Gujarat has announced an ordinance to regulate the medical marketplace after a hepatitis B epidemic engulfed Modasa town. Without any legal obligation and no punitive measures for dereliction,the medical practitioners have been using substandard facilties,admitted the Gujarat heath minister. The hepatitis B virus (HBV) speads through infected blood and sexual contact,and used needles are the target of suspicion more than fifty tonnes of biomedical waste were recovered from Ahmedabad and Sabarkantha districts,including syringes,needles,IV sets and vials. Instead of being crushed and disposed of,these materials were recycled and reused for medical treatment in the poorer areas. The outbreak has killed 53 people so far,and bewildered epidemiologists because the HBV in Modasa is a mutant form that defies the health machinerys diagnosis and treatment capacities. While the state government is frantically vaccinating everyone it can (almost 80,000 people),it is so far unclear whether the drive can check this unclassifiable rogue virus.
Entrusting oneself to a medical professional is a supreme act of trust,and as the stories from Modasa make clear,many of these people seek private healthcare at immense cost to themselves. Public oversight of private medical practice,and greater accountability and monitoring of the entire network is urgently required,but the Medical Council of India is notoriously inept,and the lack of enforcement is all too obvious. In Gujarat,incidentally,auto-disabled syringes are not the rule even with the state health department.
A law regulating clinical practices and spurious drugs,based on the Mashelkar Committee report has been shuttling between a parliamentary standing committee and the Union health ministry. In five years,the ministry has taken on Shah Rukh Khan and potato chips,but failed to get this vital piece of regulation enacted. Instead,it trumpets on full-page advertisements,that now,peoples health is in peoples hands. Between un-regulated private practice and a limp,ineffective government health system,the minister can say that again.