The Union Health Ministry implemented a ban on 156 "irrational" FDC medicines, effective immediately. These medicines, including widely used antibiotics, painkillers, and multivitamins, were commonly used to treat fever, cough, and infections. The ban was imposed due to the associated health risks and lack of therapeutic justification for the ingredients in these FDCs.

What are FDC medicines?

FDCs or fixed-dosed combinations, also known as "cocktail drugs," are medications that combine multiple drugs in a single pill. They are designed to treat multiple symptoms or conditions simultaneously. While they offer convenience, they can pose significant risks. These risks include the possibility of overdose, adverse interactions between the drugs, and the development of antibiotic resistance. Additionally, many FDC medicines lack sufficient scientific evidence to support their safety and efficacy.

Expert opinions on FDC medicines

Experts have raised concerns about the use of FDC medicines. They believe that many of these combinations lack sufficient scientific evidence to support their safety and effectiveness. Additionally, the combination of multiple drugs in a single pill can increase the risk of adverse side effects and interactions with other medications.

Experts have also found that FDC medicines may not be as effective as individual drugs in treating certain conditions. It is important to note that safer and more effective alternatives are available for most of the medical conditions that FDC medicines were used to treat. One particular concern is the inclusion of antibiotics in some FDCs. Overuse of antibiotics can contribute to the development of antibiotic resistance, a major public health threat.

The risks of FDC medicines

The use of FDC medicines can lead to adverse effects, including serious ones. Additionally, safer alternatives, tested in clinical trials, are available to treat the same medical conditions. Experts recommend prescribing drugs individually based on a patient's clinical symptoms rather than combining them in FDCs.

The ban on irrational FDC medicines by the Union Health Ministry can be seen as a positive step towards promoting rational drug use and protecting public health. The goal is to eliminate unnecessary and potentially harmful drug combinations. This is a step forward in reducing the risks associated with medication and ensure safer and more effective treatment options for patients.

In a landmark order, the Supreme Court of India has recognized the Right to Trauma Care as an integral part of the Right to Life under Article 21 of the Constitution.

The court issued comprehensive, time-bound directions covering the entire trauma chain of survival — comprising the inter-linked and coordinated chain of survival from the site of injury to definitive hospital care — aiming to strengthen emergency medical response and ensure timely access to trauma care across the country.

The directions, issued in SaveLIFE Foundation & Anr. v. Union of India & Ors., are binding on all 36 States and Union Territories. They cover the full spectrum of traumatic injuries, including:

• Road crashes

• Falls

• Burns

• Drowning

• Industrial accidents

• Fires

• Explosions

• Disaster-related trauma

In its the apex Court stated that “a uniform framework for trauma care, building public awareness, standardization of first aid skills, and proper Good Samaritan laws is required, since the right to trauma care of citizens is an integral part of the right to life enshrined under Article 21 of the Constitution of India.”

Why Is The Order Significant?

India records approximately 4.67 lakh accidental deaths every year from road crashes, falls, burns, drowning, industrial injuries, violence, and disasters.

Of these, road crashes alone account for approximately 1.77 lakh deaths annually. As per the 201st Report of the Law Commission of India, 50 per cent of those killed in road crashes could have been saved had they received timely emergency medical care.

The NITI Aayog-AIIMS Emergency and Injury Care Report (2021) found that at least 30% of all trauma-related deaths in India are attributable to delays in emergency care.

Despite the scale of preventable loss of life, India had no unified, enforceable national trauma care framework. Responses compiled from 34 States and Union Territories and placed before the Court revealed a deeply fragmented system, including inconsistent ambulance standards, unintegrated emergency helplines, absent trauma registries, ungraded hospital facilities, and patchy implementation of centrally mandated schemes.

The petition was filed by SaveLIFE Foundation in October 2024.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

What Has The Supreme Court Ordered?

The Supreme Court’s directions cover nine domains of the trauma chain of survival. All States and Union Territories are bound by these directions, with compliance to be reported before the Court-appointed monitoring authority.

1. Integration of a single national emergency number — 112 — within three months.
2. Establishment of grievance redressal systems to protect Good Samaritans who provide emergency assistance to trauma victims.
3. Establishment of a National Medical Rescue Protocol for trauma cases.
4. Addition of all registered ambulances — public and private — under the National Ambulance Code (AIS-125, December 2014). The Court also mandated GPS or Vehicle Location Tracking Device (VLTD) fitment and real-time integration with helpline 112, along with periodic audits covering response times, quality of care, equipment, and outcomes.
5. All States and Union Territories have been directed to adopt and implement the standardized Emergency Medical Technician (EMT) curriculum notified by the National Commission for Allied and Healthcare Professions (NCAHP) within three months.
6. States and Union Territories must establish State Trauma Registries linked to a Coordinated Trauma Registry within four months of the issuance of these guidelines.
7. All States and Union Territories have been directed to grade and designate all public and private medical facilities according to trauma care capacity within three months.
8. Cashless treatment for trauma victims under the PM RAHAT scheme.
9. All States and Union Territories have been directed to undertake sustained, multilingual, district-level awareness campaigns covering all the above within one month.

Compliance Mechanism

The Court has also directed that copies of its order be sent to the Chief Secretaries of all States and Union Territories, who are required to submit Action Taken Reports to the Registry of the Supreme Court within the timelines prescribed for each direction.

The matter is expected to be listed after four months for issuance of further directions based on the compliance reports received.

Amid the rising number of Ebola cases and deaths in Africa, nearly 16 people in Gujarat and Maharashtra have been quarantined after travelling from affected countries such as the Democratic Republic of Congo and Uganda, with some showing suspected symptoms.

This comes after the Ebola alert in Bengaluru over a woman who returned from Uganda and later tested negative.

Ebola Alert In Gujarat

A businessman from Congo and three individuals who came into contact with him have been admitted to isolation wards at separate hospitals in Gujarat's Ahmedabad. All four samples have been sent for Ebola virus testing, said Gujarat Health Minister Praful Pansheriya.

The 37-year-old businessman arrived from Congo earlier this month in Mumbai and stayed there for five days before travelling to Silvassa and Daman over the next few days, eventually reaching Vadodara on May 22. After developing Ebola-like symptoms, including high fever and cold, he was hospitalized on May 26 in Vadodara.

After doctors in Vadodara learned about his travel history, he was referred to a government hospital in Ahmedabad, where he has been kept in an isolation ward.

The man has been kept under observation, and tests are being conducted, with reports still awaited. The admitted patient is currently stable and safe, and his temperature is under control, Pansheriya said, adding that the people associated with the patient are not showing any symptoms.

"Two other individuals who had accompanied him have also been admitted to isolated wards at SVP Hospital in Ahmedabad as a precautionary measure. Another person who came in contact with these individuals has also been isolated," the minister added.

“Till now, there is no Ebola case anywhere in Gujarat or India, so nobody needs to fear,” the minister said.

In addition, media reports cited a total of 11 people who arrived in Ahmedabad from Ebola-affected African countries being placed under home isolation at their residences.

According to the Ahmedabad Municipal Corporation Health Department, all these 11 passengers live in the western areas of Ahmedabad. None of them have shown any symptoms of Ebola or have been in contact with Ebola virus-infected patients in African countries.

However, as a precautionary measure, the authorities have made home isolation mandatory for anyone arriving from affected African countries.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

Ebola Alert In Maharashtra

In Maharashtra's Nagpur, health authorities issued a high alert at the airport after placing a 47-year-old man who returned from Uganda under 21-day home isolation.

The Nagpur Municipal Corporation (NMC) health department is closely monitoring the man's health round the clock. Officials said he has not shown any symptoms of Ebola so far.

The individual stated that he did not come into contact with any Ebola patient during his stay in Uganda. However, as per health protocols, a medical team will regularly check his condition during the isolation period.

If any symptoms develop, arrangements have been made to immediately shift him to a hospital.

Read More:Ebola Scare In Italy: Two suspected Cases Linked To Uganda Travel

Experts Question Continued Travel From Affected Countries

Ebola has been declared a Public Health Emergency of International Concern (PHEIC) globally by the WHO. To mitigate the risk, the Directorate General of Civil Aviation (DGCA) and the Ministry of Civil Aviation have imposed strict rules for all airlines and airports in India.

The government has also issued guidelines for passengers arriving from Ebola-affected countries. As part of the precautionary measures, travelers entering the country from such nations are required to undergo a 21-day quarantine period.

Epidemiologist Dr. Amitav Banerjee, professor at DY Patil Vidyapeeth, Pune, told HealthandMe that the National Institute of Virology (NiV) in Pune is equipped to test for the Bundibugyo strain.

"The RT-PCR done by NIV is very sensitive and not likely to miss Ebola infections. A proper history of movement and contacts with sick persons during a visit to Congo and Uganda will provide more important information," he said.

The expert added that these people should also be tested for malaria, as it is endemic in Uganda and more easily transmitted than Ebola. After a couple of weeks, they can be tested for IgM antibodies against Ebola.

However, Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, raised questions about why India is still allowing travelers from Ebola-affected countries.

"Our policy should be so strict that we do not allow anybody coming from those kinds of countries where there is already an outbreak of Ebola, because Ebola has neither a treatment nor a cure nor a preventive vaccine," Dr. Gilada told HealthandMe.

India’s RT-PCR testing system is capable of detecting the Bundibugyo strain of the Ebola virus, and the chances of missing a confirmed infection are very low when standardized protocols are followed, said health experts after the suspected Ebola case in Bengaluru involving a Ugandan woman tested negative.

The woman, who arrived in Bengaluru from Kampala, Uganda, on May 23, was suspected of Ebola infection after developing mild symptoms including body ache. She was shifted from a hotel to the state-run Epidemic Diseases Hospital on May 26, and her samples were sent to the National Institute of Virology (NIV), Pune. The tests today returned negative. India currently has no reported case of Ebola, the Health Ministry said.

Let’s take a look at how testing for Ebola takes place in India’s virology labs.

Speaking to HealthandMe, Dr. NK Ganguly, former Director General of ICMR, said that RT-PCR remains the confirmatory test for Ebola infection, while rapid diagnostic tests (RDTs) are mainly used for initial screening with limited sensitivity — of around 85-89 per cent.

According to him, the World Health Organization recommends that RT-PCR should only be carried out in specialized reference laboratories due to biosafety requirements. India currently has two designated Ebola reference laboratories — the National Institute of Virology (NIV), Pune, and the National Centre for Disease Control (NCDC).

"The Altona RT-PCR kit is the real star and is highly standardized. It rarely misses Ebola cases when proper protocols are followed,” Dr Ganguly said.

Can India Detect The Bundibugyo Strain?

Bundibugyo is one of the strains of the Ebola virus currently linked to outbreaks in parts of Africa, including Uganda and the Democratic Republic of the Congo (DRC). The rare strain has caused over 900 cases and more than 200 deaths.

Dr. Ganguly said the incubation period for the Bundibugyo strain can range from six to seven days up to 15 days or even three weeks.

“If a person tests RT-PCR negative during this period, the chances of being infectious are lower. However, isolation is still necessary because there may be a short window period during which the infection may not be detected,” he said.

The expert added that travelers arriving from outbreak-hit countries should remain under quarantine even if their initial Ebola test is negative.

Why Ebola Testing Is Complicated

Dr. Ganguly explained that Ebola belongs to the filovirus family, which includes several strains such as Bundibugyo, Sudan, Taï Forest and Zaire viruses.

He noted that Ebola has a high fatality rate, with nearly 50 per cent of infected individuals dying from the disease. He added that the virus can spread through several body fluids including tears, saliva, milk and urine.

In the early stages, Ebola symptoms can resemble flu, malaria or other viral illnesses, including fever, cough, sore throat, headache, diarrhea, skin rashes and body ache, making early diagnosis difficult.

Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, told HealthandMe that the Bengaluru patient’s symptoms were similar to common viral infections, which is why epidemiological history and travel exposure become critical in suspecting Ebola infection.

“The symptoms of Ebola can be a little confusing because they are just like any other flu,” Dr. Gilada said, adding that travelers arriving from Ebola-affected countries should remain under observation for up to 21 days.

Are There Any Limitations In India’s Ebola PCR Testing?

Dr. Jatin Ahuja, Consultant, Infectious Diseases, Indraprastha Apollo Hospital, Delhi, told HealthandMe, there are no major loopholes in India’s Ebola PCR testing system, but there are certain limitations common to all diagnostic tests.

"One key limitation is the timing of testing. If RT-PCR is performed very early in the infection, there is a possibility of a false-negative result because the viral RNA levels may still be too low for detection," he said.

Dr. Ahuja also pointed out that test accuracy depends on whether the PCR targets are correctly aligned with the specific Ebola strain being tested. Improper alignment may reduce sensitivity.

He added that pre-analytical factors such as sample collection, storage, transport and RNA extraction also influence the final test outcome.

“Negative Ebola PCR substantially reduces concern, but interpretation always depends upon the clinical picture, travel history and exposure risk,” Dr. Ahuja said.