Life After Death





On Organ Donation Day, let's resolve to donate as well as set up an effective policy mechanism

Hundreds of thousands of Indians die of organ failure every year. Many of these deaths could be averted by timely organ transplants. However, the country is beset with a monumental deficit of organs available for transplants. According to latest data, as against the demand for 1.75 lakh kidney transplants, only 5,000 are carried out. Similarly , 1,000 liver transplants take place while 50,000 die of end stage liver disease. Statistics are distressingly poor in case of heart or lung transplants too. Indeed, India's organ donation rate stands at an abysmal 0.34 per million population. A country like Spain, on the other hand, has managed to ramp up the rate to 36 PMP and, hence, save many lives.Today is Organ Donation Day, an initiative of this newspaper. It aims to give a fillip to India's efforts to develop an effective organ donation ecosystem. Last week health minister J P Nadda declared that the government would soon announce a policy mechanism to facilitate cadaver organ donation and address institutional roadblocks. Those roadblocks are formidable, but hardly insurmountable.First and foremost the government, in tandem with all stakeholders, must set up a national registry of potential organ donors and recipients. Time is of the essence when it comes to organ transplants as a heart or a lung cannot be stored. A centralised database indicating demand and supply can eliminate time lag and ensure an organ harvested from a brain dead patient reaches the recipient in time to save his or her life. In fact, this week the heart and lungs of a brain-dead patient were airlifted from Kochi to Chennai and used for a successful transplant.
But such instances are exceptions rather than the rule. Indeed, the government needs to adopt a host of other measures ­ from mandatory reporting of brain death, to developing infrastructure and logistics for speedy transportation of organs, to preparing standards for transplants in registered hospitals ­ to ensure organ donation and transplants can take place smoothly .
No less important is the task of raising awareness so more and more people sign up for organ donation. Rope in film stars and role models to lead a public awareness campaign. Institute the help of religious leaders so relatives of brain dead patients do not baulk at agreeing to their loved ones' organs being harvested. Death may be inevitable. But organ donation allows you the chance to give life to someone else.

25% of Indians may die of lifestyle diseases before they are 70: Study

Sushmi Dey

New Delhi:





`Heart, Lung Ailments Claim 5.8m LivesYr'

With increasing prevalence of lifestyle diseases in India, one out of four Indians is at risk of dying from non-communicable diseases like diabetes, cardio-vascular ailments or cancer before the age of 70, according to estimates of various global and domestic organizations. The findings are part of a white paper released by the Confederation of Indian Industry and academia on Wednesday .“Every year, roughly 5.8 million Indians die from heart and lung diseases, stroke, cancer and diabetes.In other words, 1 in 4 Indians risks dying from an NCD before they reach the age of 70,“ the white paper said. Experts say the government needs to urgently build awareness programmes for NCDs in line with that for HIV and tuberculosis.
“Prevalence of NCDs is a result of lifestyle patterns which have changed significantly over the last decade.The government's programmes so far have been focused around HIV and tropical diseases. But with the increasing NCD burden, awareness needs to be created and ramped up from community level to across the country,“ said Kevin L. Walker, Executive Director, Partnership to Fight Chronic Disease, a global organization working towards raising awareness about how to counter diseases like diabetes and cardiovascular disabilities.
Many other global organizations including World Health Organisation and other agencies of the United Nations have now carved out specific strategies to tackle the rising disease burden due to changing lifestyle and eating habits.
The government said it is set to roll out a preventive and promotive programme in six districts to spread awareness about the disease.
“We have chosen six districts. Around 200 doctors will be posted in each district.They are currently undergoing training and the programme is expected to be launched by the end of this month,“ Dr Jagdish Prasad, director general of health services, said at the National NCD summit organized by CII.
According to the NCD country profiles of 2014 released by WHO, diseases like cancer, chronic respiratory problems and cardiovascular diseases are the biggest global killers accounting for 38 million deaths every year.

Message from Ms Irina Bokova,
Director-General of UNESCO,
on the occasion of International Youth Day
12 August 2015

International Youth Day is an opportunity to celebrate the creative force and the innovative impetus that young people bring to every society. This year’s theme – “Youth Civic Engagement” – emphasizes the role played by the involvement and inclusion of young people in building social cohesion and collective well-being. From social entrepreneurs to journalists, from voluntary workers to members of community organizations, young people contribute to shaping society to lead it towards political, cultural and economic renewal.
We must support their civic engagement at every level, beginning with recognizing that young people form a separate social group with specific characteristics and expectations. Civic engagement is a way to exploit this potential to enrich society, further human rights and enable improved living conditions for all.
These goals are at the core of UNESCO’s projects, to offer young people the space and skills they need to develop, which reflects on all societies.
That is the spirit of UNESCO’s project to strengthen youth networks in the Mediterranean. Young people must be considered the drivers of change, and not only beneficiaries or targets. That involves reinforcing exchanges and cooperation between generations to ensure that young people are actually involved in developing the policies intended for them. The ninth UNESCO Youth Forum, held in October, will provide a unique platform to convey this message, and I invite young people from all over the world to attend and make their voices heard, to shape the action of world leaders. These voices carry the hope of half of the planet, for a sustainable future for all.
Irina Bokova

Humane society must have universal health coverage

A humane society must have universal health coverage. This is a laudable aim in itself; it is even more significant in the Indian context.

With profound health challenges and almost 30% of its population living below the poverty line, India must confront the challenge of keeping its citizens healthy. Simply put, providing and financing universal health coverage (UHC) for 1.2 billion people can be a challenging proposition, and the government needs all the help that it can get.

India has made impressive economic gains in the post-liberalisation period.

Juxtaposed against this, inequity too has grown and this is evident in levels of access to healthcare. The uptake of health services has remained low among people at the bottom of the economic pyramid, and even the rapidly expanding lower-middle class remains susceptible to slipping back into poverty in the face of a health crisis. This is because in India 70% of health costs are paid for out-of-pocket at the point of service, with expenditure ranging from zero to more than Rs 10 lakh.

Universal health coverage would, therefore, not only ensure that Indian citizens stay healthy; it would also protect them from being driven or trapped below the poverty line by illness.

Many of India’s fundamental health indicators are dismal compared even to poorer neighbours. India’s immunisation rates are abysmally low: Only 70% of children receive even the basic vaccines today. These levels have persisted since 1990, while a lower-income country such as Bangladesh has driven significant improvement in this indicator and achieved a 95% immunisation rate.

Globally, the field of health is witnessing a shift in focus from disease-driven initiatives to projects aimed at increasing the sustainability and strengthening of health systems. A crucial component of achieving this will be to secure sustainable financing for health services.

On its part, the government has focused a large portion of its resources on primary and secondary healthcare services, while also devoting a sizeable share to tertiary services. Although urban India has better health infrastructure, the private sector is the dominant provider and costs are higher.

Innovative partnerships could certainly help address this complex set of challenges.

The private sector can help finance the capital costs involved in setting up new healthcare facilities as well as provide management and technical expertise in delivering health services at scale. It can also help train the government’s frontline health workers in the aspects of health service delivery.

The National Health Mission has adopted participatory models to fill vacancies in public healthcare facilities by contracting private practitioners.

Gujarat, Rajasthan, Uttarakhand and Karnataka have also been working with private healthcare providers to deliver essential diagnostic, telemedicine, telehealth and mobile health clinic services. The government can make investing in rural areas both profitable and sustainable for private healthcare providers.

India should leverage all available resources to improve its health services. Given the diversity across states, it should avoid embracing one-size-fits-all models and allow enough flexibility for local design experimentation within an overarching national UHC plan.

Sangita Reddy is joint managing director of Apollo Hospitals Enterprise Limited. The views expressed are personal.

Writing a new script

On Tuesday, India woke up to the news of Sundar Pichai, an engineer and executive hailing from Chennai who has made it big in Silicon Valley, becoming the CEO of Google. Far bigger in import was the news of the reorganisation of the internet behemoth Google itself, which propelled Mr. Pichai to the top slot. Larry Page, who along with Sergey Brin started the search engine in 1998, announced a corporate structure in which Google will be part of a new umbrella organisation, Alphabet. This organisation will also have a collection of other ventures, many of which are big bets that Google terms ‘moonshots’. This seems a drastic change for one of the most successful companies of the information era, a bellwether technology enterprise, a constant innovator, and one which has billions of people using its products. The company, which started off nearly two decades ago with the seemingly modest ambition of providing an organised gateway to all of the world’s information, proved hugely effective, popular and successful. Starting as a search engine and achieving success in producing a weighted ranking of webpages, it moved on to become a market leader in webmail (Gmail), browsers (Chrome), video hosting (You Tube), news aggregation (Google News) and mobile operating systems (Android), among other products. It has been so successful in its constant ownership of the latest trends in the internet that it has even created a fear of the monopolisation of the space, as a result getting embroiled in anti-trust cases in Europe.

But all that doesn’t explain the change in the corporate structure, one in which Alphabet will incorporate a “slimmed down” Google among a number of other ventures. Why this change? In his post, Mr. Page simply wrote, “Google is not a conventional company. We do not intend to become one.” A distinguishing factor for Google all these years has been its capacity and inclination to expand the frontiers of technological innovation into newer ventures beyond its core business. So, while expanding, quite smartly, into adjacent areas of its business, it also ventured into ambitious projects where pay-offs can be expected only many years into the future: cars that are self-driven, balloons that power internet access, technologies that slow down ageing, and so on. Also, remaining true to its start-up roots, Google has been open to experimentation and, therefore, to some failures (Orkut and Google Plus, to name two of them). Sometimes this has led critics and investors to worry that Google was spending too much time, effort and money on such experiments. The reorganisation, led by Alphabet, may not only provide more clarity on these differently mature businesses but also provide the leadership a structure to think like a start-up again and not get drowned in the ‘big-ness’ of the $66-billion Google.

Keywords: Sundar Pichai, Google restructure, Google CEO, Indian-origin CEOs, Larry Page

The Speaking Tree - Detached Love

SEEMA BURMAN





All religions enjoin humans to live unselfishly . Every unselfish action takes us a little closer to the Supreme Consciousness. On the other hand, every selfish action acts as an obstruction to our finding the Divine Truth. A philosopher lives with the knowledge that the world is a delusion. The unattached worker has love for the universe in his mind.He treats all duties as means with which selfishness may be overcome. A sincere worker need not believe in God or mukti; yet, he finds the Ultimate Truth by unselfish work.A nurse loves the employer's baby . Even then, if she is asked to leave, she does just that and begins work again in another household, looking after another baby . Be like the nurse, Ramakrishna advised, and know that God is our employer. When one works with detachment and freedom, then there is no tension.
But thinking that the world needs our help gives rise to attachment, arrogance and pain. It is the giver who is blessed, not the receiver. A mother loves her children selflessly .When one can give to the world like a mother, only then can one realise Divinity through work. Absence of love for the work you do makes it a boring exercise. When the mind is disciplined and detached, working will mean relaxation.
One need not go on a holiday just in order to take a break from work -work itself should be treated as relaxation.Holidays should be a passage from one joy to another and not from boredom to joy .

Land Law Must Give Way to a Better One





The goods and services tax is more important than the land Bill, said Adi Godrej, speaking for many . He is spot on. The land acquisition law is flawed in fundamental ways, not just in the version that the government now wants to distance itself from but in its 2013 form forged by the UPA. The problem is not just in terms of specific provisions of the law but far more basic. India's growing economy needs land to be released for new economic activity , without doubt. This has to be understood as a challenge of urbanisation, rather than merely as a policy of releasing patches of land across the country .As industry and organised services grow faster than agriculture, and look for expanded urban environs to accommodate them, urbanisation happens. More urban spaces come up and more people move from village to town. If half of India beco mes urban over the next 20 years -China has crossed this point already -roughly 25 crore more people will be added to Ind ia's urban population. With any reasona ble measure of population density , something like 20,000 sq km of additional urban land will be needed to accommodate this incremental urban population. Existing towns will need to expand and rebuild, new towns will need to be built. Does the land law of either the UPA or the NDA address the challenge of releasing land on this scale?
The point is to make those who lose land to economic progress stakeholders in the prosperity that comes up on their erstwhile land. There is no unique one way of doing this. But the stakeholder principle must be incorporated into whatever mechanism is adopted to release forest or agricultural land for new economic use. That should be the only purpose of a central law on the subject. Industry and farmers have to learn to become partners in India's progress.