(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. You can subscribe here to get the newsletter in your inbox.)
Every week, someone blows the lid off a key issue in the health care sector, obligingly for our health newsletter. Last week, spilling on to this one, is the NEET 2024 scam. Now, like Murphy’s law, anything that can go wrong, went wrong. For roughly the decade in which NEET has governed entry into medical colleges for undergraduates and post graduates, it has had a chequered progress. While there was strong opposition to the concept of a single test for all, on the basis of social inequities and States’ rights in a federal structure, some States cried off from implementing NEET initially, but all have fallen in line eventually - some complying under duress. Multiple cases were filed in courts across the country, Tamil Nadu passed its own legislation to circumvent NEET. The TN Admission to Undergraduate Degree Medical Courses Bill was passed by the Tamil Nadu Assembly (but not cleared by the Government) that proposed going back to medical admissions on the basis of scores of students in the 12th standard board exams. During its conduct, confusion in conduct of examination, poor management at the centres, charges of highhandedness by examination centre authorities, question paper leak, and using proxies to write the exam have been reported regularly.
Now coming back to NEET 2024: there are multiple aspects to this year’s fiasco: Question papers were reportedly leaked in advance, in some centres, the wrong question papers were distributed; there were technical difficulties; and torn OMR sheets were late/wrong OMR sheets did not allow candidates the full time to complete the paper; after the results were announced, it was noted that an extraordinarily high number of candidates had scored the full marks - 720/720, some had scored ‘impossible marks’ given the assessment protocol; and cheating during the exams using proxies was detected in some centres. The National Testing Agency that conducts the NEET, had to set up a four-member committee to go into the alleged irregularities. The authorities also tried to explain away some charges, stating that the paper was overall easy, so many students had scored full marks, and that the odd marks that were scored were a result of the grace marks granted to about 1500 students from students which had technical issues, as part of a court order. But this did not assuage any one’s ruffled feathers. Least of all, the candidates’.
Students protested across the country: Student outfits protest NEET ‘irregularities’, seek probe. Maitri Porecha spoke to Aspirants who sought NEET re-examination citing flaws in the process. A bunch of students went to court urging that NEET be reconducted in the country: SC seeks NTA’s response for conducting the exam again; refuses to stay the counselling process; In a separate case, Lawyer seeks urgent listing of plea seeking probe in NEET ‘paper leak’ case.
Naturally, the sequence of events also had political ramifications. The Congress party demanded a Supreme Court-monitored probe into ‘irregularities’ in NEET; various State and their ruling governments also pitched, including those who had strong objections to the conduct of NEET itself. T.N. CM Stalin reiterated the State’s opposition to NEET amid alleged irregularities in recent exam, while Kerala’s R. Bindu wrote to the Union Education Minister, and Karnataka’s Chief Minister Siddaramaiah joined others in demanding proper investigation of NEET results. For an overview and some pathways ahead for the government do read our edit on the subject: A NEET mess. The committee is supposed to provide its report this week, and we’ll stay the course on this story, here.
The bird flu story has not flown away yet, it is still around, causing a flutter in some quarters. Last week, the WHO said a Mexico man died of a bird flu strain that hasn’t been confirmed before in a human. This came after nations sounded the alert of the virus crossing the animal-human barrier, slipping into humans, unlike in the past. There has been culling and an increased vigil in areas where there are huge poultry and cattle farms with affected birds/cows. Siddharth Kumar Singh reported that Telangana issued an advisory amid Bird Flu outbreak in neighbouring States and Abdul Latheef Naha wrote about Kerala’s call for vigil against spread of H5N1 virus during Bakrid
There was much rejoicing in gastroenterology clinics and patients last week, as news media reported that a major cause of inflammatory bowel disease had been discovered. Despite increasing prevalence of this autoimmune disease, IBD, which encompasses Crohn’s disease and ulcerative colitis, current treatments do not work in every patient and attempts to develop new drugs often fail due to our incomplete understanding of what causes IBD.Researchers at Francis Crick Institute, in collaboration with UCL and Imperial College London published their findings in Nature. Scientists at the Crick journeyed into a ‘gene desert’ - an area of DNA that doesn’t code for proteins - which has previously been linked to IBD and several other autoimmune diseases. They found that this gene desert contains an ‘enhancer’, a section of DNA that is like a volume dial for nearby genes, able to crank up the amount of proteins they make. The team discovered that this particular enhancer was only active in macrophages, a type of immune cell known to be important in IBD, and boosted a gene called ETS2, with higher levels correlating with a higher risk of disease. Further, using genetic editing, the scientists showed that ETS2 was essential for almost all inflammatory functions in macrophages, including several that directly contribute to tissue damage in IBD. Strikingly, simply increasing the amount of ETS2 in resting macrophages turned them into inflammatory cells that closely resembled those from IBD patients.
Afshan Yasmeen brings to focus a key aspect of student life, the mental health of students. NIMHANS, State Health and Education Departments will start deliberations on an ICMR project to focus on student mental health. The Indian Council of Medical Research (ICMR) has initiated a multi-state implementation research study on student mental health that is being conducted in eight states and union territories, aimed at developing resources within educational campuses to establish an evidence-informed, feasible, scalable and sustainable implementation model for mental wellbeing promotion and suicide risk reduction among students in schools from 9th and 10th standards, pre-university and colleges.
In other important news, Health Ministry reworks its protocol as India’s Tuberculosis elimination drive hits a plateau, what with the 2025 elimination target looming large. Despite nearly 5 decades in battling with TB, India’s gains are quite meagre. TB kills an estimated 480,000 Indians every year or over 1,400 patients every day. Additionally, the country also has more than a million ‘missing’ TB cases annually, which are not notified. Most remain either undiagnosed, or unaccountably and inadequately diagnosed and treated in the private sector. Acknowledging that the drive is flailing, the Health Ministry has launched into action. The Indian Council of Medical Research (ICMR) has been tasked to rework the protocol, specifically TB medication and its duration, to reboot the TB-free initiative with zero deaths, disease, and poverty resulting from the disease.
If survival of the fittest is at the heart of evolution, then why does altruism exist in nature, asks D. P. Kasbekar in our tail piece for the week. ‘Green-beard’ genes could explain how altruism arose in nature Altruism is widespread in nature, he points out. Worker honey bees devote their entire life to foraging and caring for their sister, the queen, and her offspring, but do not themselves reproduce. In widow spiders, a male allows a female fertilised by him to eat him, and thus nourish herself and her offspring. How can the emergence of altruism in all these diverse forms be explained? Most of the progress in answering this question has come from studies of the social amoeba Dictyostelium discoideum. The take-home message is that if a gene makes a worker bee altruistic, it also helps the copy of the gene in the queen and her offspring to be passed on to the next generation, even if the worker herself does not reproduce. Such so-called ‘green-beard’ genes allow the individuals bearing them to recognise and preferentially cooperate with each other. Alternatively, a green-beard gene could provoke individuals to behave harmfully towards those carrying a different version of the gene. Thus, scientists have postulated, green-beard genes encode some kind of tag that helps the genome to know their identity (i.e. self-recognition).
Here are some of the top explainers this week on health issues:
This is a story you might want to read this week. Bindu Shajan Perappadan throws light on the National Health Claim Exchange. The Health Ministry and the Insurance Regulatory and Development Authority of India (IRDAI) are launching the National Health Claim Exchange (NHCX), a digital platform which will bring together insurance companies, healthcare sector service providers and government insurance scheme administrators.
Sridhar Sivasubbu and Vinod Scaria write on bacteria that write new genes to cope with infections. Klebsiella pneumoniae bacteria may use a newfound protein called Neo to stop a bacteriophage infection in its tracks.
Sneha Khedkar says an MRI machine with store-bought parts can be a game changer in India New low-cost MRI machine can improve access to diagnostics
If you have a few extra moments this week, also browse through the following links:
S. Vijay Kumar reports: Centre sends out alert to States, Union Territories on websites, social media trading human organs illegally
ICMR seeks to provide oral formulation of hydroxyurea to treat sickle cell disease in children
Innominds introduces deeptech-driven solution to combat antimicrobial resistance
Remove claim of ‘100% fruit juice’ from label and ads, FSSAI directs food businesses
For many more health stories, head to our health page, and subscribe to the health newsletter, here.
