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.

More than a quarter of Americans (28%) misrepresented symptoms to obtain antibiotics for themselves, while 27% did so to get antibiotics for a child in their care, according to an alarming survey.

The nationwide survey of nearly 1,000 people, published in JAMA Network Open, found that common reasons included feeling very sick, believing antibiotics were the only effective treatment and needing to recover quickly to return to work or school.

The findings highlight the need for better communication between doctors and patients so that concerns are heard and symptoms are appropriately treated, whether or not antibiotics are needed.

“Now that we have a clearer picture of how common these behaviors are and the reasons behind them, the next step is to look at strategies that help patients express their preferences and communicate what they’re feeling to their provider, and for their provider to hear them, understand their concerns, and reassure them,” said Alistair Thorpe, research assistant professor of population health sciences at the University of Utah Health and one of the study's first authors.

What Did The Survey Reveal?

Among respondents, 28% said they had deliberately exaggerated or fabricated symptoms to obtain antibiotics for themselves, while 27% had done so for a child in their care.

The most common reason was feeling that they or their child were very sick and believing antibiotics were the only treatment that could help.

“It is a tough situation,” Thorpe said. “People are experiencing unpleasant symptoms, and they can have this strong feeling that antibiotics are the only thing that can help them feel better. Being told to just rest and wait is a hard thing to do, and if you think there’s something that could make you feel better, it’s a very hard impulse to override.”

Other reasons included needing to recover quickly to return to work or school and wanting greater control over treatment decisions.

Why Is Taking Unnecessary Antibiotics Dangerous?

Antibiotics treat bacterial infections but do not work against viral infections, which commonly cause cold- and flu-like symptoms. They can also cause side effects.

“These medications are not totally benign for the patient,” explained Andrea Levy, Professor of social sciences at Connecticut State Community College Middlesex and one of the study's first authors. “And antibiotic use contributes to increasing antimicrobial resistance, which is a broader public health concern.”

Unnecessary antibiotic use contributes to antimicrobial resistance (AMR), making bacterial infections harder to treat.

Accurate symptom reporting is therefore important. Doctors need a clear picture of a patient's symptoms to determine whether antibiotics are necessary and avoid prescribing them when they are unlikely to help.

Why Are Children At High Risk With Antibiotic Misuse?

Children commonly receive antibiotics for infections such as ear infections and respiratory illnesses. However, many childhood infections are caused by viruses, against which antibiotics are ineffective.

Unnecessary antibiotic exposure can cause side effects, including diarrhoea, nausea and allergic reactions. It can also contribute to antimicrobial resistance, making future bacterial infections harder to treat.

Repeated antibiotic use may also disrupt the developing gut microbiome, which plays a role in digestion and immune function.

Why Do Patients Misrepresent Symptoms And How Can It Be Prevented?

The researchers emphasise that the findings are not intended to blame patients or caregivers.

“There are very understandable reasons that we can sympathize with about why patients might feel the need to misrepresent symptoms, or why caregivers might do so on behalf of their children,” Levy said. “We’re simply saying: perhaps there’s a better way.”

Past experiences with healthcare providers may influence these decisions. People were more likely to exaggerate symptoms if a doctor had previously dismissed or downplayed their concerns.

Another factor is the mistaken belief that antibiotics helped someone recover from an earlier viral infection. Since viral infections usually resolve on their own, patients may incorrectly attribute their recovery to antibiotics rather than the body's natural healing process, Thorpe explained.

The findings highlight the need for better communication between doctors and patients.

Healthcare providers need to reassure patients that their symptoms are being heard and taken seriously, even when antibiotics are not appropriate.

The Union Ministry of Health and Family Welfare has proposed three separate amendments to the Drugs Rules, 1945, to strengthen pharmaceutical quality control, manufacturing accountability and patient safety.

The proposals include immediate suspension of manufacturing licences for drugs failing specified critical quality tests, stricter microbial monitoring in sterile manufacturing areas, and mandatory authorisation of qualified personnel for batch release.

The announcements aim to strengthen India's drug regulatory framework and align manufacturing standards with international guidelines.

Immediate Suspension Of Licences For Drugs Failing Critical Quality Tests

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In a significant move to enable faster action against substandard medicines, the Ministry has proposed immediate suspension of manufacturing licences for drugs declared Not of Standard Quality (NSQ) on specified critical parameters.

Under the existing provisions, suspension or cancellation of a manufacturing licence involves a prescribed regulatory process, including the issuance of a show-cause notice. This can create a time gap between the identification of a quality failure and regulatory action, during which the drug may remain in circulation.

To address this, the proposed amendment would allow the Central Licensing Approving Authority or the State Licensing Authority, as applicable, to immediately suspend the manufacturing licence upon receiving a Government Analyst's report declaring a drug NSQ on any of the following parameters:

• Assay
• Dissolution
• Related substances
• Impurities
• Sterility

These parameters are critical to determining the quality and safety of medicines. The proposed provision seeks to enable prompt intervention and minimise potential risks to patients.

Stricter Microbial Monitoring In Sterile Drug Manufacturing

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The Ministry has proposed amendments to Schedule M of the Drugs Rules, 1945, to revise microbial contamination limits in Grade A clean areas in line with the World Health Organization's (WHO) Good Manufacturing Practices (GMP) guidelines for sterile pharmaceutical products.

Grade A areas are critical zones in sterile pharmaceutical manufacturing, where exposed products, containers and sterilised components are handled. Maintaining strict microbial controls in these areas is essential to preventing contamination and ensuring product safety.

The proposed revision addresses differences between the existing Schedule M requirements and WHO guidelines. It also provides for any microbial growth detected in Grade A areas to trigger an investigation, in accordance with WHO guidance.

The amendment aims to strengthen contamination monitoring and bring India's sterile manufacturing standards in line with internationally recognised benchmarks.

The development comes in the backdrop of an episode involving India’s biggest drug maker Sun Pharma, which was recently ordered to halt production at its manufacturing plant in Assam after reports of contamination in some of the eye drops made there.

Mandatory Authorization For Drug Batch Release

In another proposal, the Ministry has sought to make it mandatory for drug manufacturers to formally designate a suitably qualified and experienced person responsible for batch release.

Although manufacturers are currently required to provide details of competent technical staff responsible for manufacturing and testing while applying for licences, the rules do not specifically require them to identify the person authorised to release drug batches.

Under the proposed framework, manufacturers applying for licences under the relevant provisions of the Drugs Rules, 1945, would have to:

• Designate a qualified and experienced person responsible for batch release.
• Maintain prescribed records for every batch manufactured.
• Follow a prescribed format for the Batch Release Certificate.

Batch release is a critical stage in pharmaceutical manufacturing. It involves reviewing quality parameters and relevant documentation before a batch is cleared for distribution.

The proposed requirements seek to establish clear accountability for batch-release decisions, improve traceability and strengthen quality assurance.

The World Health Organization (WHO) has reported significant global progress against neglected tropical diseases (NTDs), with fewer people requiring treatment. However, the rising burden of dengue remains a major concern.

The Global Report on Neglected Tropical Diseases 2026 found that 63 countries had eliminated at least one NTD by June 2026, up from 42 at the end of 2020.

“Elimination of neglected tropical diseases is one of the standout success stories of global health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

However, he warned that these gains could be lost without increased domestic financing, sustained external support and the integration of NTD services into primary healthcare.

Global Progress Against NTDs

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The number of people requiring interventions for NTDs fell to 1.41 billion in 2024, a 36% decline since 2010 and a 19% decline since 2020.

Cases of sleeping sickness have dropped by 98% since 1999, while Guinea worm disease recorded just 10 human cases in 2025, its lowest number yet.

Between 2021 and 2025, 31 countries eliminated at least one NTD. Of these, 16 received WHO recognition for the first time. Between January and June 2026, five more countries received recognition: Algeria, Australia, Libya and Tunisia for trachoma, and Chile for leprosy.

By June 2026, 42 countries had eliminated one disease each, 16 had eliminated two, four had eliminated three and one country, Togo, had eliminated four.

India has eliminated three NTDs: Guinea worm disease in 2000, yaws in 2016 and trachoma in 2024.

Why Dengue Remains A Concern

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Despite progress against several NTDs, the report highlights uneven progress, with these diseases continuing to disproportionately affect the world's poorest and most vulnerable communities.

Dengue remains a major concern. Cases of the mosquito-borne disease reached a record 15.1 million in 2024, up from 2.74 million in 2020.

Locally acquired cases were reported across all six WHO regions. The organisation also classified dengue as a Grade 3 emergency, its highest emergency level, in 2024.

The Region of the Americas accounted for most reported cases, with Brazil contributing the largest share of the regional burden.

WHO said climate and environmental change, rapid and often unplanned urbanisation, population movement and the geographical expansion of Aedes mosquitoes are contributing to the spread of dengue.

WHO also warned that the geographical expansion of dengue into previously unaffected populations increases the risk of severe disease from secondary infections, making health system preparedness and the management of severe cases increasingly important.

In 2024, 12,554 deaths were reported across dengue, visceral leishmaniasis and chikungunya, against the 2030 target of 1,291 or fewer annual deaths.

Dengue accounted for 11,827 of these deaths, followed by visceral leishmaniasis (482) and chikungunya (245). Compared with the 2016 baseline of 5,163 deaths, reported deaths from these three diseases increased by 143.2%.

Other NTD Targets Remain Off Track

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The report also identified several challenges to achieving the 2030 targets. Deaths from vector-borne NTDs have increased, while progress towards yaws eradication remains off track. Only three disease-specific indicators achieved their 2025 milestones.

The WHO's 2021–2030 road map aims to:

• Reduce by 90% the number of people requiring NTD interventions

• Reduce NTD-related disability and premature deaths by 75%.

• Enable 100 countries to eliminate at least one NTD

• Eradicate Guinea worm disease and yaws

With five years remaining to meet these targets, WHO called for accelerated action, increased domestic financing and the integration of NTD interventions into universal health coverage to protect progress and address persistent gaps.