AdFalciVax: India's shot at stopping malaria on its tracks
Named AdFalciVax, the vaccine has been developed to offer both protection against Plasmodium falciparum infection in humans and interruption of community transmission, unlike the existing two vaccines that can partially prevent infection in humans but cannot stop transmission in the community.
The novel vaccine developed by Regional Medical Research Centre (RMRC), Bhubaneswar, one of the constituent institutes of ICMR, is now ready for technology transfer to manufacturers or organisations for production, clinical trials and its commercialisation. Preliminary trials on animal models have been highly successful.
The pre-clinical validation of the vaccine has been conducted in collaboration with National Institute of Malaria Research (NIMR), another constituent institute of ICMR, and National Institute of Immunology (NII), New Delhi, an autonomous research institute of the Department of Biotechnology, Government of India.
A dual-stage game changer
Unlike the currently available WHO-recommended vaccines - RTS, S/AS01 (Mosquirix), and R21/Matrix-M which have shown efficacies ranging between 33% and 67%, AdFalciVax promises dual-stage protection. It will not only shield people from contracting the deadliest strain of malaria but also prevent its spread within communities, considered an essential factor in breaking the chain of transmission.
Dr Susheel Singh, scientist-D at RMRC, said AdFalciVax deploys a full-length PfCSP (circumsporozoite protein), a key surface antigen of P falciparum, for broader immune protection. It also incorporates a novel fusion of Pfs230 and Pfs48/45 proteins to induce potent transmission-blocking antibodies.
'The new vaccine can prevent human infection and interrupts transmission in the community, thereby tackling two critical developmental bottlenecks in the malaria parasite's life cycle,' Dr Singh said.
The RMRC researchers said the vaccine has been developed using advanced protein engineering techniques and it leverages Lactococcus lactis, a safe bacterial host system, for antigen production.
Additional director general of ICMR and director of RMRC Dr Sanghamitra Pati said preclinical trials conducted on mice showed robust and long-lasting immunity, even when exposed to 10,000 dual-transgenic Plasmodium berghei parasites engineered to express P falciparum antigens.
'The immune protection lasted over four months post-booster dose, which translates to more than a decade of protection in humans. The vaccine was administered with safe alum-based adjuvants and showed no adverse reactions,' said Dr Pati. Senior scientist Dr Subhash Singh was also a key contributor to the development of the vaccine.
High stability at low cost
The uniqueness of AdFalciVax over existing vaccines is its pharmaceutical stability. The formulation remains potent for over nine months at room temperature, doing away with the need for expensive cold chain logistics, which continue to be a long-standing challenge in vaccine distribution, especially in remote and under-resourced regions.
The vaccine is also highly cost-effective, with an estimated production cost of just `20 per dose. The current vaccines are priced between `250 and `830 per dose. The affordability of the newly developed vaccine could make mass immunisation programmes significantly more viable.
ICMR has now invited expressions of interest from eligible firms and manufacturers for technology transfer and commercial-scale production. The vaccine is expected to go for clinical trial stages soon and potentially be rolled out for public use in the next few years. However, the efficacy during the clinical trials will be the key.
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First Post
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Dr explains: How air pollution, stress and late pregnancies are fuelling India's fertility crisis
Infertility affects 10–15% of Indian couples. Firstpost brings out expert views on India's growing infertility crisis, examining how lifestyle, pollution, and delayed parenthood are affecting reproductive health, IVF success rates and access to fertility care in urban and tier-2 and tier-3 cities. read more Infertility is emerging as a pressing public health concern in India, affecting an estimated 10–15% of couples according to studies published in The Lancet and other medical journals. The issue has been further spotlighted by government data and clinical observations pointing to a surge in conditions like PCOS, endometriosis and declining sperm quality, particularly in urban centres. Environmental stressors such as air pollution and exposure to endocrine-disrupting chemicals, combined with sedentary lifestyles and delayed family planning, are compounding the crisis. The Indian Council of Medical Research and the Ministry of Health have taken regulatory steps with the Assisted Reproductive Technology (Regulation) Act to ensure standardised fertility care but challenges around accessibility, affordability and awareness persist—especially in tier-2 and tier-3 cities. STORY CONTINUES BELOW THIS AD Firstpost talked to Dr. Mannan Gupta, Chairman & HOD, Obstetrics & Gynaecology & IVF, Elantis Healthcare (New Delhi) to understand the underlying medical and environmental factors behind India's infertility burden, how air pollution and lifestyle are affecting IVF outcomes, and the current state of ART practices across the country. What are the main medical and environmental factors behind the rising burden of infertility in India? Dr Mannan: Infertility now affects nearly 10–15% of couples in India, and the trend is steadily increasing. Medically, rising cases of Polycystic Ovary Syndrome (PCOS), endometriosis, thyroid disorders, diabetes, and obesity in women are significant contributors. In men, conditions like varicocele, hormonal imbalances, and poor sperm parameters are commonly seen. Environmentally, increasing exposure to endocrine-disrupting chemicals (EDCs), air pollution, and unhealthy lifestyle habits—such as poor diet, lack of exercise, smoking, alcohol consumption, and chronic stress—are worsening reproductive health. Additionally, delayed marriages and late pregnancy planning have become major socio-cultural factors contributing to declining fertility. How are declining sperm quality and ovarian reserve due to air pollution and sedentary lifestyles impacting IVF outcomes, especially in urban India? Dr Mannan: In urban settings, declining sperm counts and ovarian reserves have become major challenges for successful conception—both naturally and via assisted reproduction. Studies show increasing DNA fragmentation in sperm and diminished anti-Müllerian hormone (AMH) levels in women exposed to high-pollution environments. These directly reduce embryo quality and negatively impact IVF success rates. Sedentary habits, obesity, and poor sleep hygiene further impair hormonal health. As a result, we often require multiple IVF cycles and personalised stimulation protocols to achieve a viable pregnancy, especially in metropolitan cities. How accessible and affordable is IVF treatment across India, particularly in tier-2 and tier-3 cities? Dr Mannan: While IVF is gaining popularity and acceptance, affordability and access remain significant hurdles outside metro cities. In tier-2 and tier-3 areas, there is limited availability of advanced infrastructure, skilled embryologists, and fertility specialists. Many couples are forced to travel to metro cities, which increases emotional and financial burdens. 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Hindustan Times
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- Hindustan Times
Ludhiana: Khanna civil hospital gynaec suspended for ‘negligence' after newborn's death
Punjab health and family welfare minister Dr Balbir Singh today ordered immediate suspension of a gynaecologist at the Khanna civil hospital for 'negligence' in connection with a newborn's death. The minister warned that the doctor's medical licence could be revoked and legal action may follow pending further investigation. Punjab health and family welfare minister Dr Balbir Singh addressing mediapersons at Khanna hospital. (HT Photo) The patient, Manpreet Kaur, a pregnant woman, was brought to the hospital around 8 pm on July 21 by her family. Despite undergoing regular treatment at the facility for nine months, she was referred to another hospital during delivery hours. The attending emergency doctor, Dr Amardeep, allegedly consulted gynecologist Dr Kavita Sharma over phone who suggested referring the patient to Patiala, instead of arriving at the hospital to assess her condition. Senior medical officer (SMO) Dr Maninder Singh Bhasin rushed to the hospital at around 10 pm, called in a pediatrician and anesthetist, and proceeded to conduct an emergency C-section himself. The surgery was successfully performed, stabilising the mother's condition. However, the newborn, who had ingested meconium in the womb, was in a critical state. Despite efforts to resuscitate the infant, she was referred first to Patiala, where a lack of ventilator facilities prompted a second referral to PGIMER in Chandigarh. The family alleged that the ambulance ferrying the newborn ran out of oxygen midway, causing further distress. 'By the time a second ambulance was arranged, her body had turned blue,' said Raj Lakhia, baby's uncle. The infant was declared dead on arrival at PGIMER. 'Any negligence in patient care is unacceptable and will face strict consequences,' said the minister. Following the incident, a three-member committee, comprising an SMO and two specialists, was constituted to investigate. The committee's report found the gynaecologist's failure to address the case with due seriousness. In a message to health staff, Dr Singh urged them to perform their duties with utmost honesty, dedication and diligence, warning of severe repercussions for lapses. He commended the health department's workforce, highlighting that 98% of its doctors risked their lives during the Covid-19 pandemic to save countless lives. 'Plans afoot to hire medics' In response to queries about the shortage of doctors in Doraha and Payal hospitals, Dr Singh noted that the state has recruited approximately 3,000 healthcare workers recently, with plans to onboard 1,000 additional doctors soon. He outlined plans to ensure 24-hour maternal and child care, emergency services and initial treatment for heart attacks and neurological conditions at district-level and highway-adjacent government hospitals. Additionally, he stated that the government would establish 10-12 advanced hospitals across Punjab for specialised treatments, including heart surgeries, organ transplants and orthopedic care. He also highlighted that government hospitals in Khanna, Tarn Taran, Dasuya, Tanda and Chamkaur Sahib were already providing initial care for heart attack patients, with referrals to larger facilities for advanced treatment. He also announced that Punjab is set to become the first state in India to offer free health insurance (worth up to ₹10 lakh) to its entire population of 3 crore. Dr Balbir Singh also conducted house-to-house inspections to check larvae in various parts of Khanna. He urged the community to prevent mosquito breeding by ensuring water does not accumulate in containers, rooftops, or courtyards. He stated that the health department is fully committed to curbing dengue's spread, emphasising that the campaign's primary goal is to protect lives from this potentially fatal disease. He called on residents to maintain cleanliness, prevent water stagnation, and ensure proper drainage in their surroundings.
Indian Express
16 hours ago
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The fault in our salt: The condiment's cultural pull in India — and why it comes at a cost to public health
In one of Hindi cinema's most iconic scenes, Kalia in Sholay swears by a pinch of salt — 'Sardaar, maine aapka namak khaaya hai' — as he pledges his loyalty to Gabbar. The ubiquitous grainy white condiment failed to save his life and in the 50 years since, a shift in consumption patterns and lifestyles has seen salt slowly eating away at Indians' health. While the permissible amount of salt consumption, as prescribed by the World Health Organisation, is 5 gm a day per person (2,000 mg of sodium or about a teaspoon of salt), several studies have pointed to how Indians consume more than double the amount, posing risks of hypertension, stroke and heart diseases. According to the Indian Council of Medical Research-National Institute of Nutrition's (ICMR-NIN) 2024 Dietary Guidelines for Indians, existing evidence reveals a 'deleterious impact of high salt intake on blood vessels and blood pressure', which in turn can cause heart attack, stroke and/or kidney problems. High amounts of salt in the body results in water retention, which further increases the pressure on the heart to pump larger volumes of fluid, causing hypertension. The primary culprit, experts agree, is ultra-processed food. According to the NIN's Dietary Guidelines, processed foods such as 'snacks, savouries, soups, sauces, ketchup, salted butter, cheese, canned foods, papads, and salted dry fish, salted nuts/dry fruits contribute to higher intake of salt. Preserved meats/vegetables and ready-to-eat foods contain a lot of sodium'. Prompted by the 'alarming' salt consumption patterns, earlier this month, ICMR-NIE (the National Institute of Epidemiology) launched Project Namak, a three-year-long community-led programme that focuses on salt reduction in individuals with hypertension. Sharan Murali, senior scientist at ICMR-NIE and the principal investigator of Project Namak, says, 'Our research team evaluated the hypertension component of the NP-NCD (National Programme for Control and Prevention of Non-Communicable Diseases) programme in 21 districts in the country and understood that 78 per cent of the individuals with hypertension who come for follow-up receive some counselling for behavioural change in the OPD. This opportunity may be used to counsel the individuals with hypertension on dietary salt reduction as an add-on along with the medications.' Over the last two decades, there have been several such studies, including those published in the Journal of Hypertension, Journal of the American Heart Association and Nutrients, among others, that point to high salt intake among Indians. According to India Salt Market Report and Forecast 2025-2034 by Claight Corporation published this year, the India salt market reached around USD 2.32 billion in 2024. The market is projected to grow at a compounded annual growth rate of 6.20% between 2025 and 2034, reaching almost USD 4.23 billion by 2034. With experts also warning against too little salt — Dr Vivekanand Jha of the George Institute of Global Health says 'physiologically, at least 500 mg of sodium is compatible with good health' — how does one strike a balance with something as ubiquitous as salt? Historians say that the earliest evidence of salt production in India can be traced to the Indus Valley Civilization, although consumption would date even further back, 'particularly 11,000 years ago or a little later when they realised that they need to add salt to their diet,' notes Kurush Dalal, archaeologist and culinary anthropologist. 'Salt is indispensable to all mammals. As a rule, hunter gatherers used to get all the salt they needed from the food they ate. They didn't need to add anything at all. It's only when we became farmers that we started adding salt,' he says. 'On every continent', notes Mark Kurlansky in his book Salt: A World History, 'once human beings began cultivating crops, they began to look for salt to add to their diet. How they learned of this need is a mystery… however, most people choose to eat far more salt than they need, and perhaps this urge — the simple fact that we like the taste of salt — is a natural defense.' With that, salt became one of the most valuable commodities of trade. Kurlansky notes, 'Where people ate a diet consisting largely of grains and vegetables, supplemented by the meat of slaughtered domestic farm animals, procuring salt became a necessity of life, giving it great symbolic importance and economic value. Salt was one of the first international commodities of trade; its production was one of the first industries and, inevitably, the first state monopoly.' In India, salt holds a deeply symbolic value given how Mahatma Gandhi shook an empire with a fistful of salt with his Salt Satyagraha. While the origins of salt consumption are global, Indians took to salt more organically. In the absence of any recorded evidence, SubbaRao M Gavaravarapu, scientist and Head of Nutrition Information, Communication and Health Education at NIN, cites 'traditional knowledge' to explain Indians' tendency to consume higher amounts of salt. 'We are a tropical nation and many of our people would work outdoors and perhaps to compensate for the sodium loss through sweat, sodium was incorporated through food,' he says. To understand the detrimental effect of this condiment, however, it is important to know that salt (NaCl, with sodium and chloride ions in a 1:1 ratio) is only as harmful as its sodium content. And that, given our shifting eating patterns, sodium comes from more than just the salt we consume. While, as the NIN guidelines say, 'a major amount of sodium does come from the visible addition of salt', there are also innocuous ways sodium makes its way into our bloodstream. For instance, there is sodium bicarbonate or baking soda, the indispensable ingredient in bakery products. There's also monosodium glutamate or MSG which gives food its umami or savoury flavour and is commonly present in canned food. Then there's sodium nitrite, which is commonly used by commercial meat processing units to preserve meat, and sodium benzoate, which gives acidic foods and beverages such as colas, soft drinks, pickles, salad dressings and jams and preserves their shelf life. And for those into carbonated drinks such as diet soda, there's sodium saccharin to reckon with — all of which add to our sodium intake without any real addition of salt itself or table salt as we know it. Food critic and historian Pushpesh Pant reiterates the need for broadening the understanding of salt to manage one's sodium consumption. 'In Sanskrit, the word for salt is lavana, which does not necessarily mean sodium chloride, which we know as table salt. It could mean potassium chloride, sodium bicarbonate. It could be anything which is alkali,' he says. Khar, the alkali ash that is commonly used in food in the Northeast, is sodium carbonate, he explains. Experts broadly agree that among the easiest ways to combat this excessive supply of sodium to our bodies is to consume less table salt — and achieve a better balance of flavours. In his seminal 1998 work, A Historical Dictionary of Indian Food, the late food historian K T Achaya notes that there are six 'pure' tastes: madhura (sweet), amla (sour), lavana (salty), katu (pungent), tikta (bitter) and kasaya (astringent). 'Every meal was expected to include all the six tastes, and in the order just listed, according to Sushrutha (ancient Indian physician and doctor),' the book says. Traditionally, the use of salt in cooking has been in tandem with the other five tastes, Pant explains, while saying that different regional cuisines in India have their own equation with salt. 'If you are a coastal person, most of your salt would come from sea water fish. The pungency of mustard oil, which is used generously in Bengali cuisine, ensures a limited requirement of salt…Now, if you are a Maratha living away from the coast line, and you are eating millets, which are not very palatable on their own, you will increase the levels of salt and chillies. Or if you are having preserved foods like papad or bari, salt content is higher,' Pant says. Concerns of excessive salt intake and its detrimental effects on public health have prompted a host of studies and small-scale interventions to produce 'low-sodium' salt. This involves replacing a part of the sodium in sodium chloride with other additives, primarily potassium. But so far, these experiments haven't achieved the required scale in India. 'The concern in salt is the sodium. To reduce sodium, other kinds of salts are added. Mostly, it is replaced with potassium but there are issues with low-sodium salts — it is expensive and its supply is short,' says NIN's Gavaravarapu. The practice of adding potassium to packaged common salt, however, is yet to take off on a mass scale in the country given the lack of India-specific studies and with little clarity around its potential benefits or perceived risks. Dr K Srinath Reddy, founder president of the Public Health Foundation of India (PHFI) who formerly headed the Department of Cardiology at AIIMS, says that following initial trials across the world, where part of the sodium in salt was replaced with either potassium or magnesium, there were concerns over whether it could 'cause harm to people with reduced renal and kidney function'. 'Potassium is a bit corrosive, so we would have to use it in concentrations that won't damage the lining of the stomach and intestines. There were also concerns over whether low-sodium salt would cause hyperkalemia (excess potassium levels in the blood) in the elderly with renal function though there were successful trials in the US that said it was safe for them. But the findings weren't accepted because the trials were small,' Reddy says, while pointing to a study conducted in China by the George Institute for Global Health. With a 'fairly large' sample size of over 20,000 participants from 600 rural villages in five provinces in the country, the China Salt Substitute and Stroke Study (SSaSS), published in 2023 and conducted over five years, found that 'replacing salt with a reduced-sodium added-potassium 'salt substitute' significantly lowers the risk of stroke, heart disease, and death'. The institute has submitted a funding request to ICMR to conduct a similar study in India, said Dr Vivekananda Jha, Executive Director at The George Institute for Global Health, India. 'The study in China proves the point that lower than usual levels of dietary sodium can be tolerated without ill-effects, and a certain amount of potassium is required to balance the sodium. But whether that's going to become public policy in India, whether people are going to accept the altered tastes, we will have to see,' says Dr Reddy, emphasising that 'ideally', potassium, which negates the effects of sodium, should be consumed in the form of fruits and vegetables rich in the mineral. 'One can consume bananas and coconut water. But everybody may not be able to take all of it all through the year. So introducing a salt substitute like in the China trial is something we should maybe consider… Do some pilots to see what the response is, what the safety is, and what the popular acceptance is,' he adds. The last time a population-level health intervention in salt was carried out was in 1962, when common salt was fortified with iodine under the National Goitre Control Programme. Presently, all packaged salt sold in India, from common salt to rock salt, is iodised. NIN's Gavaravarapu flags another, largely behavioural, concern regarding low-sodium substitutes not being 'salty enough'. 'People think that because it is low-sodium, they can have more of it. Ideally, you should use it even less than usual so that the benefit of replacing it with potassium is passed on,' he says. While we wait for more research and consensus on reducing the sodium component in common salt, experts advocate the need to create awareness among consumers. Dr Reddy and NIN's Gavaravarapu reveal that the Food Safety and Standards Authority of India (FSSAI), a statutory body under the Ministry of Health and Family Welfare, is looking at the feasibility of 'front of the package labeling' that would explicitly warn customers of high levels of sugar, salt and trans fat, among others. 'If a package notes that it has so many grams per cent of fat or carbohydrate or trans fats, unless I have studied nutrition, I wouldn't understand any of it. That's why you require warning labels that communicate clearly and help people recognise there's a problem with the salt or sugar in the product,' says Dr Reddy. The UK and Ireland, for instance, follow a 'traffic light packaging' model, where red, amber and green colours are used to indicate the levels of fat, saturated fat, sugar, and salt in food products. Public health scientist and epidemiologist Dr Monika Arora says the country needs a behavioural change in terms of salt consumption. 'Salt can be reduced in the food served in schools, hospitals and government canteens, which are regulated places. The tongue and palate get adjusted to a gradual reduction. Midday meal is an excellent way of going about it. Another way is to tax high-salt products, making it an incentive for the industry to start reformulating their products,' she says. Celebrity chef and entrepreneur Sanjeev Kapoor says he realised the dangers of excess salt much before it became a talking point. 'When I dived deeper into healthier food options, I realised that it is not only sugar that is the culprit, but also salt,' he says. He also joined hands with the government to raise awareness about healthy food habits through FSSAI's 'Eat Right Movement' that focussed on 'reduction of high fat, sugar and salt foods in the diet'. 'We have to understand that taste is something that you get used to. Your palate gets trained. Salt is a flavour enhancer. If there is low salt in a dish, other flavours may also seem muted. But it also hides flavours. Which means if you add too much salt in a dish, the top note is of salt and you never experience the real flavour of other ingredients. If you want to use less salt, you can start by enhancing the flavour with other ingredients. Lemon works really well as do herbs like mint, coriander, basil and tulsi,' he says. While cutting down on salt may seem like hard work, Kapoor's new catchphrase may hold the key — around 20 years ago, while he started with 'Namak Swad Anusar (salt as per taste)', he now swears by 'Namak Sehat Anusar (salt as per health)'.
