Pakistan continues to be dealing with a polio outbreak as four fresh cases have emerged, pushing the national tally to 37 this year, according to health officials on October 19, 2024. Health officials said that the regional reference laboratory for polio eradication at the National Institute of Health in Islamabad confirmed wild poliovirus type-1 (WPV1) in two children-one from each Balochistan and Khyber-Pakhtunkhwa.

In recent cases, a girl has been affected from Pishin, and two boys from Chaman and Noshki of Balochistan, and a girl from Lakki Marwat in KP. These are the first detections of the virus within Noshki and Lakki Marwat this year; isolated cases of poliovirus were previously reported within Chaman and Pishin. The province of Balochistan was the worst hit with 20 cases, Sindh had 10, Khyber Pakhtunkhwa had five, and Punjab and Islamabad had one case each.

A gigantic fight against polio has been on going in Pakistan- especially in Balochistan and southern KP-over the last two years. Immunisation campaigns have often been suspended or delayed because of local protests, insecurity, and community boycotts. Consequently, quite a number of children did not get the necessary vaccinations, making existing patches of vulnerability for the virus to flow within those pockets.

Noshki, located near Afghanistan's border, and Lakki Marwat have also recently reported some positive environmental samples that confirm the virus is present here, said a local reference laboratory official. Samples of latest cases are currently under genetic sequencing for checking spread of virus and origin.

As the threat of polio continues to grow, Pakistan has vowed to mount a nationwide campaign against it beginning from October 28. With the zeal to tackle the menace in the most effective manner, over 45 million children under the age of five will be vaccinated across the country.

Today, Afghanistan and Pakistan remain one of the few countries where polio has not yet been eradicated. The WHO said the virus remains a potential serious public health threat in areas with low vaccination coverage and weak surveillance.

India On Alert Against Polio

The country declared itself polio-free since 2014 and has kept the disease on bay almost a decade with very robust vaccination programs; however, two cases of vaccine-derived poliovirus cases reported in recent days from Meghalaya create some amount of doubts over a possible resurgence. Experts observe that in India, despite these detections taking place, strong coverage of vaccination at 90-95% and mandatory surveillance measures keep the risk of this widespread outbreak at bay.

The experts point out, however, that such stable situation in India requires continued surveillance. "Countries like Pakistan and parts of Africa remain at a high risk because vaccination rates in those areas are much lower," Dr. Siddharth, public health expert, said. Vaccination is an indispensable act in order to avoid the spread of this incapacitating disease that manifests most importantly as a nervous system affliction leading to the paralysis of a long period.

With concerted efforts from health authorities, there is hope someday that the scourge of polio will be completely eradicated from the face of the earth and future generations will never suffer from its effects.

The XFG COVID-19 variant is driving a rise in cases and hospitalizations in the UK and France, while some US regions are also reporting increases.

XFG, nicknamed ‘American COVID’ or Stratus, is a recombinant SARS-CoV-2 variant from the Omicron lineage, formed from LF.7 and LP.8.1.2. The WHO recorded the earliest documented XFG sample on January 27, 2025, and designated it a variant under monitoring in June 2025.

The NHS has advised infected people to stay home to limit spread. The UK is rolling out COVID vaccination, while France is expected to begin its campaign next week.

COVID and flu symptoms can overlap, including cough, fever, sore throat, headache, runny nose and fatigue.

COVID Activity Rises in UK, France

In France, the estimated number of people with COVID consulting GPs for acute respiratory infections rose to 13 per 100,000, from nine the previous week, according to The Connexion. This translates to around 8,806 new cases, up from about 6,000.

In England, hospital PCR positivity rose from 5.9% to 7.0% in the week to September 20, while hospital admissions increased from 0.81 to 1.20 per 100,000. Overall activity remained low.

US CDC data from September 29 showed cases rising in some states while falling or remaining stable in others.

Also read: ‘American Covid’ Strain Drives 50% Surge in UK Hospital Admissions: XFG Symptoms to Know

Is India At Risk?

HealthandMe spoke to experts who said the UK-France rise does not necessarily mean India will see a similar increase.

“The rise in COVID-19 cases in the UK and France does not necessarily mean that India is headed towards a similar increase,” said Dr Suranjit Chatterjee, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals, Delhi.

XFG is being monitored because it has become more common in some countries, but available evidence does not indicate that it causes more severe illness than other circulating variants.

“For India, the more relevant question is whether XFG is increasing locally and whether this is translating into a rise in symptoms or hospitalizations,” Dr Suranjit told HealthandMe .

Does XFG Cause More Severe Disease?

Dr Amit Prakash Singh, Consultant - Internal Medicine, CK Birla Hospital, Delhi, said the spread of XFG highlights the need for continued surveillance as SARS-CoV-2 evolves.

“Yet at present there is no evidence to indicate that the XFG variant causes more severe disease than the other Omicron-lineage variants,” he said.

However, the “main concern for India would be a greater rate of transmission, especially among older people, those with comorbidities and the immunocompromised, should the variant become more common in the country”.

What Should India Watch?

Read More: COVID-19 Cases Rise In France, Vaccination Campaign Set To Start Next Week

Dr Amit told HealthandMe India should continue genomic surveillance and monitor hospitalizations and severe disease rather than focusing only on case numbers.

Dr Suranjit said international travel can introduce new variants, but their impact depends on community spread and existing immunity.

“At this stage, there is no reason for people (in India) to be unduly concerned or change their daily routine.”

He added that continued surveillance, timely testing when symptoms occur and sensible precautions during respiratory infections remain appropriate.

Are XFG Vaccines Available?

XFG-specific vaccines have been developed and are either in use or authorized in several countries. The US and UK have opted for XFG-targeted formulations for the 2026–27 season.

In India, an XFG-specific vaccine should be considered available only after regulatory approval and commercial supply.

The WHO continues to stress that vaccination should not be postponed while waiting for an updated formulation.

Canada has determined to restrict medical assistance in dying (MAID) for patients whose sole underlying condition is a mental illness, shelving plans to expand the eligibility in 2027.

Justice Minister Sean Fraser said the government will introduce legislation to maintain the exclusion beyond the current deadline of March 17, 2027.

The decision comes weeks after an Ontario court rejected a woman's request for an exemption that could have allowed her to seek MAID because of severe, longstanding mental illness.

Canada Extends Ban On Medical Assistance In Dying

The government says there is still no sufficient medical consensus on when a mental illness can be considered irremediable, a key requirement under Canada's MAID policy.

Fraser said, “When I hear that there is a lack of consensus within the medical community about the irremediable nature of certain mental illnesses, that gives me real cause for concern.” He also pointed out that access to mental health care in the country is uneven.

He acknowledged that the issue does not have unanimous agreement but defended the government's decision. “While there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time,” Fraser said.

Canada had originally kept the exception as temporary. When MAID eligibility was expanded in 2021 to people whose natural death was not reasonably foreseeable, mental illness as the sole underlying condition that was deemed ineligible.

The exclusion was subsequently delayed several times, with March 2027 becoming the latest planned date for possible expansion.

Also read: Canadian Parliamentary Panel Urges Indefinite Ban on Assisted Dying for Mental Illness Alone

Ontario Court Rejected A Woman’s MAID Request

The announcement comes just after a controversial case involving Claire Elyse Brosseau, a 49-year-old Toronto woman who sought a constitutional exemption from the existing MAID exclusion.

Brosseau said she has lived with severe mental-health problems for decades and had undergone multiple forms of treatment. In May, she asked the Ontario Superior Court for emergency relief that would allow her to apply for MAID.

On September 3, Justice Carissima Mathen rejected that request. She also ordered the federal government to respond to Brosseau's constitutional challenge to the exclusion.

Mathen described Brosseau's evidence of suffering as credible and compelling, but said the case also involved Parliament's role in making decisions on “sensitive social issues” and interpreting the Charter rights involved.

Brosseau, meanwhile, said the decision was nothing but another barrier for people with mental illness. “It is yet another example of governmental systems telling people with mental illnesses that we do not have the same rights nor the same autonomy as others,” she said.

Also read: Impact Of Canada’s Delay In Approving MAID For Mental Illness: Patients Say They Feel Abandoned & Hopeless

Parliament Had Already Recommended An Indefinite Exclusion

The government's decision also follows a recommendation that was passed in June from a joint parliamentary committee, which called to exclude people from MAID eligibility whose only underlying condition is mental illness.

The committee's review highlighted disagreements among experts over whether clinicians can reliably determine that certain mental illnesses are permanently irremediable.

It was based on a report that noted a "divergence of perspectives" on the issue and highlighted concerns raised during testimony about the "pressing need for increased and more equitable access to adequate mental health services".

However, the recommendation was not unanimous. Four senators issued a dismissed the report, questioning the committee's process, arguing that the government should consider seeking guidance from the Supreme Court of Canada.

Also read: New York Assisted Suicide Law: Nearly 20 People Reportedly Died Since August

The government's proposed legislation is expected to circle back to advance requests, which is another another debatable aspect of MAID.

Under the proposed changes, people diagnosed with serious illnesses who may eventually lose the ability to consent could be able to make an advance request for MAID.

According to the latest available figures from 2024, MAID accounts for around 5 per cent of all deaths in Canada. About 96 per cent of MAID cases involved people whose deaths were reasonably foreseeable, most of them terminal cancer patients.

The remaining 4 per cent involved patients whose deaths were not imminent but who had a "grievous and irremediable medical condition".

The Supreme Court, on Thursday, asked the Centre to form a panel to form statutory regulations against unethical practices by pharmaceutical companies. This includes gift giving, hospitality, and other incentives offered to doctors.

A bench of Justices Vikram Nath and Sandeep Mehta issued the direction while hearing a petition seeking stronger regulation of pharmaceutical marketing practices.

The court wants the committee to recommend whether, and how, the unethical interactions between pharmaceutical companies and doctors should be brought under a legally enforceable framework.

The matter will resume in court on January 29, 2027, when the Centre is expected to show compliance with the directions.

What Did The Supreme Court Say?

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The court's order follows earlier concerns about whether the existing system is equipped to prevent unethical pharmaceutical marketing.

Justice Sandeep Mehta, reading out the order, said, “We have directed the Union of India to constitute the committee and give its recommendations in terms of our previous directives and observations.”

The committee will examine the representations received and make recommendations to the Union government on the need for statutory regulation.

The Court had reserved order after Solicitor General Tushar Mehta informed the Court that the Union government is to form a three-member committee to assess whether a statutory framework is needed to regulate unethical practices by pharmaceutical companies.

The case was filed by the Federation of Medical and Sales Representatives' Associations of India (FMRAI), which has sought accountability for alleged practices such as expensive gifts, foreign trips, hospitality and other benefits used to promote medicines to doctors.

It said, “This has led to over-prescription of drugs resulting in a serious infringement of the right to life and the right to health of the citizens.”

What Are Pharma Freebies To Doctors?

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Pharmaceutical companies use various marketing strategies to promote their products to healthcare professionals. These can include gifts, hospitality, sponsored travel, benefits related to conference and other promotional incentives.

The concern before the Supreme Court is not just an ordinary interaction between drug companies and doctors, but whether financial or material incentives can unethically influence drug-prescribing decisions.

India already has the Uniform Code for Pharmaceutical Marketing Practices (UCPMP), 2024, which lays down rules concerning gifts, physician samples, brand reminders, continuing medical education and other promotional activities. However, questions remain over whether the framework has adequate statutory regulation.

The Centre has previously said the UCPMP is functioning, but agreed that the question of giving pharmaceutical marketing regulation statutory backing should be examined separately.

The Centre, in its response, said, “The Department of Pharmaceuticals has issued the Uniform Code for Pharmaceutical Marketing Practices (UCPMP), which is applicable to Pharmaceutical Companies, medical representatives and agents.” The code clearly prohibits pharmaceutical companies from offering gifts, travel facilities, hospitality, cash or monetary grants to physicians or their family members, it added.

Unethical Pharma Marketing Could Affect Patients

The biggest concern is that a prescribing decision could become influenced by factors other than clinical need, evidence, safety, and cost. If incentives influence prescribing, patients could potentially face:

• Unnecessary medicines when they are not clinically needed
• More expensive branded drugs when alternatives exist
• Higher doses or longer treatment than necessary
• Polypharmacy, or the use of multiple medicines when fewer may be appropriate
• Higher out-of-pocket healthcare expenses

These concerns have previously been raised before the Supreme Court in relation to alleged pharmaceutical marketing practices. The issue, therefore, goes beyond ethics for patients. The doctor-pharma relationship can directly affect what medicine a patient receives, how long they take it, and how much they pay.