Rajendra Pratap Gupta
July 08, 2013
Hindustan Unilever / Colgate Palmolive / The Himalaya Drug Co. / GlaxoSmithKline
Ref: Failure to display properly important information related to potentially poisonous effects of toothpastes / tooth powder on children
I am writing this note on behalf of ‘The Disease Management Association of India – The Population Health Improvement Alliance’.
We have come across a glaring lapse in the manner in which the important information related to the quantity of toothpaste / toothpowder to be used by children is not displayed by your company. The correct quantity should be used and the over usage could be detrimental to the health of the population has not been properly displayed on the packaging. This is a serious issue and cause of immediate concern in the interest of millions of children across the country. I am putting here the message displayed on most of the toothpastes/toothpowders sold in India. It is important to quote here that majority of the toothpastes / powders sold are have fluoride as an ingredient.
- ‘For children under the age of six; use a pea sized amount under adult supervision. Do not swallow. (Printed on Pepsodent made by HUL).
- Keep out of reach of children under 6 years of age. If you accidently swallow more than used for brushing, get medical help or contact poison control. Children under 2 years ask a dentist or physicians (Printed on Aquafresh made by GSK. Of course, I brought this particular pack from U.K. but I guess it would be same for India as well).
- Children under 6 years of age should have adult supervision and use only a pea size amount. Do not swallow (Printed on Colgate made by Colgate-Palmolive).
- Children 6 years and below should have adult supervision and use only a pea-sized amount. Do not swallow. Spit and rinse thoroughly after brushing (Printed on Active Fresh Gel by Himalaya Drug Co.)
It is evident that brushing of teeth daily twice is a message blasted on various media platforms i.e. TV, Radio & magazines every day, but the message (using the right quantity & the potential poisonous effects on the health of children if used more than the size of a pea), which should ideally be put as a warning in bold & red colored alphabets or read out aloud in the TV / Radio is completely ignored in these media blasts.
Also, the message to use ‘pea size’ is put in small alphabets and that too, in English only, It is important to consider, how many Indians would understand ‘size of pea’ keeping in mind the rural & non-English speaking population? This is a serious issue, and I am quite surprised that this has not been raised till date by anyone, and this would have already harmed millions of children across the country.
This amounts to a serious ethical lapse on your company’s part, and conveys lack of seriousness towards the health of the country’s innocent children who are coerced into using tooth paste daily without understanding the harmful effects based on the numerous advertisements blasted on various media platforms.
I also must quote the annual report of the Ministry of Health & Family Welfare, Government of India; “Excess intake of fluoride over a long period of time leads to major health disorders like Dental Fluorosis, Skeletal Fluorosis and Non-Skeletal Fluorosis besides inducing ageing. The harmful effects being permanent and irreversible in nature are detrimental to the health of an individual and the community which in turn has an impact on growth development economy and human resources development of the country” and the Government has started a national programme for prevention and control of Fluorosis (NPPF).
Clearly, business interests of your company have ignored the health issues related to children of this country and this has to be addressed without any further delay.
I would like to hear from you about the action taken in this regard in terms of;
- Immediate warnings to be issued on radio, newspapers and television about the quantity of tooth paste to be used by children and harmful / poisonous side effects.
- Mentioning this warning prominently and highlighting it in local language in red color on the packing and the toothpaste tube.
- Withdrawing the old stocks from the market and replacing them with the new stocks with proper warning.
I am also marking this note to Shri Keshav Desiraju, Secretary- Health, Ministry of Health & Family Welfare, Government of India, for actions that might be needed on an urgent basis & how medical associations like IMA (Indian Medical Association) & IDA (Indian Dental Association) have been endorsing some of these brands might need to be looked into.
In hope of the needful at the earliest possible.
Rajendra Pratap Gupta
Shri. Desiraju, Secretary to the Government of India, MOHFW.
Rajendra Pratap Gupta
President & Member
Board of Directors
Shri Ghulam Nabi Azad
Union Minister of Health & Family Welfare October 10th, 2012
Government of India.
Nirman Bhawan, New Delhi – 110108.
Reference: Empowering people , ‘Pre-emptive care’ model & update on the Government Industry Dialogue
Dear Shri Azad ji,
Hope this finds you doing good.
I attended a workshop for health ministers of NDA two days ago . During the workshop , we also visited a village in Gadhchiroli ( A naxalite area in Maharashtra ). Here, I came across a 7th class failed lady who has been delivering healthcare information and advice in the village for many years on mother and child health, and out of the past five years , the village has been ‘Child death free’ for four years .
This service of the 7th class failed lady makes me believe that time has come to move from, ‘Health for All’ to ‘All for Health’ and under this ,
- Move to a system for self care
- We must come out with a healthcare booklet for all the citizens in regional languages
- Give generic names with prices for medicines ( OTC – Over the country or non-prescription pharma or non-pharma products ) , for common seasonal and acute ailments
- Also, the Government must make this booklet available to all the citizens on its website & as an application in Android / Nokia and other phone operating systems. It is time to empower people to take to primary and preventive care . Healthcare indications with OTC products application must be made mandatory in all languages for cell phones sold in India . May be, MOCIT ( Ministry of Communications & IT ) can take the lead in doing this .
More than 3 years back , I had written in the document titled ‘Healthcare reforms agenda’ (http://www.dmai.org.in/Healthcare_Reforms_Agenda.pdf ) , about ‘mass screenings’ for people, and I am glad that your ministry has accepted it , and has already done over 10 million screenings in the past 10 months , which is really commendable . Now , it is time for India to move from ‘Preventive’ care to ‘Pre-emptive’ care ( till now, I haven’t heard this word used for health ! ).
‘Pre-emptive healthcare’ ( Before teen age ) , starts before the age ( late twenties ), when ‘Preventive care’ starts . It would include ;
- Starting with health screening for children when they turn the age of 10 . Earlier the better ! So that children grow up healthy .
- The screenings will include obesity , blood pressure and diabetes screenings, every 6 months . These checks would not cost more than Rs. 10 a year , but can help in making India the healthiest nation !
- Also, major healthcare problems arise due to deficiency of vitamins A, D & B & Omega 3. We must recommend guidelines for all children to undergo tests for deficiency of these vitamins and Omega 3, and also tie up with national level labs for offering these tests at rates mutually agreed by the Government . I understand that currently , it is difficult to have a test for Omega 3 in India, even if one needs to get it done !
- Also, dental examination and eye check – ups must be made mandatory from the age of 6 years
We should, therefore, focus on drafting the child health guidelines and ensure that these become the basic requirement for school admissions and thus, are enforced nationally.
Lastly , on the Government Industry Dialogue (GID) for Healthcare that was organized by the Disease Management Association of India (DMAI) . I understand that you could not attend due to your pre-occupation, but I did receive the note conveying your good wishes for this initiative. This dialogue was a massive success with 60 CEO’s from the Healthcare sector companies attending the dialogue and was addressed by ;
- Dr.Sam Pitroda , Advisor to the Prime-Minister
- Shri Keshav Desiraju, Spl. Secretary , MOHFW
- Dr.Ashok Kumar – representing the DGHS , Dr.Jagdish Prasad
- Shri. Anil Swarup, Addl. Secretary, Ministry of Labour & Employment
- Dr.K.Srinath Reddy, President , PHFI & Chairman, High Level Expert Group on Universal Coverage
- Dr.Prathap C. Reddy, Chairman, Apollo Hospitals Group;
- Besides CEO’s & Managing Directors of leadings healthcare corporations
Besides , the dialogue was well attended by the media . Details of the deliberations are available on http://governmentindustrydialogue.org
This dialogue showed the keenness from both the sides ( Industry & the Government ) to work shoulder to shoulder to address the key healthcare challenges facing the nation .
Three areas of cooperation have emerged; i.e. adoption of districts under mass screening programs , companies willing to work on secondary prevention program in addition to the mass screening program , IT & mHealth companies willing to provide innovative solutions for managing chronic diseases and program evaluation tools, training front line health workers & Rural health . It would be good if the MOHFW now moves to focused meetings under the Government Industry Dialogue to decide the scope of collaboration specific to each program. I am sure that this will lead to more effective implementation of existing programs . I look forward to your guidance on the same.
Over the next couple of weeks, I will be attending meetings in USA – ‘International Wellness and Chronic Care Symposium’, and in Manila – ‘The Asia Pacific Leadership & Policy Dialogue’, hosted by WHO and the World Economic Forum for digital health . Will update you on the developments
With best regards ,
Rajendra Pratap Gupta
Dr.Manmohan Singh, Prime Minster, Govt. of India.
Dr.Sam Pitroda ,Advisor to the Prime Minister of India .
Shri Keshav Desiraju, Special Secretary, Health & Family Welfare, GOI.
Shri Anil Swarup, Addl Secretary, Ministry of Labour & Employment , GOI
Dr.K.Srinaty Reddy, President , PHFI & Chairman, HLEG- Universal Coverage
Dr.Jagdish Prasad, DGHS, Min. of Health & Family Welfare, GOI.
The recommendations that i made in 2011 on the invite of Planning Commission , Government of India have been implemented .
Seeing that healthcare in urban India is deplorable , i had asked to convert NRHM into NHM ( National Health Mission ) and this has been implemented along with tax rebate on preventive checks
Thanks to all the policy makers for making it happen !
Rajendra Pratap Gupta
I have dedicated this blog to the Indian Healthcare System .
I will share my ideas on the healthcare system in India & would love to hear your views . Please feel free to write back to me with your views
Thanks for taking out time
Rajendra Pratap Gupta
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