BMI and risk of death

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That obesity is a causal factor for many lifestyle diseases such as cardiovascular disease, and
diabetes, which in turn increases the risk of death, has been well established in the developed
world. Similarly, being underweight increases the risk of death. A study published online in The
New England Journal of Medicine (NEJM) (“Association between body- mass index and risk of
death in more than 1 million Asians” by Wei Zheng et al.,) finds a strong correlation between
underweight and increased risk of death in all Asians. The study is an analysis of published data
involving 1.1 million people living in Asian countries, including 287,000 Indians and
Bangladeshis. The risk of death in the case of East Asians was high for those with a high body
mass index (BMI), but not in the case of Indians and Bangladeshis. Indians and Bangladeshis
were more prone to death when they were underweight. It is a fact that severely underweight
people are malnourished, and hence very unhealthy. Low immunity levels seen in such people
make them highly prone to several infections. Large-scale studies done in India, which has a
huge malnourished population, are more likely to show a large percentage of deaths associated
with lower BMI than higher BMI. Several small studies done in India have shown the risk of
mortality increasing with higher BMIs.

The study reported in NEJM has several limitations. Being underweight increases the risk of
infections but a person can become underweight as a result of an underlying infection. The
researchers were not able to exclude, at the time of enrolment, underweight people already
suffering from some infection, and hence at a higher risk. That many people were reported to be
dying soon after enrolment suggests they may have had some underlying infection or disease at
the time of enrolment. Waist-to-hip ratio or waist circumference is a better marker than BMI to
know fat distribution in the body. Indians, even those who are thin, tend to accumulate fat in
their waist. Abdominal adiposity is a causal factor for hypertension and diseases such as diabetes
and cardiovascular disease. Those with a BMI between 22.6 and 25 with less central adiposity
have the greatest chances of living free of any infections and lifestyle-related diseases. With
more urban children becoming obese, public health messages should address the increasing
chances of health complications when the BMI is lower or higher than the normal range. They
should also stress the need to reduce abdominal adiposity even when the BMI is within the
normal range.

Illusory tax concessions

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Except for senior citizens, the Union budget has very few major initiatives on the personal
taxation front. The Direct Tax Code (DTC), which aims to revamp the existing direct tax
structure, will come into effect on April 1, 2012. In a limited way, the budget proposals aim at
bringing about a transition to the DTC. The exemption limit for the general category of taxpayers
has been raised from Rs.1,60,000 to Rs.1,80,000, providing a relief of a little over Rs.2,000. But
by far the most significant initiative has little to do with tax rates or slabs. It is an administrative
1
decision to reduce the qualifying age for senior citizens from 65 years to 60. With the exemption
limit raised to Rs.2,50,000 from Rs.2,40,000, this new segment of senior citizens will get over
Rs.9,200 as relief. The Finance Minister has also created a new category of „Very Senior
Citizens', 80 years and above, who will qualify for a higher exemption limit of Rs.5,00,000. This
category can save on taxes up to Rs.26,780.

The tax saving for senior citizens may look significant. For many, however, it will be illusory.
For one thing, one must have an income stream that is large enough to qualify for savings. Not
many in the salaried class are likely to have a taxable income of more than Rs.2,50,000, after
retirement. It is even less likely that there will be many taxpayers in the 80-plus age group with
an annual income of Rs.5,00,000. Even more contrived is the logic that senior citizens can plan
their taxes better by investing in tax-saving instruments up to Rs.1,20,000. Such instruments are
essentially long-dated and even if senior citizens have enough income they would be ill-advised
to lock their money in these. The Finance Minister is absolutely right when he says that senior
citizens deserve special attention. Today's senior citizens depend on limited fixed incomes and
did not have many opportunities to save and plan for their retirement during their working years.
For instance, access to home loans and life insurance was minimal until not too long ago. That
has made them extremely vulnerable after retirement. Government support to them ought to go
well beyond tax reliefs and address the concerns of the aged in a holistic manner.

Keywords: Union Budget, personal taxation, Income Tax, tax ememption

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Comments:

It is the responsibility of the Government to tend to the citizens in their twilight years. Pranabda's
symbolic gestures of easing the 'tax' burden of senior citizens are basically cosmetic in nature
and have no real meaning. Some suggestions for the 'holistic' approach sought in the editorial - i)
Health Insurance at a nominal premium of Rs. 600-1000 per year to cover all illnesses and
treatment including surgeries in all hospitals , ii) 66-75% concessions in travel by train, air and
bus within limits, iii) door delivery mechanisms for PDS related entitlements like rice, wheat,
2
sugar etc., + 25-33% concessional rates, iv) specified special darshan quotas facilities in temples
and other places of worship, v) special counters in all major government offices from Tahsils and
upwards to deal with and take spot decisions to redress their grievances, vi) old age pensions for
the unemployed - not the current Rs 300-400 BUT say a minimum of 2500-3000 etc., There are
many more useful steps - yes, it will cost over Rs. 45,000-50,000 crores/year BUT governments
spend and waste 100,000's of crores every year apart from the loss due to scams. Also tighten up
the defence procurements - you will save about Rs. 30,000 crores NOW. So, financial crunch
cannot be allowed to be cited as a reason. Minor tinkering with the income tax rates when such
levels of income do not exist for nearly 80-90% of the 80+ citizens may get headlines from the
chatterati media but it is a pure cosmetic exercise.

from: R Rajagopal

Yes, but what led to the 'error'?

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It took a nudge from Sushma Swaraj, the Leader of the Opposition, for Prime Minister
Manmohan Singh to admit in Parliament that he had made an “error of judgment” in appointing
P.J. Thomas as Central Vigilance Commissioner. Although Dr. Singh can be given credit for
allowing himself to be coaxed into reiterating his acceptance of full responsibility for the
appointment, which was set aside by a censorious Supreme Court, his statement throws no
further light on the shameful episode. How did it come about that a senior civil servant charge-
sheeted in a corruption case was chosen as the country's top anti-corruption watchdog? Were the
Prime Minister and the Home Minister, who were part of the three- member selection committee
that appointed Mr. Thomas, really unaware of this? Why did they not apply their minds to the
objections raised by Ms. Swaraj who, as the third member of the committee, specifically raised
the issue of the pending charges against Mr. Thomas in the palmolein import case? Was there
pressure from any quarter to make Mr. Thomas CVC? Answering these questions is vital to
institutional integrity.

The little we know officially about the circumstances that led to Mr. Thomas' appointment is a
piece of obfuscation. This is in the form of Attorney General G.E. Vahanvati's laboured
submission in the Supreme Court that the Department of Personnel had failed to place the full
facts about Mr. Thomas, or the relevant “papers and file,” before the selection committee. This
sounded like a lame attempt to absolve the Prime Minister and Home Minister of accountability
by making out that the appointment was a result of bureaucratic inefficiency or oversight. As we
have made clear in earlier editorials, Mr. Thomas is entitled to a fair trial under the procedure
established by law and no presumption of guilt should be attached to his part in the palmolein
import case. What is scandalous is the government's decision to shield him and ipso facto protect
itself against the fierce criticism about the highly coloured circumstances under which he was
selected for the post. After the Supreme Court quashed his appointment and indicted the
government for attempting to defend the indefensible, the least Dr. S ingh should have furnished
was a detailed account of how or why he was led into 'error'. An acceptance of responsibility is a
step forward but insufficient. The proper course for a Prime Minister with a reputation for

3
personal financial integrity would be to square with Parliament and the public on what it was that
made him and his senior government colleague insist on, and rush through, the appointment of
Mr. Thomas in defiance of morality, the law, and common sense.

Of mercy and ending life

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“We could have dismissed the petition on the short ground that…the right to life guaranteed by
Article 21 of the Constitution does not include the right to die,” observe Justices Markandey
Katju and Gyan Sudha Misra sagely in the Aruna Shanbaug case. “However, in view of the
importance of the issues involved we decided to go deeper into the merits of the case.”
Negotiating the grey ethical areas relating to euthanasia in a humane, progressive, and persuasive
way, this detailed Supreme Court judgment lays down a broad legal framework for dealing with
a subject that has not received the attention it deserves from the legislature. The court's decision
on the immediate matter at hand — the plea that Aruna Shanbaug, the nurse who has been lying
in a vegetative state on a Mumbai hospital bed since she was brutally raped and strangulated in
1973, should be allowed to die — is largely based on medical evidence. The evidence furnished
by a panel of experts showed that while Ms Shanbaug may be in a permanent vegetative state
(PVS), she is neither brain dead nor in a coma. The court also went into the question of who
could initiate the move to withdraw life support to a person in PVS. Its answer is that such
decisions can be taken by parents, spouses, and close relatives or, in their absence (as in Ms
Shanbaug's case), the “next friend.” Justices Katju and Misra held that her next friend was
clearly KEM Hospital staff, “who have been amazingly caring for her day and night for so many
long years,” and not the petitioner who urged that Aruna be allowed to die in dignity.

Upholding the distinction between active euthanasia, which involves taking specific steps such
as injecting a person with a lethal substance, and passive euthanasia, which is withdrawing
medical treatment with the knowledge that it will cause death, the court has held that the latter is
permissible in exceptional circumstances — for example, when a patient is kept alive purely
mechanically and when he or she is “only able to sustain involuntary functioning through
advanced medical technology.” Citing a slew of international case laws on the subject, the
Supreme Court has laid down a strict framework for the procedure to be adopted for non-
voluntary passive euthanasia until suitable legislation is in place. All mercy-killing pleas should
be heard by a two- member bench of the appropriate High Court and decisions may be taken only
after seeking medical opinion from three empanelled doctors, who must examine the patient, his
or her medical records, and also get the views of the hospital staff. Leaving such decisions
entirely to a patient's relatives or doctors carries the risk that murders will be carried out in the
guise of mercy killing. In its judgment, the court has struck a fine balance — it has shown great
sensitivity in handling the heart-rending case of Aruna Shanbaug and her wonderful „next friend,'
the KEM Hospital staff, taken a progressive and empathetic view about dying with dignity, but
subjected it to exacting and rigorous procedures.

Keywords: Aruna Shanbaug case, euthanasia, mercy killing

4
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Comments:

You are right to uphold the decision of the Supreme court in the Aruna shanbaug case.To no one
should befall such a fate and even in the most dismal of the fate for Aruna Shanbaug,a most
relieving thing to happen is the preparedness of the KEM Hospital staff to look after her till the
natural end.As a parent my pain is endless.

from: Chidambaram Kudiarasu

Posted on: Mar 9, 2011 at 07:31 IST

Approaching the Supreme Court for a decision on euthanasia is a cruel joke on the justices.Yet
justices Katju and Misra were undaunted to take on the case and proved themselves to be second
to none of the judges of the civilised world.They redeemed themselves from this excruciating
task with a trail blazing judgement.Neither did they duck the issue nor they left a scope for
sloppiness by greenhorn judges of the days to come.They should be hailed for settling the issue
even in the absence of a specific legislation.Thirty seven years of PVS of Ms Aruna Shanbaug is
mind-boggling.May God bless her soon! The incredible aspect of her case is the loving care she
has been receiving from the KEM hospital and its staff. Unabated flow of milk of mercy from
her fraternity obviates the need for mercy-killing.However the marvellous support given to Ms
Aruna in terms of monetary and human resourses for the thirty seven long years by the KEM
hospital and its staff needs to be compensated and encouraged by awards and liberal funds from
the government and world benefactors like Bill Gates,Ajit Premji of Wippro et al

from: G.Rajaram.

5
In search of a second earth
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The discovery of six exoplanets or extra-solar planets (planets outside the Solar System) orbiting
a single sun-like star, dubbed Kepler-11, at a distance of about 2,000 light- years from Earth
makes it the largest collection to be ever found. Those found earlier using ground-based
detection methods were single exoplanets orbiting a star. The discovery by the Kepler spacecraft
launched in March 2009 and reported recently online in Nature (“A closely packed system of
low- mass, low-density planets transiting Kepler-11” by Jack J. Lissauer et al.,) became possible
as the Kepler telescope continuously looks out for exoplanets transiting the more than 150,000
stars in a specific region of the sky in the Cygnus and Lyra constellations. A transiting planet
causes a dip in the brightness of the star. Three to four transits causing the same dip in
brightness, taking the same time to transit the star, and taking the same amount of time between
successive transits are necessary for confirmation that the object is a planet. Though several
thousand planets may be present in the region studied, the actual number that may eventually be
found will be smaller as the orbital plane of the transits must be perfectly aligned with Kepler's
line of sight. All the six exoplanets have orbits smaller than Venus's, with the orbits of the first
five being smaller than Mercury's. The innermost planet must have a dense and rocky core as it
has 4.6 times Earth's mass despite being only 1.4 times the size of the Earth. Most of the other
planets have significant amounts of light gas.

The main objective of the Kepler mission is to find Earth-sized planets orbiting Sun-like stars
and capable of supporting life. All the six exoplanets are bigger than Earth, with the largest ones
comparable with Uranus and Neptune. Like Mercury and Venus, they are too close to the star to
support life. According to the U.S. National Aeronautics and Space Administration (NASA),
finding an Earth-sized planet in the habitable zone that is neither too close nor too far from the
star may take at least three years; one transit would take nearly a year and three such transits are
needed for planet confirmation. With Kepler only halfway into its mission, we cannot possibly
expect discovery of an Earth- like planet before 2013. The Kepler finds add to our understanding
of the universe. For instance, with ground-based instruments, generally only the radius and not
the mass of the planets can be measured, and hence the density and composition would remain
unknown; the size and mass of only three exoplanets smaller than Neptune used to be known.
Kepler has added five more to that list.

Keywords: exoplanets, Kepler-11, extra solar planets, NASA

Opposition in Libya struggles to f orm a united front

Anthony Shadid

Kareem Fahim

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6
A Libyan rebel who is part of the forces against Libyan leader Muammar Qadhafi holds a rocket
propelled grenade launcher as another carries spare ammunition outside the village of Bin Jawwad, west
of Ras Lanuf on March 5, 2011. Photo: AP

The question of its capabilities is likely to prove decisive to the fate of the rebellion, which
appears outmatched by government forces.

In less than three weeks, an inchoate opposition in Libya, one of the world's most isolated
countries, has cobbled together the semblance of a transitional government, fielded a ragtag rebel
army and portrayed itself to the West and Libyans as an alternative to Col. Muammar el-
Qadhafi's four decades of freakish rule.

But events this week have tested the viability of an opposition that has yet to coalesce, even as it
solicits help from abroad to topple Colonel Qadhafi.

Rebels were dealt military setbacks in Zawiyah and Ras Lanuf on March 8, part of a
strengthening government counteroffensive.

Meanwhile, the opposition council's leaders contradicted one another publicly. The opposition's
calls for foreign aid have amplified divisions over intervention. And provisional leaders warn
that a humanitarian crisis may loom as people's needs overwhelm fledgling local governments.
7
‘I am Libya'

“I am Libya,” Colonel Qaddafi boasted after the uprising erupted. It was standard fare for one of
the world's most outrageous leaders — megalomania so pronounced that it sounded like parody.
It underlined, though, the greatest and perhaps fatal obstacle facing the rebels here — forging a
substitute to Colonel Qadhafi in a state that he embodied.

“We've found ourselves in a vacuum,” Mustafa Gheriani, an acting spokesman for the
provisional leadership, said on March 8 in Benghazi, the rebel capital. “Instead of worrying
about establishing a transitional government, all we worry about are the needs — security, what
people require, where the uprising is going. Things are moving too fast.”

“This is all that's left,” he said, lifting his cell phone, “and we can only receive calls.”

The question of the opposition's capabilities is likely to prove decisive to the fate of the rebellion,
which appears outmatched by government forces and troubled by tribal divisions that the
government, reverting to form, has sought to exploit. Rebel forces are fired more by enthusiasm
than experience. The political leadership has virtually begged the international community to
recognise it, but it has yet to marshal opposition forces abroad or impose its authority in regions
it nominally controls.

Organisers acknowledge the chaos but contend that there is no one else to talk to.

‘We require help'

“We require support, whether it's military or otherwise, we require help,” Abdel-Hafidh Ghoga,
the deputy leader of the provisional leadership, told a news conference in Benghazi. “The
international community has to assume its duty at this point.”

While the mood remains ebullient in parts of eastern Libya, largely because few believe that
Colonel Qadhafi can reconquer a region that long seethed under his rule, it is more sullen in
Benghazi, a Mediterranean port and Libya's second largest city.

At the courthouse that has served as a government headquarters, bedlam reigned on March 8, as
gusts of wind slammed doors shut and shattered a window. Nationalist music blared over hurried
conversations that unfolded beneath cartoons lampooning Colonel Qadhafi.

Security has begun to deteriorate, with gunfire echoing in the distance, some robberies and
assailants' throwing a grenade at a hotel housing foreign journalists.

At the front, three and a half hours away, rebels sought to recover from a government offensive
that forced them from Bin Jawwad and sent them reeling toward Ras Lanuf, a strategic refinery
town. The government also appeared to deal setbacks to the rebels in Zawiyah, a rebel-held town
near Tripoli, and Misratah, a strategic coastal city.

8
With momentum seeming to shift, the rebels face the prospect of being outgunned and
outnumbered in what increasingly looks like a mismatched civil war.

“They don't understand,” said Sami Tujan, an officer trying, unsuccessfully, to command rebels
near a checkpoint. “They're a big target.”

Aging but effective weapons

The rebels won their initial battles with an assortment of aging but effective weapons, and a
seemingly plentiful supply of ammunition, including some from North Korea and Russia. On the
beds of Toyota pickup trucks, many of the soldiers mounted an old Soviet heavy machine gun,
which they referred to by the 14.5- millimeter rounds it fires. The guns are bundled together and
used as antiaircraft weapons, and may have been responsible for downing a government
warplane earlier this week near Ras Lanuf. Men holding rocket-propelled grenade launchers
complete the patchwork rebel air-defence system.

At the front lines at Ras Lanuf, the opposition forces relied on more rudimentary tracking
methods to spot planes: a lanky man standing on top of a large dump truck with a pair of
binoculars, along with hundreds of sets of ears of eager volunteers.

Even then, the government's Soviet-made planes mostly operated with impunity. Government
forces have also marshalled artillery, better tanks and helicopters that the rebels cannot match.

On March 8, as government forces gathered near Ras Lanuf, rebels strategised and argued among
themselves, complaining that they did not have enough rocket-propelled grenades and that a spy
was among them.

Logistics, namely resupplying the front, has proved to be a challenge for the rebels. So has
leadership. Small units of men who said they belonged to specialised branches of Libya's army
joined the fight, including members of special forces units and paratroopers. Some senior
officers are also seen at the front, but many of the rebels are bankers, policemen and the
unemployed, who have formed enthusiastic but somewhat hapless brigades.

“Apart from a few mechanised units in Benghazi and Tobruk, and a few armoured battalions
near Bayda, rebel-controlled areas lack any substantial hardware with which to take on the pro-
Qaddafi stronghold of Tripoli,” said a report on March 3 by the London-based International
Institute for Strategic Studies. “The pro-Qaddafi regions are also well garrisoned with artillery,
antiaircraft and mechanised formations,” it added. After government authority collapsed in much
of eastern Libya, residents set up what they call local councils of varying numbers of
representatives — three in Darnah, six in Bayda. Theoretically, each is supposed to send a
representative to Benghazi, where the opposition has set up a group called the Provisional
Transitional National Council of Libya, a kind of state in waiting. Composed of 30
representatives, it is led by Mustafa Abdel-Jalil, a former Justice Minister and perhaps the sole
figure who enjoys national support.

9
Its authority remains tentative, a point acknowledged by those involved. “We didn't have any
authority, of course; we just gave ourselves authority,” said Iman Bugaighis, a spokeswoman for
the council. “Nobody has any political experience.”

The council has barely begun to address the major choices the rebels need to make: whether to
support foreign intervention and whether to negotiate in any way with the government.

The council has pleaded for a no- flight zone, still being debated by the West, but rebel leaders in
Darnah warned that they would oppose any foreign interference with arms.

In his news conference, Mr. Ghoga ruled out any talks with the government, though Mr. Abdel-
Jalil, theoretically his superior, told an Arabic satellite channel that if Colonel Qadhafi left in 72
hours, no one would pursue him.

“How do we talk about something that hasn't been proposed?” Mr. Ghoga asked.

Partition?

Opposition leaders also differ on whether to formally declare a transitional government,

underlining fears that it may lay the groundwork for Libya's partition. Two of its representatives
met European officials on March 8, but the council has yet to unite with disparate, divided
opposition groups abroad, activists say.

“There is no communication between opposition groups and no leadership for the opposition,”
said Adem Arqiq, an exiled Muslim Brotherhood member in Dublin. “There are opposition
groups in Europe, in the United States and in some Arab countries, but each works for himself.
There were efforts to unify them, but they failed.”

For days, convoys of aid, many from Islamic relief organisations, have barrelled across the
Egyptian border, helping stanch shortages, in a remarkable show of organisation and solidarity.
Mr. Gheriani estimated that Benghazi had six months of supplies, and the United Nations was
sending more aid to the port. But in the hinterland, where local councils are still struggling to
reconstitute bureaucracies that collapsed last month, some worry a crisis is approaching.

“No one knows how long supplies will last — a week, two weeks,” said Ahmed Boughrara, an
engineer and organiser in Bayda. “Then it's going to be a huge crisis.”

Some have expressed a more lurking concern: that in a protracted fight, it may grow difficult to
maintain the unity that the opposition has sought to bridge religious and tribal divides.

“The longer this conflict lasts, the more people are going to be radicalised,” said Ibrahim el-
Gadi, a hydrogeologist in Darnah, whose son was wounded in a fight with government forces.
“We are not now, but it will be so if this conflict doesn't finish.” (David D. Kirkpatrick
contributed reporting from Tripoli, Libya, and Nada Bakri from Beirut, Lebanon.) — © New
York Times News Service
10
Keywords: Libyan crisis. Qadhafi opponents

UAE plans to buy Australian uranium

AP

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Australia will soon begin negotiating to sell uranium to the United Arab Emirates on condition
that it is only used for peaceful power generation, the Australian government said on March 8.
Australian Foreign Minister Kevin Rudd announced the negotiations on a bilateral uranium trade
agreement while visiting the Middle Eastern country's capital Abu Dhabi, according to a
government statement released in Australia's capital, Canberra.

Australia, which holds 40 per cent of the world's known uranium reserves, does not sell uranium
on the open market and bans nuclear power generation at home.

But it sells uranium solely for power generation under strict conditions that ban any military
applications in bilateral trade agreements with the United States, China, Taiwan, Japan, South
Korea and several European countries. Australia refuses to consider uranium sales to India until
New Delhi signs the Nuclear Non-proliferation Treaty. The UAE has already ratified that treaty
and is negotiating or has concluded nuclear safeguards agreements with countries including the
United States, France, the United Kingdom and Japan, Mr. Rudd said.

“Australia welcomes the UAE‟s efforts to establish a responsible approach to nuclear power
generation and hopes that it will serve as a model for other countries in the Middle East,” he said.

The trade conditions will ban nuclear material from being transferred to any third country and
from being used in weapons or to power warships.

The seven-state Emirates federation is building its first nuclear reactors on a sparsely populated
desert along the Persian Gulf near the border with Saudi Arabia. Although it sits atop one of the
Middle East's largest oil reserves, the OPEC member must import natural gas to fuel its existing
power plants. Blackouts occasionally occur in pockets of the country during the hot summer
months as power demand outstrips supply. The country expects its energy needs to double by the
end of the decade. The federal government in Abu Dhabi awarded a South Korean consortium
the $20 billion contract to build four 1,400- megawatt reactors in late 2009.

Before that deal was signed, the UAE reached an agreement with the United States to import, not
produce, fuel for its nuclear reactors. The Emirates committed not to enrich uranium or reprocess
spent nuclear fuel into plutonium, which is used in nuclear bombs.

Washington has promoted its plan to help the UAE develop peaceful nuclear power as a model
of the kind of cooperation it would like to achieve with nearby Iran. The U.S. and its allies
suspect Tehran is using a civilian program as a cover to develop an atomic weapons capability.

11
Keywords: UAE, Australia, uranium

Antibiotic challenges, dilemmas, policies

K.S. Jacob

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India was recently in the news for the wrong reasons. The serious threat posed by the newly
discovered microbe, NDM-1 (New Delhi metallo--lactamase-1), resistant to many antibiotics,
triggered alarm and panic. Predictions that the country will not meet the millennium
development goal for child mortality caused dismay. They highlighted the nation's paradox. The
country faces two conflicting challenges. The urban rich with their easy access to medical
treatments often receive inappropriate antibiotic therapy. On the other hand, the rural poor, with
their lack of basic medical facilities, find it difficult to obtain such medication. The former
results in microbial resistance, while the latter in preventable deaths. The official reactions to
both these problems and their implications were denials. However, after the short-lived
indignation and outrage, it is back to business as usual, the old inertia with its deceptive calm.

Microbial resistance

Resistance of microbes to standard antibiotics is well known. Hospital-acquired infections, in

circumstances where the use of antibiotics is high, are common. The development of bacterial
resistance to antibiotics is natural and occurs due to adaptation to hostile environments.
However, the rapidity of its development and increased prevalence of such resistance
documented in many tertiary hospitals reflect a serious problem. In addition, the life-threatening
nature of many infections, a limited availability of existing antibiotics and the absence of new
ones in the drug development pipeline are causes for alarm. This is true for many bacteria,
including those causing tuberculosis. It indicates the emergence of new and lethal dimensions for
old diseases, which had effective and affordable cures. The increase in antibiotic resistance in
community-acquired infections compounds the problem. It suggests that resistant microbes,
usually found in hospital environments, are now prevalent in the community.

The misuse and abuse of antibiotics by physicians is serious. Inadequacy of training in

prescribing rational antibiotic therapy is a major lacuna. Prescribing antibiotics for simple viral
infections to prevent possible secondary bacterial infections is common practice among
physicians, despite good clinical trials showing no value of such prophylaxis. Absence of
sentinel surveillance and regular guidance for prescribing also makes practice diff icult.
Indiscriminate prescription of newer antibiotic medication while allowing for recovery in
individual patients, risks development of microbial resistance.

The generally safe profile of antibiotics, their minimal side effects and short duration of the
course of medication are factors that lend themselves to abuse. The pharmaceutical industry
contributes to the problem by promoting the sale of antibiotics independent of patient need.
Pharmacists readily dispense antibiotics without a doctor's prescription. A widely prevalent
belief among the general population that all infections respond to antibiotics also perpetuates
12
inappropriate use. Many fail to realise that the majority of fevers are due to viral infections,
which do not respond to antibiotic therapy.

Poor access

The lack of surveillance of microbial resistance at primary and secondary hospitals and the
absence of guidance in prescribing encourages the use of newer broad-spectrum drugs in
situations were older medication would have sufficed. The poo r state of the public health care
system, the private sector with its focus on profits and deficiencies in the regulation and sale of
antibiotics also muddy the waters.

While NDM-1 grabs the headlines, the true magnitude of the problem of antimicrobial resistance
to common antibiotics remains unknown. Widespread multi-drug resistance essentially implies a
return to the pre-antibiotic era and represents a major crisis in health. On the other hand, the lack
of affordable access to basic medical facilities fo r the poor in Bharat complicates the issues.
Pneumonia, an acute respiratory infection, is the leading cause of child deaths in the world and a
common cause of under- five mortality in India. The World Health Organisation (WHO)
estimates that less than a quarter of children with pneumonias receive antibiotics, resulting in
significant mortality. Similarly, mortality in adults with bacterial infections is also a major
concern. The absence of adequate and timely antibiotic therapy due to a lack of access to
affordable medical care (for the vast majority of the rural population in the country due to the
urban-centric nature of our health care delivery system) contributes to preventable deaths.

The way forward

Urban and rich India, with its inappropriate use of antibiotics, requires strict practice guidelines,
tighter regulation and an audit of antibiotic utilisation. On the other hand, poor and rural India
needs improved access to antibiotics and affordable health care.

Rational antibiotic therapy prevents the development of resistant micro-organisms, superbugs

and untreatable infections. Rational use will also result in a massive reduction in the cost of
health care. High- income countries have managed to decrease the rate of antimicrobial resistance
through a multi-pronged approach. Their well-regulated health-care systems allow for
monitoring of antibiotic consumption and resistance, prescriber and consumer education and
regulation of use.

Fighting antibiotic resistance in India with its inadequate public health care infrastructure,
unenforced regulation and poor health education is a major challenge. Continuing physician
education, guidance on prescribing and monitoring practice is necessary. Regulating the sale of
antibiotics and microbial surveillance are mandatory.

India should start sustainable action to contain antibiotic resistance. It should raise awareness
using the mass media. Hand washing routines, to prevent the spread of infection within hospitals,
are observed more in the breach in most health facilities. These need to be made mandatory.
Antibiotic sensitivity patterns, minimum inhibitory concentrations and a strategy of de-escalation
13
of an antibiotic regimen should guide therapy in tertiary hospitals. The latter mandates a change
to an appropriate “older” antibiotic rather than continuation of a newer broad-spectrum drug,
after obtaining information on microbial sensitivity.

The formation and functioning of hospital infection control committees are obligatory. They
should monitor hospital-acquired infections at surgical sites and secondary to the use of
intravenous access, urinary catheters and ventilators. The committee should compile sensitivity
patterns, recommend prescribing guidelines, audit practice and educate health professionals.
Specialist hospitals should have consultants in infectious diseases who should advice in making
rational choices for complex clinical situations. Modern technology allows for support in
prescribing, tracking of antibiotic use and in containing the spread of resistance. In fact, it should
be mandatory for hospitals to make public their rates of hospital-acquired infections and
microbial sensitivity patterns, to allow for informed choice for patients.

The surveillance of microbial resistance should not be restricted to tertiary hospitals, as currently
practiced. It should also involve primary and secondary care centres to identify local and
regional patterns. The people of Bharat need a different surveillance network and practice
guidelines tailored to meet their specific needs. Sentinel centres in primary and secondary care
hospitals, with regional coordinating facilities, should be set up to help smaller hospitals.
National and regional databases and advisory councils are mandatory. The implementation of
such systems is the challenge facing the country.

The solution to improve access to basic health care for poor and rural constituencies may lie in a
different set of practice guidelines. Regulation of antibiotic use for this sector must be balanced
by adequate availability and access to such treatments. Antibiotic policies should factor in
different microbial resistance profiles. Simplified antibiotic prescribing protocols for use by
highly trained paramedical workers and nurse practitioners have been found to be useful in many
low- income countries. Such strategies merit consideration for increasing access and availability
in rural and remote parts of the country.

Another cause for concern is the use of antibiotics in the agriculture- food industry (e.g. poultry,
pig, fish farming and in honeybee hives) where these drugs are used as growth promoters.
Policies for rational use in this sector are also urgently required.

A decade has passed since the flagging- up of concerns about antibiotic resistance and increased
mortality due to untreated infections. The divergent and complex demands of the different
segments of the country have resulted in inertia and inaction. There is an urgent need to put in
place suitable policies and mechanisms for reductions in antibiotic resistance and yet provide
easy access to antibiotics in areas with poor penetration of health-care services. The challenges
for India and for Bharat are different and demand different solutions. The country is yet to have a
comprehensive antibiotic policy. Implementation plans remain on paper. The country needs
carefully tailored strategies to meet the dissimilar challenges of its diverse contexts.

( Professor K.S. Jacob is on the faculty of the Christian Medical College, Vellore.)

14
India faces the challenge of inappropriate use of antibiotics while Bharat copes with poor
access to treatment, resulting in a policy conundrum and inaction.

French diplomacy f alls from grace

Vaiju Naravane

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Stung by criticism both within the country and abroad at France's slow response to the Tunisian
and Egyptian revolutions and the subsequent developments in Libya, President Nicolas Sarkozy
has taken the bull by the horns, jettisoning his discredited Foreign Minister Michèle Alliot-Marie
and appointing a seasoned politician, the former Prime Minister, Alain Juppe, to re-shape
France's foreign policy.

Mr. Juppe, who held the post of Defence Minister at the time of the Cabinet reshuffle on
February 27 (the fourth within the space of one year), has served as Foreign Minister before, and
commands universal respect in France. He bargained hard and obtained the departure from Mr.
Sarkozy's side at the Elysee Palace of Claude Gueant, a tough right-winger widely considered to
be Mr. Sarkozy's Grey Eminence on foreign policy, who has no w been named Minister for the
Interior and Immigration, although the President's diplomatic Sherpa, Jean-David Levitte,
remains in place.

Naming Mr. Juppe to the post became a hard yet inevitable choice for Mr. Sarkozy, given the
rebellion within French diplomatic ranks. On February 22 a group of serving and retired
diplomats calling themselves the “Marly” group published what can only be described as a
diatribe against the President's foreign policy, saying it was “amateurish, impulsive and
preoccupied by media considerations.”

The writers of the article said that “despite loudly trumpeted announcements, Europe remains
powerless, Africa escapes us, the Mediterranean snubs us, China dominates us and Washington
ignores us. More seriously, the voice of France has disappeared from the world and our
following of the United States perturbs many of our partners…. Today, aligned with the U.S., we
are of interest no one since we have lost our visibility and our capacity for diplomatic
manoeuvre…”

Trouble in Tunisia

The “revolt of the diplomats” was a consequence of a series of diplomatic incidents and gaffes
including the sacking of the Ambassador to Tunisia, Pierre Menat, who was blamed for not
anticipating the country's social unrest. After sacking Mr. Menat, the President named Boris
Boillon, a 41-year-old Arabist, to the post in Tunis. But the new Ambassador, whose experience
as the head of a French mission abroad was limited to Iraq, had a violent altercation with the
Tunisian press corps for which he was forced to apologise on Tunisian national television.

15
Quick on the heels of this, came revelations that Foreign Minister Ms Alliot-Marie had offered
ousted Tunisian strongman French expertise in riot control measures and had vacationed in
Tunisia after the unrest began, using planes belonging to close Ben Ali aides. Worse, Ms Alliot-
Marie issued a series of half truths to cover up her ties to the Ben Ali coterie and her family's
business deals there. Such was the anger against France in Tunisia that the Minister who
supported Ms Alliot-Marie was also forced out of office. It turned out that just weeks earlier,
Prime Minister Francois Fillon, too, had accepted the hospitality of Hosni Mubarak during a
family Christmas holiday in Egypt.

Damaged image

For weeks, French diplomacy was seen to be faltering in what is considered to be its sphere of
influence, the North African Maghreb region of Tunisia, Algeria, Morocco and Libya and the
Machreq or the Levant. Opinion polls indicated that 72 per cent of the French felt France's public
image had been irretrievably damaged abroad. With his popularity ratings consistently low at 30
per cent, Mr. Sarkozy, who has been counting on foreign policy initiatives such as his presidency
of the G20 to bolster his image at home in view of the 2012 elections, realised that urgent action
was needed. Ms Alliot-Marie had to go with French diplomacy passing into more experienced
and more capable hands.

Several of Mr. Sarkozy's foreign policy initiatives have gone wrong. In 2007, he announced the
creation of a Union for the Mediterranean, an attempt to bind the 17 nations around the
Mediterranean with the European Union through a series of specific projects and initiatives both
cultural and economic. The objective was twofold — to give a sop to the Turks who had to be
kept out of the European Union at all costs and to increase French influence amongst the
Mediterranean rim countries while increasing controls on illegal immigration into countries such
as Greece, France, Spain or Italy. However, the project never really got off the ground because of
a lack of consultations with other EU partners and the revolutions in Tunisia, Egypt and Libya
have severely compromised what remains.

More recently, by publicly criticising the 60- year sentence meted out by a Mexican court to a
French woman accused of kidnapping, Mr. Sarkozy prompted the writer and former Mexican
Ambassador to France Carlos Fuentes to describe Mr. Sarkozy as “the dictator of a banana
republic.” This is a classic example of how the French President's hyperactivity and desire to be
centre stage at all times undercuts discreet diplomatic efforts to resolve tangled problems with
partners.

In France's Fifth Republic established in 1958, foreign policy has always been the special
preserve of the President. However, successive French heads of state, from de Gaulle to Jacques
Chirac have relied heavily on precious inputs from the French foreign office and its impressive
panoply of diplomats. These close ties between career diplomats and the President's office were
vastly diminished, if not interrupted, by Mr. Sarkozy who has tended to run French foreign
policy directly from the Elysee Palace with the help of a few close aides, bypassing successive
Foreign Ministers and ignoring the advice proffered by French envoys abroad.

16
France has the second largest diplomatic service in the world after the U.S., but repeated budget
cuts have crippled the service and demoralised the men and women working to defend French
interests abroad. In July 2010, Alain Juppe and Hubert Vedrine, two of France's most respected
Foreign Ministers, the first a rightist the other a socialist, jointly published an article calling for a
halt to a further reduction in force in the French diplomatic corps. The effect of constantly
trimming the Foreign Ministry budget and reducing personnel has been devastating, they said.
“The instrument is at breaking point and the entire world has noticed this. All our partners are
aware of it. … Other great powers do not similarly destroy their diplomatic instruments.”

Priorities redefined

In his first speech after taking over as France's new Foreign Minister on March 1, Mr. Juppe
redefined the priorities for French diplomacy: Re-founding the Union for the Mediterranean,
increasing European integration and strengthening ties with emerging powers such as China,
Brazil, India or Russia while anticipating the emergence of Africa in the 21st century. It would
be a “strategic mistake” to withdraw from Africa with which France has historic ties, Mr. Juppe
said. Given his past declarations on the subject, it was understood that Mr. Juppe would not
allow any further trimming of the diplomatic corps.

Mr. Juppe has followed this up with strong words against the Qadhafi government and on a
recent visit to Cairo he insisted on meetings across the political spectrum, from members of the
Muslim Brotherhood to the group of young computer specialists and professionals who were
instrumental in organising the uprising against President Hosni Mubarak.

But the loss of French influence in the world says Isabelle Lasserre, writer and journalist, author
of a book on French diplomacy entitled French Powerlessness, began with the fall of the Berlin
Wall and has continued unchecked since — the only highpoint, President Chirac's threat to use
the French veto over Iraq, now definitely in the past. France has joined NATO's Integrated
Command Structure without obtaining very much from the Americans in return. And France,
once looked up to in West Asia because of its specialist understanding of the Arab world, now
generates mistrust because of its new closeness to Israel.

Inevitable erosion

“During the Cold War period we were able to position ourselves as an independent voice within
NATO. France handled German reunification badly, failed to grasp the importance of the 9/11
World Trade Centre attacks and has been unable to deal with globalisation. We have seen several
foreign policy reverses, especially in Africa and the Arab world. But our increasing
marginalisation on the world stage is due also to old tropes that have dominated our world view,
both historic and colonial. In a certain way, we continue to see ourselves as an imperial power
and our attitudes are shaped by that. We must come to terms with the fact that we are a second
level power, that the days or empire are over and we must devise a new foreign policy that is in
keeping with these new realities, by building bridges within the EY, for instance. Without which,
we shall see an inevitable erosion of French influence in the world,” says Ms Lasserre.

17
Whether Mr. Juppe is capable of reversing the tide and giving France its lost pride and glory is
very much a matter for conjecture, especially if foreign policy continues to be seen through the
prism of the old colonial relationship with Africa or the clientelism in West Asia. Nevertheless,
in terms of the electoral timetable (France holds presidential elections in May 2012), Mr.
Sarkozy is taking a considerable risk in naming Mr. Juppe. The new Foreign Minister has a
prodigious reputation for efficiency and decisiveness. He is also respected by large numbers of
voters from Mr. Sarkozy's own UMP party as well as from the centre and Left who admire him
for his sober personal style coupled with his forthright criticism of attempts to use issues such as
national identity or Islamophobia for electoral ends. This move by Mr. Sarkozy could lead to a
draft-Juppe movement that would be difficult for the President to counter or resist.

A series of blunders has forced President Nicolas Sarkozy to bring in a potential rival to
handle foreign affairs.

OPEN PAGE
Let's fix the problem, not the fees
Sekar Viswanathan

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Even though health care is more essential to the public than education, our government does not
fix the fees to be charged by each hospital for various services…The same model can be
followed in the educational institutions.

The government shackles were removed and the Indian industry was freed from permit licence
raj in the early 1990s. There has been no looking back for industry ever since. The growth rate of
our economy has been phenomenal and industry has proven its prowess by becoming one of the
world leaders in the IT sector. But these winds of liberalisation have never touched our ed ucation
sector.

Education still remains a highly regulated sector. The permit licence raj exists in its fullest form.
So the private players are subject to the usual government bureaucracy, delays and corruption.
The fee charged by the private institutions is fixed by government-appointed committees in most
cases. On the face of it, it would appear that it is a good thing that the government controls the
fees to be collected by private institutions. But it is only when you get into the issues that you
will realise that it has harmful effects.

Let us take engineering colleges. Most State governments fix the fees to be collected from
students through fee-fixing committees. This fee is uniform for all colleges in that State. The
expenses, both operational and capital, vary from college to college. Land price, construction
cost and staff salary are much higher for an institution in Chennai than in a college located in a
18
remote village. Yet, the fee fixed is the same. The infrastructure, labs and the quality and
strength of faculty vary from college to college. Yet, the fee fixed is the same. (In Tamil Nadu,
for the NBA-accredited courses the fee is Rs.7,500 more. But the NBA accreditation has run into
many problems.)

The solitary reaper

Dr. Sanjay Rajagopalan

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Sekhar, at his daily routine of cleaning up the mess of civilisation in Chennai. Photo: Special
Arrangement

19
Related

TOPICS
conservation habitat (conservation)
environmental cleanup pollution control
environmental issues natural resources
nature
waste
people accomplishment
human interest

A solitary figure is crouched over the sands under the rays of the early morning sun on the
stretch of the beach adjoining the Adyar river estuary and the Theosophical Society in Chennai.
He makes his way slowly, picking up trash, cups, cans, plastic covers — anything that he can
possibly collect in his wicker basket. I watch as he drags the wicker basket lightly over the sand,
harnessed by a knot to his gnarled and weather-beaten hand. He pauses momentarily, squinting at
the horizon as he surveys the work ahead. Sekhar, a 75- year-old appearing man, with a shy smile
(he does not know his true age) and a slight hunch, moved to Chennai about 21 years ago
seeking work. He has since found gainful employment with a group of civic- minded citizens
who initially employed him with personal contributions to pick up trash nearly 20 years ago. He
is now paid a „princely' sum of Rs. 500 a month, in addition to ad hoc contributions from
charitable folk who visit this stretch of the beach.

Sekhar is literally a one- man operator who maintains some semblance of hygiene and decorum
along these sands. He arrives everyday promptly at 6 a.m., and cleans the beach for
approximately an hour. In the evening, he typically arrives at 5.30 p.m. and again spends an hour
removing refuse. The cleanliness along this stretch is in stark contrast with the beach a mile
further south, in the residential area of Besant Nagar.

A visit to the stretch of the beach referred to as Elliott's beach these days reveals an astonishing
array of remnants originating from human civilisation (or lack thereof) that includes every
conceivable entity not suitable for human consumption or sale. There is unfortunately no Sekhar
here to pick up the littler dropped with impunity by the thousands of people who visit the beach
everyday.

My mind wandered back to the period 30 years ago when these beaches were pristine, where the
shores were still strewn with shells and seaweed as opposed to the current grotesque collection of
human ingenuity. There were no Sekhars then, nor were there throngs of insensitive tourists to
pollute the beach. I pondered over this immense resource that we have in Chennai, miles of the
otherwise pristine public beaches for one and all to enjoy and the immense impact they have had
on the lives of millions of people who call this city their home. However, the level and scale of
pollution that threatens these sands on a daily basis, together with growing helplessness and
resultant apathy of its citizens, represents an existential threat to this ecosystem. How much
longer will it take before the beaches are rendered unfit for recreation and for the larger purpose
20
for which beaches were meant — as a beachhead against natural calamity and ecosystem for a
myriad of life forms? Something needs to be done soon and it may require many Sekhars and
many civic-minded citizens who have been the happy beneficiaries of the largesse of Chennai
beaches. The intent of Wordsworth's solitary characters in many poems was to show how to be
one with nature. Perhaps, the citizens of Chennai could use Sekhar's example to rally efforts to
make the environment, at least around the beaches, a priority and allow all of us to be one with
nature.

(The writer is John W. Wolfe Professor of Cardio vascular Medicine, Professor of Medicine and
Radiology, The Ohio State University School of Medicine, Columbus, U.S. His email is:
Sanjay.Rajagopalan@osumc.edu)

Moreover, many State governments consider fixing fees a populist measure which will affect
voting patterns. So there is a lot of pressure on the elected politicians to keep the fees as low as
possible regardless of the financial suffering of the education providers. The government
subsidises fees in its institutions like charging Rs.50,000 annually from IIT students, whereas it
costs the taxpayers Rs.2,50,000 annually to educate each student. (The only exception perhaps
are the IIMs which charge an annual fee of Rs.6,00,000). But it is unfair for the go vernment to
force the private sector to provide subsidy.

The government does not fix the price of land, cement, steel, loan rates or any other expense
incurred by the private institutions, yet it fixes the fees to be collected by them. It keeps hiking
the dearness allowance every six months. Under pressure to retain the faculty members, the
private institutions follow suit. Yet, the fees are not increased annually in many States. It is
locked for three years. The model of government committees fixing the fees has become a
failure, as it is impractical.

The institutions are under a lot of financial pressure as they have to bear the spiralling costs and
pay bribe to obtain licence (known as approvals) from various government offices. Unable to
withstand the financial pressure, some institutions lower the quality of education, and some
others resort to the capitation fees or collect fees higher than fixed by the government without
providing a receipt. Why are we driving our own institutions to indulge in illegal activities?

What is the solution?

Let us take the health care industry as an example. Even though health care is more essential to
the public than education, our government does not fix the fees to be charged by each hospital
for various services. For the same surgery, a reputed private hospital in the city with wonderful
infrastructure and senior doctors might charge a higher fee compared to a small private hospital
with fewer facilities. The same surgery would be done free of charge in the government hospital.
The citizen chooses which hospital he/she wants to go to.

21
The same model can be followed in the educational institutions. Each institution should have the
freedom to fix the fees, which could vary for each course, based on the expenses incurred. The
government's role will be to ensure a free and fair competition between private-private and
private-public institutions. This competition will ensure that no institution charges an
unreasonable fee. The public will not pay high fee to an institution which provides low quality
education, especially when there are competitors who offer their services at a reasonable fee.

The government can leave accreditation to professional organisations (as proposed in an

upcoming bill in Parliament). The accreditation agencies can visit the institution, examine the
facilities and faculty, interact with students, issue a grade and publish a detailed report on their
website and in the government websites. This will help the public understand fully about an
educational institution. People are willing to pay more for better quality education, as it provides
the students a great career in their life. The competition will put a lot of pressure on the
institutions to perform better. In addition, the government can provide scholarships to poor
students regardless of whether they are studying in government or private institutions.

After allowing the institutions to fix the fees, the government can monitor if they collect any
other fee without providing receipts. In India, educational institutions can be run only by non-
profit organisations such as trusts and societies. So they come under the purview of the Income
Tax department, in order to get income tax exemption. The Income Ta x department can monitor
if any fee is collected without providing receipts and also audit accounts to check if the fee is
diverted.

There are Supreme Court judgments which favour higher educational institutions fixing their
own fees. Also, in the proposed Foreign Universities Bill, the fees will be fixed not by the
government but by the foreign universities themselves.

In order to increase our dismal Gross Enrolment Ratio (GER), we have to encourage the private
sector by removing the permit licence raj. This needs to be done soon to take advantage of our
demographic dividend. It is time to wake up and seize the opportunity.

(The writer is Vice President, VIT University, Vellore, Tamil Nadu. His email is:
sekar@vit.ac.in)

Keywords: educational institutions, fee structure

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Comments:

Good analogy. enjoyed reading it.

from: Srini R

Posted on: Mar 6, 2011 at 11:16 IST

One thing that this article does not address is who benefits and who will be at loss, what are the
potential harm from how much will that projected benefit outweigh the potential harm. It should
also project some evidence that a profit making private sector has done good to all calls in
public. However there are many private players in health sector still the National Programme on
Health are government run, which are cost effective and efficient.

from: Deepak Kumaraswamy

Posted on: Mar 6, 2011 at 22:45 IST

Very good thinking to set a bench mark in our future education standards.

from: B. Muthuvelan

Posted on: Mar 7, 2011 at 09:26 IST

Government must include Research and Development Fees and this fess they can only spend on
the development of Labs strictly. Say 5000/-. If a Chennai college has 1000 student then total
amount will be 50 lakhs. This amount is sufficient to develop one decent lab to do research and if
five colleges come together in same priority area then they can develop the world class facility,
although machines are at five different location.
23
If this idea is implemented tamilnadu engineering colleges will be no 1 in infacture in R&D and
other states will think that tamilnadu is USA or UK of India.

from: Pankaj

Posted on: Mar 7, 2011 at 09:35 IST

Shekar sir is great.perhaps govt. follow this article as best reference for structuring the policies
education of education.
It is unfortunate that inspite constructive measures of probelums we are spending more on
agencies like CBI for investigating corrupt cluster in country.

from: DR.GIRISH JOSHI

Posted on: Mar 7, 2011 at 09:36 IST

In a country where most of the / every other service or product (cost)is not controlled (and
encouraged to compete among service providers,) why would the education fee alone, it is to be
left to the consumer to decide. If some institutions are charging abnormally, without matching
infrastructure facilities and HR the consumer themselves will penalize them. The consumer is no
more ignorant, he gets to know the worth of the service / product (competitors also educate the
consumer about quality) before paying for it. Its also a fundamental right for a consumer to be
given choice to choose the right quality service/ product (I should not be forced to drink only
corporation water, when I need and can afford for mineral water).

from: C. Ramalingam

Posted on: Mar 7, 2011 at 17:39 IST

I am sorry to say that above article is biased and skewed towards. In our country almost all
private institutes (99.9%) are highly corrupt and have virtually no ethics. If someone pays Rs 1
more than an another candidate irrespective of his merit he will get the seat.I am absolutely sure
these entrance exams conducted by the private institutes are bogus and just a joke. They can
mark the papers and even change the answer paper so that who pay the money gets the seat. I
certainly agree that fees has to be different in various institutes depending upon their facility. But
if you allow the college to fix their own fees, can you guarantee that they won't collect money
through all the possible illegal means. In our country we Indians has some petty pleasure in
earning illegally however small the amount may be. So fees to be fixed by the college doesn't
work for highly corrupted Indian society.All the private instiute are owned by trusts and not by
individual. If certain individual cannot run it succesfully they can very well resign from the post
and let others to do the job. If no one can do it they can hand over to the government or any other
trust because the institutes don't belong to single individual(at least as per the law). The amount
of illegal activities in the admission processes in India is very shameful,and not heard in any
other countries in the world(Even in Africa). I think the best way is to have some control over

24
this institutes for another 5 decades and than once the government finance is adequate the
government can take over all the private institutes by law amendment. That is the only way our
education system would be cleaned. I am sure that it will happen one day because any nation
cannot allow this unethical practice to continue for ever.

from: R.Manivarmane

Posted on: Mar 7, 2011 at 18:10 IST

You missed the point.....we have fewer educational institutes compared to students and if fees
not regulated by govt, these private institutes will suck the blood of the common man because
not every one gets admission in IIT/NIT/IIM's where people can complain to govt about the fee.

from: Mahi

Posted on: Mar 7, 2011 at 19:01 IST

Beware the sharks are listening. Any comment, may be hijacked to suit one's own interest. By
hiking fees, a college may reduce its number of students it takes in, yet can end up in same profit.
Smaller number of students, requires less teachers. While, the case for restructuring fees
structure is important, playing into the hands of private engg colleges owners would be suicidal.
While a few institutions may benefit and actually implement infrastructural enhancements, most
would simply pocket it. The effect of competition may be either slow/absent. By the time, the
damage is done. We cannot jump into quick conclusions without pondering over the
ramifications.

from: Shankar

Posted on: Mar 7, 2011 at 22:10 IST

The analogy seems to be a bit out of place.It's very important to note that,India has a very large
middle class population,and a majority of capable students come from this bracket.If we would
allow institutions to fix there own fee structure.There is a very good possibility that these
students would not have the financial muscle

25