India ranks 145th among 195 countries in healthcare, disparity among states

Goa and Kerala had the highest scores in 2016, both over 60, whereas Assam and Uttar
Pradesh had the lowest, both below 40.
While India has seen improvements since 1990, its HAQ score was lower than 50 for 23 of
the 32 causes of death.
India ranks a lowly 145th among 195 countries in terms of healthcare access and quality in
2016, as assessed in a Global Burden of Disease study published in The Lancet. The study
used an index based on 32 causes of death that should be preventable with effective medical
care. Each country was given a healthcare access and quality (HAQ) score between 0-100.
India’s HAQ score is 41.2, up from 24.7 in 1990.
For the first time, the study also analysed healthcare access and quality between regions of
seven countries including India. China and India had the widest disparities of 43.5 and 30.8
points, respectively, while Japan had the narrowest of 4.8 points. In India, the 30.8-point
difference marks an increase in disparity from 23.4 points in 1990. Goa and Kerala had the
highest scores in 2016, both over 60, whereas Assam and Uttar Pradesh had the lowest, both
below 40.
While India has seen improvements since 1990, its HAQ score was lower than 50 for 23 of
the 32 causes of death. Particularly low were scores like 12 for skin cancer, 24 for neonatal
deaths and adverse medical treatment, and 30 for tuberculosis and chronic kidney ailments.
“This is really disappointing – well behind BRICS countries,” Dr Madhukar Pai, Canada
Research Chair in Epidemiology and Global Health told The Indian Express.
About India’s low score in TB, Pai said: “This does not surprise me, since TB deaths should
be rare if quality care was available. We know India accounts for nearly 30 per cent of global
TB deaths… TB is often missed by practitioners, and MDR-TB is diagnosed very late. In the
public system, patients are lost along the entire care cascade, and this means only 1 in 2 TB
patients make it to the finish line. With MDR-TB, only 1 in 5 patients cross the finish line
and successfully complete therapy. All this makes for a poor HAQ score. The bottom line,
simply focusing on coverage of TB services is not enough. We need to also improve quality
of TB care, in both private and public sectors.”
Dr K Srinath Reddy, president of Public Health Foundation of India, felt that the reason for
India’s poor show is the low density of health workers in the poorly performing states. “For
instance the Janani Suraksha Yojana has registered a rise in the number of institutional
deliveries. However there is no demonstrable correlation with lowering of maternal mortality
in certain states,” Dr Reddy said.
This scorecard shows that the health system is weak and while centrally funded schemes have
provided health access in some areas, quality has not improved in certain states, he added.
The global average HAQ score was 54.4. Iceland and Norway top the list with a HAQ score
of 97 each.

Source : The Indian Express

170 potential lung cancer drug targets identified

Scientists, who tested over 200,000 chemical compounds, have identified 170 candidates that

can be potentially used for developing new drug therapies for lung cancer.

The five-year project set out to identify new therapeutic targets for non-small cell lung cancer

as well as potential drugs for these targets - a significant step forward towards personalising

cancer care, researchers said.

For the large majority of compounds, we identified a predictive biomarker - a feature that

allows the development of 'precision medicine,' or individualised treatment for each patient,"

said John Minna, from University of Texas in the US.

For the study, published in the journal Cell, the researchers searched for compounds that

would kill cancer cells but not harm normal lung cells.

"We began an ambitious project with the goal of identifying 'therapeutic triads': chemicals

that kill cancer cells, biomarkers that predict who would respond, and the therapeutic targets

on which those active chemicals work," said Minna.

Continuing to uncover the mechanism of action for the majority of the 170 chemicals will be

a key focus of future research. Follow-up work will also include testing the chemicals on

other types of cancer.

Preliminary work shows some of the compounds are likely effective against certain breast

and ovarian cancers as well.

The researchers have carefully developed and curated a collection of lung cancer cell lines

since the 1970s that is now recognised as the world's largest.

The team of scientists began by testing 200,000 chemicals against 12 lung cancer cell lines.

"The initial screen gave us 15,000 chemical 'hits,' way too many to work with in detail, but

with repeat testing we eventually narrowed the number down to 170," said Bruce Posner,

Professor of Biochemistry and Director of the High-Throughput Center at University of

Texas.

The set of 170 chemical compounds was then tested across 100 lung cancer lines.

At the same time, researchers conducted in-depth molecular analyses of the lung cancer lines,

including identification of genome mutations and protein expression.

This information, paired with whether or not an individual cancer cell line was sensitive to a

particular chemical, allowed the researchers to develop a set of biomarkers - indicators that

could be used to determine if a particular cancer will respond to one of the 170 chemical

compounds.

Source: The Tribune