The document proposes several solutions to improve healthcare access and affordability in India: 1. Introducing a Bachelor of Primary Health Care (BPHC) course to train more primary care practitioners and increase healthcare access in rural areas. 2. Establishing a public distribution system for medicines to provide affordable drugs to below poverty line populations through special medical ration shops across India. 3. Adopting nanopatch vaccine delivery technology which does not require cold storage, uses less vaccine, and could improve vaccine accessibility especially in remote areas.

1. Manthan Topic: Healing Touch
 BPHC (Bachelor of Primary HealthCare)
 Public Distribution System
 Nanopatch
TEAM “AAROHAN ” DETAILS:
• DIKSHA SINGH
• PRASHANT BHARDWAJ
• DIKSHA SONAL
• DEEPANKAR MATHUR
• DHANASHREE KANMADIKAR
PROJECT “ HEAL INDIA”

2. INDIA HAS A POPULATION OF 1.2415 BILLION ; BUT INFANT MORTALITY
RATE OF 46/1000 LIVE BIRTHS; MATERNAL MORTALITY OF 20/1000LIVE
BIRTHS AND THESE FIGURES SHOW A STUNTED HEALTH GROWTH OF
THE POPULATION MAKING IT UNPRODUCTIVE
LACK OF PRIMARY HEALTHCARE FACILITIES IN
RURAL INDIA
Nearly 50% of villagers have no access to primary
healthcare leading to high mortality rate in these areas
INEFFECTIVE VACCINATION AND REUSE OF
SYRINGES:
Repeated use of same syringe for vaccination
leads to spread of communicable diseases ;
requirement of cold storage to store liquid
vaccines
HIGH COST OF MEDICINE MAKING HEALTH
CARE EXPENSIVE AND INACCESSIBLE TO POOR:
High cost medicines make health care facilities
inaccessible to poor; inflation as well as
privatization has lead to increased cost
India ranks
136 in HDI
out of 185
countries
Over 1.25
million
children die
annually in
India
10% of
babies die
before the
age of one
year
37% are
chronically
starved

4. • Designing a bachelors course targeting the candidates
wanting to pursue medical career but unable to
because of high fees and fierce competition level.
• Duration-3 years and 6 months
• Nominal fee structure
Introduction of a
new course
“BPHC”
• Introduction of the new course in already existing
medical colleges or opening small scale institutions for
the same
• Training the candidates in basic healthcare
• Curriculum design and regular monitoring
Implementation
of the idea
• Number of seats in medical can be increased
• Increase in number of doctors in rural areas
• Aims at solving the present unemployment issue of
the country.
Merit over
existing system

5. District wise merit based
scholarship test for the
selection of 25 candidates
from each district
3 and ½ year BPHC course
Promises a graduation
degree
Guarantees job as a
medical practitioner in
rural areas
Opens wide opportunity
for further study
Salient features
of the course:
• Duration- 3 years and 6 months
• 1st year-Study of basic physiology and basic practical adhering to this field
It will have 3 phases:-
1. Study of health problems of the community, basic principles of diagnosis
and prevention of common rural aliments such as malaria, anaemia,
hookworm, TB and diarrhoea.
2. Involves taking patient history, basic clinical examination and management
of diseases. They will be tied up with national health programmes.
3. Phase III will deal with training to prevent basic health problems.
• 2nd year- Practise of practical implementation of the syllabus of 1st year
• 3rd year- Expert guidance of senior doctors or retired doctors in the field
• 6 months-Rotatable internships to assure complete knowledge of the syllabus content and its practical
applications.
•Degree after completion of the course-This course will grant the candidate a bachelor’s degree after will he
is eligible to practise basic primary healthcare issues in rural parts of the country.
IMPLEMENTATION

6. Availability of
primary
health care in
rural India
Job
opportunities
for the youth
A
Developed
INDIA
IMPACT
• Sharp growth in
availability of basic
healthcare facilities in
especially in rural areas
• Creates job opportunities
especially for the
candidates wanting to
pursue medical career
Challenges & Risks
• Difficulty in integrating
with government
infrastructure and
institution
• Requires government
funding and support on a
large scale
Mitigation Factors
• Tie-ups with private
institutions for providing
infrastructure
• Funding from other
sources

7. ProposedSolutionandImpact:
Nanopatch
Nanopatch to deliver
Polio,BCG,Cholera,
Hepatitis B vaccinations
Nanopatch:
i)array of thousands of
vaccine-coated
microprojections which
perforate into outer skin layers
when applied with an
applicator device
ii)tips of microprojections
coated with a vaccine material
released directly to key
immune cells immediately
below skin surface.
iii)Nanopatch significantly
reduces the amount of
adjuvant required for effective
vaccination
TechnologybehindNanopatch
i)Nanopatch array consists of a
1 cm2 square of silicon with
~20,000 microprojections on its
surface - invisible to the naked
eye.
ii)penetrates through
protective outer skin layer
(stratum corneum) targeting
immune-activating material to
immune-cell rich layers just
beneath the outermost skin
layer utilizing the
microprojections with
optimized spacing and length.
iii)effective increase in
immunogenicity,leveraged for
two different purposes: either
reducing the dose required to
achieve efficacy (100-fold
reduction has been achieved)
and for amplifying the vaccine
efficacy.

8. Evaluation index Using syringes Using nanopatch
Cold storage
requirements
Requires
refrigeration as
content must be in
liquid state for
effective immunity
Does not require cold
storage as vaccine is
coated with a dry
protective layer
Accessibility Can be used in
remote locations
only after proper
storage
Can be provided to
distant, remote
villages , towns and
cities
Portability Requires storage
units
Potable, compact, as
small as few nm
Cost of procurement Ranging from
Rs100-3000
Can be manufactured
under Rs70
Efficiency Requires 4X the
amount in
nanopatch
Requires a quarter of
the amount
Portability
• Accessible
• Time saving
Economical
• Infrastructure
cost reduced
• Cost savings
Medical
benefits
• Prevents
reuse of
syringes
• Uses less
amount of
vaccine

9. • Under developmental stage by Mark
Kendal from Queensland University
• Not been tested for vaccines other
than influenza
Concept risks
• Difficulty in integrating with
government institutions as it is
patented
• Technology yet to be tested for
viability
• Lack of technical infrastructure for
development
Implementation
challenges
• Tie-ups with WHO can help in
acquiring nanopatch
• Advertising/ Campaigning
• Technical development by use of
biotechnology
Mitigation
Factors
Requires same
infrastructure as
Syringes
Doctors & Nurses
need a Dispensor
to dispatch it
People safe from
threats of reused
syringes with
immunity
Distribution
of
nanopatch
by
Government
Dispatch
Supplying to
hospitals,
Clinics and
aangan baaris
Processing
Injecting it to
people
Immunizati
on

10. PUBLIC
• Introduce generic drugs for public use and promote its uses. For
this, initially, do not allow any medicine patents in India to be for
period longer than 20 years from the date of filing. As per the
WTO’s TRIPS agreement.
• Drugs in the market for more than 10 years to be given 3 additional
years of patency protection after revoking the 20 year patent
protection.
DISTRIBUTION
• Provide the medical ration card to the BPL population of
India
• Establish special PDS shops for these card holders across
major regions in India (similar to the setting up of the
normal ration shops.)
SYSTEM
• No sales tax on generic as well as branded drugs.
• No levying of distribution cost or retailer benefits on these drugs
(which should be a part of government subsidies for the medicines.)
Insist doctors and provide them with
incentives to recommend generic drugs
if available rather than branded
expensive drugs.
In all other pharmacy shops all
over the country, sales tax
should not be levied on the
generic drugs.

11. • Setting up of medical ration shops across
country may not be as fast as possible. But
government should take all necessary steps
to do so.
• Creating awareness amongst the people
regarding the generic drugs and their safety.
• Issuing medical ration cards quickly
CHALLENGES
• Reduction in prices of medicines by 60%-80%.
• Employment opportunities for the people at
these shops
• Increase in the sales of the domestic generic
drugs and hence it will be a great boost to the
Indian economy in the medicine field.
BENEFITS
PUBLIC DISTRIBUTION SYSTEM OF MEDICINES

12. SL NO. REFERENCE PUBLISHING AUTHOR/WEBSITE
1 NANOPATCH TECHNOLOGY OVERVIEW http://www.vaxxas.com/nanopatch-
technology
2 PUBLIC DISTRIBUTION SYSTEM http://en.wikipedia.org/wiki/Pharmaceutical_i
ndustry_in_India
http://www.wto.org/english/tratop_e/trips_e/
techsymp_feb11_e/laing_18.2.11_e.pdf
http://www.medicinenet.com/script/main/art.
asp?articlekey=46204
http://www.forbes.com/sites/johnlamattina/2
013/04/08/indias-solution-to-drug-costs-
ignore-patents-and-control-prices-except-for-
home-grown-drugs/
http://ww.itimes.com/blog/generic-drugs-vs-
patented-drugs-vs-branded-drugs-vs-generic-
names-of-the-drugs
http://en.wikipedia.org/wiki/Indian_Patent_Of
fice
3 INTRODUCTION OF BPHC http://www.who.in/countries/ind/en/
http://www.mciindia.org/
4 FACTS AND FIGURES http://www.who.in/countries/ind/en/
http://nrchm-mis.nic.in