Editorial Notes

Editorial Notes 19th October 2016

Nexus Between Pharma Companies and Hospitals in India; India-Russia Summit; Antarctic Circumpolar Expedition (ACE); etc.
By IT's Editorial Notes Team
October 19, 2016


Polity & Governance

  • Big Pharma’s India shadow

Environment & Ecology

  • Scientists launch unprecedented Antarctic research mission

Bilateral & International Relations

  • Reinventing old links


Polity & Governance

GS (M) Paper-2: “Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.”

Big Pharma’s India shadow



  • The nexus between pharma companies and hospitals in India is pushing up treatment costs while exposing patients to huge, unknown risks.
  • The medical world is in the grip of a fierce debate triggered by the findings of two academic studies both related to the impact on use of statins.

Statins and the Debate:

  • Statins are a class of drugs often prescribed by doctors to help lower cholesterol levels in the blood. By lowering the levels, they help prevent heart attacks and stroke. 
  • An article in The LancetInterpretation of the evidence for the efficacy and safety of statin therapy, concluded that “statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken. It de-emphasised the side-effects from prolonged use of the drugs.
  • On the other hand, an older piece and its more recent follow up in the venerable British Medical Journal (BMJ) stated that “statins have no overall health benefit in this population”, while suggesting that side-effects of statins are very common.

While it is difficult to pick sides, the overwhelming research over the last 20 years supports the BMJ findings.

It’s about Business not Patient:

  • Pfizer’s Lipitor, the original cholesterol-lowering statin, is one of the best selling drugs of all time having grossed over $125 billion in sales for the company.
  • “In the conflicting demands of drugs for profit and drugs for curing diseases, there can be only one winner and it is certainly not the patient.
  • The harmful impact of silicone breast implants or certain hormone drugs were revealed long after they had been in use for decades.
  • In India, the nexus between pharma companies and hospitals is pushing up treatment costs while exposing patients to huge, unknown risks.
  • Ranbaxy, the original(Lipitor) generic pharmaceutical manufacturer of atorvastatin since 2011, ran into enough problems with the USFDA to suggest that the future well-being of consumers of its products was the last thing on its mind.

Regulatory Mechanism in India:

In India, branded generics dominate the pharma market, constituting nearly 80% of the market share (in terms of revenues).

  • Over the last decade, drug withdrawals from the Indian market have been mainly due to safety issues involving cardiovascular events.
  • The typical lag between the banning of a drug in developed markets and in India is 3-5 years. There is a process in place for this very purpose. Pharmacovigilance, as defined by the WHO, relates to the detection, assessment, understanding and prevention of adverse events or any other possible drug-related problems.
  • In India, the pharmacovigilance programme is run by the Central Drugs Standard Control Organisation (CDSCO), under the ministry of health & family welfare and coordinated by The Indian Pharmacopoeia Commission (IPC).
  • The trouble is any such programme relies upon spontaneous reporting by healthcare professionals in an effort to prevent or reduce adverse drug reactions (ADRs). Predictably, that’s not happening in India, where the ADR reporting rate is below 1% compared to the worldwide rate of 5%.


  • With India emerging as the diabetes and coronary heart disease capital of the world, it is also among the fastest growing markets for pharma products.
  • But as much the benefits of these accrue to Indians, the absence of adequate oversight and monitoring for long-term effects shouldn’t leave the country in the shadow.
[Ref: LiveMint]


Environment & Ecology

GS (M) Paper-3: “Conservation, environmental pollution and degradation, environmental impact assessment”

Scientists launch unprecedented Antarctic research mission



  • Organisers of the Antarctic Circumpolar Expedition(ACE) hope to foster collaboration in a bid to gain a deeper understanding of humankind’s effect on the Southern Ocean.
  • More than 50 researchers from 30 countries gathered in London to carry out the first scientific circumnavigation of Antarctica in an attempt to measure pollution and climate change, with the official launch held recently.

Mission: Circumnavigation of Antarctica:

  • The international team will sail on Russian research vessel Akademik Treshnikov, leaving Cape Town on 20 December and returning on 18 March next year.


  • “Researchers will work on a number of interrelated fields, from biology to climatology to oceanography, for the future of this continent,”
  • Adopted projects include mapping whales, penguins and albatrosses in the Southern Ocean; Measuring the effect of plastic pollution on the food chain; and logging the extent of phytoplankton—the base of the food chain—and its role in regulating climate.
  • Scientists will also take ice core samples and study biodiversity on the continent in an attempt to reveal conditions before the onset of the Industrial Revolution.
  • ACE is the first project of the newly-created Swiss Polar Institute (SPI)—a joint venture comprising various Swiss research and educational institutions that aims to “enhance international relations and collaboration between countries, as well as to spark the interest of a new generation of young scientists in polar research.”
  • The journey will be divided into three legs, with Hobart in Australia and Punta Arenas in Chile serving as staging posts. Other stop-offs include the Crozet Islands, South Sandwich, South Georgia and the Mertz iceshelf on Antarctica itself.


“A better understanding of Antarctica is critical, not just for its preservation, but for the whole planet,”

[Ref: LiveMint]


Bilateral & International Relations

GS (M) Paper-2: “Effect of policies and politics of developed and developing countries on India’s interests, Indian diaspora.”

Reinventing old links



  • The bilateral agreements and the joint statement in the recent India-Russia summit in Goa contained significant substance.
  • The three defence cooperation projects are notable.
  • Joint dedication of India & Russia on Unit 2 of the Kudankulam power plant and the “pouring of concrete” for Units 3 and 4 projected a unique partnership in nuclear energy.

Pillars of the partnership:

  • Eight years after India’s foreign collaborations in civil nuclear energy were legitimised, Russia       remains the only foreign country involved in nuclear power production in India.
  • The decision to jointly manufacture Kamov Ka226T helicopters in India was announced in 2014, an Intergovernmental Agreement (IGA) was concluded in 2015, and a shareholders’ agreement was signed in Goa along with S-400 air defence system and building of naval frigates.
  • These agreements consolidate Russia’s position as India’s principal defence partner. About 70 per cent of our weapons and equipment are of Russian or Soviet origin.
  • The Russian partnership can be leveraged to increase benefit from other partnerships. Whether it is technology or other support, the Russian benchmark is what other partnerships will be pressed to match. The more we raise this benchmark, the more we benefit.
  • Agreements for Units 5 and 6 in Kudankulam are under finalisation and six more units are in the pipeline.
  • There are major developments in hydrocarbons: in the last four months alone, Indian companies have invested about $5.5 billion in the Russian oil and gas industry. Equally significant is the acquisition, by a consortium led by Russian oil major Rosneft, of about 98 per cent of Essar Oil and its Vadinar port in a cash deal worth $13 billion.
  • A joint fund of $1 billion, equally shared by Russian sovereign fund RDIF and our National Investment and Infrastructure Fund (NIIF), is to promote investment in infrastructure and technology projects.
  • The agreement for information security cooperation should enable India to benefit from Russia’s globally acknowledged expertise in cyber technologies.
  • There has been a significant increase in university exchanges and joint science and technology research projects funded by the two governments.
  • The joint statement declares “zero tolerance for direct or indirect support of terrorism”, stressing the need “to deny safe havens to terrorists”.
  • In Afghanistan, too, it calls for eliminating “terror sanctuaries, safe havens and other forms of support to terrorists”. The target of these references is clear.
  • Russia reaffirmed support for India’s permanent membership of the UN Security Council.
  • India “recognised” Russia’s efforts for a political settlement in Syria.

Areas that need improvement:

  • The effort to broad-base the India-Russia economic partnership has not percolated fully to our private sector industry.
  • IMF statistics highlight some strong fundamentals of the Russian economy: a healthy current account surplus, low unemployment (under 6 per cent), undervalued corporate stocks and external sovereign debt of only 13 per cent of GDP, predicting growth of over 1 per cent in 2017.
  • There is also misinformation about sanctions. The sanctions against Russia bind only a few countries — G7 and the European Union — and are specific in their application.
  • Recent investments in Russia by our hydrocarbons companies have also shown the way. The RDIF-NIIF fund provides an opportunity to cast off misconceptions about the Russian economy and sanctions.
  • Concern in the relationship must have discussed relating to aspects of Russia-China relations and Russia-Pakistan defence links — dramatically highlighted by joint military drills barely a week after the Uri attack.
  • On Russia’s arms supplies to Pakistan, the CEO of Rostec, the apex holding company of the Russian defence industry, confirmed publicly that besides four Mi-35 helicopters, no other military equipment supply to Pakistan is in the pipeline, while welcome, this assurance needs a continued reality check.

New dynamics

  • Russia pursues a “multi-vector” foreign policy, dealing with countries of widely divergent perspectives. Contacts with Japan, Turkey and Saudi Arabia are examples. The partnership with China and dalliance with Pakistan are part of this mix.
  • Equally, India is broad-basing its international engagement to maximise its room for manoeuvre.
  • This new dynamic has not diminished the political and strategic relevance of India-Russia relations. India-Russia, India-U.S.-Japan and India-West Asia alignments are not mutually exclusive.


  • A frank and continuous high-level dialogue, reinforced by regular backchannel communications, should ensure that each partner remains sensitive to the core concerns of the other and discordant public messaging is avoided.
[Ref: The Hindu]


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