Tripura, Nagaland, and Arunachal Pradesh) have completed the tendering process and are in the program implementation stage. Five states namely Uttar Pradesh, West Bengal, Chhattisgarh, Karnataka, Gujarat have released the RFP and are in the process of finalizing the tenders. Other states are yet to issue the RFP. For 12 States where work orders have been issued, the dysfunctional equipment costing Rs 378.11 cr became functional in 4 months of work order. There has been a reduction in dysfunctionality rate of about 25% with downtime of 3-4 months to about 5% with maximum downtime of 7 days.

savita thakur thakur