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 & Board Member
February 13, 2013.
Dr. M.M. Pallam Raju
Union Minister for Human Resource Development
Government of India
Shastri Bhawan, C- Wing, Dr.Rajendra Prasad road.
New Delhi- 110001
Subject: Implementing strategies focusing on Child Health through Ministry of Human Resource Development
I am sure this finds you doing well.
This note is a follow up on my earlier communications on including health education in school / college curriculum. Please refer
- Communication regarding Child Health dated 11th Feb,11 http://dmai.org.in/sites/default/files/Unhealthy_Promotions_MOHFW.pdf
- Communication dated July 11, 2011 on the UN High level summit for Heads of States. http://dmai.org.in/sites/default/files/Note%20to%20PMO%20for%20UN%20Summit%20on%20NCD’s%20%20September’11.pdf
- Communication dated 8th August 2011 regarding, Right to Preventive Care & child health . http://dmai.org.in/sites/default/files/Right%20to%20Preventive%20Care.pdf
- Communication to Shri Kapil Sibal, Former HRD Minister, for including health in the school curriculum. http://dmai.org.in/sites/default/files/Healthcare%20in%20School%20Curriculam.pdf
- Communication dated October 10th, 2012 to Shri Ghulam Nabi Azad, Union Minister of Health & Family Welfare on ‘Pre-emptive care’ focused on child health. http://dmai.org.in/Pre-emptive-Care-A-new-model-of-care.pdf
- My address at the United Nations, on why we need to focus on Child Health? http://www.youtube.com/watch?v=qCTKC4ndjsc
Implementing strategies to ensure good heath among children would require collaborative working between the
Ministry of Human Resource Development along with Ministry of Health & Family Welfare & the Ministry of
Women & Child Development & the Ministry of IT & Communications . We have been following this issue very
closely, and have sent numerous proposals and met up with various officials from time to time.
The following, if not yet implemented, would be a good step to promote child health ;
1. Start a chapter on hygiene & oral care from class 1 onwards
2. Create animated pictures and videos for children’s health that could be multilingual, and can be screened nationally in classes or using mobile health as a medium to disseminate the audio visuals .
3. Have a chapter and subject called ‘Essentials of health’ , which is exam based
4. Define child health and check-up guidelines on the lines of vaccination charts till the age of 15 years. This can
be done by the Ministry of Health & Family Welfare and incorporated in the school curriculum.
5. Child obesity is a serious issue, and this can be addressed by giving right knowledge about ‘Calorie exchanges’. Since parents teach the children, they will also get educated on the same and impact the family’s health. This must be added in school curriculum from class 3 onwards
6. Work outs or Yoga / mediation must be introduced in all schools
- All schools must have ideal height / weight / age charts in all classes, and every 6 months these must be reported in the half-yearly and annual report card. The same way as attendance, neatness , punctuality etc. are reported in class report cards at the PTMs (Parents Teachers meetings)
- It would be a great move if we start giving out 3 %marks or give a grading of A, B or C ( A for being fit for standards , B for borderline & needs improvement & C for being much below the child health metrics ), for various health indicators like dental hygiene, height and weight (BMI – Body Mass Index ), hemoglobin, Vitamin B & D etc.
- Each school / college should have a full-time doctor / health educator
- Junk foods & associated calorific intake needs adequate attention in school level awareness campaigns
- Children do not realize the importance of having adequate quantity of water, and since, in school, they are sometimes restricted to go to toilets, it is high time that the guidelines are issued to all schools for adequate water consumption & availability of drinking water & toilets in school (It might sound trivial, but it is very
Hope this issue will be given the highest priority and attended at the highest level. We will be raising this issue in parliament though members of Parliament from different political parties
For this generation, we are already too late, but we must ensure that the next generation is a healthy one.
In hope of the needful
Rajendra Pratap Gupta
Shri. Ghulam Nabi Azad, Union Minister for Health & Family Welfare.
Shri Kapil Sibal, Minister for Communications & IT
Smt.Krishna Tirath, Minister of state (I/C) for Women & Child Development
Dr.Syeda Hameed, Member, Planning Commission, GOI.
Shri. T.K.A. Nair, Advisor to the Prime Minister.
Shri Keshav Desiraju, Health Secretary, GOI.
Shri Ashok Thakur, Secretary, Min. of HRD.
Shri Prem Narain, Secretary, Min. for Women & Child Development.
Dr.Jagdish Prasad, DGHS, MOHFW
Dr.K.Srinath Reddy, President, PHFI.