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The Hindu
3 days ago
- Health
- The Hindu
Kerala needs to support transplant patients for immunosuppressive therapy
Last July, 13-year-old Anushka with severe cardiomyopathy, her heart's pumping capacity reduced to just 18%, was nearly dying at Sree Chitra Tirunal Institute for Medical Sciences and Technology, when a donor heart saved her life. This first paediatric heart transplant at SCTIMST was a much-celebrated event. A year later, Anushka is doing very well. But the last one year has been marked by anxiety, along with financial and emotional distress for her parents, Ramesh and Vijitha. They had to uproot themselves from their home town at Engandiyoor, Thrissur, to a small rented house in the capital city for her treatment. Anushka's case is just one example of how life-transforming and positive an experience organ transplant can be, for a patient and his/her family. But the road ahead is tough and scary for the family which is already in dire straits and which has to find close to Rs. 30,000 a month just for life-long immunosuppressive therapy to ensure the survival and best post-transplant outcome for their child Catastrophic health expenditure and rising out of pocket expenditure on health has been pushing families into impoverishment in Kerala . Post-transplant care is one such catastrophic health expenditure causing much financial distress to many families. Organ transplants are life-saving and life-transformative but it is just the beginning of a long road ahead, for the patient as well as the family. The high cost of immunosuppressant drugs a patient has to take for a lifetime, post-transplant, is not an affordable proposition to most families. The State Government has been promoting organ donation and transplantation in a big way since 2012-13 but even a decade later, there is no universal State-wide project which provides immunosuppressants free of cost or takes care of the financial burden incurred by organ transplant recipients for the same. There have indeed been some isolated initiatives by some district panchayats (Kollam, Ernakulam and Kannur) or NGOs and a token support through Kerala Social Security Mission for transplant patients, but this has not been enough. Kerala has fairly good survival rates for solid organ transplants, with the five-year valid kidney transplant survival rate pegged at 85.3% and that of liver transplants at 77.3%, according to a 2018 study. But non-adherence to immunosuppressive therapy because of financial constraints of families is increasingly becoming the single most cause of poor transplant outcome and organ rejection, which is extremely distressing, says Noble Gracious, Executive Director of K-SOTTO. Shammy Sajeev, a 43-year-old housewife from Changanassery, who underwent a renal transplant two years ago at Alappuzha Government Medical College Hospital is now back at the hospital because her transplanted kidney has failed. 'My father is an auto driver and he had donated one of his kidneys to my mother. We had to spend close to ₹14 lakh for her treatment, transplant and medicines. Her medicines cost about ₹10-15,000 every month. Because of extreme financial hardships, we were unable to buy her medicines for the last four months,' says her son, Abhishek, a Plus Two student, who has temporarily discontinued school now. The family knew that the immunosuppressants were important but they were in no position to borrow money anymore. Shammy will now have to go back to dialysis till another related donor as well as funds for the transplant can be arranged, he says. Maintenance immunosuppression drugs with antibacterial, antiviral prophylaxis varies from Rs. 20-30,000 per month in the first year for renal transplant patients, which stabilises to Rs. 8,000- 15,000 per month for subsequent years, for life. For liver transplant patients too, the approximate monthly medicine expenses would be around 15-20,000, according to doctors. The transplant patients would also have to spend another Rs. 10-15,000 per year for the routine check ups and blood tests that they need 'The State will have to think about a comprehensive project to ensure equitable access to free immunosuppressive therapy for those who really need it,' a senior Health official says. In Kerala, a majority of patients undergoing maintenance haemodialysis have some form of financial assistance or are being subsidised by the Government. But the care needs of a minority which has access to transplants is something the State has to prioritise. Non-adherence to immunosuppressive therapy because of financial barriers resulting in the waste of precious organs is not something that any health system can afford, he says. A recent national review meeting on organ transplantation activities, jointly by National Organ and Tissue Transplant Organisation and the Union Health Ministry had pointed out that the high cost of immunosuppressant drugs was a significant concern as patients often do not get financial support for drugs beyond the first year. It had strongly recommended that liver and heart transplantation, including the lifelong cost of immunosuppressants for post-transplant recipients, be comprehensively included under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana scheme
New Indian Express
16-07-2025
- General
- New Indian Express
Sri Chitra Institute changes stand, to make info of meetings public under RTI Act
THIRUVANANTHAPURAM: After dragging its feet on a Central Information Commission directive, the Sree Chitra Tirunal Institute of Medical Sciences and Technology (SCTIMST) has finally decided to furnish information under the Right to Information (RTI) Act about the decisions taken during its governing body and institute body meetings since July 2020. It was in December 2023 that the SCTIMST first turned down an RTI query seeking a copy of the minutes of its governing body (GB) meetings number 107 to 113 as well as of the institute body (IB) meetings since July 2020. The applicant had cited doubts regarding the transparency of decisions taken by the two top bodies of SCTIMST after a new director assumed office in 2019, as the reason for filing the query. However, SCTIMST's central public information officer (CPIO) denied providing the information sought, citing the institute's GB and IB had earlier resolved that response could be given only to an RTI query that relates to 'a particular or relevant issue'. Dissatisfied, the applicant filed an appeal with SCTIMST's First Appellate Authority (FAA). It was not adjudicated, prompting the applicant to approach the CIC. 'I informed the CIC that the CPIO denied information sought without invoking any exemption clause, which constituted a gross violation of the RTI Act,' the applicant told TNIE. The CIC ruled that to deny information, it is important the denial should be as per the provisions of the Act. 'Also, if any of the exemption clauses mentioned under Sections 8 and 9 of the RTI Act, 2005, is claimed, the respondent (SCTIMST) is required to provide justification or establish the reason why such exemption was claimed,' the CIC's May 15 order said. The CIC also directed SCTIMST to take necessary steps for 'suo motu disclosure of maximum information on its website', related to the minutes of the GB meeting in compliance with the provisions of Section 4 of the RTI Act.
New Indian Express
13-06-2025
- Health
- New Indian Express
SCTIMST to resume surgeries after deal with HLL
THIRUVANANTHAPURAM: The Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) is set to resume surgeries that were postponed due to a shortage of implant devices, following a new agreement with HLL Lifecare. Under the deal, Amrit Pharma – a division of HLL – will supply the necessary devices to the institute. 'To address the immediate requirements, SCTIMST has signed a Memorandum of Understanding (MoU) with Amrit Pharma. The hospital will now procure essential supplies through them to ensure smooth and uninterrupted operations,' said Dr Kavita Raja, medical superintendent of the institute. However, the hospital has not yet announced when the delayed procedures will be rescheduled. The current arrangement with HLL is viewed as a temporary measure, while the hospital works on streamlining its procurement process. Earlier this week, the Department of Imaging Sciences and Interventional Radiology (IS & IR) at SCTIMST had suspended all peripheral and neuro-interventional procedures due to a critical shortage of devices. The disruption affected patients from across Kerala, Tamil Nadu, and other regions referred to the hospital. The delay in procurement was further aggravated by a Union government directive mandating purchases through the Government e-Marketplace (GeM) portal. Though intended to improve transparency, doctors have criticised the policy for slowing down the supply chain and impacting patient care. As some of the surgeries were suspended, the Union Minister Suresh Gopi called an emergency meeting to arrange the materials through HLL Lifecare. Youth wing of Congress and CPM staged protests against the apathy of the authorities of the premier institute. Temporary measure
Time of India
10-06-2025
- Health
- Time of India
Study to explore impact of indoor air pollution on heart failure patients
T'puram: Air pollution is increasingly being recognised as a serious threat to heart health, contributing to heart failure and other cardiovascular conditions. To explore whether cleaner indoor air can lead to better health outcomes for heart failure patients, the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) launched a new study. The research is part of the Indo-US collaborative agreement on environmental and occupational health and focuses on one key question: Can reducing indoor air pollution improve the health of people with heart failure? The study is being carried out at three major medical centres in India: All India Institute of Medical Sciences (AIIMS), New Delhi; Dayanand Medical College (DMC), Ludhiana; and SCTIMST, Trivandrum. As part of the study, air purifiers were installed in the homes of 10 heart failure patients in Trivandrum and Kollam districts. The plan is to expand this number and install a total of 200 air purifiers in patients' homes across these districts. "Air pollution is often seen as a problem of cities and traffic, but indoor air pollution is equally dangerous, especially in places where people spend most of their time — their homes. For patients with heart failure, who are particularly vulnerable to environmental stressors, breathing cleaner air could significantly reduce complications, hospitalisations, and even death," Dr Harikrishnan S, the principal investigator, said. He said if successful, it could lead to new guidelines for managing heart failure, emphasising the importance of air quality at home. It may also inform national health policies, making air purifiers a potential part of patient care for high-risk groups. The findings could benefit millions of people living in polluted regions, not just in India, but globally. With heart disease being the leading cause of death in India, innovative, evidence-based interventions are urgently needed. By focusing on the connection between clean air and cardiac health, this research places India at the forefront of an emerging area of public health. SCTIMST and its partners are hopeful that the study will provide valuable data to shape the future of care for heart failure patients — one breath at a time, Dr Harikrishnan added.
The Hindu
09-06-2025
- Health
- The Hindu
Temporary solution to supply crisis at SCTIMST
The crisis that evolved at the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) following supply shortage of cath lab materials used for interventional radiology procedures seems to have had a temporary resolution, with the institute reaching an interim agreement with HLL Lifecare Ltd. for the procurement and supply of materials. At a meeting called by the Director of SCTIMST with HLL Lifecare Ltd. here on Monday, it was decided that the latter would procure and supply the high-end cath lab materials required by the institute through its AMRIT (Affordable Medicines and Reliable Implants for Treatment) retail pharmacy network, so that the immediate crisis at SCTIMST, which had resulted in a total halt to all neuro interventional procedures, can be resolved. Union Minister of State for Petroleum and Tourism Suresh Gopi was also present at the meeting, along with senior faculty members of the institute. The supply shortage of cath lab materials had reached a situation wherein the doctors at the Imaging Sciences and Interventional Radiology department had informed the director that from Monday, they would not be performing any interventional procedures till a regular and uninterrupted supply of materials could be ensured. Without an MoU 'It would require a lot of paperwork and legal vetting before we can enter into a formal MoU with HLL Lifecare Ltd. so that steady procurement through the AMRIT pharmacy network is possible. However, in view of the current crisis, HLL Lifecare has agreed to ensure uninterrupted supply of cath lab materials for us even without the MoU. We hope to resume interventional procedures at the hospitalmaybe within a week,' a senior administrative official at SCTIMST told The Hindu. 'For the past two years, the institute has been trying to shift to a new procurement system and this involved a lot of process delays. In 2023, we renewed the rate contract with 24 medical device companies who had been our suppliers for the past several years. The current crisis resulted when four companies, who had the monopoly over the specific materials, refused to go with the 2023 prices and in effect, pulled the rug from under our feet,' he added. Mostly imported materials He added that the Institute now has the option of procurement through the Government e-Marketplace (GeM) portal as well as AMRIT, which is also a fair price initiative under the Health ministry. However, there have been many quality concern issues and technical rejections due to non-conformance to specifications under the GeM. Most of the materials used by the interventional radiology department are imported, many of which do not have Indian substitutes. While the meeting was on, a group of Youth Congress activists had barged into the SCTIMST, protesting against the disruption in patient care. A minor scuffle ensued, but the protesters were pacified by the director. In a statement here, CPI(M) district secretary V. Joy, MLA, claimed that the Union government was systematically trying to undermine the functioning of the SCTIMST.
