Friday, March 26, 2010

ISG Advocacy Committee

Dear Colleagues,
In the last Governing Council Meeting held in Kolkata, several memebrs felt the need for enlarging the scope of our society from its present role of promoting good gastroenterology practice, need based research and awareness about digestive disorders, to advocate and implement policies that promote Digestive Health (DH) .The glaring example is our country’s paradoxical position of having 4 of the 10 richest men in the world, and yet not being among the 150 odd countries that provide Hepatitis B vaccination to all infants. While we may point fingers at the government, have we, as a united body, done enough to advocate or lobby for such causes that concern us?
The Advocacy Committee, as I understand it, is a move in this direction.
How do we go about it?
I suggest that we seek as many suggestions as possible from al, the members, generate discussions and debate on any or all issues and try develop a consensus building approach to go forward. This blog is therefore a brainstorming and consensus-forming platform; it in no way seeks to reduce the sanctity of the ISG website. A blog may provide an opportunity to discuss issues on an ongoing basis, and may help us formulate and consolidate our thoughts and plans that we may place before the Governing and General Bodies of the ISG when those meetings occur.
To initiate discussion, I am putting down some of my ideas as a template for you to respond.

Aims and Objectives

1.      To identify issues pertaining to digestive health that need change  in the community
2.      Generate consensus among members regarding the type of change required.
3.       Identify agencies through which the change can be brought about (such as local or central government, world organizations, NGOs etc)
4.      Undertake research and planning to estimate the magnitude of the problem, strategies for change and the quantum of resource needed for effecting the change.
5.      Advocate the issues with the concerned agencies
6.      Monitor progress of the group as well as hurdles encountered.
This is aimed as an activity for social change; hence I feel all of us (along with our sister societies INASL and SGEI) could work together. In the end, it would be worthwhile for all of us to be part of a movement that brings positive change to society, rather than splitting ourselves to claim credit for it.
A.   Issues that need advocacy
This list could be long and needs your inputs, but may be broadly divided into the following sections and subsections.
1.       Health Care Delivery
a.       Hepatitis B related (example)
                                                                 i.      Vaccination programmes and implementation at different levels
                                                                ii.      HbsAg screeing /testing at antenatal check-ups
                                                              iii.      Ensuring HBsAg testing, vaccination and protection of all health care workers


                                                               iv.      Formulating regulations for health care providers who are HBV infected
b.      Endoscopy : availability, standardization and reporting of services
c.       Water and Civic Services for prevention of water borne infections
d.      Prevention and diagnostic strategies for common GI and Liver cancers, developing screening or surveillance programmes for high risk groups
e.      Act as facilitator for providing information on free/low cost special services for rare diseases like Gaucher’s Disease ( Dr Aabha is quite active in this area) or Wilson’s Disease etc
f.        Others
2.       Teaching and Training:
a.       Gastroenterology education
                                                                 i.      Creation of Gastroenterology departments in medical colleges (how many in the sate, where, justification, requirements of facilities and staff, scope of the department, common curriculum etc)
                                                                ii.      Ensuring adequate representation of Gastroenterology education (topics, contents) in
1.       Postgraduate (MD, DNB) training
2.       Undergraduate (MBBS) training.
                                                              iii.      Others
3.        Research:
a.       Identifying  thrust areas for research in India
b.      Advocate with research agencies for designing and funding of research on these topics.
                                                                 i.      Multi-centric
                                                                ii.      Single centre / Single PI based, on relevant topics
c.       Ongoing field / data based research by a team of “Research Core Group” to identify unmet needs and plan startegies.
4.        Policies
a.       Identify policies that need change/ thrust
b.      Advocacy with the concerned agencies
5.       Budget
a.       Adequate budgetary allocation may be attempted by the advocacy group at different levels
                                                                 i.      Central and state government, for Digestive Health (DH) related issues
                                                                ii.      Internationa agencies, for issues related to DH in India or region (south Asia)
B.  B.    Whom to Advocate with
a.       Government
                                                               i.      Central
                                                             ii.      State level
                                                            iii.      District or local level
b.      International Bodies such as WHO, UNICEF, WGO etc
c.       Industry
d.      NGO’s
e.      Public / media / support groups
C.  Approach
I suggest a consensus building inclusive approach. ISG members may express their views by e-mail or post them on the blog, thus generating discussion and debate. We could use the same approach for nominating people to diferent subcommittees of the Advocay Group.
D.  Structure of the ISG Advocacy Group
I suggest we have the following subcommittees to tackle specific tasks:
a.       Negotiators or Lobbyists: this group ( please suggest a better name) should comprise senior members with standing, who have reach and can advocate on behalf of ISG with the government or agencies, listed in “B”. Nominations are welcome. Some senior members can be invited to join this subcommittee.
b.      Research Wing: should comprise members who are good at gathering data, evaluating scientific reasons and evidence, and preparing presentations for supporting the senior lobbyists.
c.       Core subcommittee: to coordinate and keep all members of the Advocacy Group comnnected and monitor progress. This role could be performed by the president and Hon Secretary, along with 1or 2 others ( might be important to maintain continuity of the program as the President’s term will be short and the change too frequent.
E. Examples of the Advocay role played by other societies
         I understand that the pediatric society has played an important role in recommending or rejecting                the role of Pneumococcal vaccines being promoted in India, arguing that the strains in the vaccines do not match the ones that occur in India. I am sure there will be many examples. Please share your observations that we may emulate, on the blog.

F.        The functioning of the committe will have to be monitored, time lines will have to be followed and impact evluation done from tome to time. I propose that the progress be placed before the Governing Council of ISG 2 times a year by the Core Sub-committee, for the purpose.

This is a concept paper. I request all of you to provide your suggestions, comments and ideas, preferrably on the blog, so that we may have a truely open discussion forum and evolve a consensus building approach. I will upadet the blog fortnightly till we resolve the plan of action and decide our course. Seeking your active participation.






7 comments:

  1. Dear GC,

    Congratulations and Thanks for the wonderful succinct "concept paper" put up by you. It must have required quite an effort. I endorse your views and would suggest that we pick up one or two major issuers at a time rather than dabble with too many.

    The most important issue to me is the issue of Hepatitis B Vaccination. I must confess that as a community we have shamefully abdicated our responsibilities in this context. We should concentrate all our efforts in this field first before embarking on any other issue and try to achieve our goal as fast as possible.

    In this area, I would propose to involve Prof Rakesh Aggarwal & Prof Subrat Acharya to team up for Advocacy Planning along with you. Of course I am game if you want me to join this effort.

    Best Wishes,

    S.P. Singh.
    G.C. Member, ISG,
    &
    Hony Secretary,
    INASL.

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  2. Its interesting and worth noting that although 3 days have gone by, no one has yet responded to this blogspot/advocacy issue. Time and again, it has been raised by some members that we should have e-elections and "other 'e-things'. I feel that on the whole the ISG Community is not very e-savvy, and traditional communication pathways [postal letters/sms/telephone] are the predominant mode of preferred communication by the majority of ISG Members. We haven't yet 'come of age'. I would love to be proved wrong !

    S.P. Singh
    Cuttack.

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  3. Dear Dr Singh, I am highly appreciative of your enthusiasm and response. In fact I was, and still am, waiting for other senior members to post their responses and comments, so that we can move collectively. As regards the response and updating, I thought about once every week or 10 days should suffice. As regards including Profs Subrat Acharya and Rakesh Aggarwal, they would be pivotal in this venture. I am waiting for their comments and responses. Regards, GC

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  4. Dear Dr GC sir,
    This is a wonderful and worthy initiative for inititiating advocacy for GI issues. I congratulate you for this. This is a great plateform. My thoughts.
    1a. Organise liver camps for promotion of Hepatitis B detection, vaccination and dissemination of information. Let's choose a day - say world hepatitis day and every ISG memeber can hold a camp in his area of influence. (i hold once -a-year) where a lecture , HBsAG detedction and Hep B vaccination can be done.
    2. Help / mentoring in initiating DNB (gastro)programmes in one's institute will be helpful and welcome. please let us know the path.
    3. lobbyists can be protrayed as Think tanks or visionaries. We can establish a indian Hepatitis B foundation for the purpose
    4. Research in Hepatitis B should not be exslusive to govt colleges and tertiary institiutions. rather all isg members can contribute to a central hepatitis B registry. That will improve the nos. and help every member to contribute to reseaarch and avancement of science.
    Dr Kunal Das

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  5. Dear Sir
    I congratulate you for giving a serious thought to this advocacy committee. I haqve gone through the proposed adovocacy committee recommendations. You have incorporated almost all the important points .If I have any further points I would mail you.
    Thanking you once again.
    Yours sincerely

    V.k.Dixit

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  6. This is indeed a visionary document and I congratulate you on putting the concept on paper very vividly . The concept write up has crystallized all the major points for the initial framework . It is quite comprehensive and has not missed out any major issues . I believe the key issue now is going to be the URGENCY with which we transform these very wise perceptions into actualities. So maybe a meeting of the group and identifying the broader issues to be tackled foremost and a stringent time line to adhere to.
    Carpe diem ( 'Seize the day')

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  7. Dear Sir,

    Late, but have something to say (most of which already put by you.
    India is moving, let us also move (may be a bit more faster).


    1.Standardization of DNB / DM training Curriculum: ISG should raise itself to become Guardian of training in Gastroenterology
    a.Preparation of a document for basic standard course for DM/DNB training
    b.Submit to MCI / NBE/ Universities
    c.Pattern of examination
    d.Credentialing/ evaluation
    e.Log book
    How to do it:
    a.Pre-requisite: Should be done in time honored manner
    b.Who to do: A committee of 7 Senior Profs
    c.Duration: 1 year
    d.How to do: Deliberations through Emails, use opportunities to meet at various meetings

    2.Societal responsibility
    Enough evidence for utility of HBV: Lobbying for vaccination (In my opinion, this is PRIORITY 1).
    a.Preparation of a document
    b.Meeting with Secretary ICMR, Health Sec, HM,
    Lobby to put up in both Houses, Health activists, (Convince PM)
    c.Media (Print and visual): National and State level

    3.Draft of Priorities areas in research to be submitted to Funding agencies: ICMR / DBT / DST

    4. More collaborative study
    5. Change of mind set from individualistic approach to collabotrative work
    6. There generally is no South and North difference as far as diseases are concerned. We have always (mostly) proved wrong. Let us not waste on our time in proving and disproving such hypothesis. (It takes tons of years).

    Cheers

    Govind Makharia

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