Heat of the moment

This week in Health Matters: why heat is a hot-button issue this election season, Indian spices’ quality crisis and the elite race to become superhumans.

This week in health: why heat is a hot-button issue this election season, Indian spices’ quality crisis and the elite race to become superhumans.

We end April by circling back to a conundrum we raised at the start of this month. The Election Commission of India suspects heatwaves are contributing to lower voter turnouts in the first two phases of the General Election. Kerala, which had a relatively low voter turnout on April 26, recorded its second-highest temperature since 1901. Elsewhere too, the IMD predicts temperatures can soar up to 46°C, including many regions scheduled to vote in the upcoming phases.

The turnout is not the only casualty. We emphasised earlier how heat exposure is the least kind to people, giving way to a cascade of health impacts and diseases. The retelling of the 2024 elections must also document the remarkable contest that is sizzling on the side. In the fray are political parties and people both fighting an unbending and uncompromising opponent: the Indian summer. Union Minister Nitin Gadkari fainted recently after feeling dizzy due to the heat at a rally in Maharashtra’s Pusad region. Doctors are cautioning — repeatedly and resoundingly — that the unrelenting heat is likely to impact the health of children, pregnant women, the elderly and people with co-morbidities. States like Telangana have issued heatwave advisories; others including Tamil Nadu have erected 1,000 rehydration points offering water and Oral Rehydration Solution (ORS) across the city. Heat exposure is a hot-button issue this time, and the ECI should implement measures to minimise the health impact, we pointed out in our recent editorial. Increasing voters’ awareness of managing heatwaves, along with collecting robust data on heat-related morbidity and mortality, could institute a long-term defence.

It’s worth probing if the heat action plans are realistic, evidence-based, and most importantly, inclusive. The heat and health relationship also nurtures collective neglect at times. Suggestions on avoiding outdoor activities, drinking lassi or staying hydrated may be impractical prescriptions for people like gig workers who travel miles and miles every day to deliver goods for a living. Occupation, gender or caste places communities at the heart of heat exposure. Here, C. Palanivel Rajan argues for a need for inclusive health and heat action plans that address the intricacies of local challenges. What makes a heat action plan successful? Liffy Thomas traces the lessons learned from plans implemented by Ahmedabad and Odisha. 

Speaking of plans and probing, we follow up on IRDAI’s move from last week to remove the 65-year age limit for purchasing health insurance. The fine print troubled many: the premiums for this demographic might be higher priced. And if the only effect is to provide many more unaffordable health insurance policies, well, “it would be equivalent to admiring the icing on an inedible cake”. Click on this link to read our editorial on why the reforms are being met with a reluctant embrace. For a refresher on IRDAI’s new rules and their relevance, do read N. Ravi Kumar’s detailed explainer on this. 

Bindu Shajan Perapaddan reports on an escalating concern among druggists’ associations. The Union Government recently allowed the retail sale of over-the-counter (OTC) drugs, for common medical problems, like flu and allergies, without license. The All India Organization of Chemists and Druggists flagged that this change contravenes existing drug laws, pharmacy regulations, and legal frameworks, including directives from the Supreme Court. Unregulated OTC drugs may spell graver health consequences – including drug abuse, increased risk of adverse drug reactions, delayed access to healthcare and possible compromise in storage of medicines. 

These, by no means, are hypothetical scenarios. You’ve heard our alarm bells and read our warning signs about the threat antimicrobial resistance poses to public health. A key driver of AMR? Misuse and overuse of antibiotics, which are often sold OTC. New evidence from the World Health Organisation shows the same antibiotics that were sold and used indiscriminately during the COVID-19 pandemic may have exacerbated the “silent” spread of AMR (they also did nothing to improve clinical outcomes for patients). The new data called “for improvements in the rational use of antibiotics to minimise unnecessary negative consequences for patients and populations,” said Dr. Silvia Bertagnolio, WHO Unit Head for Surveillance, Evidence and Laboratory Strengthening, Division for AMR. Restraint, at times, is the best self-medication for pharma and the patients it caters to.