West Bengal is battling with one of its worst outbreaks of avian influenza. Thirteen of Bengal’s 19 districts are affected. Officials have put 26 people under isolation. But preliminary reports for bird flu are negative in all humans so far. The first Indian case of avian influenza in birds after July 2007 was reported from West Bengal on 15 January 2008 and 2.1 million birds have been culled so far. Medical and veterinary workers and villagers who have been in close contact with dead or infected birds are being kept under isolation and close observation. The fear is that the H5N1 virus may mutate into a form which undergoes easy human to human transmission and result into a pandemic (www.in.reuters.com 1st February 2008).

A novel idea from Dr David Sachs from Massachusetts General Hospital, Boston may allow transplant patients to wean off from anti-rejection drugs early. Immunosuppressants to prevent organ rejection are widely prevalent since the 1980's. However serious adverse effects include risk of cancers and renal failure.

In Sachs treatment the organ transplant recipient first received immunosuppressants and then got both organ and bone marrow transplant from the same donor. The stem cells from the marrow reprogram the body by allowing new immune cells to grow which do not reject the donated organ. A kind of hybrid immune system develops. In the study by Sachs, 4 out of 5 patients who received a kidney transplant could be weaned off immunosuppresants after a few months (The Economic Times 25 January 2008).

Consumers have something to rejoice. Prices of thousands of drugs will soon become cheaper. Because the government is all set to introduce a new system of drug pricing called pro-rata pricing. Currently the National Pharmaceutical Pricing Authority (NPPA) fixes prices of a specific quantity of medicine of a particular strength. But companies are quick to change the package size and charge a higher price. So a 5mg pack may cost higher than a 10 mg pack. By the time NPPA discovers this and sets a new price, companies have booked hefty profits. Between April and December 2007, NPPA scrutinized 3603 brands in the market and found that 87% were overpriced. By ensuring pro rata pricing, once a price of a certain strength of medicine is fixed, all other strengths and packs will have to be sold at a corresponding price. The NPPA’s role of fixing, revising, and monitoring drug pricing is vital for bringing some kind of order in India's chaotic drug marketplace (The Economic Times 21 January 2008).

Gouri Rao Passi,
Consultant, Department of Pediatrics,
Choithram Hospital and Research Center,
Indore, India.
Email: [email protected]