India has reimposed an internet ban on the restive Manipur state after violent protests erupted following the circulation of photographs of two dead students killed during the months-long conflict, officials said.

More than 150 people have been killed in the remote northeast state since armed clashes broke out in May between the predominantly Hindu Meitei majority and the mainly Christian Kuki community.

The far-flung state has fractured on ethnic lines with rival militia groups setting up blockades.

A nearly five-month-long internet ban was lifted last week, but was reimposed late Tuesday after dozens were injured during violent protests in the state capital Imphal.

On Tuesday, police fired tear gas as hundreds of angry students marched following the release of photographs of two dead bodies on social media, a 17-year-old woman and a 20-year-old man from the Meitei community, local media reported. The pair went missing in July.

The internet was then cut to curb the “spread of disinformation, false rumours, and other types of violent activities through social media platforms”, a government order read.

Biren Singh, the state’s chief minister, said on late Tuesday that officers were investigating the deaths.

Prime Minister Narendra Modi has been criticised for his administration’s failure to end the violence in the state, which is governed by his Hindu nationalist Bharatiya Janata Party (BJP).

Human Rights Watch has accused the Manipur authorities of facilitating the conflict with “divisive policies that promote Hindu majoritarianism”.

Mallikarjun Kharge, leader of the opposition Congress party, on Wednesday accused the ruling party of turning Manipur “into a battlefield”, in a post on X.

LAHORE: The Punjab government has slapped a ban on the use of Avastin injection for eye patients for an indefinite period across the province, besides launching a portal to collect data of the patients affected by the drug and provide them treatment facilities.

The data collection through the portal launched by the Primary and Secondary Healthcare Department will help the government prepare a policy regarding the use of the injection.

Provincial health ministers Dr Jamal Nasir and Dr Javed Akram said this while addressing a joint press conference here on Tuesday.

They said the ban was imposed as a high-level inquiry was underway to find out the prime factors leading to vision loss among patients administered the injection in Punjab.

68 affected patients have surfaced in Punjab so far

They asked the affected patients to provide necessary information on the portal to get treatment and help the government in assessing the true impact of the drug’s reaction.

They said that so far 68 patients affected by this injection have been reported in the province, for whom special beds have been allocated in the Holy Family Hospital Rawalpindi, Mayo Hospital, Lahore and Nishtar Hospital, Multan.

The ministers said a new 10-member committee has also been constituted by Punjab Chief Minister Mohsin Naqvi to analyse the situation caused by Avastin injection’s reaction.

The committee will point out deficiencies and weaknesses at various levels in handling and use of the injection and prepare a comprehensive action plan to prevent recurrence of such incidents in future.

Primary Healthcare Minister Dr Jamal Nasir said this injection, available in the market in 100mg pack, was primarily meant for the treatment of colon cancer and its use for the treatment of eyes in diabetic patients falls under the category of “off-label” use, adding that the injection was neither fake nor locally manufactured.

“The diabetes patients require only 1.2mg dose and some people sell this injection in small syringes for this purpose,” Dr Nasir said.

He said the injection should be kept at 2 to 8 degrees Celsius temperature and administered to the patient within six hours of opening the pack. However, he said, apparently due to increase in temperature its chemical composition changed and this might have happened because of not maintaining the required temperature during its transportation.

Dr Nasir said that efforts were under way to arrest those who sold this injection in small syringes illegally, adding that the Punjab Healthcare Commission (PHC) has also been directed to trace the doctors and hospitals involved in this issue.

The minister said that 11 drug inspectors in eight cities of Punjab have been suspended from service and an inquiry has been ordered against them for failing to check the illegal sale of the injection in small doses.

Punjab Specialized Healthcare Department Minister Dr Javed Akram said new members have been added to the committee constituted by the chief minister, including Professor of Microbiology Dr Sidra, Professor of Ophthalmology Dr Moin and Professor of Forensic Medicine Dr Allah Rakha.

He said the committee would also inspect the premises where the injection was being packaged in small syringes and determine whether those places were suitable for the process or not.

Apart from this, he said, the record of temperature maintained during shipment, off-loading and transportation etc of the “contaminated” lot of the injection would also be sought from Switzerland-based company.

Dr Akram apprehended that it seemed good clinical practices had not been taken into account while using this injection for eye treatment. He said it was mandatory to seek consent of the patient in local language before administering the injection, adding that those responsible for this episode would be held accountable without any leniency.

PHC: The Board of Commissioners of the Punjab Healthcare Commission (PHC) has directed the senior management of the commission to be prepared for special inspections of the hospitals where eye infection cases were reported due to the administration of Avastin injection to the patients.

The directions were issued in an emergent meeting of the PHC Board of Commissioners (BoC) headed by chairperson retired Justice Muhammad Bilal Khan.

A representative of the PHC, who had attended the meeting of the recently formed committee by the government also attended the BoC meeting.

He briefed the BoC regarding the proceedings of the meeting convened by both interim health ministers – Prof Javed Akram and Dr Jamal Nasir.

The BoC was informed that the issues related to import, compounding and dispensing of the dosage for eye patients will be investigated by the committee, while the PHC was asked to investigate the practices in the hospitals where the injection was administered.

After deliberations, the BoC directed the PHC senior management to make preparations for any action, especially, the inspections of the hospitals where the infections have been reported.

The BoC also ordered inspections of these healthcare establishments to ensure implementation of the minimum service delivery standards, especially pertaining to infection protection and control, medication management, qualifications of the medics, and sterilisation of operation theatres.

The BoC also ordered issuance of an advisory for the affected patients to initiate complaint about these incidents. For this, they can also WhatsApp their complaints at 0306 0843500, for initiation of investigation by the PHC.

In a related development, the Lahore police arrested a suspect, Bilal, from Arifwala, in connection with Avastin injection scam.

The police said a case had been registered against the suspect by Faisal Town police.

A special police team investigating the case traced the location of the suspect at Arifwala and arrested him in a raid on a premises, with the help of local police, sources said.

Published in Dawn, September 27th, 2023

The Senate Standing Committee on Cabinet Secretariat has summoned the Ministry of Foreign Affairs and Attorney General for Pakistan (AGP) to brief the panel on objections reportedly raised by the US on the multi-billion-dollar Iran-Pakistan (IP) gas pipeline project.

Tehran has been claiming to have completed its side of the 1,150-kilometre pipeline for which a groundbreaking ceremony was jointly conducted by then presidents Asif Ali Zardari and Dr Mahmoud Ahmadinejad on the Iranian site of Gabd, near Chahbahar in March 2013 with an estimated cost of $7.5bn at the time.

Pakistan had committed to complete its side of the project by January 2015. However, in February 2014 then petroleum minister Shahid Khaqan Abbasi told the parliament that the Iran-Pakistan project was “off the table” due to international sanctions.

Earlier this year, former petroleum minister Musadik Malik explained that despite being fully committed to its contractual obligations under the Gas Sales and Purchase Agreement (GSPA), the Government of Pakistan had been unable to start construction of the pipeline due to US sanctions on Iran.

Officials said Pakistan had requested Washington earlier this year for a solution for the project to help overcome energy shortages but had not yet received any response.

In August, Pakistan issued a notice of ‘Force Majeure and Excusing Event’ to Iran to suspend its contractual obligation on completion of the gas pipeline. Simply put, Pakistan had expressed its inability to pursue the project as long as US sanctions on Iran remain in place or Washington tacitly green lights Islamabad to go ahead with the project.

The matter came under discussion today during the Senate panel today.

Petroleum Additional Secretary Hassan Yousafzai briefed the committee that a deadline for 2024 had been given by Iran regarding the completion of the gas pipeline and failure to meet it would lead to fines.

“We are trying to renegotiate the matter with Iran,” he said, adding that efforts were being made to find out other ways of obtaining gas.

The secretary further expressed concerns that Pakistan could be subject to “liabilities of $20 billion”. The issue, he went on to say, was also raised with the US.

“Laying the gas pipeline till Gwadar will cost us $2bn,” he told the panel, adding that reneging on the deal with Iran could lead to a whopping $18bn penalty.

Commenting on the matter, Senator Mushtaq Ahmed called for summoning the Ministry of Foreign Affairs to “find out why can’t we purchase cheap gas from the neighbouring country”.

“We should know the reason behind the obstruction,” he said.

Meanwhile, the chairperson of the Senate committee, Sadia Abbasi, highlighted that India never faced such restrictions. “How was the agreement even signed amid these restrictions?” she asked.

Here, PPP Senator Waqar Mehdi said the agreement was signed under the government of ex-president Zardari.

The Iranian pipeline was aimed to supply 750 million cubic feet per day (MMCFD) of gas, although it was vehemently opposed publicly and diplomatically by the US authorities, particularly when Pakistan and Iran signed framework agreements and GSPA in 2009 and 2010 respectively.

Pakistan signed the pipeline agreement in 2014, which included a condition that Islamabad will pay billions of dollars in penalties if it abandons the project.