India Needs ‘Opt-Out’ Model for Organ Donation to Meet Shortages: Doctors

- Vinod Kumar

To address shortages of organs available for transplant, India needs an opt-out model for organ donation on the lines of some European countries where consent for organ donation is assumed to be granted by everyone unless an individual while alive had explicitly opted to bar donating his/her organs after brain death.

Said Dr. Tanmay Pandya, HOD & Director – Nephrology and Renal Transplantation, Faridabad: “India faces an acute shortage of organs harvested from cadavers for transplant. More than 2.5 lakh new kidney failure patients are diagnosed in the country each year. Transplant is the only long-term solution in these cases. However, kidneys harvested from people declared brain-dead account for less than 5% of kidney transplants happening in India. The rest are contributed by living donors such as family members. As a result, vast majority of patients of kidney failure continue to remain on dialysis.”

 

Organ donation rates are very discouraging in India. Increasing the percentage of people who opt to donate organs after death will radically change the organ transplantation scenario in India for the better.

 

Said Dr. Tanmay Pandya: “All organs that can be donated are in short supply in India. The nationwide deceased donation rate is less than 1 per million population here, compared to countries like Spain where this figure is 34. The difference is that Spain in 1979 moved to a ‘soft opt-out’ organ donor register, meaning that when someone dies, it is presumed they want to donate their organs, unless they actively opted out of the system when alive. India should explore a similar system which is being adopted in other Western countries too. If deceased donation rates improve to 8 to 9 per million population in India, there will be no need to harvest organs from living donors, and the waiting list will drastically reduce.”

 

He added: “There are other reasons too for low organ donation rates. Not many patients are declared brain dead in India, especially in smaller towns, due to lack of awareness among doctors and the belief that as long as the patient’s heart is beating, there is hope. This impacts the identification of potential donors. Even for brain-dead patients, the next of kin needs to give consent, but they are so emotionally devastated at the time, any talk with them for organ donation is very awkward and painful. They are not in the frame of mind to talk and cannot comprehend the donor formalities. Many of them are suspicious that the hospital may try to sell the donated organs. There are some misconceptions too. Many people feel that if they donate an organ, they will be born without that organ in their next birth.”

 

The solution is a continuing pan-India campaign to encourage organ donation, the doctor added. “Awareness about organ donation should start early in one’s life. School children should be taught about organ donation as part of their biology class. Also, movement of donated organs from one state to another wherever there is a need should be encouraged and made easier. For this, coordination between states needs to improve. In the absence of an opt-out system in India for organ donation, the family of donors should be incentivized by the government in some way to make them more receptive to the idea.”

Input cost inflation continues to push up corporate revenues but disrupts margins: ICRA

 

·       While Corporate India reported positive revenue growth trends during Q1 FY2023, earnings pressure continued due to commodity and energy cost inflation, and supply chain disruptions

·       ICRA’s sample of 620 listed companies (excluding financial sector entities) reported 39% YoY growth in revenues during Q1 FY2023, while OPM contracted by 213 bps

·       Margin recovery is expected from H2 FY2023, although contingent on resolution of aforementioned challenges

 

A study of 620 listed companies by ICRA Research of Q1 FY2023 performance has expectedly shown positive trends in revenues, with Corporate India’s  aggregate revenues (excluding financial sector entities) growing by 39.1% on a YoY basis. This growth in revenues was optically aided by the low base of the previous year, which had been impacted by the second wave of the pandemic, as also the price hikes witnessed across several sectors. However, the sequential growth in revenues during the quarter was dismal at 1.5% and the trends varied across sectors. Companies were however, unable to realise the benefits of the revenue growth in its earnings performance, with the OPM contracting on both the YoY as well as the sequential basis during Q1 FY2023.

 

Commenting on the trends, Ms. Kinjal Shah, Vice President & Co-Group Head, ICRA, said, “Demand revival post the pandemic led to the sharp rally in prices of most commodities especially metals to multi-year highs during FY2022, exerting pressure on India Inc.’s margins. Prices of other commodities have also moved up over the past four-five quarters, and continued to act as headwinds to margins in Q1 FY2023. Consequently, the operating profit margin (OPM) contracted by 213 bps to 17.7% during the quarter. While these have seen some softening over the recent months, they remain at elevated levels.  In addition, several sectors also faced rural demand softening, which impacted revenues and margins to an extent. Nevertheless, price hikes taken by several entities across sectors, coupled with the softening in input costs during Q2 FY2023, should provide some comfort to the OPM going forward.”

 

In terms of industry-wise performance, while sectors like hotels, power, retail and oil & gas, among others, reported significant QoQ growth in revenues in Q1 FY2023, a few other sectors like airlines, construction, capital goods and iron & steel witnessed sequential decline in revenues. ICRA notes that the sequential growth momentum was most pronounced in energy-oriented sectors such as oil and gas, power, and also hospitality sectors such as hotels, with both volume and realisation growth supporting revenues during the quarter. Sectors like FMCG, on the other hand, reported modest single-digit growth, primarily led by price hikes undertaken to offset the input cost inflation, while volume growth was subdued.

 

The interest coverage ratio of ICRA’s sample, adjusted for sectors with relatively low debt levels (IT, FMCG and pharma) witnessed a YoY improvement in Q1 FY2023 to 5.5 times, despite the moderation in OPM. The YoY improvement in credit metrics was on account of the a) expansion in absolute operating profits as the demand situation improved and b) reduction in interest costs, given the general deleveraging trends across most sectors.

 

Ms. Sruthi Thomas, Assistant Vice President & Sector Head, ICRA Ratings, added, “While the credit metrics remained at an adequate level in Q1 FY2023, marginal improvement is likely going forward given the recent trends in softening of commodity prices, reduction in energy cost and easing of supply chain constraints. However, the ongoing geo-political developments, as well as the changes in Monetary Policy, including firming up of interest rates, and their impact on the demand environment, remains to be seen.”

ICRA believes that the Q2 FY2023 performance of India Inc. would face similar constraints as supply chain issues are easing only gradually, while commodity-led headwinds continue, especially in the wake of the elevated crude oil prices, depreciation of the INR vis-à-vis US$ and the geo-political developments. Further, the progress of monsoon will be critical to support demand recovery in rural markets, which have been subdued. The combined impact of these multiple factors on the credit metrics of India Inc. remains to be seen. The weakening of overall performance would be especially visible in sectors which have limited ability to pass on the inflationary pressures through price hikes to end customers. Fear of global recession also remains an evolving risk for export-focused sectors such as IT, automotive and industrials. 

Ahead of World Heart Day, Doctors Collaborate with IACTS to Launch its Outreach Program

- Vinod Kumar

The outreach program’s launch coinciding with World Heart Day aims to disseminate knowledge to the public and influence fellow healthcare professionals to foster cardiac health 

 

Bengaluru, 13 October 2022: Fortis Hospital today joined hands with The Indian Association of Cardiovascular Thoracic Surgeons (IACTS) for the launch of its Outreach Program organized at the hospital. 

Inspired by Azadi ka Amrit Mahotsav, the outreach program is a nationwide initiative launched by IACTS to engage with the public to foster cardiac health and inspire a new generation of cardiac enthusiasts to make every heartbeat count.  

 

Fortis CG known for its excellence in interventional cardiology and cardiac surgery has always been at the forefront of promoting heart health and delivering state of the art cardiac care to the patients. In line with its objectives, the hospital has partnered with IACTS to strengthen its mission and reach of the same.   

 

The event witnessed introduction of the outreach program by Dr. CS Hiremath, Secretary, IACTS and a video message from the President of IACTS followed by a talk on cardiac health awareness by Dr. Vivek Jawali - Chairman: Cardiovascular Sciences & the Executive Council of the Fortis Hospitals, Bangalore and Past-President, IACTS. A yoga session was also conducted post the talk to demonstrate how yoga promotes heart health to commemorate World Heart Day.  

 

Speaking on the occasion Dr. Vivek Jawali – Chairman: Cardiovascular Sciences & the Executive Council of the Fortis Hospitals, Bangalore and Past-President, IACTS said, “I congratulate IACTS on the launch of the Outreach Program. This is a great initiative by IACTS which not only helps in creating awareness on cardiac health but also provides support and exposure to the medical community that they demand and deserve. Maintaining our heart health is extremely important. However, unfortunately many ignore it as it does not have immediate effect on the body. Sedentary lifestyle, poor eating habits, unhealthy food choices and stress can all contribute to your chances of developing a heart disease. Having said that, maintaining a healthy lifestyle while getting regular heart screenings can minimize the risk factors and diagnose your conditions at an early age as well as minimize the risk factors respectively.”  

Speaking on the launch Dr. C.S Hiremath, Secretary, Indian Association of Cardiovascular-Thoracic Surgeons, said, “We are extremely pleased and honoured to have Fortis CG join hands with us to launch IACTS Outreach. Through this program, we intend to strengthen the Association's activities beyond the CTVS community. The goals of the program are to educate everyone about heart health and persuade healthcare professionals to promote cardiac health, and make every heartbeat count.”