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25 September 2024 – The Indian Express

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What are rare illnesses

Rare Illness:

  • It is characterised as a low-prevalence illness that affects fewer individuals than other common diseases in the broader population.
  • Numerous uncommon disease instances have the potential to be grave, persistent, and even fatal.
  • Of the more than 7,000 identified diseases globally, just 5% are curable.

Dermatomyositis:

  • This kind of autoimmune illness is uncommon.
  • The sickness impacts the skin as well as the muscles. 

Symptoms of it:

  • Swelling of the muscles
  • The skin has red rashes.
  • Weakness and weariness in the body
  • It is more common in the following two age groups:
  • In kids, those who are between the ages of five and fifteen
  • In individuals between the ages of 40 and 60
  • More women than males are affected by this illness.
  • uncommon illnesses in India
  • With over 450 diseases identified, India accounts for one-third of the occurrence of rare diseases worldwide.
  • They include Whipple’s disease, mucopolysaccharidosis type 1, and spinal muscular atrophy as well as Gaucher’s disease.
  • Rough calculations indicate that 8–10 crore Indians are afflicted with a rare disease;
  • More than 75% of them are kids.

Problems related:

  • These illnesses are generally disregarded.

Resource limitations:

  • When it comes to rare disease awareness, diagnosis, and drug development, India lags well behind.
  • In order to address uncommon diseases, the Ministry of Health and Family Welfare developed a national strategy in 2017, but it was withdrawn in 2018 due to

“Implementation challenges” and uncertainty around disease coverage:

  • Patient authorization
  • spending-sharing.
  • In 2021, the National Policy for Rare Diseases (NPRD), a revamped policy, was unveiled.
  • The policy blames a lack of data, as though routine data gathering and epidemiological analyses are outside the purview of the government.
  • An accurate and timely diagnosis is essential to the effective therapy of any illness.
  • Patients with uncommon diseases may have to wait seven years for a diagnosis—if one is made at all.
  • Most doctors don’t know how to analyse the symptoms and indicators.
  • For healthcare personnel to become more accurate in their diagnoses, they must receive training.
  • It is required that expectant mothers who have a family history of uncommon disorders receive prenatal screening as well as postnatal diagnosis and management.
  • Of the roughly 450 uncommon diseases found in India, less than half can be cured.
  • Only a small number of rare diseases have treatments approved by the Drugs Controller General of India, and these treatments are only available through Centres of Excellence (CoEs).
  • CoEs are few (12), dispersed erratically, and lack coordination.
  • delayed diagnosis
  • insufficient treatments
  • It’s common to be unavailable on time.

Problems:

  • Despite growing each time, the budget’s allotment for uncommon diseases—which is only ₹93 crore for 2023–2024—remains modest.
  • As per the NPRD standards, each patient is eligible to receive up to ₹50 lakh, which will be paid to the relevant CoE.
  • This sum is woefully insufficient, given chronic uncommon diseases typically require lifelong management and therapy.
  • The CoEs are hesitant to start any treatment that they might have to stop later, as this puts them at risk of legal action from patients and their families.
  • Fund utilisation confusion: Of the ₹71 crore in financial support allotted to the 11 CoEs for the current year, almost ₹47 crore is still unutilized.
  • There isn’t any equality among CoEs.
  • Mumbai used up all of its resources while only treating 20 out of 107 patients.
  • Delhi uses fewer than twenty percent.
  • The CoEs are being asked by NPRD to crowdfund patients’ treatment for rare diseases.
  • In three years, less than ₹3 lakh has been received from a portal with over 1,400 registered patients.

The Way Ahead:

  • The Central government must define rare diseases uniformly, allocate more funds for research and development, enhance the number of CoEs, and boost budgetary expenditures.
  • Make sure there is improved collaboration and prudent financial management.
  • Under the CoEs, state governments are required to establish satellite centres and implement social assistance activities.
  • financial for public and private enterprises might be pooled; partnerships and CSR initiatives could be used to make up for financial gaps.
  • It is necessary to address the problem of excessive drug pricing and availability.
  • The government eliminated customs and GST duties on medications for uncommon illnesses last year.
  • Only medications that are to be “imported for personal use” are exempt from this law; medications that are sold commercially in India are not.
  • The government should consider alternatives including bulk imports and repurposed medications, as well as lowering clinical trial requirements when appropriate and providing incentives to domestic manufacturers through the Production-Linked Incentive Scheme.
  • The GST on life-saving medications must be removed by the government.

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