GS Paper III Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

India runs out of life -saving HIV drug for children

What’s Happening-

  • Cipla, sole manufacturer of Lopinavir syrup, stopped production of the drug after govt failed to clear dues.
  • Desperate over withdrawal of a lifesaving drug, children living with HIV (CLHIV) have written to Prime Minister Narendra Modi for help.

Key Points discussed were:

  • The pharmaceutical company Cipla has in various forums cited delay in payments by the national programme for the HIV medicines by several years and even non-payment of its dues in many cases.
  • Profits on child doses of HIV medicines are small and delayed payments are having a chilling effect on the ability of the National AIDS Control Organisation (NACO) to convince the company to participate in the bids it invited annually.
  • Stocks of Lopinavir syrup — a child friendly HIV drug — ran out after Cipla, the sole manufacturer of the drug, stopped manufacturing it over the issue of non-payment from the Health Ministry.
  • Cipla is the dominant player in the Indian market across the HIV segment and has not stopped participating in government tenders after the Health Ministry failed to pay Cipla for consignments sent in 2014.


  • Experts say the critical shortages are proving to be both tragic and embarrassing for India’s HIV programme.
  • The government is abdicating its constitutional responsibility to make available life-saving medicines for the HIV community.

Government Measures:

  • Emergency tender Faced with a crisis, the Health Ministry says it has instructed State AIDS Control Societies (SACS) to purchase from local markets.
  • An emergency tender has been placed but we have instructed SACS and State Governments to purchase from local markets,”.
  • However, since the syrup has gone out of production, they are not available in retail markets. Across the country, in every State, there is no one to make this drug.
  • Cipla asked for guarantees of payment from HIV patients.

GS Paper II – Statutory, regulatory and various quasi-judicial bodies.

Small businesses lobby for rules to increase liquidity

What’s Happening-
Five years after the introduction of a separate segment for listing of small and medium enterprises (SMEs).Market participants are now looking at ways to increase the liquidity to attract more institutional and market participants are now lobbying hard with the capital market regulator to review the trading norms to increase liquidity in the segment.

Key Points discussed were:

Main Issues:

  • One of the main issues being proposed is lowering the trading lot size post listing, which is currently pegged at ₹1 lakh retail investors.
  • Minimum lot size refers to the minimum amount that an investor has to put in to trade in the shares of a company.
  • Concerns over lesser liquidity still take centre-stage in discussions on SME investing.

Views of Merchant Bankers:

  • Merchant bankers are of the view that once the company has been listed for a certain period of time and a trading history has been created, the lot size could be lowered to one share so that retail investors can also participate if they are convinced with the quality and potential of the entity.

SEBI Opinion:

  • SEBI proposal Incidentally, a formal proposal on behalf of Association of Investment Bankers of India (AIBI), the umbrella body of merchant bankers, is likely to be submitted soon to the Securities and Exchange Board of India (SEBI).
  • Stock exchanges, however, seem to differ over the issue of lowering the lot size. While NSE favours a reduction in lot size post listing, BSE believes that the current framework has worked well and hence should not be changed.

Separate platforms
The country’s leading equity bourses -BSE and the National Stock Exchange (NSE)-introduced their separate SME platforms in 2012.While both (NSE, BSE) have been pitching their respective platforms to SMEs by way of awareness camps across the country, BSE has marched ahead in terms of numbers of companies.
Asia’s oldest stock exchange has seen 165 SMEs listing on its segment, while NSE has close to 60 entities on board so far.
When SEBI framed the guidelines for the SME segment, it intentionally kept the minimum trading lot at ₹1 lakh to keep out retail investors since the view was that SMEs carry higher risk compared to companies on the main board.

GS Paper II- Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

Why is TB bacterium not on deadly superbug list?

What’s Happening-

  • Of the estimated 10.4 million new tuberculosis cases globally in 2015, nearly 0.5 million were multi-drug-resistant (MDR).
  • Another one million were resistant to rifampicin drug alone. India accounted for 2.84 million new cases in 2015, of which 79,000 had MDR TB. There were 1.4 million TB deaths worldwide in 2015.

Key Points discussed were:

Lack of data

  • The lack of large-scale safety data and the paucity of effective TB drugs, especially for MDR-TB, are the reasons for the World Health Organization (WHO) to insist that the drug be used only when all “options to treat TB using the existing drugs have been exhausted.”
  • The WHO also makes it abundantly clear that all efforts should be made to avoid TB bacterium from developing resistance to bedaquiline as a result of misuse.

Not a priority pathogen?

  • This is the first time that the WHO has released such a list and the prime objective of listing the “priority pathogens,” in its own words, is to “guide and promote research and development of new antibiotics… and to address the growing global resistance to antimicrobial medicines.”
  • The list is divided into three categories — critical, high and medium — based on the urgency of need for new drugs. While the WHO reasons that malaria and HIV have not been included in the list as they are not bacterial infections, it cites a different reason for not including TB bacteria. According to the WHO, TB bacterium was not included in the list as it is already targeted by other “dedicated programmes.”

Meets criteria for inclusion:

  • The Union Against Tuberculosis and Lung Diseases has reacted so strongly is that the TB bacterium meets each of the 10 criteria used for inclusion in the list — how deadly the infections are, the number of infected people in a community, prevalence of resistance, how easily the bacterium spreads from one person to another, options to prevent the infection in hospital and community, treatment options and whether new drugs are already in the R&D pipeline.
  • The Union wants the TB bacterium to be included in the list before the WHO publishes the full protocol and results by the end of May 2017.