Government Schemes

CURRENT AFFAIRS STRATEGIST PROGRAM
Target Prelims 2019: Booklet 7

S&T – CA – Part 3
TABLE OF CONTENTS
1. Basic Helath Stats, Schemes, Policies etc. ................................................................................................................................ 3
1) Some Health and Nutrition Stats ........................................................................................................................................ 3
2) National Health Profile, 2018 ............................................................................................................................................. 4
3) ‘Healthy States, Progressive India’ – A Report by NITI Aayog ........................................................................................... 4
4) National Health Policy (NHP), 2017 .................................................................................................................................... 5
5) Health Insurance: AB-PMJAY (AB-NHPM): Financial Protection for Catastrophic Expenditure ....................................... 7
6) hEALTH AND wELLNESS cENTRES OF aYUSHMAN bHARAT ............................................................................................... 8
7) pRADHAN mANTRI sURAKSHA bIMA yOJANA (pmsby) ..................................................................................................... 9
8) Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) ......................................................................................................... 9
9) Pradhan Mantri Swastha SUrakha Yojana (PMSSY) ......................................................................................................... 10
10) INtegrated Disease Surveillance Program (IDSP) ......................................................................................................... 10
11) Integrated Health Information Platform...................................................................................................................... 10
12) Laqshya: Labor Room Quality Improvement Initiative................................................................................................ 11
2. Nutrition and Related Issues .................................................................................................................................................. 12
1) Global Hunger Index (HDI) Report, 2018 .......................................................................................................................... 12
2) Global Nutrition Report, 2018 .......................................................................................................................................... 12
3) Nutrients (Micro and Macro) ............................................................................................................................................ 13
- Micronutrients are the vitamins and minerals ............................................................................................................ 13
- Macro-nutrients ............................................................................................................................................................ 14
Fats - Significance - Limitations and Types ........................................................................................................................... 14
Trans fat vs Saturated Fat vs Mono-saturated Fat vs Poly-unsaturated Fat ....................................................................... 14
4) Food Fortification .............................................................................................................................................................. 15
5) Biofortification .................................................................................................................................................................. 17
6) Vitamin D Deficiency -> Project DHoop ............................................................................................................................ 18
7) Eat Right Indian Movement (July 2018) ........................................................................................................................... 18
3. Diseases Due to Nutritional Deficiencies ............................................................................................................................... 19
4. Viral Diseases ......................................................................................................................................................................... 20
1) Ebola Virus Disease ........................................................................................................................................................... 20
2) Human Immunodeficiency Virus (HIV)/ AIDS (Acquired Immuno-Deficiency Syndrome) .............................................. 22
3) WHO Efforts to Fight HIV .................................................................................................................................................. 23
4) HIV Situation in India ........................................................................................................................................................ 24
5) HIV and AIDS (Prevention and Control) Act, 2017 ........................................................................................................... 24
6) Polio ................................................................................................................................................................................... 25
7) Three Different Strains of Polio Virus ............................................................................................................................... 25
8) Two Types of Polio Vaccines -> OPV and IPV ................................................................................................................... 25
9) Issue of Vaccine Derived Polio Virus Infection ................................................................................................................. 26
10) Dengue .......................................................................................................................................................................... 27
11) ZIKA Fever / Zika Disease ............................................................................................................................................. 28
12) Japanese Encephalitis (JE) ............................................................................................................................................ 29
13) Chikungunya ................................................................................................................................................................. 30
14) World Mosquitoe Program ........................................................................................................................................... 30
15) Monkey Disease (Kyasanur Forest Disease) ................................................................................................................ 31
16) Influenza........................................................................................................................................................................ 31
17) Swine Flu ....................................................................................................................................................................... 32
18) Avian Influenza/ Bird Flu .............................................................................................................................................. 33
19) Crimean Congo Hemorrhagic Fever (CCHF) .................................................................................................................. 33
20) NIPAH ............................................................................................................................................................................ 33
21) Small Pox ....................................................................................................................................................................... 34
22) Hepatitis ........................................................................................................................................................................ 34
3. Non-Viral Diseases (next s&T Booklet) ................................................................................................................................. 35
4. Non Communicable Diseases ................................................................................................................................................ 35
5. Other Issues to be Covered (Next S&T Booklet) ................................................................................................................... 35
http://shubhraranjan.com/ (Classes by Santosh Kumar (Santoshkumar9897@gmail.com)) P a g e 2 | 36

1. BASIC HELATH STATS, SCHEMES, POLICIES ETC.
1) SOME HEALTH AND NUTRITION STATS
Indicators Current Target
TFR 2.2 (NFHS-4) 2.1 (replacement
level)
Birthrate 20.6/1000 (2011 Census), 20.4/1000 in 2016 (NHP,
2018)
Lowest Andhra Pradesh, Highest Bihar
Death rate 7.43/1000 (census 2011) 6.4 (2016 - NHP, 2018)
IMR (Infant Mortality 34 in 2016 (NHP, 2018) 25 (FYP),
Rate) Lowest Kerala, Highest MP (Census 2011) 28(MDG)
Death of infant before first Lowest Manipur Highest Rajasthan (NHP 2013)
birthday
MMR (Maternal Mortality 178/1 Lakh (Census 2011) 70 (SDG)
Rate)
Death of mothers during or
within 42 days.
Highest Assam (382),
lowest Kerala (66)
Sex Ratio 943/1000 (rural : 949 , Urban : 929)

Highest Kerala (1084) Lowest Haryana (879)
Child Sex Ratio 919, constantly declining since 71, (it was 927 in
2001)
Population Density 382/km2
Highest Delhi, Lowest Arunachal
Decadal Population 17.7%
Growth Rate Lowest Kerala (5%), Highest Bihar (25%)
Life Expectancy 66.1 (2011 Census)
Per capita food grain 417 g per capita per day (it was 394 gram in 1951)
available
Per capital pulse available 26 g per capita per day (it was 62 g per capita per
day in 1951)

2) NATIONAL HEALTH PROFILE, 2018
- Why in news?
▫ NHP 2018 was released in June 2018. The E-Book (digital version) of the document was also released
(June 2018)
- Facts about NHP
▫ NHP, published annually since 2005, brings together all health related information in a single
platform.
▫ It covers demographic, socio-economic, health status and health finance indicators, Human
Resource in health sector and health infrastructure.
▫ It is also a major source of information about communicable and non-communicable diseases.
- Prepared by Central Bureau of Health Intelligence (CBHI)
▫ CBHI was established in 1961 and is the health intelligence wing of the Directorate General of Health
Services in the MoH&FW, GoI.
- Introduction
▫ India accounts for a relatively large share of world's disease burden and is undergoing an
epidemiological transition that the non-communicable diseases dominate over the communicable
in the total disease burden of the country.
- Key Highlights about NHP, 2018
▫ Birth Rate has declined to 20.4/1000 (in 2016).
▫ Death Rate has declined to 6.4/1000 (in 2016) population over the same period. So, the natural
growth rate has come down to 14 in 2016 from 17.3 in 2000.
▫ Total Fertility Rate - the average number of children that will be born to a woman during her lifetime
▪ Below 2 in 12 states. 9 states have reached the replacement rate of 2.1 and above.
▪ Delhi, TN and WB have lowest fertility among other countries.
▪ Fertility is declining rapidly including among poor and illiterates.
▫ Life Expectancy at birth has increased.
▫ Infant mortality and crude death rates have been greatly reduced.
▪ 34 in 2016.
▫ Health Spending in India is paltry
▪ 1.02% of the GDP which leads to a spending of Rs 3 per day per capital.
- This is much below the global average of 6 percent.
- The figure is lower than even the economically weak countries like Nepal, Maldives Bhutan etc.
▫ Doctor: Patient Ratio is very poor in India
▪ 1:11,082 (WHO recommendations 1:1000) for allopathic doctors.
3) ‘HEALTHY STATES, PROGRESSIVE INDIA’ – A REPORT BY NITI AAYOG

- Why in news recently?
▫ 'Healthy States, Progressive India' report was published by NITI Aayog in Feb 2018.
- Introduction
▫ It is a comprehensive health index report which ranks states and UTs innovatively on their
year on year incremental change in health outcomes, as well as their overall performance
with each other.
▫ The report has been prepared by NITI Aayog with technical assistance from WB, and
consultation with MoH&FW.

▫ States and UTs have been ranked in 3 categories namely Larger states, smaller states, and
Union Territories (UTs) to ensure comparison among similar entities.
▫ The Health Index is a weighted composite index, which for the larger states, is based on
indicators in three domains: (a) Health Outcomes (70%); (b) Governance and Information
(12%); and (c) Key inputs and processes (18%), with each domain assigned weights based on
its importance.
- Significance of the report – comparison, competition, systematic data.
- Rankings
▫ Among Larger States: Kerala, Punjab and TN have ranked top among the larger states in terms
of overall performance, whereas Uttar Pradesh, Rajasthan and Bihar are at the bottom of the
list. Jharkhand, J&K and UP are at top in the terms of annual incremental performance.
▫ Among Smaller States: Mizoram and Manipur were the top ranked state, and Manipur
followed by Goa were top ranked states in terms of annual incremental performance.
▫ Among UTs Lakshadweep has topped both in terms of overall performance and the highest
annual incremental rates.
- Other Key Highlights

▫ The report notes that states and UTs that start at lower levels of development are generally
at an advantage at notching up incremental progress over states with Higher Index scores.
▫ The report also reveals that about 1/3rd of the states have registered a decline in their
performance in 2016 as compared to 2015.
▫ Key challenges for the states: Address vacancies in key staff, establishing of Cardiac Care Units
and quality accreditation of public health facilities.
4) NATIONAL HEALTH POLICY (NHP), 2017

- Background
▫ Need: The last health policy was formulated in 2002. The socio economic and epidemiological
changes since then necessitated the formulation of a New Health Policy to address the current
and emerging challenges.
- Approved by Cabinet in March 2017.
▫ The Broad Principles of the policy is centered on:
• Professionalism, Integrity and Ethics, Equity, Affordability, Universality, Patient Centered
& quality of care, Accountability and pluralism.
▫ Main Objective
1. Achieve the highest possible level of good health and well-being, through a preventive
and promotive healthcare orientation in all developmental policies
2. Achieve Universal Health Access to good quality health care services without anyone to
face financial hardship as a consequence.
▫ Raising public health expenditure proposes to raise public healthcare expenditure to 2.5% of
GDP (current 1.4%) in a time bound manner, with more than 2/3rd of those resources going
towards primary health care followed by secondary and tertiary care.
▫ Assigns specific quantitative targets

• Aims to increase life expectancy from 67.5 to 70 years by 2025.
• Aims to reduce total fertility rate (TFR) to 2.1 at national and subnational level by 2025.
• Reduce mortality rate of children under 5 years of age to 23 (per 1000) by 2025.
• Reduce infant mortality rate to 28 by 2019.
• Reduce neo natal mortality to 16 and still birth rate to a 'single digit' by 2025.
▫ Improving health facilities

• The policy envisages providing a larger package of assured comprehensive primary
health care through the 'Health and Wellness Centers'.
• Most Secondary care at district level: The policy aspires to provide at the district level
most of the secondary care which is currently provided at a medical college hospital.
• Increasing number of beds: It aims to ensure 2 beds per 1000 population distributed in
a manner to enable access within golden hour.
• Strategic Purchases : Strategic purchase of secondary and tertiary care services as a short
term measure to supplement and fill critical gaps in the health system.
• To provide access and financial protection
• It proposes free drugs, free diagnostics, and free emergency and essential
healthcare services in public hospitals.
▪ Leverage the pluralistic health care legacy

• The policy recommends mainstreaming the different health system.
• Better access to AYUSH facilities through co-location in public facilities
• Yoga would be introduced much more widely in school and workplace as part of
promotion of good health.
- Private Sectors as strategic Partners

▪ The policy advocates a positive and proactive engagement with private sector for
critical gap filling towards achieving national goals.
- Giving back to society initiative

• The policy supports voluntary service in rural and under-served areas on pro-bono basis
by recognized healthcare professionals under a 'giving back to society' initiative.
- New Bodies to be established

i. A National Healthcare Standard Organization
ii. A National Health Information Network
▪ Would be established by 2025.
iii. A National Digital Health Authority
▪ This will be set up to develop, deploy and regulate digital health across the
continuum of care.

5) HEALTH INSURANCE: AB-PMJAY (AB-NHPM): FINANCIAL PROTECTION FOR
CATASTROPHIC EXPENDITURE
- Why in news?
▫ PM Modi has recently launched Ayushman Bharat - Pradhan Mantri Jan Aarogya Yojana (AB-
PMJAY). The program was announced first in budget 2018-19 as one of the component of
Ayushman Bharat initiative (the other being setting up of Health and Wellness Centres)
- Introduction
▫ India is the country with the highest disease burden in the world. According to WHO the
human and economic cost of this disease burden is tremendous - to the tune of $6.2 trillion
between 2012-2030.
▫ This disease burden becomes more problematic for a common citizen in the absence of any
insurance cover. According to NSSO more than 85% of rural households and more than 82%
of urban households don't have any access to healthcare insurance/assurance.
▫ Further, government facilities which may be affordable are marked by acute shortage of
human resource and infrastructure and 70% of healthcare is concentrated in private sector
which is very expensive.
▫ This leads to very high out of pocket expenditure (more than 70% of the total health
expenditure) which leads to millions of people sinking into poverty every year.
- Steps Taken by government before Ayushman Bharat
▫ Rashtriya Swastha Bima Yojana (RSBY) by MoH&FW provided an annual coverage of Rs
30,000 to poor families..
i. Inadequate Coverage:
ii. Corruption/ Fraud
iii. Poor Regulation failed to check insurers not covering the health cost and medical
procedure inflation on the part of health providers looking for a heftier insurance pay
out.
iv. Poor Infrastructure in public sector
• So, RSBY failed in both targeting and reducing health related poverty in the households
it did reach.
▫ Various state government initiatives also faced the above limitations.
- About AB-PMJAY
▫ Interim Budget 2019-20: Already, 10 lakh people have benefited from medical treatment
which would have otherwise costed them Rs 3,000 crore.
▫ AB-PMJAY is an entitlement-based scheme that aims to provide health insurance cover of upto
5 lakh rupees per family to over 10 crore poor families (about 50 crore population) for
secondary and tertiary care hospitalization. There is no cap on the size of the family or age of
the beneficiary.
▫ The scheme comes under the Ministry of Health and Family Welfare (MoH&FW).
▫ The eligible poor families will be decided on the basis of SECC, 2011 data and will include
poor, deprived rural families and occupational category of urban worker's families (Roughly
8.03 crore rural families and 2.33 crore urban families (11 occupational criteria))
• In addition, the existing beneficiaries of RSBY will also be included.

▫ The scheme will provide cashless and paperless access to services for the beneficiary at the
point of service. Eligible people can avail the benefits at both government and listed private
hospitals.
▫ It will be a centrally sponsered scheme, so, there will be a state component too (60:40).
▫ In case of hospitalization, members of the beneficiary families don't need to pay anything
under the scheme, provided one goes to a government or an empanelled private hospital.
▫ It is a portable scheme, which means beneficiary can avail benefits in any of the states that is
implementing the scheme.
▫ Adhaar card is not mandatory - identity to avail benefit can be established through ration card
or election ID card.
▫ Empanelled hospitals have agreed to about 14,00 packaged rates for various medical
procedures under the scheme.
▫ Federal process, flexibility to states
• The scheme also allows flexibility to states in terms of package, procedures, scheme
design, etc.
• States have an option to use existing trust/society or set up a new Trust/Society to
implement the scheme as State Health Agency and will be free to choose the modalities
of implementation. States can use an insurance company to implement the scheme or
the existing/ new trust societies.
▫ The National Health Agency (NHA), the apex body implementing the AB-PMJAY, has launched
a website (mera.pmjay.gov.in) and a helpline number (14555)
• This body will coordinate and improve the scheme over time, through investment in a
robust IT infrastructure.
▫ Each empanelled hospital will have an 'Ayushman Mitra Help Desk' where a prospective
beneficiary can check documents to verify the eligibility and enrolment to the scheme.
▫ Focus on fraud detection and data privacy
• Detailed guidelines have been issued for the purpose and anti-fraud cells will be
established at national and state levels. Major use of IT tools to prevent and detect fraud.
• NHA Information Security Policy & Data Privacy Policy are being institutionalized to
provide adequate guidance and set of controls on the secure handling of personal data.
▫ All the beneficiaries families will be given letters having QR Codes for identification purpose.
This letter will spread awareness and ease the identification process when the patients visit
point of care.
▪ No Launch States/UTs
• 30 States and UTs have signed MoUs with the centre and will implement the program
over the next 2-3 months.
• Some states and UTs (Telangana, Odisha, Delhi, Kerala and Punjab) have not signed, so
the scheme will not be implemented there till they come on board.
6) HEALTH AND WELLNESS CENTRES OF AYUSHMAN BHARAT

- NHP, 2017 had envisioned Health and Wellness centres as the foundation of India’s health system.
▪ While the existing health sub-centres, aimed at delivery of selective care at community level
(mostly for women and children), the new health and wellness centre will focus on a
comprehensive health care.

- The will provide a package of 12 essential health services and will also integrate AYUSH, Yoga, and
lifestyle changes and screen people for NCD.
- The centres will also provide free essential drugs and diagnostic services.
- These 1.5 lakh centres are expected to bring health care closer to the homes of people.
- Other than the allocation of 12,00 crore rupees for these centres, the FM also invited private sectors
to adopt these centres through CSR and philanthropic institutions.
- Each health and Wellness centre will be having an eight-member health and wellness team
comprising of a mid-level provider called Community Health Officer (nurse practitioner or
Ayurveda practitioner), two multi-purpose workers and 5 ASHAs
7) PRADHAN MANTRI SURAKSHA BIMA YOJANA (PMSBY)

- One of the 3 schemes under Jan Suraksha Yojana to move towards creating a universal social security
system, targeted specially for the poor and the under-privileged
- Ministry: Department of Financial Services, Ministry Of Finance
- A large proportion of the population have no accidental insurance cover
- PMJJBY is aimed at covering the uncovered population at a highly affordable premium of just Rs.12 per
year.
- Age group: 18 - 70 years
- Available to people with a savings bank account who give their consent to join and enable auto-debit on
or before 31st May for the coverage period 1st June to 31st May on an annual renewal basis.
- Risk coverage available will be Rs. 2 lakhs for accidental death and permanent total disability and Rs. 1
lakh for permanent partial disabilities.
- It is offered by Public Sector General Insurance Companies or any other General Insurance Company
who are willing to offer the product on similar terms with necessary approvals and tie up with banks for
this purpose.
- Participating Bank will be the Master policy holder
8) PRADHAN MANTRI JEEVAN JYOTI BIMA YOJANA (PMJJBY)

- Ministry: Department of Financial Services, Ministry Of Finance
- It is one year life insurance scheme renewable from year-to-year.
- Coverage for death due to any reason and is available to people in the age group of 18 to 50 years
( life cover up to age 55)having a savings bank account who give their consent to join and enable
auto-debit.
- Life cover of Rs. 2 lakhs is available for a one year period stretching from 1st June to 31st May at a
premium of Rs.330/-per annum per member.
- Individuals who exit the scheme at any point may re-join the scheme in future years by paying the
annual premium and submitting a self-declaration of good health.
- Assurance will be terminated under:
a. On attaining age 55 years (age near birth day) subject to annual renewal up to that date (entry,
however, will not be possible beyond the age of 50 years).
b. Closure of account with the Bank or insufficiency of balance to keep the insurance in force.

c. A person can join PMJJBY with one Insurance company with one bank account only.
- It is offered / administered through LIC and other Indian private Life Insurance companies. For
enrolment banks have tied up with insurance companies. Participating Bank is the Master policy
holder.
9) PRADHAN MANTRI SWASTHA SURAKHA YOJANA (PMSSY)
- Interim Budget 2019-20: 22nd AIIMS to be opened up in Haryana.
- Introduction
▫ The scheme was announced in the Independence Day speech in 2003 by the then Hon’ble
Prime Minister Atal Bihari Vajpayee. It envisaged the setting up of six AIIMS type hospitals.
▫ The scheme was approved in March 2006
▫ Ministry of Health and Family Welfare
- Primary Objective
▫ To correct the regional imbalance in availability of affordable/reliable tertiary level healthcare
in the country in general and,
▫ To augment facilities for quality medical education in under-served or backward states, in
particular.
- Key Components
▫ Setting up AIIMS in different parts of the country
▫ Upgradation of existing Government medical colleges/institutions in different states in the
country.
- What has been done so far?
▫ 21 AIIMs and around 100 GMCIs have been upgraded.
▫ 22nd AIIMS will be established in Haryana.
▪ By May 2017, setting up of 20 AIIMS and upgradation of 71 GMCIs has been undertaken under
PMSSY.
• Under this scheme, AIIMS have been established in Bhubaneshwar, Bhopal, Raipur,
Jodhpur, Rishikesh and Patna while work of AIIMS Rae Bareli is in progress.
10) INTEGRATED DISEASE SURVEILLANCE PROGRAM (IDSP)
- IDSP is a disease surveillance scheme under the MoH&FW in India, assisted by World Bank.
▫ It was initiated by WB in Nov 2004 and ran under it till 2010.
▫ The program had continued during 12th plan (2012-17) under National Health Mission with a budget
of 64.04 crores from domestic budget only.
▫ The WB fund was used to set up CDSUs and SDSUs.
- Aims
▫ Strengthen disease surveillance for infectious diseases to detect and respond to outbreaks quickly
- Key steps taken
▫ Setting up Central Disease Surveillance Unit (CDSU) and State Diseases Surveillance Units (SDSUs) in
each state where data is collected and analyzed.
11) INTEGRATED HEALTH INFORMATION PLATFORM

- Why in news?

▫ MoH&FW soft launches IHIP platform in 7 states (Nov 2018)
- More about IHIP
▫ Need: Medical records and Health records are collected by hospitals in a non-uniform way. With a
view to provide electronics health records to every citizens of country, GoI intends to introduce a
uniform system of maintenance of Electronic Medical Records/ Electronic Health Records
(EMR/EHR). To provide interoperability of various EHR systems already implemented, an IHIP has
been set up by MoH&FW.
▫ IHIP is real time, village wise, case based electronic health information system with GIS tagging
which will help in prompt prevention and control of epidemic prone diseases.
▫ Objectives
▪ Digitize healthcare data
▪ Standards Compliant EHRs of citizens on a pan India basis.
▪ Interoperability and integration of EHRs
▪ Enable better continuity of care, secure and confidential health data/record management,
better diagnosis of diseases etc.
▫ Advantages
▪ Real time data to policy makers for detecting outbreaks, reducing the morbidity etc.
12) LAQSHYA: LABOR ROOM QUALITY IMPROVEMENT INITIATIVE

- Need of such an initiative
▫ There is enough evidence to show that the quality of care in Labour rooms especially on the
day of birth, is central to maternal and neo-natal survival.
▫ This initiative is expected to improve the quality of care that is being provided to the pregnant
mother in the Labor room and Maternity Operation Theatres, thereby preventing undesirable
adverse outcomes associated with child birth.
- Ministry : Laqshya is initiative by Ministry of Health and family welfare
▫ Launched in Dec 2017.
- Hospitals Covered : This will be implemented in Government Medical Colleges (MCs), District
Hospitals(DHs), high-delivery load sub-district hospitals (SDHs) and community health centres
(CHCs).
- Key interventions
▫ Quality Certification of labor rooms
▫ Incentivize facilities achieving targets.
- Goals / Expected Outcomes
▫ Reduce preventable maternal and new born mortality, morbidity, and stillbirths associated
with the care around delivery in Labour room and Maternity OT and ensure respectful
maternity care.

2. NUTRITION AND RELATED ISSUES
1) GLOBAL HUNGER INDEX (HDI) REPORT, 2018
- 2018 Report (released in Oct 2018) - India ranked 103 in 119 countries
▫ South Asia (GHI Score: 30.5), and Africa south of Sahara (29.4) have shown serious hunger
levels.
▫ World has made overall progress, but this progress has been uneven.
▫ India is among the 45 countries that have "serious hunger levels".
▫ India ranked 100 in 2017 report and 97 in 2016 (but the rankings are not comparable)
- About GHI report
▫ It is released by the International Food Policy Research Institute (IFPRI). It has been released
since 2006. So, the 2018 report was 13th report in the series.
▫ GHI is a multidimensional tool used to describe the state of the countries' hunger situation
▫ It highlights the successes and failures in hunger reduction and provides insights into the
drivers of hunger.
▫ Thus, GHI aims to trigger actions to reduce hunger.
▫ It is calculated by taking into account 4 indicators
a. Undernourished population (1/3rd weight)
b. Child wasting (1/6th weight)
c. Child Stunting (1/6th weight)
d. Infant mortality (1/3rd weight)
- Key Highlights about 2018 Report
▫ GHI Score: 31.1 (A score of 0 is the best with no hunger)
▫ Percentage of undernourished population has dropped to (18.2%).
▫ India has the highest level (after Sudan) of child wasting at 21%.
▫ Child Stunting has also come down to 38.4% in 2018.
▫ Child mortality has reduced to 4.3% for the same period.
▫ India accounts for a quarter of world's malnourished people.
▫ India's comparison with neighbouring countries
▪ China(25), Sri Lanka (67), Myanmar (68), Nepal (72) and Bangladesh (86) have done
better than us.
▪ Pakistan (106) and Af (111) are below India.
▪ Bhutan (no ranking -> insufficient data)
- Key Learning from the report
▫ Stagnation of wasting calls for careful analysis of the factors that underlie wasting
▫ It will be useful to examine the inequities in progress in some of these indicators across India's
states.
2) GLOBAL NUTRITION REPORT, 2018
- About the GNR
▫ The Global Nutrition Report was unveiled as a result for commitment made at the 2013 Nutrition
for Growth summit. It is the first ever comprehensive tool that tracks progress against all forms of
malnutrition.

▫ Currently, the report measures the progress being made to meet the United Nations Sustainable
Development Goal Number two: Zero hunger by 2030.
▫ It is released by the chairs of an Independent Expert Group (IEG) of world leading academics,
researchers and government representatives. It is backed and supported, among others, by the Bill
& Melinda Gates Foundation, the Department of International Development (UK), other countries
like Germany, Ireland, the Eleanor Crook Foundation and the European Commission.
- The 2018 Report
▫ The fifth edition of the report was released in Nov 2018 and highlights the concrete overview of the
progress made so far
- Key Highlights - Global
▫ No country is on track to meet all 9 of the SDG2 targets. The burden of malnutrition across the world
remains unacceptably high, and progress unacceptably slow.
▫ 28% of the countries are affected by all three forms of malnutrition - stunting among children and
anaemia and obesity among women. A whopping 88% countries suffer from atleast two forms. In
fact, the occurrence of Anaemia has increased in percentage terms since the beginning of the
century.
▫ Malnutrition is responsible for more ill health than any other cause.
▫ Slow progress on mal-nutrition is also leading to negative social and economic implications costing
around US$3.5 trillion per year.
- Key Highlights India
▫ India holds almost a third (46.6 million) of the world's burden on stunting and 31% (25.5 million)
burden of wasting.
▫ India also figures in the list of countries which have more than 1 million overweight children (other
countries include China, Indonesia, Egypt, US, Brazil, and Pakistan).
▫ Huge variation in stunting on district basis
• 239 districts have stunting level of more than 40%.
3) NUTRIENTS (MICRO AND MACRO)

- MICRONUTRIENTS ARE THE VITAMINS AND MINERALS that our bodies need each day
in order to properly function. Unlike macronutrients they are needed in small amounts.
▫ Vitamins can be classified into 13 major types Vitamins A, B-Complex (Thiamine, riboflavin
(Vitamin B2), niacin, pantothenic acid, biotin, vitamin-B-6, Vitamin B12, and folate), C, D, E
and K.
▪ They are organic compounds. They can be classified into two categories:
i. Fat Soluble
• A,D, E and K
• Important role in overall health by promoting healthy bones, skin, eyesight,
lungs and digestive systems.
ii. Water Soluble
• B-Complex and C
• Not stored in fat (like fat soluble vitamins), so daily consumption is important.
• They boost metabolism, act as powerful anti-oxidant and assist in the
formation of collagen helping in healing wounds.
▫ Minerals can be further classified as major minerals and trace minerals.

▪ The six major minerals include sodium, potassium, chloride, calcium, phosphorus and
magnesium. They are required in large amounts in body as compared to trace minerals.
They are important for maintaining proper fluid balance and electrolytes (sodium and
potassium) as well as help in supporting bones, hair, skin and nail health.
▪ Trace minerals are required in smaller quantities, but are as important as major minerals.
The nine trace minerals include cooper, zinc, iron, iodine, manganese, molybdenum,
cobalt, selenium and fluoride.
- MACRO-NUTRIENTS are the main nutrients that make up the foods we eat. There are three
macro-nutrients - Carbohydrate, Protein and Fat.
FATS - SIGNIFICANCE - LIMITATIONS AND TYPES

▪ Why in news?
• Higher consumption of fats has been blamed for the increase in non-communicable
diseases.
▪ Significance of fats as nutrients
i. It is the most concentrated form of energy. Body uses fat as a fuel source and as
major storage of energy.
ii. It helps in absorbing vitamins like A,D, E and K.
iii. They also provide cushioning for the organs.
iv. They are an important constituent of cell membrane and provide taste, consistency
and stability.
TRANS FAT VS SATURATED FAT VS MONO-SATURATED FAT VS POLY-

UNSATURATED FAT
▪ All fats have a similar structure - a chain of carbon atoms bonded to hydrogen
atoms.
▪ The differentiating factor is the length and shape of the carbon chain and the
number of hydrogen atoms connected to the carbon atoms.
i. Trans Fat (worst type of dietary fat)
• Artificial Trans fats or Trans fatty acids, are made when vegetable oil hardens
in a process called hydrogenation (hydrogen atom are injected into molecules
of vegetable fat).
• This turns healthy oil into solids and to prevent them from becoming rancid.
• No known health benefits and no safe level of consumption.
• Eating trans-fat increases harmful LDL cholesterol in the blood stream and
reduces the amount of beneficial HDL cholesterol.
• It is linked to heart disease, stroke, diabetes, and other chronic conditions.
They also affect insulin resistance.
• It is banned in many countries. India currently allows trans-fatty acids upto
5% (by weight).
• In May 2018, FSSAI proposed to limit the maximum amount of trans-fats
in vegetable oils, vegetable fats and hydrogenated vegetable oil to 2

percent by weight as part of its goal to make India trans-fat free by
2022.
• In May 2018, WHO also gave a call to eliminate trans-fat in foods by 2023.
• For this WHO has launched an initiative REPLACE, that will provide
guidance for all countries on how to remove artificial trans fats from
their foods, possibly leading to worldwide eradication.
• It stands for Review dietary sources, promote use of healthier fats,
legislate, assess changes, create awareness, and Enforce regulation.
• The initiative promotes countries to establish legislation to eliminate the
trans-fats.
ii. Saturated Fats

• A saturated fat is a type of fat in which the fatty acid chains have all or
predominantly single bonds.
• Common source of saturated fats are red meat, whole milk and other whole
milk dairy products, coconut oils etc.
• Health Impacts
▪ Can drive harmful LDL cholesterol.
▪ But recent research, have again raised the debate whether saturated
fats are actually harmful and cause heart disease.
Mono unsaturated Fat and Poly Unsaturated Fats

• Mono unsaturated Fats are fatty acid chains that have one double bond in
the fatty acid chain with all the remainder carbon atoms being single-bonded.
• Poly Unsaturated Fats are fatty acids with more than 1 double bond.
• Thus, these fats have fewer hydrogen atoms bonded to carbon atoms when
compared to saturated fats.
• They are liquid at room temperature.
• Sources of monounsaturated fats
▪ Olive Oil, peanut oil, canola oil, avocados, nuts etc.
• Sources of Polyunsaturated oils
▪ Corn oil, sunflower oil, and safflower oil, fish oil etc are common
examples.
▪ These are essential fats and are required for normal body functioning,
but our body can't make them. They are used in building of cell
membrane and covering of nerves. They are also needed in blood
clotting, muscle movement and inflammation.
• Two Main types of Polyunsaturated Fatty Acids
• Omega-3 Fatty Acids
• Omega-6 Fatty Acids
4) FOOD FORTIFICATION
- Why in news?
▪ Ministry of Health and Family Welfare has notified Food Safety and Standards (Fortification of
Foods) Regulations, 2018 to regulate and promote food fortification in India. (Aug 2018)

▪ FSSAI, TATA Trust and NDDB organized a national consultation on Milk Fortification to discuss
the need for fortification of micro-nutrients and low-cost milk fortification with Vitamin D.
(Sep 2018)
- Food Fortification
▪ Fortification means deliberately increasing the content of essential micronutrients (such as
iron, folic acid, iodine, vitamin A, Zinc etc) in a food so as to improve the nutritional quality of
food and to provide public health benefits with minimal risk to health. According to FSSAI it is
a scientifically proven, cost effective, scalable and a sustainable intervention that addresses
the issue of micronutrient deficiencies.
▪ Advantages of Food Fortification over other nutrition fulfillment mechanisms:
▪ Cost Effective: It is increasingly becoming one of the most cost-effective health
interventions that exists today to address micronutrient malnutrition.
▪ Well Proven Method: It has been used around the world since 1920s. The World Health
Organization (WHO), UNICEF, and the Gates foundation, to name only a few, endorse
food fortification as a primary means of improving micro-nutrient health.
▪ Eating Habits not needs to be changed
▪ Socio-culturally more acceptable
▪ Scalable and Sustainable: Can be introduced quickly and can provide nutritional benefit
to people in short period of time.
▪ Different ways in which people get micro-nutrients and why food fortification can be
effective.
▪ Some Limitations of Food Fortification

i. For some particular segments, fortification alone is not enough to provide adequate
nutritional status since fortification only works when food is processed. There will always
be people who grow and process their own food or buy non-processed food.
ii. There are concerns raised about synthetic micro-nutrients being added in this fortified
food and their quality.
- Steps taken by government to promote food fortification

▫ FSSAI and FFRC (Food fortification Resource Centre) has launched massive advocacy
campaigns.
▫ MoH&FW and MoHRD have made fortified staples (wheat, oil, DFS) under ICDS and Mid-Day
meal schemes.
▫ FSSAI has also urged dairy firms to begin voluntary milk fortification.
▫ Fortification regulation by FSSAI in Aug 2018
- Food Safety and Standards (Fortification of Foods) Regulations, 2018 (Aug 2018)
▫ MoH&FW have notified the regulation to regulate and promote the food fortification in India.
▪ It allows addition of micro-nutrients for:
▪ Correcting the deficiency or reducing the risk of deficiency of one of more micro-
nutrients in the population or specific population group.
▪ Maintaining or improving health, and nutritional quality of food.
▪ Micronutrients can also be added when fortification of food is made mandatory.
▫ Fortification can be made mandatory: The regulation also provides that FSSAI can make
fortification of any stable food mandatory on the direction of GoI.
Heme Iron can't be used: In case iron is used as a source of nutrient, heme iron shall not be
used in any form in any article of food.
▫ Provides for quality assurance mechanism such as compulsory certification, random testing,
regular audit etc.
▫ The regulation also provides that FSSAI shall take steps for promotion of fortified food by
encouraging production, manufacture, distribution, sale and consumption of fortified food by:
▪ Advising and promoting, technical assistance, enabling labs and research institutions etc.
▫ Applicability
▪ Food business operators need to comply with the norms from 1st Jan 2019.
5) BIOFORTIFICATION
- Biofortification is the process by which the nutritional quality of the food crops is improved through
agronomic practices, conventional plant breeding, or modern biotechnology.
- It differs from conventional fortification process in that biofortification aims to increase nutrient level
in crops during plant growth rather than through manual means during processing of the crops.
- Biofortification may therefore present a way to reach population where supplementation and
conventional fortification activities may be difficult to implement and/or limited.
- E.g.
▫ Zinc biofortification of wheat, rice, beans, sweet potatoes and maize

6) VITAMIN D DEFICIENCY -> PROJECT DHOOP
- Why in news?
▫ FSSAI recently launched Project Dhoop to address vitamin D deficiency among youngsters
- Introduction
▫ Vitamin-D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of
Calcium, Magnesium, and phosphate, and multiple other biological effects. In humans, the most
important compounds in the group are vitamin D3 (also known as Cholecalciferol) and Vitamin D2
(ergocalciferol).
▫ Vitamin D is essential for strong bones, because it helps the body use calcium from the diet.
Traditionally it has been associated with a disease called rickets in which bone tissues doesn't
properly mineralize, leading to soft bones and skeletal deformities. Recent researches are starting
to reveal the importance of Vitamin D in protecting from a host of other health issues.
▫ Vitamin D is produced by the body in response to skin being exposed to sunlight.
▪ This is the major natural source in which Cholecalciferol is prepared in the skin from Cholesterol
through a chemical reaction that is dependent on sun exposure (specifically UVB radiation).
▫ It also occurs naturally in a few foods - including some fish, fish liver oils, and egg yolks - and in
fortified dairy and grain products.
- Key causes
▫ Lack of sunlight
▫ Strict vegan diet (as most of the Vitamin D sources are animal based)
▫ Allergy to milk products
▫ Dark Skin: The pigment melanin reduces the skin's ability to make Vitamin D in response to
sunlight exposure
▫ Non conversion of Vitamin D to active form by Kidney.
- FSSAI's Project Dhoop
▫ FSSAI along with NCERT, New Delhi Municipal Council (NDMC) as well as north MCD schools have
launched Project Dhoop.
▫ Project Dhoop urges school to shift their morning assembly to noon time, mainly between 11 am
and 1 pm to ensure maximum absorption of Vitamin D in students through natural sunlight.
▫ The sunshine between 11 am to 1 PM provides best exposure to Ultraviolet B (UVB) radiation
which converts cholesterol to Vitamin D.
7) EAT RIGHT INDIAN MOVEMENT (JULY 2018)
- Why in news?
▫ Food Safety and Standards Authority of India (FSSAI) unveiled 'The Eat Right Movement', built on two
broad pillars of 'Eat Healthy' and 'Eat Safe'. (July 2018)
- More Details
▫ It is a multi-sectoral effort to cut down salt sugar and oil consumption by 30% in three years. It also
targets phasing out of trans-fats from diets and promoting healthier food options.
This program engages and enables citizens to improve their health and well-being by making the
right food choices.

3. DISEASES DUE TO NUTRITIONAL DEFICIENCIES
Disease Deficiency of Other comments
Rickets Vitamin D along with • Rickets is characterized by weak and soft bones, bowed legs
calcium and potassium and bone deformities.
• Fish, fortified dairy products, liver, oil and sunlight are some
rich source of vitamin D.
Osteoporosis Vitamin D with Calcium • Deficiency of Vitamin D and calcium in the body can
negatively affect the health of the bones and spine. It leads
to unhealthy, soft and brittle bones that are prone to
fractures and defects in the spine structure.
• Bananas, spinach, milk, okra, soy and sunlight are natural
sources of Vitamin D and calcium that act to eliminate this
deficiency
Pellagra Vitamin B3 or Niacin • 4D's : Dementia, diarrhea, dermatitis and death are the four
Ds that characterize Pellagra.
• Tuna, whole grains, peanuts, mushrooms, chicken etc.
Scurvy Vitamin C or ascorbic • Scurvy basically inhibits the production of collagen in the
acid body which is the structural protein that connects the
tissues.
• Decaying of skin and gums, abnormal formation of
teeth and bones, delay or inability to heal wounds and
bleeding are the effects of scurvy
• Vitamin C can be derived from Citrus fruits like oranges,
lemon, strawberry etc and Broccoli regularly.
Beri-Beri Vitamin B1 or Thiamin • The most common symptoms of this illness are altered
muscle coordination, nerve degeneration and cardiovascular
problems.
• Meat, eggs, whole grains, dried beans etc are rich in
thiamine and thus, should be consumed in proper amounts
every day to avoid this painful ailment
Xerophthalmia Vitamin A • Xerophthalmia or night blindness is characterized by

or Night blindness due to the poor growth, dryness and keratinisation
Blindness of epithelial tissue or chronic eye infection.
• In worsened situations, night blindness can aggravate to
complete loss of vision
• The safest way to enhance the Vitamin A levels in the body is
by consuming natural food sources like carrots, green and
leafy vegetables, cantaloupes etc
•

Goitre Iodine • Goitre leads to enlarged thyroid glands causing
hypothyroidism, poor growth and development of infants in
childhood, cretinism and even mental retardation
• This disease is commonly found to occur in places having
iodine deficit soil. Iodised salt and saltwater fish are rich
sources of iodine and must be consumed regularly to avoid
Goitre.
Anaemia Iron • It is characterized by a decrease in the red blood cell count

or haemoglobin in the body, resulting in fatigue, weakness,
dyspnoea and paleness of the body.
• It can be easily treated by changing to a healthy diet and
consuming iron supplements on a regular basis. Squashes,
nuts, tofu, bran etc are rich sources of iron for the body.
•
Kwashiorkor Protein and Energy • It is characterized by anorexia, an enlarged liver, irritability

and ulcerating dermatoses.
• These are the one of the nutritional deficiencies in children,
especially from famine-struck areas and places with poor
food supply, Kwashiorkor is caused by malnutrition.
• A healthy and balanced diet enriched with protein and
carbohydrate sources like eggs, lentils, rice etc helps combat
this problem
Depression deficiency of Vitamin B7 • This deficiency can be fatal if present in an aggravated form.
or biotin • Consume poultry products, dairy items, peanuts, nuts etc
that are rich sources of biotin. These must be consumed
along with supplements to recover and prevent these
illnesses
•
4. VIRAL DISEASES
1) EBOLA VIRUS DISEASE
- Why in news?
▫ Since Aug 2018, more than 900 people in DRC have been infected by EBOLA (Feb 2019)
- Introduction:
▫ The Ebola virus causes an acute, serious illness which is often fatal if untreated.
▫ Ebola Virus Disease first appeared in 1976 in two simultaneous outbreaks, one in Nzara,
Sudan, and the other in Yambuku, Democratic Republic of Congo. The later occurred in a
village near the Ebola river, from which the disease takes its name.

▫ 2014-2016 outbreak: The outbreak in West Africa, (first case notified in March 2014), wa the
largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976.
▪ The most severely affected countries, Guinea, Sierra Leone, and Liberia has very weak
health systems, lack human and infrastructure resources, and have only recently
emerged from long periods of conflict and instability.
▫ Ebola Continues to spread in 2018-2019 in Democratic Republic of Congo
▪ Less awareness
▪ Poor Health services
- Virus: The virus family Filoviridae includes the Ebolavirus genus. This Ebolavirus Genus has 5
identified species so far: Zaire, Bundibugyo, Sudan, Reston and Tai Forest. The first three Zaire
Ebola virus, Bundibugyo Ebolavirus, and Sudan Ebolavirus have been associated with large
outbreaks in Africa. 2014 outbreak has been caused by Zaire Ebolavirus.
- Transmission
▫ Introduction in Human -> from infected animals: It is believed that fruit bats of the
Pteropodidae family are natural Ebola virus hosts.
▪ Ebola is introduced in human population through close contact with the blood
secretions, organs or other bodily fluids of infected animals such as chimpanzees,
gorillas, fruits bats, monkeys, forest antelope and porcupines found ill or dead or in the
rainforest.
▫ Human to Human : Ebola spreads through human to human transmission via direct contact
(through broken skin or mucous membranes) with the blood, secretions, organs or other fluids
of infected people, and with surface and materials (e.g. bedding clothing) contaminated with
these fluids.
▪ Healthcare workers in close contact with patients, without practicing infection control
precautions.
▪ Burial ceremonies in which mourners have direct contact with the body of the deceased
person can also play a role in the transmission of Ebola.
▪ Sexual transmission not confirmed yet but cannot be ruled out.
- Symptoms of EVD
▫ The incubation period, that is, the time interval from infection with the virus to onset of
symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms.
▫ First symptoms are sudden onset of fever fatigue, muscle pain, headache and sore throat.
▫ This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver functions,
and in some cases both internal and external bleeding.
- Treatment and Vaccine
▫ Supportive care rehydration with oral or intravenous fluids - and treatment of specific
symptoms, improves survival.
▫ There is as yet no finally approved treatment available for EVD
▫ However, a range of potential treatments including blood products, immune therapies and
drug therapies are currently being evaluated
▫ Vaccines: No licensed vaccines are available yet, but several vaccines being tested have shown
potential.

- Prevention and Control
▫ Good outbreak control relies on applying a package of interventions, namely case
management, surveillance and contact tracing, a good laboratory service, safe burials and
social mobilization.
▫ Community engagement is key to successfully controlling outbreaks
▫ Risk reduction messaging should focus on several factors
1. Reducing the risk of wildlife to human transmission: Animal should be handled with
gloves and other appropriate clothing. Animal products (blood and meat) should be
thoroughly cooked before consumption.
2. Reducing the risk of human to human transmission: Gloves and appropriate personal
protective equipment should be worn when taking care of ill patients at home. Regular
hand washing is required after visiting patients in hospital, as well as after taking care of
patients at home.
3. Reducing the risk of possible sexual transmission, because the risk of possible sexual
transmission cannot be ruled out, men and women who have recovered from Ebola
should abstain from all types of sex (including anal - and oral sex) for atleast three
months after onset of symptoms. If sexual abstinence is not possible, male or female
condom use is recommended.
2) HUMAN IMMUNODEFICIENCY VIRUS (HIV)/ AIDS (ACQUIRED IMMUNO-DEFICIENCY
SYNDROME)
- Why in news?
▫ According to the MoH&FW, the three north eastern states - Meghalaya, Mizoram and Tripura
have emerged as the new hotspots for HIV.
▫ The good news is that the rest of the country has seen a steady decline in the number of HIV
cases in India.
- Introduction:
▫ The Human Immunodeficiency Virus (HIV) targets the immune system and weakens people's
surveillance and defence systems against infections and some types of cancers.
▫ As the virus destroys and impairs the function of the immune cells, infected individuals
gradually become immunodeficient. Immune function is typically measured by CD4 cell count.
The most advanced for of HIV infection is Acquired Immunodeficiency Syndrome (AIDS),
which can take from 2 to 15 years to develop depending on individual. It is defined by
developments of certain cancers, infections, or other severe chemical manifestations.
▫ Note: CD4 cells are a type of white blood cells that play a major role in protecting your body
from infection. They send a signal to activate your body's immune response when they detect
"intruders" like the viruses or bacteria.
- Transmission
▫ HIV can be transmitted via the exchange of a variety of body fluids from infected individuals
such as blood, breast milk, semen and vaginal secretion.
▫ Individuals cannot become infected through ordinary day to day contact such as kissing,
hugging, shaking hands, or sharing personal objects, food or water.
- Risk Factors
▫ Behaviours and conditions which put individuals at greater risk of contracting HIV include:
1. Having unprotected anal or vaginal sex

2. Having another sexually transmitted infection such as syphilis, herpes, chlamydia,
gonorrhoea, and bacterial vaginosis.
3. Sharing contaminated needles, syringes and other injecting equipment and drug
solutions when injecting drugs.
4. Receiving unsafe injections, blood transfusions and medical procedures that involve
unsterile cutting or piercing
5. Experiencing accidental needle stick injuries, including among health workers
6. From an infected mother to unborn child
- Diagnosis
▫ An HIV test reveals infection status by detecting the presence or absence of antibodies to HIV
in blood. Most people have "window period", usually 3 to six weeks.
- Prevention
1. Male and female condom use
2. Testing and Counselling for HIV and STIs
▫ for all people exposed to any of the risk factors.
3. Voluntary medical male circumcision
▫ reduces the risk of heterosexually acquired HIV infection in men by approximately
60%.
4. Antiretroviral (ART) use for prevention
▫ ART as Prevention
▫ Pre-exposure prophylaxis (PrEP) for HIV negative partner
▫ Post Exposure prophylaxis for HIV (PEP)
5. Harm reduction for injecting drug users
▫ using sterile injecting equipment.
6. Elimination of Mother to Child Transmission (eMTCT)
▫ In the absence of any interventions during these stages, rates of HIV transmission
from mother to child can be 15-45%. MTCT can be nearly fully prevented if both
the mother and the child are provided with ARV drugs throughout the stages
when infection could occur.
- Treatment
▫ HIV can be suppressed by combination ART consisting of 3 or more ARV drugs. ART doesn't
cure HIV infection but controls viral replication within a person's body and allows an
individual's immune system to strengthen and regain the capacity to fight off infection. With
ART, people living with HIV can live healthy and productive lives.
3) WHO EFFORTS TO FIGHT HIV
- WHO is cosponsor of the United Nation Program on Aids (UNAIDS). Within UNAIDS, WHO leads activities
on HIV treatment and care, HIV and tuberculosis co-infection, and jointly coordinate with UNICEF the
work on the elimination of mother to child transmission of HIV
- 90-90-90 - An ambitious treatment target to help end the aids epidemic
▫ By 2020,
▪ 90% of all people living with HIV will know their HIV status
▪ 90% of people diagnosed with HIV infection will receive sustained antiretroviral therapy.
▪ 90% of all people receiving retroviral therapy will have viral suppression.

4) HIV SITUATION IN INDIA
- There are estimated 21 Lakh persons living with HIV in India (June 2018)
▫ India is the third largest country in terms of population affected by the disease (After South Africa and
Nigeria)
- Adult prevalence is 0.3% of which 40% are women.
- Almost 12.28 lakh people are covered under ART.
▫ The target is to bring 90% of the 21 Lakh people living with the HIV infection in India under ART.
- Four high prevalence states of Maharashtra, Andhra Pradesh, Karnataka, Tamil Nadu and Kerala account
for 55% of the total cases in the country.
- Prevalence of HIV has been decreasing over the past decade.
- Success in controlling AIDS
▫ 2015 HIV estimates results reaffirm the country's success story in responding to HIV/AIDS epidemic.
India has successfully achieved 6th Millennium Development Goal (MDG6) of halting and reversing
the HIV epidemic.
▪ Emergence of three north Eastern States as new HIV Hotspots (July 2018)
▫ HIV Sentinel Surveillance (HSS), a biennial study conducted by the National Aids Control Organization
(NACO), is one of the largest regular studies in the world dealing with high risk groups of the
population.
▫ HSS has referred that HIV Prevalence in the context of ANCs in the northeastern states of Mizoram
(1.19%), Nagaland (0.82%), Meghalaya (0.73%), Tripura (0.56%) and Manipur (0.47%) were among
the highest.
▫ Reasons: Injecting Drug Users and Unsafe Sexual Practices.
5) HIV AND AIDS (PREVENTION AND CONTROL) ACT, 2017
- The Act safeguard the rights of HIV positive people.
▫ Prohibits any kind of discrimination against affected people in terms of employment,
education, renting property, standing for public office, insurance etc.
▫ Access to public facilities without discrimination
▫ Right to reside in shared household: Every HIV infected or affected person below the age of
18 years has the right to reside in shared household and enjoy the facilities of the household
▫ Confidentiality
▪ No compulsion of disclosure of HIV status: Data protection measures
▪ An HIV test only with consent
▫ Guardianship Clause
▪ Reason: HIV/AIDs often causes children to be orphaned, and extended families are
reluctant to shoulder their responsibility
▪ Provision: the act says that any person aged between 12 and 18 years with sufficient
maturity in understanding and managing affairs of his HIV and AIDS affected family can
act as guardian of another sibling below 18 years of age to be applicable in matters
relating to admission to educational establishments, operating bank accounts, managing
property, care and treatment etc.
▫ Priority Court Proceedings

▪ Cases related to HIV positive persons shall be disposed off by the court on a priority basis.

▫ Prevent and Control spread of HIV and AIDS: The central and state governments shall take
measures to :
1. Prevent the spread of HIV or AIDS
2. Provide ART and infection management for persons with HIV or AIDS
3. Facilitate their access to welfare schemes especially for women and children
4. Formulate HIV/AIDS education and communication program that are age appropriate, gender
sensitive, and not stigmatizing, and
5. Lay guidelines for the care and treatment of children with HIV or AIDS.
6) POLIO
- Why in news?
▫ A routine surveillance recently has detected Type-2 vaccine virus in stool samples from children in
Uttar Pradesh. It implies that the type-2 serotypes vaccines were still being made. This has emerged
as a major concern as the wild, disease causing virus was eradicated globally in 1999.
- Basics of Polio
▫ Polio is a highly infectious disease caused by a virus. It invades the nervous system and can cause total
paralysis in a matter of hours.
▫ Transmission: The virus is transmitted by person to person and spread mainly through faecal-oral
routes, or less frequently by, a common vehicle (e.g. contaminated water or food) and multiplies in
the intestine
▫ Symptoms: Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in
the limbs.
▫ Affect: 1 in 200 infections leads to irreversible paralysis (usually in legs). Among those paralyzed, 5%
to 10% die when their breathing muscles become immobilized.
▫ People most at risk
▪ Polio mainly affects children under five years of age
▫ Prevention and Cure
▪ There is no cure
▪ It can only be prevented. Polio vaccine given multiple times can protect a child for life.
7) THREE DIFFERENT STRAINS OF POLIO VIRUS

- 3 strains of poliovirus (type 1, type 2, and type 3).
- Wild polio virus type 2 was eradicated in 1999.
- Cases of type 3 are down to the lowest ever levels with no cases reported since 2012 from Nigeria.
8) TWO TYPES OF POLIO VACCINES -> OPV AND IPV

- Oral Polio Vaccine (OPV) is taken orally as drops. It has served as the main preventive measure against
polio and is easily administered not requiring very trained health workers. Further, the cost per dose of
OPV is much less than IPV. It also leads to passive immunization.
▫ Other Advantages
▪ Passive immunization
▫ Limitations
▪ Virus may mutate and turn virulent Or;

▪
Virus may multiply in intestine and spread through excreta and over the period mutate to become
virulent.
- Inactivated Polio Vaccine (IPV) is given through an injection by a trained health worker.
▫ It is not a "live" vaccine (i.e. it is inactivated) and thus carries no risk of vaccine associated paralysis.
▫ In countries still using OPV, IPV hasn't replaced OPV but is used to strengthen a child's immune
system and protect them from polio.
9) ISSUE OF VACCINE DERIVED POLIO VIRUS INFECTION

- How vaccines may lead to infection
▫ Oral Polio Vaccine (OPV) contains an attenuated vaccine-virus. This weak form of the virus is
used to activate an immune response in the body, which protects the child when challenged
by WPV.
▫ But when child is immunized with OPV, the virus replicates in the intestine and during this
time the virus is excreted.
- Two types of Vaccine Derived Polio
▫ VAPP (Vaccine Associated Paralytic Poliomyelitis)
▪ In this case, the vaccine becomes virulent within the body of a recently vaccinated child
and causes polio.
▪ According to WHO, for every 1 million children being immunized there are 2-4 cases of
VAPP in OPV-only using countries. Of these 40% are caused by OPV's type 2 component.
▪ There is no outbreak associated with VAPP and there is very little evidence that virus
circulates from VAPP.
▫ cVDPV (Circulating Vaccine Derived Polio Virus)
▪ They are mutated versions of OPV which can cause paralysis and spread from person to
person.
▪ Almost all cVDPV outbreaks in recent years have been caused by a type-2 vaccine derived
virus.
▪ Two preconditions
▪ Lack of immunization in the region
▪ The virus is allowed to circulate for long time - at least 12 months (so that enough
mutation can take place in the virus).
▫ Note: the real problem is poor immunization in the area, which makes population susceptible
to both vaccine derived and wild polio viruses.
- WHO recommendations
▫ Use of OPV must eventually be stopped (starting with OPV containing Type-2 poliovirus)
worldwide and at least one dose of IPV must be introduced, to protect against Type-2 Polio
virus and to boost population immunity.
▫ Why??
• Since, wild Polio virus of type 2 was eradicated in 1999, the risk of paralytic disease due
to OPV type 2 now outweighs its benefits.
• A single dose of IPV before OPV protects against VAPP.
- IPV is very safe vaccines in humans, whether used alone or in combination vaccines.
▫ No serious adverse events have been reported, only minor side effects.

▫ It doesn't cause VAPP or cVDPV
- Situation in India
▫ India was declared Polio free in 2014, 3 years after the last case of Polio in 2011. But we still see
cases of vaccine derived Polio.
▫ Further, there have been cases of Non-Polio Acute Flaccid Paralysis (NPAFP) which are associated
with OPV.
- Issue of Contamination of Polio Vaccine (Sep - Oct - Nov 2018)

▫ Background
▪ Since 2016, the OPV around the world contains only two of the three serotypes - Type 1 and Type
3. Type 2 is not allowed as the wild, disease causing version was eradicated globally by 1999, and
because OPV itself can cause polio in rare cases.
▫ Contamination of Polio Vaccine with type 2 strain
▪ Recent surveillance detected the type 2 strain in the faecal samples from children in Uttar
Pradesh.
▫ Can contamination cause VAPP or cVDPV
▪ The risk is very small, virtually zero (but not absolutely zero).
▫ So, what is the concern?
▪ Source of the contamination has not been traced yet. CDSCO needs to focus on this to prevent any
future such contamination.
• Gaziabad based Bio-Med Pvt ltd (supplier of the vaccine) and Indonesia based PT Bio pharma
(supplier of raw material) are on the radar.
▪ Further, the authorities have not yet clarified about how widespread the contamination was.
▪ Lack of transparency may give rise to unfounded fears that upset the use of established vaccines.
10) DENGUE
- Dengue fever , also known as break bone fever, is a mosquito borne tropical disease caused by the
dengue virus.
▫ Dengue Virus (DENV) in one of the five serotypes is the cause of Dengue fever.
▪ It is a mosquito borne single positive stranded RNA virus of the family Flaviviridae; genus
Flavivirus.
▪ Dengue can affect anyone but tends to be more severe in people with compromised
immune systems.
▫ Dengue hemorrhagic Fever (DHF) is a specific syndrome that tends to affect children under
10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse
(shock).
- Possible to get dengue multiple times:
▫ Because it is caused by one of the five serotypes of virus, it is possible to get dengue fever
multiple times. However, an attack of dengue produces immunity for a lifetime to that
particular serotype to which the patient was exposed.
- Symptoms
▫ Severe joint and muscle pain, swollen lymph nodes, headache, fever, exhaustion, and rash.
The presence of fever, rash, and headache (the dengue "triad") is characteristics of dengue
fever.

- Geographical Regions
▫ Prevalent throughout the tropics and subtropics.
- Transmission
▫ The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously
bitten an infected person. The virus is not contagious and cannot spread from person to
person directly. There must be person to mosquito to another person pathway.
- Treatment
▫ Because Dengue fever is caused by a Virus, there is no specific medicine or antibiotic to treat
it. For typical dengue fever, the treatment is directed towards relief of symptoms
(symptomatic treatment)
▫ Currently no vaccine for dengue fever. A vaccine is undergoing clinical trial, but it is too early
to tell if it will be safe or effective.
- Prevention
▫ Interruption of transmission of the virus to mosquitoes to prevent the spread.
▫ Control and eradication of mosquitoes carrying the virus that cause dengue.
▫ Prevent mosquito bite
11) ZIKA FEVER / ZIKA DISEASE

- Why in news?
▫ The confirmation of more than 100 cases of Zika in Rajasthan marks the first large Zika
breakout in India. (Dec 2018)
▫ Bihar had earlier alerted all the districts for Zika (Oct 2018)
- About Zika Virus
▫ Zika virus (ZIKV) is a member of the Flaviviridae virus family and the Flavivirus genus,
transmitted by daytime-active Aedes mosquitoes, such as A. aegypti, A. Africanus, A. furcifer
etc.
▫ Zika virus is related to dengue, yellow fever, Japanese Encephalitis, and West Nile virus. The
illness it causes is similar to mild form of dengue fever, is treated by rest, and cannot yet be
prevented by drugs or vaccine.
- Earliest discovery
▫ Virus was first isolated in 1947 from a rhesus macaque monkey that had been placed in a cage
in the Zika Forest of Uganda, near Lake Victoria, by the scientists of yellow fever research
institute.
▫ In 1950s and 60s, first human cases in Uganda, Tanzania and Nigeria.
- Geographical Expansion
▫ In 1960s - 80s the virus distribution expanded in equatorial Asia including India.
▫ The year 2007 saw first large outbreak in humans (185 cases) on the pacific island of Yap
(Micronesia) - prior to these less than 20 human zika virus disease were known.
▫ In 2014, the virus spread eastwards across the Pacific Ocean to French Polynesia, then to
Easter Island, and in 2015 to Mexico, Central America, the Caribbean, and South Africa, where
the Zika outbreak has reached pandemic level.
- Transmission
▫ Zika virus is transmitted by daytime-active mosquitos in the genus Aedes.
▫ Transmission among humans
▪ Sexual contacts

▪ Virus can cross the placenta, affecting an unborn fetus. A mother already infected with
Zika virus near the time of delivery can pass on virus to the new born around the time of
birth, but this is rare.
- Symptoms and treatment
▫ Common symptoms include mild headaches, maculopapular rash, fever, malaise,
conjunctivitis, and joint pains. Thus far, Zika fever has been a relatively mild disease of limited
scope, with only one in five persons developing symptoms, with no fatalities, but is true
potential as a viral agent is unknown.
▫ As of 2018, no vaccine or preventative drug is available. Symptoms can be treated, with rest,
fluids, and paracetamol, while aspirin and other non-steroidal anti-inflammatory drugs should
be used only when dengue has been ruled out to reduce the risk of bleeding.
- Zika's link with Microcephaly and GB Syndrome
▫ Microcephaly is a condition where a baby has a head size much smaller than other babies of
the same age and sex. According to WHO this condition may be caused in newborn by mother
to child Zika virus transmission.
▫ GBS (Guillain-Barre Syndrome) is a rapid-onset of muscle weakness as a result of damage to
the peripheral nervous system. In a French Polynesian epidemic, 73 cases of GBS and other
neurological conditions occurred in a population of 270,000, which may be complications of
Zika virus.
- Steps being taken in Rajasthan
▫ ICMR and state officials have changed the insecticide which is being used in Jaipur to kill
mosquitoes
▫ Intense fogging and anti-larvae activities are being carried out in the areas where the cases
have been reported.
▫ Pregnant women have been advised not to visit the affected areas.
12) JAPANESE ENCEPHALITIS (JE)

- It’s a viral fever that affects the brain and is considered extremely dangerous for children, and it
also has a high "mortality and morbidity rate".
- About JE Virus
▫ Japanese Encephalitis virus (JEV) is a flavivirus belonging to same genus as dengue, yellow
fever and west nile viruses.
▫ It is the main cause of viral encephalitis in many countries of Asia with an estimated 68,000
clinical cases every year.
- Symptoms of JE includes sudden onset of fever, vomiting, headache, neck stiffness, and seizures.
- Transmissions
▫ The virus is maintained in a cycle between mosquitoes and vertebrate hosts, primary pigs and
wading birds. Humans are incidental or dead-end hosts because they don't develop high
enough concentration of JE virus in their bloodstream to infect feeding mosquitoes.
▪ So It is not transmitted from human to human
▫ JE virus transmission often occurs in primarily rural agricultural areas, often associated with
rice production and flooding irrigation.
▫ Transmitted by the bite of Culex tritaeniorhynchus and Culex vishnui mosquitoes.
- Management Control and Prevention

▫ Vaccination: Safe and effective JE vaccines are available to prevent disease. WHO
recommends having strong JE prevention and control system?
▪ In the mission Indradhanush - JE vaccination was included in May 2016.
▫ Controlling mosquitoes
▫ Pigs act as a carrier for the virus - so it is also important to control mosquito population around
the pig domestication areas
• Animal husbandry department plays an important role here.
- Treatment
▫ No specific treatments have been found to benefit patients with JE, but hospitalization for
supportive care and close observation is generally required. Treatment is symptomatic.
• Rest, fluids, and use of pain relievers and medication to reduce fever may relieve
symptoms.
13) CHIKUNGUNYA
- Why in news?
▫ The number of Chikungunya cases in the country saw a sharp rise from 2013 to 2017: National Health
Profile (NHP)
- Introduction
▫ Chikungunya is a viral disease transmitted to humans by infected mosquitoes.
▫ It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea,
fatigue and rash.
▫ Shares some clinical signs with dengue and can be misdiagnosed in areas where dengue is common.
▫ There is no cure for the disease.
▫ Treatment is focused on relieving the symptoms
▫ The proximity of mosquito breeding sites to human habitation is a significant risk factor for
chikungunya.
- About Virus
▫ It is an RNA virus that belongs to the aphavirus genus of the family Togaviridae.
- How transmitted between humans
▫ By the bites of infected female mosquitoes, most commonly, the mosquitoes involved are Aedes
Aegypti and Aedes albopictus.
- Detection of Chikungunya
▫ Detection is done by testing serum or plasma to detect virus, viral nucleic acid or other substances
associated with virus.
▪ It is detected using Real Time Polymerase Chain Reaction (RT-PCR).
- Prevention and Control -> Reducing Mosquito exposure
- How dangerous
▫ It is less dangerous than dengue, in the sense that it rarely leads to fatalities. However, it does affect
patients severely, leaving them with pain in the joints and swelling.
14) WORLD MOSQUITOE PROGRAM
- Why in news?
▫ Recent experiments in Australia has clearly shown a correlation between introduction of Wolbachia in
the mosquito population and decrease in the mosquito borne diseases.
- Intro

▫ WMP is a not-for profit initiative that works to protect the global community from mosquito-borne
diseases such as Zika, Dengue, Chikungunya.
▫ Pioneered by Australian researchers, the WMP uses safe and natural bacteria called Wolbachia to
reduce the ability of mosquitoes to transmit these viruses.
▫ WMP was first launched in Australia in 2011 and has expanded rapidly since then.
- About Wolbachia
▫ Wolbachia is a natural-bacteria present in upto 60% of insect species, including some mosquitoes. It is
one of the most common parasitic microbes and is possibly the most common reproductive parasite in
the biosphere.
▫ However, they are naturally not found in Aedes aegypti mosquito, the primary species responsible for
transmitting human viruses such as Zika, Dengue, Chikungunya and yellow fever.
- WMP research has shown that when introduced in Aedes aegypti mosquito, Wolbachia can help reduce
the transmission of these virus in people. Thus, it can be used to fight life-threatening diseases.
- How is it introduced:
▫ Video link: World Mosquito Program - Our Wolbachia method
15) MONKEY DISEASE (KYASANUR FOREST DISEASE)
- Why in news?
▫ Two more people died to KFD in Karnataka (Jan 2019)
- Introduction
▫ KFD is caused by KFDV, a member of virus family Flaviviridae. It was first identified in 1957 when it was
isolated from a sick monkey in Kyasanur Forest in Karnataka state India.
▫ Since then, about 400-500 cases are reported every year from the state.
- Reservoirs for Virus
▫ Hard Ticks (Hemaphysalis spinigera) are the reservoir of the KFD virus and once infected, remain so for
life.
▫ Monkeys, shrews, and Rodents are common hosts for KFDV after being bitten by an infected tick.
- KFDV can cause epizootics with high fatality in primates.
- Transmission
▫ Infected tick bite or contact with an infected animal (monkey, shrew etc). No person-to-person
transmission has been known so far.
▫ Transmission from other infected animals like goats, cows etc is extremely rare.
- Symptoms
▫ Chills, fever, headache, muscle pain, low platelet, low RBCs and WBCS.
- Treatment
▫ No specific treatment -> hospitalization and support therapy like hydration and usual precautions is
important.
- Vaccine: Yes
▫ Used in endemic areas of India.
- Distribution
▫ Historically limited to western and central district of Kar, India. However, some samples have also been
found from Tamil Nadu and Kerala.
16) INFLUENZA

- There are 4 types of influenza viruses : A, B, C and D.
- Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the
hemagglutinin subtypes and 11 different neuraminidase subtypes (H1 through H18 and N1 through
N11 respectively)
17) SWINE FLU

- Why in news?
▫ Various states in India have been put on high alert as swine flu cases spike across the country.
There have been 49 swine flu deaths and 1694 new cases reported in just first two weeks of
the year 2019.
- Swine Flu is a respiratory disease caused by influenza A viruses
that infect respiratory tract of pigs and result in barking cough,
decreased appetite, nasal secretion, and restless behavior; the
virus can be transmitted to human.
▫ Virus
▪ The 2009 swine flu outbreak was due to infection
with the H1N1 virus and was first observed in
Mexico. Investigators decided to name it H1N1 flu
since it was mainly found infecting people and
exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase
type 1). The eight RNA strands from novel H1N1 flu have one strand derived from human
flu strains, two from avian (bird) strains, and 5 from swine strains.
▪ In 2011, a new swine flu virus was detected named influenza A (H3N2)v.
▫ Transmission
▪ Swine flu is transmitted from person to person by inhalation or ingestion of droplets
containing virus from people sneezing or coughing.
▪ Not transmitted by eating cooked pork products.
▫ Symptoms
▪ Similar of swine flu in humans are similar to most influenza infections: - fever, cough,
nasal secretion, fatigue and headache.
▫ Prevention and cure
▪ Vaccination is the best way to prevent or reduce the chances of becoming infected with
influenza virus
▪ Two antiviral agents, zanamivir (Relenza) and oseltamivir (Tamiflu), have been reported
to help prevent or reduce the effects of swine flu if taken within 48 hours of the onset of
symptoms.
- Jan 2019 Outbreak in India
▫ First two week of 2019 -> large number of cases as per the data released by Integrated Disease
Surveillance Program (IDSP).
▪ Steps taken
i. States have been asked to spread awareness about the spread, testing and prevention
of Swine flu.
ii. Further, states have been directed to ensure enough number of beds and medicines to
treat any cases that are being reported.

18) AVIAN INFLUENZA/ BIRD FLU
- Intro
▫ Avian Influenza (AI), commonly called bird flu, is an infectious viral disease of the birds. It is
caused by Type A strain of virus carried and infected by birds.
▫ Most avian influenza virus don't infect humans; however, some such as A(H5N1) and A(H7N9),
have caused serious infections in people.
- Two major groups based on their ability to cause their disease in poultry
▫ High Pathogenicity - may result in high death rate (upto 100%) within 48 hours. E.g. : (A(H5N1))
▫ Low Pathogenicity - not associated with severe diseases. e.g. : A(H7N9)
19) CRIMEAN CONGO HEMORRHAGIC FEVER (CCHF)

- Introduction
▫ CCHF is a wide spread disease caused by a tick-borne virus (Nairovirus) of the
Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever
outbreaks, with a case fatality rate of 10-40%.
▫ Transmission: The virus is primarily transmitted to people from ticks and
livestock animals. Humans to humans transmission can occur resulting from
close contact with the blood, secretions, organs or other bodily fluids of
infected persons.
▫ CCHF is endemic in Africa, the Balkans, the Middle east and Asia, in countries
south of 50th parallel north.
▫ Vaccination - No vaccination available yet for people or animals.
20) NIPAH
- Why in news?
▫ Nipah virus outbreak in Kerala's Kozhikode and Malappuram district in May 2018 claimed 16
lives.
▫ In June 2018, the Kerala government announced containment of Nipah virus with recovery of
the last two positive cases.
- Introduction
▫ According to WHO Nipah Virus (NiV) infection is a newly emerging zoonosis (a disease that can
be transmitted from animals to humans) that can infect both humans and animals.
▫ The natural host of the virus are fruit bats of the Pteropodidae family, Pteropus genus.
▫ Human to human transmission is also known including in the hospital setting.
- First identification
▫ The NiV was first identified during the outbreak of disease that took place in Kampung Sungai
Nipah, Malaysia in 1998. In this case pigs were intermediate hosts. Since, then there have
been several outbreaks even without intermediate hosts.
▫ In India it was first detected in Siliguri in 2001.
- Vaccine
▫ There is no vaccine either for humans or animals.
- Symptoms of NiV can be neurological, respiratory and pulmonary. They include:
▫ Inflammation of the brain
▫ Confusion, disorientation and even persistent drowsiness
▫ Headache, fever, nausea and dizziness (flu like symptoms)

- Prevention
▫ Avoid date palm sap as the chances of its contamination is very high.
▫ Don't share food, bed or proximity to a sneezing or coughing NiV patient
▫ Avoid physical contact with saliva of an infected person.
▫ Avoid direct contact with pigs/bats in endemic areas.
- Treatment
▫ Intensive Support care (no vaccine available)
21) SMALL POX

- Why in news?
▫ The US Food and Drug Administration (FDA) approved the first drug with an indication for treatment
of Small Pox on July 14 2018.
- Introduction
▫ Smallpox was a fatal, contagious viral disease caused by the virus variants, Variola major and Variola
Minor.
▫ It was declared eradicated in 1980 by the World Health Organization.
- Concerns of Bio-terrorism
▫ Though it has been eradicated and survives only in some labs in the world, defence experts are always
worried about its use in bio-terrorism.
- Anti-viral treatment
▫ TPOXX (tecovirimat) is a small-molecule antiviral treatment for smallpox, the first therapy specifically
approved for this indication.
▫ TPOXX effectiveness has been evaluated on animals infected with viruses that are closely related to
the virus that causes smallpox. It's safety has also been tested on 359 volunteers without a small pox
infection.
- ORPHAN DRUG Designation
▫ TPOXX has also been given Orphan drug designation. This provides incentives to assist and encourage
development of the drugs for rare diseases.
22) HEPATITIS
- Why in news?
▫ MoH&FW have launched a National Viral Hepatitis Control Program on 28th July (World
Hepatitis Day)
- About Hepatitis
▫ Hepatitis refers to inflammatory condition of liver. It's commonly caused by viral infections,
but there can be other causes too (e.g. auto-immune hepatitis that occurs as a secondary
result of medication, drugs, toxins etc.)
- 5 Types of Viral Hepatitis
▫ Hepatitis A, B, C, D, and E. A different virus is responsible for each of these types.
▫ Hepatitis A by Hepatitis A Virus (HAV)
▪ Transmitted by consuming food or water contaminated by faeces from a person infected
with hepatitis A.
▫ Hapatitis B (HBV) is transmitted through contact with infectious body fluids, such as blood,
vaginal secretion, semen etc.
▫ Hepatitis C (HCV) is transmitted through direct contact with infected blood fluids typically
through injection drug use and sexual contact.

▫ Hepatitis D (HDV), also called Delta Hepatitis is transmitted through direct contact with
infected blood.
▫ Hepatitis E (HEV), is mostly found in areas with poor sanitation and typically results from
injecting fecal matter that contaminates the water supply.
- Hepatitis B and C are responsible for more than 96% of cases.
▫ Vaccine for Hepatitis B is available
▫ Vaccine for Hepatitis C is not available
- National Viral Hepatitis Control Program (launched in July 2018)
▫ By MoH&FW
▫ It is aimed at eliminating the deadly condition by 2030.
▫ It has been launched in collaboration with WHO.
▫ Under the program, government will be providing free drugs and diagnosis for Hepatitis B and
C.
▫ Key strategies under the program
▪ Preventive and Promotive Interventions with focus on awareness generation
▪ Safe injection practices and socio-cultural practices
▪ Sanitation and Hygiene
▪ Safe drinking and water supply
▪ Infection control and immunization
▪ Coordination and collaboration among different ministries
▪ Increasing access to testing and management of viral hepatitis
▪ Building capacities at national, state and district levels
- World Hepatitis Day - 28th July
▫ Aims at raising awareness of hepatitis (A,B,C,D,E) and encourage prevention, diagnosis and
treatment.
▫ World Hepatitis Day is one of the 8 global public health campaigns marked by WHO, along
with World Health Day (7th April), World Blood Donor Day (14th June), World Immunization
Week (last week of April), World Tuberculosis Day (24th March), World No tobacco day (31st
May), World Malaria Day (25th April), and World Aids Day (1st December).
3. NON-VIRAL DISEASES (NEXT S&T BOOKLET)
1) Malaria
2) Kala Azar
3) Tuberculosis
4) Typhoid
5) Diptheria
6) Leprosy
7) Leptospirosis
8) Yaws
9) Trachoma
10) Cholera
11) Neglected Tropical Diseases
12) Mitochondrial Diseases
4. NON COMMUNICABLE DISEASES

5. OTHER ISSUES TO BE COVERED (NEXT S&T BOOKLET)

1) Thalassemia
2) Fluorosis
3) Silicosis
4) Jaundice
5) Rare Diseases -> Withdrawal of National Policy for Treatment of Rare Diseases.
6) Anti-microbial Resistance
7) Food Quality Regulation in India
8) Smoking -> COTPA
9) E-Cigarette
10) Drinking -> Hooch Tragedies
11) Mental Health Issues
12) Sanitation -> Swatch Bharat Abhiyan
13) Surrogacy and Related Issues
14) Regulation of Medical Devices in India
15) Traditional Medicines -> Ayurveda -> National Ayush Mission
• Ayush Mission
• SATYAN Initiative
16) Medicines/ Medical Devices and Related Issues
• FDCs
• Generic Medicines
DPCO -> Controlling price of Medicines

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CURRENT AFFAIRS STRATEGIST PROGRAM

Target Prelims 2019: Booklet 7

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Sex Ratio 943/1000 (rural : 949 , Urban : 929)

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3) ‘HEALTHY STATES, PROGRESSIVE INDIA’ – A REPORT BY NITI AAYOG

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- Other Key Highlights

4) NATIONAL HEALTH POLICY (NHP), 2017

▫ Assigns specific quantitative targets

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▫ Improving health facilities

▪ Leverage the pluralistic health care legacy

- Private Sectors as strategic Partners

- Giving back to society initiative

- New Bodies to be established

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6) HEALTH AND WELLNESS CENTRES OF AYUSHMAN BHARAT

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7) PRADHAN MANTRI SURAKSHA BIMA YOJANA (PMSBY)

8) PRADHAN MANTRI JEEVAN JYOTI BIMA YOJANA (PMJJBY)

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11) INTEGRATED HEALTH INFORMATION PLATFORM

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12) LAQSHYA: LABOR ROOM QUALITY IMPROVEMENT INITIATIVE

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3) NUTRIENTS (MICRO AND MACRO)

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FATS - SIGNIFICANCE - LIMITATIONS AND TYPES

TRANS FAT VS SATURATED FAT VS MONO-SATURATED FAT VS POLY-

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ii. Saturated Fats

Mono unsaturated Fat and Poly Unsaturated Fats

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▪ Some Limitations of Food Fortification

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- Steps taken by government to promote food fortification

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Xerophthalmia Vitamin A • Xerophthalmia or night blindness is characterized by

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Anaemia Iron • It is characterized by a decrease in the red blood cell count

Kwashiorkor Protein and Energy • It is characterized by anorexia, an enlarged liver, irritability

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▫ Priority Court Proceedings

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7) THREE DIFFERENT STRAINS OF POLIO VIRUS

8) TWO TYPES OF POLIO VACCINES -> OPV AND IPV

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9) ISSUE OF VACCINE DERIVED POLIO VIRUS INFECTION

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- Issue of Contamination of Polio Vaccine (Sep - Oct - Nov 2018)

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11) ZIKA FEVER / ZIKA DISEASE

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12) JAPANESE ENCEPHALITIS (JE)

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