National Vaccine Policy: ethical equity issues.

The ministry of health and family welfare published the national vaccination policy in April 2011. The policy document drew severe criticism from several public health experts. A review of the print and web-based literature on the national vaccine policy was done and the issues of ethics and equity involved in introducing new vaccines under the Universal Immunisation Programme (UIP) were studied.

Medical education in India: Time to make some changes.

India is in need of well-trained doctors. We highlight and analyse some of the problems affecting medical education in India and their possible solutions. The medical education system can be reviewed under four heads: selection of students, medical training, evaluation, and the development and accreditation of faculty. In India, students enter medical colleges without receiving sufficient orientation about the profession. If students were given some exposure to various professions in the final years of school, it would help address this issue. Medical students are selected on the basis of pre-medical tests consisting of multiple-choice questions, the validity of which is being questioned increasingly. There is no coordination between the scheduling of lectures on various diseases and their management and the clinical exposure of the students. Active involvement in treatment is limited to the final year, called internship, which is hampered by preparation for postgraduate entrance examinations. Efforts should be made to provide hands-on experience at an earlier time in the course. A systematic and reliable programme for evaluation is a must. There is a need for a shift in the focus of evaluation, which should assess the application of knowledge rather than the ability to recall facts. The replacement of the traditional long-/short-case examinations with more valid and reliable instruments for the assessment of clinical skills should be considered. ‘Vision 2015’, a document developed by the Medical Council of India, contains many notable recommendations for the improvement of the current system. If these are implemented effectively, the impact of improvement in Indian medical education will be felt globally.

Saving lives, or styling them.

he past few years have witnessed the rise of highly publicised “lifestyle” drugs. They are used to alter our appearance, physical and mental capabilities, the effects of aging, and so on. As the availability of a treatment can convert a lifestyle wish into a health need, the pharmaceutical industry becomes a key player in the process of medicalisation, where normal conditions get pathologised.

Newer vaccines in the Universal Immunisation Programme.

Vaccines are important preventive medicines for primary healthcare and critical for a nation’s health security. In India the Universal Programme of Immunization (UPI), launched in 1985, included six childhood vaccines. A well thought out immunisation schedule must be epidemiologically relevant to the country’s health status, covering only diseases that are public health problems and for which effective vaccines are available. There has been pressure from the drug industry to include all newly developed vaccines in the government’s UIP, even though the clinical and epidemiological justification for their inclusion is debated. Many developed countries have included several other new vaccines in their regular immunisation programmes.