PARALYMPIC legend David Roberts has set his eyes on breaking Baroness Tanni-Grey Thompson’s record next year at London 2012.
The Pontypridd swimmer and Cardiff wheelchair athlete stand level on 11 gold Paralympic medals and Roberts has the chance to break the record next year.
“I have one more Games and I will make sure I am prepared to get that one gold I need and then we can all relax,” said Roberts.
“The record is important but it is not the driving force.
“I love swimming and it is all I can imagine doing.
“Inevitably when you equal someone like Tanni questions will be asked and it is a home Games so people will be more interested in it.
“If I am injury free and fit I can do it.
“There will be nothing better to finish your career becoming the most successful Paralympian ever.”
Roberts admits the home Games factor is a driving force behind him competing at one more Olympics.
“London was a massive driving force in me carrying on,” added Roberts.
“I always said I wanted to equal Tanni’s record because I wanted to be known as someone who is good at what they do.
“I managed to do that in Beijing and I got a bit of recognition and it felt like it was everything I ever dreamt of and I could finish happy.
“But it was not just the fact of beating Tanni.
“It was more the chance to walk out in front of a home crowd.
“If you think of all the great Olympians who have not had the chance to compete in a home Games, you realise the importance.
“I could not walk away from that because it was too good an opportunity to miss.”
But the 31-year-old has experienced a difficult couple of years in the build-up to London.
Roberts fractured his elbow in October 2009 after he was dragged into a tree while taking his beloved lurcher-collie for a walk.
The following March he spent a week in hospital having his kidney stones removed.
Roberts was then forced to pull out of the European Championships in April this year after breaking his elbow again in a freak accident at his training pool in Caerphilly. Going into a routine turn he collided with a fellow swimmer and instantly heard a crack in his elbow.
“It has been the toughest year of my career,” admitted Roberts, who hails from Llantwit Fadre.
“I was out of the water for eight months.
“It was such an innocuous injury as I collided arms with another swimmer.
“I just knew instantly it was bad because I heard a crack.
“I did not realise the full extent of the damage until I saw a surgeon who explained to me he had only seen this type of injury twice before and that is with the weightlifters.
“I had to have the surgery and I feel refreshed.
“A lot of the baggage has gone because not everyone is expecting a huge amount from me because I have been injured.
“It has also given me a lifeline and a chance to sneak in the back door which is how I like it. I have the time. I need to train smart and hard at my age and every session needs to count. I am training through Christmas and New Year before going away to South Africa in early January.
“The trials are in March and once you have qualified and get the letter then you can focus your mind and you will have five months to prepare.”
Roberts, who has cerebral palsy and competes in the S7 category swimmer, has seen his achievements recognised within and outside sporting circles.
Roberts addressed the Human Rights Council earlier this year to promote Britain’s proud tradition of supporting its Paralympian’s. And the swimmer was recognised by sporting legends at an awards ceremony in London when he was handed the esteemed Jaguar Academy of Sport Patrons Award for Sporting Legacy at the Savoy.
“It was very humbling and totally unexpected,” added Roberts.
“To be recognised by your peers is an amazing thing. The award was won by Dame Kelly Holmes last year so it is amazing.
“There were so many sporting stars and heroes of mine there and you don’t expect to see that many in one room.
“It was great to see people like Kriss Akabusi, Sir Ian Botham, Gareth Edwards, Dai Greene and Jamie Baulch.”
2011年12月21日星期三
2011年12月11日星期日
Tablets and powder no substitute for food
They are the lifeblood of elite athletes and body builders looking to push their bodies to extremes – but experts warn those looking for a shortcut to fitness with food supplements had better do their homework first.
Loading up on protein can put high stress on important organs, while supplements with caffeine or appetite suppressants can provoke other health issues, they warn.
Selasi Berdie, a human performance specialist at Body Science, said people should reduce the intake of dietary supplements if they're training only once or twice a week.
He said the body had to work harder to expel unnecessary supplements, and an overdose of protein, with unmatched training, would put high stress on the liver and urinary system.
“Supplements that contain really high levels of caffeine or even appetiser suppressant pills are a lot more dangerous than nutritional overdose. But worst case scenario, an overdose of protein can cause kidney stones.”
However if you're doing intense exercise, four-to-five times a week, such as, cycling, running and heavy weight lifting, then the body will most likely demand more protein, enzymes and minerals than a healthy diet can easily supply, said Rachel Horscroft, exercise physiologist and nutritionist.
Horscroft said too much fresh protein in the form of meat, chicken and fish, could cause your body to become extremely acidic, leading to body fatigue, depressive tendencies and a drastic decline in your wellbeing.
“The tablets and powders are there for repair, as they come to use only once you've exercised. Don't load up, especially when you're sedentary or only slightly active,” she said.
And it's not just a protein-overdose that causes the imbalance; even excessive exercise can hike the acid levels, hindering the body from getting optimum results.
To compensate, Horscroft recommended a shot of wheatgrass on an empty stomach to rebalance the pH level of the body and make it more alkaline, and improve performance, vitality and energy levels.
“The body treats wheatgrass like real food – since it's cultivated in its most nutritious stage – and unlike taking synthetic vitamins, wheatgrass absorbs naturally and easily,” she said.
Another supplement suitable for every lifestyle, blood type, fitness levels and diet, is a good quality Omega-3, said Dr Angus Pyke, spokesperson for Chiropractors' Association of Australia.
“When the ratio between Omega-6 and Omega-3 fats gets out of balance, the end result is an inflamed body. We are already consuming a lot of the former fat,” said Pyke.
Supplementing with Vitamin-D is also deemed to be a life changing choice, said Pyke because despite the abundance of sunshine in this country, research showed that the Vitamin D levels in Australian men were significantly low.
Loading up on protein can put high stress on important organs, while supplements with caffeine or appetite suppressants can provoke other health issues, they warn.
Selasi Berdie, a human performance specialist at Body Science, said people should reduce the intake of dietary supplements if they're training only once or twice a week.
He said the body had to work harder to expel unnecessary supplements, and an overdose of protein, with unmatched training, would put high stress on the liver and urinary system.
“Supplements that contain really high levels of caffeine or even appetiser suppressant pills are a lot more dangerous than nutritional overdose. But worst case scenario, an overdose of protein can cause kidney stones.”
However if you're doing intense exercise, four-to-five times a week, such as, cycling, running and heavy weight lifting, then the body will most likely demand more protein, enzymes and minerals than a healthy diet can easily supply, said Rachel Horscroft, exercise physiologist and nutritionist.
Horscroft said too much fresh protein in the form of meat, chicken and fish, could cause your body to become extremely acidic, leading to body fatigue, depressive tendencies and a drastic decline in your wellbeing.
“The tablets and powders are there for repair, as they come to use only once you've exercised. Don't load up, especially when you're sedentary or only slightly active,” she said.
And it's not just a protein-overdose that causes the imbalance; even excessive exercise can hike the acid levels, hindering the body from getting optimum results.
To compensate, Horscroft recommended a shot of wheatgrass on an empty stomach to rebalance the pH level of the body and make it more alkaline, and improve performance, vitality and energy levels.
“The body treats wheatgrass like real food – since it's cultivated in its most nutritious stage – and unlike taking synthetic vitamins, wheatgrass absorbs naturally and easily,” she said.
Another supplement suitable for every lifestyle, blood type, fitness levels and diet, is a good quality Omega-3, said Dr Angus Pyke, spokesperson for Chiropractors' Association of Australia.
“When the ratio between Omega-6 and Omega-3 fats gets out of balance, the end result is an inflamed body. We are already consuming a lot of the former fat,” said Pyke.
Supplementing with Vitamin-D is also deemed to be a life changing choice, said Pyke because despite the abundance of sunshine in this country, research showed that the Vitamin D levels in Australian men were significantly low.
2011年11月30日星期三
Human organs can now be grown, one cell at a time
Luke Masella was born with spina bifida, and after 10 years it was getting the best of him.
The congenital disorder affects the development of the nerves and vertebrae along the spinal cord, and can result in paralysis, neurological complications and organ damage.
In Masella's case, his bladder was failing and he spent much of his early childhood in the hospital. He was plagued by aches and pains, and often was too tired and lethargic to get out of bed. Because his bladder didn't work properly, his kidneys were shutting down.
"I remember being really scared," said Masella, a native of Madison, Conn. "I thought I was going to die."
Masella was gravely ill and needed a new bladder. This was 2001, and conventional treatment would have been to use a portion of Masella's intestine to make a new bladder.
But because the intestine is designed to absorb nutrients and a bladder is designed to excrete, it's a risky procedure, especially with young patients who often develop kidney stones and cancer.
So Masella was referred to Dr. Anthony Atala, then at Children's Hospital Boston. Atala is a pioneer in regenerative medicine, a cutting-edge field of study in which a patient's own cells are used to grow healthy tissue and organs. He has been director of the Wake Forest Institute for Regenerative Medicine in North Carolina since 2004.
To engineer a new bladder for Masella, Atala took samples of muscle cells from his bladder and grew them in a Petri dish. Once he had grown enough, he attached the cells to a bladder-shaped framework or scaffolding he created using collagen, the primary biological material found in skin and connective tissue.
The biological structure was placed inside an incubator, where it continued to grow for two months.
"It's like cooking a layered cake," Atala said.
Finally, the engineered bladder was sutured to Masella's original bladder. The biodegradable scaffolding dissolved, and as the new bladder integrated with the body, it grew its own blood supply and nerves.
Masella soon made a full recovery and went on to captain his high school wrestling team. He's now a healthy 21-year-old junior at the University of Connecticut.
Masella was one of the country's first patients to receive a regenerated organ grown from his own cells. Atala has since performed similar procedures many times, growing and implanting everything from urethras and skin to cartilage.
Atala and his team at Wake Forest are now working on more than 30 replacement tissues and organs for future trials, including the kidney, liver and even the heart.
Part of this groundbreaking research includes a technique called "bioprinting." While it may sound like science fiction, Atala said that in the last decade great strides have been made with this technology, in which modified inkjet printers are used to create biological molds of organs.
Rather than ink, the jury-rigged printers spray cells and heat-sensitive gel that fuse together to form tissue and organs.
Atala said he's made a number of organs and tissue prototypes using this technique, but none that is suitable to be placed inside a human.
Nonetheless, as the technology continues to advance, it stands to revolutionize how science treats diseased and injured tissues and organs.
One potential application is bioprinting skin for soldiers with life-threatening burns. Using this still-developing technology, skin cells could one day be printed directly on the soldier's wound.
And because regenerative medicine uses a patient's own cells to create organs and tissue, it eliminates much of the risk that the patient's body will reject a donor organ.
The congenital disorder affects the development of the nerves and vertebrae along the spinal cord, and can result in paralysis, neurological complications and organ damage.
In Masella's case, his bladder was failing and he spent much of his early childhood in the hospital. He was plagued by aches and pains, and often was too tired and lethargic to get out of bed. Because his bladder didn't work properly, his kidneys were shutting down.
"I remember being really scared," said Masella, a native of Madison, Conn. "I thought I was going to die."
Masella was gravely ill and needed a new bladder. This was 2001, and conventional treatment would have been to use a portion of Masella's intestine to make a new bladder.
But because the intestine is designed to absorb nutrients and a bladder is designed to excrete, it's a risky procedure, especially with young patients who often develop kidney stones and cancer.
So Masella was referred to Dr. Anthony Atala, then at Children's Hospital Boston. Atala is a pioneer in regenerative medicine, a cutting-edge field of study in which a patient's own cells are used to grow healthy tissue and organs. He has been director of the Wake Forest Institute for Regenerative Medicine in North Carolina since 2004.
To engineer a new bladder for Masella, Atala took samples of muscle cells from his bladder and grew them in a Petri dish. Once he had grown enough, he attached the cells to a bladder-shaped framework or scaffolding he created using collagen, the primary biological material found in skin and connective tissue.
The biological structure was placed inside an incubator, where it continued to grow for two months.
"It's like cooking a layered cake," Atala said.
Finally, the engineered bladder was sutured to Masella's original bladder. The biodegradable scaffolding dissolved, and as the new bladder integrated with the body, it grew its own blood supply and nerves.
Masella soon made a full recovery and went on to captain his high school wrestling team. He's now a healthy 21-year-old junior at the University of Connecticut.
Masella was one of the country's first patients to receive a regenerated organ grown from his own cells. Atala has since performed similar procedures many times, growing and implanting everything from urethras and skin to cartilage.
Atala and his team at Wake Forest are now working on more than 30 replacement tissues and organs for future trials, including the kidney, liver and even the heart.
Part of this groundbreaking research includes a technique called "bioprinting." While it may sound like science fiction, Atala said that in the last decade great strides have been made with this technology, in which modified inkjet printers are used to create biological molds of organs.
Rather than ink, the jury-rigged printers spray cells and heat-sensitive gel that fuse together to form tissue and organs.
Atala said he's made a number of organs and tissue prototypes using this technique, but none that is suitable to be placed inside a human.
Nonetheless, as the technology continues to advance, it stands to revolutionize how science treats diseased and injured tissues and organs.
One potential application is bioprinting skin for soldiers with life-threatening burns. Using this still-developing technology, skin cells could one day be printed directly on the soldier's wound.
And because regenerative medicine uses a patient's own cells to create organs and tissue, it eliminates much of the risk that the patient's body will reject a donor organ.
2011年10月20日星期四
Abbott Northwestern patient left 'writhing in pain' sues
"Hi, love," Sarah May Casareto greeted Larry V. King as he lay on a gurney before surgery. As they wheeled down the hall, he recalled in court records, she told him that he'd have to "man up" because they couldn't give him a lot of medication.
The next 57 minutes of surgery were excruciating, according to a lawsuit filed Tuesday in Hennepin County District Court that accuses the drug-addicted former nurse of skimming his narcotics, which left him "writhing in pain" during a medical procedure for kidney stones last year at a Minneapolis hospital.
The lawsuit filed by King, a Carver County sheriff's deputy, follows the same scenario laid out by prosecutors who charged Casareto, 34, in February with felony theft of a controlled substance for allegedly stealing the powerful painkiller.
Casareto, of Forest Lake, entered an Alford plea of guilty Sept. 1 to a fifth-degree controlled substance crime for possessing Fentanyl, a high-powered painkiller, and was sentenced to probation in connection with the Nov. 8 incident at Abbott Northwestern Hospital. The plea enabled Casareto to maintain her innocence while acknowledging ample evidence to convict her.
The suit, which seeks at least $50,000 in damages, alleges that she was "negligent and careless" in her care for King, 57, of Bloomington. The suit also names Abbott as a defendant.
It contends that Abbott "knew or should have known [before the procedure] that Casareto was exhibiting drug-seeking behavior and that she had become dependent upon narcotic pain medications." It also notes that Abbott officials knew that she had failed "on at least six different occasions" to properly handle patients' pain medication obtained from the hospital pharmacy.
King's attorney, Tony Nemo, called the lawsuit reflective of "a growing problem" that should draw closer scrutiny to drug diversion, or the theft of medications intended for patients.
"One of the things I know Mr. King is hoping is that this case may cause Twin Cities hospitals to reveal procedures and protocols to, if not prevent, at least minimize this problem in the future," he said.
The Casareto case and others involving medical staffers have prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators in recent months to improve security measures. The new coalition hopes to recommend tougher controls early next year. State regulators say drug pilfering by doctors and nurses isn't new -- but the latest cases come with a disturbing wrinkle, leaving some patients in excruciating pain as they are robbed of needed medications. In the past year, seven nurses and aides have been caught stealing narcotics from hospitals and nursing homes across Minnesota to feed their own habits or to sell drugs on the street.
Casareto's attorney, Brian Toder, said Wednesday that he believes the lawsuit is no more valid than the criminal charges, which did not result in a conviction. Once Casareto's three years of probation is over, the case will be expunged from her record.
Hospital spokeswoman Gloria O'Connell declined to comment on the suit, saying, "We can't talk about pending litigation."
The suit did not name the surgeon, Dr. Subbarao Inampudi, as a defendant because he "began the procedure with the reasonable assumption that [Casareto] would follow his orders and administer" the painkiller as he directed, Nemo said Wednesday.
According to the lawsuit, King said that his doctor told him he would not likely feel pain during the procedure, and when King's pain was obvious, Inampudi repeatedly ordered Casareto, who struggled to stay awake and was rocking back and forth, to "get back to her patient and figure out why the pain medication was not working."
The next 57 minutes of surgery were excruciating, according to a lawsuit filed Tuesday in Hennepin County District Court that accuses the drug-addicted former nurse of skimming his narcotics, which left him "writhing in pain" during a medical procedure for kidney stones last year at a Minneapolis hospital.
The lawsuit filed by King, a Carver County sheriff's deputy, follows the same scenario laid out by prosecutors who charged Casareto, 34, in February with felony theft of a controlled substance for allegedly stealing the powerful painkiller.
Casareto, of Forest Lake, entered an Alford plea of guilty Sept. 1 to a fifth-degree controlled substance crime for possessing Fentanyl, a high-powered painkiller, and was sentenced to probation in connection with the Nov. 8 incident at Abbott Northwestern Hospital. The plea enabled Casareto to maintain her innocence while acknowledging ample evidence to convict her.
The suit, which seeks at least $50,000 in damages, alleges that she was "negligent and careless" in her care for King, 57, of Bloomington. The suit also names Abbott as a defendant.
It contends that Abbott "knew or should have known [before the procedure] that Casareto was exhibiting drug-seeking behavior and that she had become dependent upon narcotic pain medications." It also notes that Abbott officials knew that she had failed "on at least six different occasions" to properly handle patients' pain medication obtained from the hospital pharmacy.
King's attorney, Tony Nemo, called the lawsuit reflective of "a growing problem" that should draw closer scrutiny to drug diversion, or the theft of medications intended for patients.
"One of the things I know Mr. King is hoping is that this case may cause Twin Cities hospitals to reveal procedures and protocols to, if not prevent, at least minimize this problem in the future," he said.
The Casareto case and others involving medical staffers have prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators in recent months to improve security measures. The new coalition hopes to recommend tougher controls early next year. State regulators say drug pilfering by doctors and nurses isn't new -- but the latest cases come with a disturbing wrinkle, leaving some patients in excruciating pain as they are robbed of needed medications. In the past year, seven nurses and aides have been caught stealing narcotics from hospitals and nursing homes across Minnesota to feed their own habits or to sell drugs on the street.
Casareto's attorney, Brian Toder, said Wednesday that he believes the lawsuit is no more valid than the criminal charges, which did not result in a conviction. Once Casareto's three years of probation is over, the case will be expunged from her record.
Hospital spokeswoman Gloria O'Connell declined to comment on the suit, saying, "We can't talk about pending litigation."
The suit did not name the surgeon, Dr. Subbarao Inampudi, as a defendant because he "began the procedure with the reasonable assumption that [Casareto] would follow his orders and administer" the painkiller as he directed, Nemo said Wednesday.
According to the lawsuit, King said that his doctor told him he would not likely feel pain during the procedure, and when King's pain was obvious, Inampudi repeatedly ordered Casareto, who struggled to stay awake and was rocking back and forth, to "get back to her patient and figure out why the pain medication was not working."
2011年6月8日星期三
India urged to double health spending to aid its impoverished sick
ALIGARH // When Nasir Khan cried out at night from the searing pain of kidney stones, the entire slum could hear him.
A magic healer promised an inexpensive cure through chanting while pinching his side where the kidney stones were lodged, but it only made it worse. His condition became life-threatening, and doctors said he would need surgery for a fourth time.
The operation cost him - and his extended family - their home.
Without insurance and unable to get a loan, they sold the broken brick shack in the industrial north Indian city of Aligarh for 250,000 rupees (Dh20,500). It had been home to the Mr Khan, 35, his four brothers, three wives and 11 children.
"There is no choice. It is my life," Mr Khan said in gasps, writhing atop a crude wooden cot as his relatives hovered helplessly nearby. He screamed for his mother. He screamed for Allah. He screamed for anyone to deliver him from the pain.
His story is repeated so often across India it evokes little sympathy, yet it represents one of the biggest threats to India's battle to lift its poor up from squalor.
Each year, the cost of health care pushes 39 million people back into poverty, according to a study published in The Lancet medical journal. Patients shoulder up to 80 per cent of India's medical costs. Their share averages about 3,000 rupees (Dh246.4) annually per person - a crippling sum for the 800 million or so Indians living on less than US$2 (89 rupees) a day.
A diagnosis of asthma, a broken leg or a complicated childbirth can mean having to choose between medicine or food, spending on treatment or relying on prayer.
While India boasts an economic growth rate near 9 per cent, the wealth has done little to help millions burdened by poverty and disease. The poor, aside from struggling to afford care, also face extreme shortages of doctors and medicines.
The situation is particularly dire in rural areas, where more than 70 per cent of the country's 1.2 billion people live. Some desperate patients resort to seeing quacks. Others pay bribes. Many simply don't seek help until it is too late.
The World Bank and other experts have warned that failure to address the country's healthcare woes could take a toll on long-term growth.
Yet India's government spends comparatively little on health care: just 1.1 per cent of the country's GDP, a figure that has not changed much since 2006 when China was spending 1.9 per cent; Russia, 3.3 per cent and Brazil, 3.5 per cent, according to World Health Organisation figures.
Dr K Srinath Reddy, the president of the Public Health Foundation of India and a member of a government-commissioned committee recommending reforms, said: "The political will is simply not there yet. We have to help realign the country's priorities."
Statistics that might highlight areas of need are scarce, thanks to erratic case reporting, few autopsies and a tradition of quick cremation that destroys evidence of disease. WHO reports often leave India out for lack of data. A recent study in The Lancet suggests malaria deaths could be 10 times higher than estimated.
India, which says hospital costs impoverish a quarter of all patients, has vowed to raise spending on health to 3 per cent of GDP by 2015 and provide universal primary health care - but it is an unfulfilled promise that has been made before.
The Lancet, in a series on India in January, urged the government to double its pledge to 6 per cent by 2020 or jeopardise its ability to shake off poverty.
"What is the point of economic success if there is nothing in it for the population?" editor Richard Horton said.
Meanwhile, India boasts a thriving medical tourism industry with shiny private clinics luring tens of thousands of foreigners for everything from bargain tummy tucks to experimental stem-cell treatments in an industry estimated to be worth nearly 100 billion rupees. The pharmaceutical industry is making lifesaving drugs at cut-rate costs, private hospitals are pioneering advances in open-heart surgery and medical schools are churning out physicians eager to work in the West.
A magic healer promised an inexpensive cure through chanting while pinching his side where the kidney stones were lodged, but it only made it worse. His condition became life-threatening, and doctors said he would need surgery for a fourth time.
The operation cost him - and his extended family - their home.
Without insurance and unable to get a loan, they sold the broken brick shack in the industrial north Indian city of Aligarh for 250,000 rupees (Dh20,500). It had been home to the Mr Khan, 35, his four brothers, three wives and 11 children.
"There is no choice. It is my life," Mr Khan said in gasps, writhing atop a crude wooden cot as his relatives hovered helplessly nearby. He screamed for his mother. He screamed for Allah. He screamed for anyone to deliver him from the pain.
His story is repeated so often across India it evokes little sympathy, yet it represents one of the biggest threats to India's battle to lift its poor up from squalor.
Each year, the cost of health care pushes 39 million people back into poverty, according to a study published in The Lancet medical journal. Patients shoulder up to 80 per cent of India's medical costs. Their share averages about 3,000 rupees (Dh246.4) annually per person - a crippling sum for the 800 million or so Indians living on less than US$2 (89 rupees) a day.
A diagnosis of asthma, a broken leg or a complicated childbirth can mean having to choose between medicine or food, spending on treatment or relying on prayer.
While India boasts an economic growth rate near 9 per cent, the wealth has done little to help millions burdened by poverty and disease. The poor, aside from struggling to afford care, also face extreme shortages of doctors and medicines.
The situation is particularly dire in rural areas, where more than 70 per cent of the country's 1.2 billion people live. Some desperate patients resort to seeing quacks. Others pay bribes. Many simply don't seek help until it is too late.
The World Bank and other experts have warned that failure to address the country's healthcare woes could take a toll on long-term growth.
Yet India's government spends comparatively little on health care: just 1.1 per cent of the country's GDP, a figure that has not changed much since 2006 when China was spending 1.9 per cent; Russia, 3.3 per cent and Brazil, 3.5 per cent, according to World Health Organisation figures.
Dr K Srinath Reddy, the president of the Public Health Foundation of India and a member of a government-commissioned committee recommending reforms, said: "The political will is simply not there yet. We have to help realign the country's priorities."
Statistics that might highlight areas of need are scarce, thanks to erratic case reporting, few autopsies and a tradition of quick cremation that destroys evidence of disease. WHO reports often leave India out for lack of data. A recent study in The Lancet suggests malaria deaths could be 10 times higher than estimated.
India, which says hospital costs impoverish a quarter of all patients, has vowed to raise spending on health to 3 per cent of GDP by 2015 and provide universal primary health care - but it is an unfulfilled promise that has been made before.
The Lancet, in a series on India in January, urged the government to double its pledge to 6 per cent by 2020 or jeopardise its ability to shake off poverty.
"What is the point of economic success if there is nothing in it for the population?" editor Richard Horton said.
Meanwhile, India boasts a thriving medical tourism industry with shiny private clinics luring tens of thousands of foreigners for everything from bargain tummy tucks to experimental stem-cell treatments in an industry estimated to be worth nearly 100 billion rupees. The pharmaceutical industry is making lifesaving drugs at cut-rate costs, private hospitals are pioneering advances in open-heart surgery and medical schools are churning out physicians eager to work in the West.
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