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.

A new global study in The Lancet’s eClinicalMedicine has drawn serious concern about the sharp rise of antimicrobial resistance (AMR) in India, placing the country at the centre of what many specialists now consider a fast-moving superbug crisis. The research, titled Preprocedural screening for multidrug-resistant organisms in endoscopic retrograde cholangiopancreatography: an international, multicentre, cross-sectional observational study, shows that Indian patients had the highest worldwide rates of multidrug-resistant organisms (MDROs) among those undergoing a common endoscopic procedure.

These numbers far exceed the levels documented in Italy, the United States and the Netherlands.

What Are Superbugs?

A superbug is a strain of bacteria that no longer responds to one or more groups of antibiotics that previously worked well. This can happen through enzyme production such as carbapenemases, changes in drug targets, increased pumping out of drugs or shifts in the cell wall that block antibiotics from entering, as per National Institute of Health. When bacteria gain resistance to several antibiotic classes, the list of possible treatments becomes very small. Such resistance makes infections tougher to manage because routine medicines no longer work, leading to more severe illness.

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The recent Lancet paper used screening of patients scheduled for endoscopic retrograde cholangiopancreatography (ERCP), a frequently performed procedure, to highlight how widespread MDROs already are among Indian patients even before major interventions.

Superbugs: What Did The Lancet Study Find?

The study assessed more than 1,200 patients across India, Italy, the Netherlands and the United States. Among them, 83.1 per cent of Indian patients carried at least one superbug, a figure far higher than those in the other countries.

• Italy: 31.5 per cent
• United States: 20.1 per cent
• Netherlands: 10.8 per cent

Which Superbugs Are The Biggest Culprits In India?

A few resistant pathogens account for most of the problem in the country, as per The Lancet Study:

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Enterobacterales, especially Klebsiella pneumoniae and Escherichia coli: These cause a large share of urinary tract infections, bloodstream infections and hospital-related illnesses. The study noted that nearly 70.2 per cent of Indian patients carried ESBL-producing strains.

Carbapenem-resistant Gram-negatives (CRGNs): India’s carbapenem-resistance rate for key pathogens was around 23.5 per cent, signalling that even some last-resort drugs fail against these infections.

Acinetobacter baumannii and Pseudomonas aeruginosa: These are common in intensive care units, often highly resistant and linked with ventilator-associated pneumonia. Surveillance in India shows very high resistance levels in both.

Staphylococcus aureus (MRSA, or methicillin-resistant Staph. aureus): This remains an established cause of surgical site and hospital-acquired infections.

Together, these organisms form part of the “ESKAPE” group (Enterococcus, Staph. aureus, Klebsiella, Acinetobacter, Pseudomonas and Enterobacter), which represents the central challenge in antibiotic resistance. India’s unusually high carriage and infection rates of these pathogens increase the threat both in hospitals and in the community, as highlighted in The Lancet study.

Resistance may be inevitable, yet it can still be controlled. The new findings make it clear that India cannot afford further delays. Antibiotic resistance is no longer a niche concern. With such high carriage levels, every hospital visit becomes a potential source of spread and every procedure carries added risk. Officials often speak about “containing resistance,” but the timeframe to act is shrinking. Without stronger antibiotic stewardship, timely diagnostics and firm infection-control practices, the country may lose access to many dependable first-line antibiotics for everyday infections, undoing years of medical progress.

Ultra-processed food (UPF) is linked to harm in every major organ system of the human body and poses a seismic threat to global health, according to the world’s largest review, as per The Lancet Study. The scientists, including the Brazilian professor who coined the term with colleagues around 15 years ago, argue that UPFs are now increasingly common worldwide and linked to a decline in diet quality and a number of diseases, from obesity to cancer.

What Are Ultra Processed Foods?

Ultra processed foods are factory-made products built from refined ingredients rather than whole foods. They usually contain additives such as preservatives, flavor enhancers, stabilizers or artificial colors that you would not use in an ordinary kitchen. Items like soft drinks, chips, packaged sweets and heat-and-eat meals fall into this group. They are created for convenience and taste, last a long time on shelves and often provide little real nourishment. In many cases, the final product no longer resembles the raw ingredients it came from.

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Ultra Processed Food Are Now A Global Health Threat

The growing presence of ultra-processed foods in daily diets is now tied to serious health risks. A group of three papers published in The Lancet examined existing evidence and found clear links between UPFs and many non-communicable diseases. A report by The Guardian noted that UPFs are associated with harm across major organ systems. The review described these foods as a significant public health danger. It also stressed that worsening diets have become an urgent concern. The Lancet team called for stronger policies and wider public action to reduce the reach of UPFs and to make fresh and minimally processed foods easier to access.

The review, which combined findings from three papers, comes at a time when millions rely on UPF products such as ready meals, packaged cereals, protein bars, fizzy drinks and fast food. In both the UK and the US, more than half of a typical person’s daily intake now comes from UPFs. Among younger people and those from economically strained or underserved communities, a diet made up of nearly 80 percent UPF is common, according to the study.

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How Are Ultra-Processed Food Harming Your Health?

UPFs are replacing fresh foods for children and adults across all regions. These products are linked with higher chances of obesity, type 2 diabetes, heart disease and depression, according to the Lancet study as per the Guardian report.

Professor Carlos Monteiro, a public health nutrition expert at the University of Sao Paulo and a contributor to The Lancet series, said the findings underline the need for immediate measures to address UPF consumption. He told The Guardian that rising intake of ultra-processed foods is changing diets everywhere, pushing aside fresh and minimally processed meals. The evidence from the first paper in the series pointed out that this shift from traditional food habits toward UPFs is playing a major role in the rise of many long-term diet-related illnesses around the world.

Ultra Processed Food: Proposal Of Policies

The second paper in the series outlined possible steps to reduce UPF production, marketing and intake. The third paper explained that large global corporations are steering the spread of UPFs, rather than individual choices, according to The Guardian coverage. Experts who were not part of the research welcomed the findings while also noting that more studies are needed. They cautioned that links do not always prove direct cause.

Ultra Processed Food: UPF Labelling On Products Should Be Mandatory

The researchers suggested that UPF ingredients should be clearly listed on the front of food packages. They also recommended warnings for high sugar, salt and saturated fat. They said this clarity is important because UPFs have become part of ordinary eating habits. From common breakfast cereals to packaged juices sold as organic, these products are everywhere.

Professor Marion Nestle of New York University said that improving diets across countries will require plans suited to each region’s needs and the level to which UPFs have become part of routine meals. She added that priorities may vary but action is necessary in all places to regulate ultra-processed foods, along with existing efforts to limit high fat, salt and sugar levels.

The two legendary German twins, Alice and Ellen Kessler, the greatest of entertainers, who rose to fame in the post war era died at the age of 89. They truly were inseparable, as they chose to leave the world in the same way they came, together. The sisters chose medically assisted dying on November 17, as reported by the German newspaper Bild.

The twin had shared that they "no longer wanted to live" and the decision to die together was made together with clarity and intention.

How Does Assisted Dying Work?

In terms of the Kessler Sisters, the police confirmed that there were no signs of foul play. The German Society for Humane Dying also stated that the sisters had chosen assisted suicide. This practice is legal in the country since 2019.

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How Is Assisted Dying Different Than Euthanasia?

In assisting dying, the law allows and enables the individuals to self-administer the medication, so the choice and the agency to die remains with the individuals.

What Is Assisted Dying?

This refers to the practice of ending a person's life through medication. However, when the term 'dying' is replaced by 'suicide', the medication is then administered by self, whereas in other procedures, it may be done by a medical professional. Thus the term 'assisted dying' refers to both assisted suicide and euthanasia.

In assisted suicide, the person's will to die matters, and it may not require a terminal diagnosis. However, this definition to varies from country to country.

Also Read: Can Right To Die Be Practiced By Non-Terminally Ill Patients?

In many ways can assisted suicide be practiced including providing lethal medication, or helping the individual travel to another jurisdiction to die.

What Does The Law In Germany Say About Assisted Suicide?

In 2020, Germany's Federal Constitutional Court determined that individual autonomy should include the choice to die. This means that every person could decide for themselves. The law has a wider scope, which also includes any person helping an individual who has chosen to end their life, and they cannot be penalized for doing so. However, this condition only comes from the person who wants to end their life, and the decision must be taken freely.

The debate was introduced in 2015 due to the section 271 of the criminal code, which made assisted suicide almost impossible in Germany. The law stated that anyone who aided someone to take their own life could be jailed for up to three years.

Palliative sedation is administered to prevent suffering and ensure a dignified death. However, medication aims to relieve patients of unbearable pain, this is why its use as an alternative medically assisted suicide raises concerns. Currently, there is no approved medication for medically assisted suicide in Germany. though several medications are could be used, for instance in the United States, severely ill patients receive high doses of sodium pentobarbital and thiopental. However, pentobarbital is only approved for veterinary use in Germany.

In Germany, the intravenous route is often chosen, where the medication is administered through IV, and the patient must be the one opening the infusion. Doctors can assist but should not be directly involved in the act.