• The National Organ and Tissue Transplant Organization's guidelines contained a stipulation that only allowed patients under the age of 65 to register for transplants. This rule has been abolished by the Union Health Ministry.
• The Transplantation of Human Organs Act, 1994 in India sets up a number of rules regarding the removal and preservation of human organs. Additionally, it controls the transplantation of human organs for medical treatment and to stop the trade in human organs.

About new guideline

• No Domicile Requirement: As part of the "One Country, One Policy" initiative, the domicile need to register as an organ recipient in a certain state has been eliminated.
• According to the most recent regulations, a needy patient can register to receive an organ in any state of their choosing and can also have the surgery performed there.
• Nil Registration Fee: The former registration fees levied by the states of Gujarat, Telangana, Maharashtra, and Kerala will no longer apply.
• States imposed fees ranging from Rs 5,000 to Rs 10,000 to add a patient to the waiting list for organ recipients.
• Removing the Upper Age Limit:
• Because individuals are now living longer, the upper age limit has been removed.
• Before, a patient with end-stage organ failure who was older than 65 was not permitted to register for the organ transplant, per NOTTO (National Organ and Tissue Transplant Organization) rules.

Need for New Regulations

• encompassing framework :The rules are designed to create a uniform and open regulatory framework for organ transplantation operations in India, guaranteeing that all procedures are carried out in a morally and openly manner.
• In order to establish a national transplantation policy, the Center intends to amend the Transplantation of Human Organs (Amendment) Act of 2011's regulations.
• States have varied laws, and the federal government is considering amending them to create a uniform standard that would be observed by all states in the nation.
• Health is a state concern, though. As a result, the states will not be required to abide by the rules established by the federal government.
• The guidelines call for the creation of an appropriate regulatory framework to regulate organ transplantation activities, including the creation of a national register of organ donors and recipients, in order to protect the interests of both donors and recipients.
• To urge the general people to sign up as organ donors and to promote organ donation and transplantation, the guidelines call for the creation of a public awareness campaign.
• Enhancing the standard of organ transplant services: The recommendations establish a mechanism for the accreditation of transplant centres and the performance evaluation of those centres with the goal of enhancing the standard of organ transplant services in India.

What is the Organ Transplantation Situation in India?

• The third-highest number of transplants worldwide are performed in India.
• For all transplants in 2022, organs from dead donors accounted for almost 17.8% of all procedures.
• From 837 transplantation of deceased organs in 2013 to 2,765 in 2022, the total number has increased.
• By 2022, there will have been 15,561 organ transplants overall, using organs from both deceased and living donors, up from 4,990 in 2013.
• An estimated 1.5 to 2 lakh people require a kidney transplant each year.
• In 2022, a mere 10,000 people received one. Less than 3,000 of the 80,000 patients who needed liver transplants received one in 2022.

Only 250 of the 10,000 people in need of a heart transplant received one in 2022.

Government initiatives for secure organ transplantation

• The Transplantation of Human Organs and Tissues Act (THOTA):
• To control the removal, preservation, and transplantation of human organs and tissues for therapeutic purposes, the THOTA was enacted in 1994 and revised in 2011.
• The National Organ and Tissue Transplant Organization (NOTTO) was founded: In order to organise organ donation and transplantation activities across the nation, the NOTTO was founded in 2014. The group is in charge of encouraging organ donation, keeping a national registry of donors and recipients, and making sure organ transplant procedures are carried out safely and morally.
• Transplant centre accreditation: A system for accrediting transplant centres in the nation has been established by the government. The credentials and expertise of the medical staff, the infrastructure and facilities at the centre, and the effectiveness and security of the transplantation operations are some of the factors that determine whether a facility is accredited.
• Public awareness campaigns: These initiatives seek to inform the general public of the value of organ donation and to persuade people to sign up as donors.
• Use of technology: The government is utilising technology to improve the efficiency and transparency of the organ transplantation procedure.

Way forward

• We can increase the number of potential donors and make organ and tissue donation more accessible by raising awareness, educating the general public, and enhancing the donation procedure.

The public hospitals need to expand their infrastructure so they can perform transplants and give the poor access to affordable, high-quality care in order to improve the availability of donated organs to weaker populations.

• The enormous environmental damage, human exposure, and serious public health issues brought on by the widespread use of lead have affected many regions of the world.

Regarding Lead Poisoning:

• Lead poisoning, also known as chronic intoxication, is brought on by the body absorbing lead, and symptoms include weakness or paralysis of the muscles, as well as weariness, nausea, diarrhoea, nausea, lack of appetite, anaemia, and a dark line along the gums.
• Lead poisoning can have a serious negative impact on a child's physical and mental development, and it is particularly dangerous for children under the age of six. Lead poisoning can be lethal at very high concentrations.
• Anemia, hypertension, renal impairment, immunotoxicity, and toxicity to the reproductive organs are further effects of lead exposure.
• The production of lead-acid batteries for automobiles accounts for more than three-quarters of all lead usage worldwide.
• What about the burden of lead disease?
• The Institute for Health Metrics and Evaluation (IHME) estimates that lead exposure resulted in 900,000 fatalities and 21.7 million DALYs (Disability-Adjusted Life Years), or years of healthy living lost, globally in 2019.
• The weight of the problem was greatest in low- and middle-income nations.

What was the reaction of the world?

WHO's Response:

• One of the ten substances with the greatest potential to harm human health is lead, according to the World Health Organization.
• Also, WHO is a participant in the Global Environment Facility (GEF), which supports the implementation of mandatory lead paint regulations in at least 40 nations.
• The GEF is a catalyst for the environment as well as other things. It was created on the eve of the 1992 Rio Earth Summit.
• The Global Partnership to Reduce Lead Paint has been established by the World Health Organization and the United Nations Environment Programme.

Lead paint is still a problem in a lot of nations.

India's Response:

• The Ministry of Environment, Forest, and Climate Change (MOEFCC) issued a notification titled "Regulation on Lead Contents in Household and Decorative Paints Rules, 2016," which prohibits the manufacture, trade, import, and export of household and decorative paints containing lead or lead compounds in excess of 90 parts per million (PPM).

What Consequences Can Lead Poisoning Have?

High Blood Lead Levels:

• In India, 50% of children report having excessive blood lead levels, according to a 2020 research from the UN Children's Fund (UNICEF) and Pure Earth.
• According to the report, 275 million children in India have blood lead levels that are more than the acceptable range of 5 g/dL.
• Among these, the blood lead levels of 64.3 million kids are more than 10 g/dL.
• About 23 states have average blood lead levels over the 5 g/dL limit; the levels in the 13 other states and Union Territories cannot be estimated because there aren't enough studies or screening methods to gather data.

Disability-Adjusted Life Years:

• A 2016 study by the Institute for Health Metrics and Evaluation (IHME) found that lead exposure causes 165,000 annual deaths and 4.6 million Disability-Adjusted Life Years (the amount of years lost due to disease burden).
• IHME is a university of washington school of medicine-affiliated independent centre for population health research.

Negative effects on health

• Lead enters the bloodstream and travels straight to the brain, especially in young infants.
• During pregnancy, it can be passed on to the foetus, which can result in low birth weight and sluggish growth. Lead poisoning can impair the neurological, skeletal, and neuromuscular systems and result in anaemia and other disorders in both children and adults.

What are the difficulties in managing lead poisoning?

• Less Attention: Compared to other possible public health issues, lead receives less attention in India.
• Systems to check populations for potential exposure are lacking in India. There are around 48 national referral centres for lead projects in India where blood lead levels can be checked; however, non-profit organisations typically conduct screening on a volunteer basis or at health fairs.

Ineffective recycling laws

• There aren't many strict rules regulating the informal recycling industries in many developing nations, like India and underdeveloped nations.
• As a result, massive amounts of (lead)-acid batteries are retrieved in an unregulated and uncontrolled manner without the use of scientific methodologies.
• The Batteries (Management and Handling) Regulations of 2001 governed the management of lead-acid batteries. But, there hasn't been enough enforcement to guarantee secure and environmentally responsible recycling.
• The Battery Waste Management Regulations, 2022 were announced by the government in 2022, although it is unclear whether they would be put into effect.
• Strong demand for inexpensive goods
• In India, many inexpensive products contain lead, and consumers might not be able or ready to spend more for lead-free alternatives.

Way ahead

• Restricting unauthorised activity and regulating the industry will be beneficial because recycling used lead-acid batteries runs the risk of exposure.
• The government should provide facilities for blood lead level screenings at every district hospital and increase India's testing capacity for blood lead levels.

A discussion of India's health situation must include lead poisoning.