Citizens' Issues
Ratan Tata invests in two more start-ups
Bengaluru : To encourage entrepreneurship, Tata Sons chairman emeritus Ratan Tata on Monday announced investing an unspecified amount in two more start-ups Moglix and Invictus Onclogy, which are based in New Delhi.
 
As an e-commerce firm, Moglix specialises in procurement of industrial products in business-to-business (B2B) space, while medical firm Invictus is an innovation-driven firm developing next-generation cancer therapeutics.
 
By investing in Moglix, Tata has forayed into a manufacturing tech-start-up as an investor, adding to his varied portfolio of e-commerce and new-age tech-enabled firms.
 
"With his expertise in the manufacturing sector, Tata will play an important role in mentoring Moglix on business growth, global expansion and leadership," the company said in a statement.
 
Founded by Rahul Garg, an ex-Google geek, Moglix is focused on disrupting B2B industrial products space for suppliers and buyers the world over.
 
"We are pleased to have an icon of Indian manufacturing as our advisor. Tata's contribution to the manufacturing sector has been inspirational and we look forward to his guidance to steer the company in transforming the buying and selling process for manufacturers across the country," Garg said in a statement.
 
Moglix recently raised undisclosed pre-series A funding from venture fund Accel Partners and Jungle Ventures to enhance its e-platform, build a wider supplier base and increase marketing spend across Asia.
 
In Invictus, Tata has invested as part of its series A financing round along with institutional investors Navam Capital and Aarin Capital.
 
"The funds will be used to advance our lead molecule to complete phase-one clinical studies and to file a second investigational new drug application, which translates into substantial value inflections for us over the next 18 months," Oncology said in a statement.
 
Invictus Oncology employs a supra-molecular technology platform to design anti-cancer drugs that home into the tumour and modulate the tumour immune response.
 
"Tata's investment is an affirmation of the technology quality we have developed. We are getting good traction from investors in India and overseas," Oncology co-founder and Harvard Medical School assistant professor Shiladiyta Sengupta said in the statement.
 
In the past 18 months, Tata has invested in a slew of start-ups, including Infinite Analytics Inc., Snapdeal, Paytm, Ola, Tracxn Technologies, Dogspot.in and Zivame.
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.

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How India tackles adverse drug reactions - by ignoring data
With 10 percent of 3.63 trillion medicines popped worldwide in 2015, India is the world’s third-largest medicine market. It stands to scientific reason that these drugs will have side effects.
 
Yet, in 2013, India reported no more than two percent of globally occurring adverse drug reactions (ADRs), jargon for side effects of medicines, logged in Vigibase, maintained by the Uppsala Monitoring Centre, a World Health Organisation collaborating centre for international drug monitoring.
 
It isn’t as if drugs have fewer side effects in India. Serious effects were seen in 6.7 percent of patients, a 2014 study reported. Other studies have cited drug side effects as the reason for 3.4 percent of hospital admissions in India, 3.7 percent hospital readmissions and 1.8 percent mortality. In the developed world, adverse reactions are believed to be the fourth-leading cause of death.
 
Within India, the ADR reporting rate (ADRs reported per million population) has almost doubled in the last three years to 40, but it is lower than 130, the average ADR reporting rate for high-income countries, and clearly disproportionate to the country’s population and medicine consumption.
 
In other words, India addresses the problem of adverse drug reactions by ignoring or not reporting the data. That could prove costly, said experts, if it isn’t already.
 
Ignoring Indian data makes drugs more unsafe
 
Reporting the side effects of a drug could help determine if the medicine should stay or be pulled off shelves. A medicine labelled safe for clinical use after trials could still be found to be dangerous – as happened with Rofecoxib, a non-steroidal anti-inflammatory drug, a runaway success after its 1999 launch.
 
Between its launch and 2004, Rofecoxib reportedly caused between 88,000 and 140,000 cardiac events. This forced Merck, the drug’s maker, to voluntarily withdraw it from the US market, in turn prompting a ban in India, although no significant cardiac event was reported as a side effect.
 
In 2004, pharmacovigilance in India existed only on paper, although formal monitoring began 18 years before that, in 1986, and India signed up to the WHO Programme for International Drug Monitoring in 1997. Reporting was lax until the launch of the Pharmacovigilance Programme of India in 2010.
 
Carelessness, insensitivity among reasons for India’s poor reporting of side effects
 
Some key reasons behind India’s poor track record in reporting ADRs:
 
Nurses, who are most likely to see a patient suffer a side effect, are expected to inform the treating doctor but seldom do. 
 
“Doctors in India are careless in prescribing medicines, because they know they will not be held accountable for their actions, and are equally careless about reporting ADRs,” said Kunal Saha, a US-based doctor who has waged a decade-long legal battle after his wife Anuradha Saha died of side effects of a drug overdose when she was being treated for a skin allergy in 1998. 
 
Settling Saha’s case, the Supreme Court ruled that medical negligence includes not informing patients about the possible side effects of a drug. “Physicians prescribe new drugs at the behest of medical representatives even without reading the drug pharmacology, driven by the promise of gifts, despite this being illegal,” said Saha. “Patients are prescribed excessive doses, unwarranted drugs or unwarranted combinations.”
 
Some doctors don’t know that drug side effects should be reported to any one of 150 ADR monitoring centres across India, nor are they adept at recognising a drug side effect.
 
Half of India’s population depends on drug stores not run by pharmacists, and on doctors holding alternative medicine qualifications who aren’t permitted to prescribe allopathic medicines in many states. 
 
Scarce data preclude regulatory action on questionable drugs
 
Drug side effects in India are scarcely reported, even in scientific literature.
 
A 65-year-old woman with cardiovascular disease developed chest pain after being put on Nimesulide, a popular pain-killer, for fracture-related pain, as this 2003 study reported. Swapping Nimesulide with an alternative, Ibuprofen, quickly alleviated the chest pain.
 
A 78-year-old man with heart disease was prescribed Nimesulide for a wrist injury. He developed breathlessness, blue pallor and restlessness, and quickly succumbed to further complications, another 2004 study reported.
 
On the Naranjo scale — a scale developed by Canadian pharmacologist Claudio Naranjo and others to assess the causality for an adverse drug reaction — the complications the 78-year-old patient developed after taking Nimesulide scored two, indicating the drug could ‘possibly’ have been the cause of cardiac artery insufficiency, a shortage of blood in one or more coronary arteries.
 
Nimesulide has been available in India since 1997. It currently sells as Nice (listed as a ‘top brand’ on Dr Reddy’s Laboratories) and Nimulid MD (on Panacea Biotech). Nimesulide has never been licensed for use in the US, UK, Australia, New Zealand and Canada.
 
Over a decade later, a group of experts ruled that Nimesulide adversely affects the liver in children and should not be prescribed, said Gupta. So, Nimesulide was banned for children in 2011 (the Panacea website still lists Nimulid MD Kid as being available.)
 
To ban or not to ban: India needs data-driven action
 
Reporting adverse drug reactions makes the experience of a few physicians available to the entire country.
 
Or, the manufacturer could be asked to add further information on the drug label or insert.
 
For instance, in 2015, Indian authorities recommended the inclusion of advisory notes mentioning hepatotoxicity, haemorrhage and cardiovascular events as possible side effects of Sunatinib Malate, an anticancer drug, and cardiac dysfunction as a possible side effect of Pazopanib HCl, another anticancer drug.
 
However, sometimes in India, a drug ban has been reversed in court or by the regulatory authority.
 
Watch out for side effects with a slow onset
 
Side effects are usually thought of as an immediate adverse drug reaction. That’s not always the case.
 
For instance, a blockbuster diabetes drug, Metformin, reduces the absorption of Vitamin B12 from dietary sources, according to a 2014 study.
 
“A deficiency of vitamin B12 can, in turn, cause mental disabilities, slowness, forgetfulness, and, most significantly, exacerbate the onset and progression of diabetic neuropathy, a disease of the nerves that commonly occurs in advanced diabetes patients,” said study co-author, Atul Gogia, consultant, Internal Medicine, at Sir Ganga Ram Hospital, New Delhi.
 
While his finding has not led Gogia to change his prescriptions for diabetes patients, it has made him more conscious about the potential impact of his prescriptions.
 
“Vegetarian diabetes patients could especially be at high risk of developing vitamin B12 deficiency because of the combination of their diet and prescription,” said Gogia. “Now we get patients’ vitamin B12 levels tested and prescribe them supplements if needed.”
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.

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COMMENTS

Subramani P K

10 months ago

The side effects of drugs are very seldom recognized and even if recognized not taken serious care of as a matter of caution to avoid such drugs or report to the appropriate authorities for further investigation & study. In many cases it is ignored & continue to be prescribed and the patient who reports the side effects is advised not to worry & continue the drug as if the side effect is a blessing for cure. After all the medicine manufacturers decide the treatment & dosage based on what research they have done God only knows & doctors blindly follow seeing the compliment offered by such companies for prescribing those medicines. Every one has to be at the mercy of God & believe his/her fate and that is the only answer for this predicament.

Aye to Net neutralists but work just begins
On Monday afternoon, India's telecom regulator finally put to rest the fiery net neutrality debate in India -- by ruling against zero rating and differential tariffs.
 
Zero rating lets Airtel users use Facebook, for instance, free of data levies, while charging for access to other services or websites.
 
This violates net neutrality, which says there should be no differential pricing -- free data for one service, but priced for another -- based on the content or web sites.
 
The Telecom Regulatory Authority of India (TRAI) has now forbidden such "discriminatory pricing" by whatever name it may be called.
 
The watchdog's ruling is clear and sharp, and a blow to Facebook's high-stakes Free Basics platform, born as Internet.org, as well as to Airtel Zero and other zero-rating platforms tried out, or planned, by telcos.
 
The year-long battle between the heavyweights, including telecom giants and Facebook, and a bunch of volunteers under the SaveTheInternet.in banner, was fiery, and seemingly unequal.
 
Facebook ploughed in an estimated Rs.300 crore into its three-month campaign defending Free Basics. Against it, though, the lone volunteer-activists gradually managed to drum up a great deal of public support.
 
A spokesman said Facebook was "disappointed with the outcome, but we will continue our efforts to eliminate barriers and give the unconnected an easier path to the internet and the opportunities it brings".
 
Expectedly, the activists were ecstatic.
 
"This is a historic outcome," said Kiran Jonnalagadda, a co-founder of the SaveTheInternet.in movement.
 
"For the first time, India leads where the US and Europe will follow. Many thanks to TRAI chairman R.S. Sharma for backing such an important ruling as his first major act in office."
 
The TRAI ruling got widespread applause, including from tech association Nasscom, which had given a submission supporting net neutrality. Its Internet council chairman Sanjeev Bikhchandani said the ruling would "help address apprehensions of young start-ups fearing lack of a level playing field."
 
Entrepreneur Arvind Jha of TiE said the collective power of 7,000 start-ups (whose founders had written to the PMO supporting Net Neutrality) and a dedicated team of volunteers has won over Facebook's ad blitzkrieg running into hundreds of crores of rupees.
 
So have David and the good guys vanquished Goliath, ending the battle?
 
The reality may be more nuanced than that. A battle much bigger than activists versus Facebook is up ahead: Providing Internet access to nearly a billion Indians who are offline, or nominally online, today.
 
First, the nuances.
 
Facebook is responsible for a great deal of the Internet penetration in India. Of the 300 million mobile users who make up over 90 percent of India's internet base, 56 percent use WhatsApp daily, and 51 percent use Facebook, according to a TNS survey released last October.
 
So, at least two out of every three Internet users in India use mobile data -- purely to use one or the other of Facebooks apps, including WhatsApp. It would be great to find a net-neutral way to let users access the apps or sites they need to (which may include WhatsApp or Facebook), free, or cheaply.
 
The Net neutrality movement, and now TRAI, have shot down Free Basics, which would have got Facebook and a few select apps free of data charges to subscribers of one telco (Reliance Communications).
 
But TRAI hasn't yet suggested what alternatives could be used to provide cheap or free Internet access to the hundreds of millions of mobile users who are unable or unwilling to pay for mobile data.
 
And no! They don't have access to even wireline broadband.
 
The watchdog did ask that question in its consultation paper. So we're all hoping it will yet come up with some workable ideas.
 
There are several options as well.
 
For instance, letting telecom companies offer a certain amount of free data for all, or using apps like Gigato which allow sponsors to top-up data, free, for prepaid users of specific apps: that recharged data can then be used for accessing any website or app.
 
Then there's Digital India, which aims to put Wi-Fi into towns and villages, letting smartphone users access the internet free or cheaply.
 
Former journalist Pierre Fitter puts it well: "Good that all Web content will be treated as equal. Now comes the important bit: making sure everyone can access the Internet."
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.

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