Attempt the questions individually by clicking on them.
According to report by United Nations, India ranked 148 in the world for the number of women in Parliament. Through 73 and 74 Constitutional Amendment Act women were given 33% reservation in elections to panchayats and municipalities. Though women constitute nearly 50% of India’s population but women’s participation and representation in politics have been marginal since independence at 12.5% in Parliament.
Reasons for low women participation and representation in the politics:
- Lack of education and awareness-Women literacy rate at national level is below men, consequently they are not aware of their political and civil rights. Illiteracy also hampers their decision making power.
- Patriarchal society- Indian society is largely patriarchal in nature. Men takes all the major decisions in the household subsequently this same pattern is reflected at national level.
- Economic- Men are the primary earners, it is not considered important for a woman to earn. Thus, they accustomed to be a housekeeper.
- Women quota can trip the governments in India, for example the recent Nagaland stir where a protest was sparked off by a decision of the Nagaland State Assembly to give women 33% reservation on seats in the elections to the civic bodies, turned violent with male dominated traditional tribal bodies calling it an infringement of the customary laws.
- Many a times people associate politics with corruption, crime, bad and full of quarrels and it is not considered respectful for a women to venture into this arena. Also security concerns are also there.
The government recently introduced Women’s Reservation Bill, which seeks to reserve one-third of seats in the Lok Sabha and state assemblies for women. It is important because:
- It will usher Gender Neutrality in the politics, Election commission is also working on it.
- Women are better in understanding gender specific issues and society is general like gender equality, rape, glass ceiling effect etc. It will ensure gender sensitive legislation.
- It would lead greater representation of women in different ministries and departments thus resulting in holistic development.
However, many are of the view that such a bill will give advantage to women from upper castes, who are better educated and more resourceful. But the reservation of women in local bodies has brought socio economic development of the women along with their empowerment. Thus, this bill is the need of the hour provided proxy women participation must be checked .It has been noticed at the village and municipal level that women file their candidature under pressure from male members of the family and they come out to be just the figure head not the actual decision makers. This trend needs to be arrested.
The land of Nalanda, Vikramasila and Taxila, which featured vividly in the accounts of travellers like Hsuan Tsang, I. Tsing and Strabo, currently has no varsity in the world’s top 200 university ranking. Also, it is being stated that by 2030, India will be the youngest nation. So to reap maximum socio economic benefit, foreign universities are eyed upon to set up their campuses in India. It will be beneficial because:
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- Foreign universities will help in raising the bar of quality education (example by faculty and student exchange programs) in the country thereby ushering in healthy competition and also giving impetus to research and development.
- They will help improve infrastructure of the educational institution by infusing much needed funds.
- It will increase the level practical learning exposure for the students as with more foreign university campuses in India, students will have more options of courses to pursue leading to best utilization of individual potential.
- Foreign universities will bring in better management and efficient use of the resources.
- They can lead to establishment of enterprises which will potentially drive the urban growth. For Example-Silicon Valley benefited from Stanford academia and Boston from Harvard and MIT.
- Allowing foreign universities to set educational institutions in India is in align with India’s Digital India program which encourages Massive Open Online Courses (MOOCs).
The resistance to entry of foreign universities in the country is on the following grounds:
- It is considered that foreign university have profit making as primary motive and will facilitate global trade in education which will benefit only a section of financially abled people.
- The high fees and higher standard of education set by foreign universities will increase educational disparity creating a class differentiation.
- Many fear that foreign universities will fail to deliver the cultural and historical awareness about Indias glorious past to the students. This will lead to domestic westernization.
- Also, students graduating from such foreign institutions of learning may move abroad for job and further education leading to brain drain.
- It will not fit into social dynamics of the country which is a mesh of caste, class, minorities, untouchability, gender inequality etc.
- The questions regarding how students who have done their secondary education in regional languages will fit in such universities is not clear.
- Not all foreign universities are of high quality, therefore tighter regulation is required.
- The profits made by foreign institutions must be spent in India not anywhere else.
There is a need to address the above challenges and they must be supplemented by more innovation, investment in the primary and secondary sectors of education. The recent initiatives by the government like Global Initiative of Academic Networks (GIAN), National Institutional Ranking Framework (NIRF), SWAYAM are steps in the right direction.
The recent decision of the Supreme Court to ban the sale of fireworks in the Delhi NCR to keep a check a check on air pollution has revived the debate of judiciary transgressing into the boundaries of the executive and legislative organs of the State. It is being said that there is already a specialized forum that is, National Green Tribunal for keeping check on pollution and other environment destructing activities and already burdened Supreme Court must make judicious use of its time because-
- The Pendency– of the cases in the Supreme Court has risen over 88% since its inception in 1950.
- The lack of environmental experts in the SC– The technical expertise available with the NGT is more suited to take environment related decisions and also SC is is eight short of the sanctioned strength of 31 judges.
- The recent judgement undermines the stature of NGT along with Central Pollution Control Board(CPCB) and State Pollution Control Board (SPCB). NGT can coordinate with executive more effectively to address environmental problems.
- The judgement is aligned with the SC protecting the fundamental right that is, Right to life (Article-21) but at the same time it is encroaching upon the right to livelihood of the firecracker manufacturers who have already produced the stock for this Diwali.
- Also, NGT has tasted many successes in the past like ban on diesel vehicles in the past, protected Indian rivers, cancellation of coal blocks in Chattisgarh etc.
However, NGT in spite of its specialized functions it lacks fast track justice, credibility, has limited capacity and staff ushering more pendency of cases and inefficiency and also it does not have suo moto powers which make its functioning less effective.
Therefore, SC always being the torchbearer in enabling issues like these has to step in when other institutions fail to deliver upon.
But at the same time the SC must not encroach upon the domains of other organs of the government and judicial activism must no convert into judicial overreach in the veil of guarding peoples fundamental rights.
The Government and other institutions like NGT, SPCB, CPCB should become more efficient and effective in their functioning and along with this active participation of people would only save Indian cities from becoming gas chambers.
The recently released Global Hunger Index has ranked 100 out of 119 nations which clearly highlights the fact that India has a serious hunger problem. More than one-fifth of Indian children under five weight too little for their height and over a third are too short for their age.
For a country which is food surplus these are ironical and disturbing facts. Various reasons for the failure to eradicate malnutrition are-
- Poverty- Approximately 22% of people in India are below poverty line that means they cannot afford healthy nutritious square meal a day. Poor cannot afford protein, vitamins and mineral rich diet.
- Policy Paralysis– With the change of government new schemes are introduced without improving upon the existing ones. Also the surveys considered by the government while formulating policies fail to represent the true data and numbers.
- Structural Problems– like Diversion of grains from PDS to open market for the private profiteering of store owners, failure of state governments to implement National food Security Act, 2013 which ensures grains to poor, lactating mothers at subsidized costs.
- Infrastructural bottlenecks– Example lack of cold storage facilities lead to food grains being rotted and high prices in the market which ultimately lead to malnutrition.
- Financial Problems have always been the prime hurdle in eradicating hunger but with various scams, corruption, nepostism and favoritism has further complicated the problem. Example- The current spending of government on mid-day meals is low which in turn forces school management to take feed two children from one meal.
- The hunger eradication programs have been focussed only towards villages there is a complete negligence of urban areas.
- Lack of awareness– More than half of our population reside in rural areas, lack of awareness programs, social media reach has resulted in that people are even unaware of word malnutrition.
- Sanitation– Unhygienic surroundings give rise to various diseases like cholera, diarrhea, malaria, typhoid etc. which further leads to death and people being trapped in vicious cycle of poverty.
Approach that can be adopted to fight malnutrition-
- Food fortification must be encouraged and fortified food must be introduced in mid day meal to increase the level of nutrition in children.
- Infrastructural bottlenecks must be plugged so that foodgrains are not wasted.
- A decentralized PDS system with the least influence of bureaucratic hurdles and steps.
- Sustainable Urban & Rural farming practices including GM crops, hybrid varieties etc.
- Proper implementation of policies & dedicated political will is the need of the hour.
- The recent decision by Women and Child development ministry to distribute nutrition packets through post office is a right step.
To reap the maximum benefit of the demographic dividend, the above mentioned approaches must be implemented effectively. Schemes like ICDS, JSY, RSBY, various immunization programs, mid-day meal, food for work, NFSA are the steps in the right direction.
Hints:
Stubble Burning:
- Stubble burning is the deliberate setting fire of the crop residue that remains after wheat, paddy and other grains have been harvested. The carbon (C) component in stubbles is lost by burning and that the process of burning stubbles even occasionally, seriously affects the organic carbon levels of the soil and adversely affects the environment.
Effect on Environment:
- Around 80 per cent of the C in standing stubble will return to the atmosphere as CO2. Losses of carbon as CO2 to the atmosphere through burning are often only slightly greater than through natural decomposition, but they are of course immediate and harmful.
- Burning straw leads to increase in particulate matter (PM) in the air. The burning causes release of acids like sulfates, nitrates, metals in the air and could cause severe health problems.
- According to the experts, burning of straw burns out 1 lakh tonnes of nitrogen, 0.5 lakh tonnes of phosphorus and 2.5 lakh tonnes of potash in the soil over the 29-30 lakh hectares in which paddy is grown annually.
- Stubble burning leads to loss of nutrients, loss of carbon, impact on soil microbes and fauna, reduction in soil structure (soil aggregate stability), increase in erosion (wind and water) and can increase acidity over time.
Measures to persuade farmers:
- In response to alarming air pollution level in the National Capital Region, the Delhi High Court recently had taken the ‘suo motu’ action to ban burning of crop residue.
- The court issued a direction to the states of Punjab, Haryana, Uttar Pradesh, Rajasthan, and the National Capital Territory of Delhi to implement notifications and directions issued under the Air Pollution Act to ban burning of crop residues.
- Recognizing the need for companies and industries to comply with their corporate social responsibility towards curbing air pollution, the Court directed to some corporate entities to collect crop residue from fields of farmers by providing them money as consideration for lifting the agricultural residue.
- Setting up of more biomass plants as they will buy the stubble to be used to feed into the plants in order to rot and decay for power generation. This will also generate income to the farmers for which they will be paid.
- The farmers should be persuaded to allow their animals to feed on the stubble or by conversion of stubble into goat fodder. Converting stubble into animal fodder will lead to increase into milk and meat which will add more value that using it as fuel.
- The plants of mushroom grow on the heaps of stubble. The farmers should also be persuaded of how the stubble can be used for making compost and ploughed back and can also be used to grow mushroom by making its heap can save from being disposed in a manner which damages the soil and environment.
- Zero-till farming is another alternative which sows wheat seeds without removing the stubble. Tractor-mounted happy seeders, rotavators, and straw-reapers simultaneously cuts rice stubble and sows wheat seeds, depositing the cut stubble on top as mulch.
Conclusion:
- The farmers should be encouraged to adopt conservation farming systems. Alternative options to manage stubble residues, particularly in high rainfall areas, are continuing to evolve.
- An all-round aggressive approach is needed on behalf of the government, scientists and farmers in the form of adoption of ‘straw management technologies’.
http://indianexpress.com/article/opinion/columns/more-than-toilets-4807546/
Hints:
- Swatch Bharat Abhiyan or clean India Mission is a campaign of Government of India aiming towards clean up the streets, roads and infrastructures of India’s cities, smaller towns and rural areas. The objectives of Swatch Bharat Abhiyan includes elimination of open defecation by 2019 through the construction of household owned and community owned toilets and establishing an accountable mechanism of monitoring toilet use.
Achievements:
- In the completion of 3 years in 2017, various government initiatives towards Swatch Bharat Mission have worked well with good achievements in rural sanitation coverage having gone up from 39 per cent to 67 per cent in three years and over 230 million people in rural India have stopped defecating in the open. Five states, 186 districts and over 2, 31,000 villages have been declared as ODF.
- The construction of septic toilets with the help of government has reduced the use of dry and pit latrines. This has also to some extent helped the Manual Scavengers who used to clean such pit and dry latrines.
- Rajasthan and Haryana made having toilet as a compulsory qualification for contesting panchayat elections. This has led to increase in the number of toilet use especially in rural areas.
- Government’s awareness campaign which roped in celebrities has been able to bring issues such as sanitation and hygiene in the public discourse.
Criticisms:
- However, rising number of rural sanitation does not mean its proper usages. As per the recent Swachhta Status Report of the National Sample Survey Office (NSSO), in 2017, half of the rural population (about 47%) of the country still defecates in open.
- It is one thing to build physical infrastructure like roads, bridges and power plants and quite another to engage 550 million people to fight against the centuries-old practice of open defecation. The SBA also seeks to carry out one of the largest behaviour change campaigns in history, mainly through effective information, education and communication (IEC).
- Focus in urban under SBA is only statuary towns i.e. 4,041. So, other cities are being neglected.
- Economically good states are not doing very well. Only 43 % sanitation is going to BPL, which means marginal groups are being neglected.
- Training part in civil engineers and administrators is missing about garbage disposal, location of dustbin, etc. And also insensitive implementation machinery where Municipal Corporation lacks capacity.
- Solid waste even in remote areas also becoming major issues. In urban areas also the implementation is not very impressive. Issue of maintenance is also a major cause of concern as toilets constructed remain unused on account of not being clean or due to the lack of water.
Way forward:
- Citizen participation is very much necessary for successful implementation of any schemes or mission. Change in attitude is already visible, but more awareness is needed. Separation of garbage should be part of behaviour of citizens. Composting should be made compulsory and profit making at society level.
- Designing and modeling for efficient toilets are needed. Bureaucracy needs to be trained in improving the management system related with sanitation.
- Skill building should be tied up with garbage management, composting, etc. and SBA should adopt integrated approach.
- Strengthen the municipality and financing should be top priority. Private investment is a challenge since only CSR will not be sufficient.
- Aadarsh Gram Yojna should converge on SBA targets composting, sanitation, garbage management, fertilizer units, etc.
http://www.livemint.com/Opinion/Grb0hnRk6GTSm7LpbDM7gN/The-need-for-doing-digital.html
Hints:
- With increasing complexity and in order to sort out complexity various innovations especially in ICT and need of digital can hardly be overstated. It is true that digital technologies, especially IoT, machine learning, artificial intelligence (AI), blockchain and big data analytics, are reaching maturity.
- They are no longer the stuff of science fiction and have become very real in our lives. Individually, all these technologies provide tremendous value. However, when combined under one unified orchestrated platform, the business value that can be derived is pushing the envelope of possibilities.
- India which has high potential in digital technology as noted in digital evolution index 2017 particularly poised to take advantage of digital technology as they have the potential to add economic value of $ 550 billion to $ 1 trillion per year by 2025 and create millions of well paying productive jobs.
Areas of advantages:
- In the public domain for policy formulation, digital services can blend seamlessly with the physical reality of urban spaces, optimizing energy, vehicles and assets across the urban footprint to improve the live-ability of public spaces.
- Likewise, production at an agriculture farm can be monitored digitally, thereby allowing informed, intelligent decisions that can prevent crop spoilage, increase efficiency and drive sustainability.
- For large manufacturing companies, cognitive processing of data—without having to wait for the data to be pulled out and processed offline—can empower the workforce to fix critical problems in real time.
- With the help of collection and processing of millions of data points through IoT, telematics and predictive analytics, it is possible today to track and report on every detail of vehicle fleet operations covering thousands of vehicles to establish safety and 100% transparency with customers.
- Digital leaders are seeing possibilities and realizing them across diverse aspects of our lives, such as prior warning of an impending earthquake to the phones of citizens, personalization of sales experience across millions of customers, improvement in the last-mile water supply through proactive management with predictive analytics and machine learning, and so on.
India’s readiness to harness the potential of digitalization:
- Various Government initiatives towards digitalization have certainly empowered the nation such as UMANG, UDAAN, SWAYAM, SUGAMYA PUSTAKALAYA, STARTUP INDIA AND MOBILE APP, SOIL HEALTH CARD, SMS-BASED MID-DAY MEAL MONITORING SCHEME, SHALA SIDDHI etc. to count a few.
- However, internet connectivity is must on a National level to realize the full scale of digital India. Affordability of digitalization and digital technology is also important in order to create demand.
- While technology is core to digital transformation, it is the mindset that sets digital leaders apart. Imparting digital literacy, changing mindset which involves focusing on design thinking and business outcomes and bringing about a paradigm shift from merely looking at individual transactions are need of the hour.
- Today, the more user friendly technology need to be designed which is now the first port of call in the new age digital business that intelligently connects people, things and business to create a wow experience for their customers. This will result into simultaneous growth in revenue and reduction in costs.
Conclusion:
- However, with the availability of technology platforms that extend the organisations’ digital core with adaptive applications, big data management and connectivity, India seems to be ready to bring transformation in revolutionizing digitalization.
- With the effective use of these digital platforms digital leaders can connect people, processes and things to deliver experience to their customers and bring efficiency in their processes.
- Today the digital transformation needs to be viewed in a holistic manner that impacts end-to-end business processes, creating delight at every user interface, and delivering real business value.
https://www.civilsdaily.com/abolition-of-fipb/
Hints:
- The Foreign Investment Promotion Board (FIPB) was a national agency of Government of India, with the remit to consider and recommend foreign direct investment (FDI) which does not come under the automatic route. It used to act as a single window clearance for proposals on FDI up to Rs 5000 crore in India. The FIPB was under the Department of Economic Affairs, Ministry of Finance.
- The 25 years old FIPB was abolished by the Union Government with the aim of making India a more FDI attractive destination by easing the norms for ease of doing business in order to promote the ‘Maximum Governance and Minimum Government’ principle.
Reasons for its abolishment:
- Over 90% of the foreign direct investment (FDI) is coming through automatic route. In such cases FIPB had no significant role.
- In case of FDI under approval rout, FIPB offers a single window clearance. The sectors under automatic route do not require any prior approval from FIPB and are subject to only sectoral laws. Over the years, increasing liberalization of the country’s FDI regime has resulted in more and more FDI through the automatic route.
- The FIPB has lost its erstwhile pre-eminence and the discretionary power with its bureaucrats doesn’t inspire much confidence within foreign investors. Hence government thought to abolish it.
Criticisms:
- FIPB was the epitome of license raj, where powerful bureaucrats used to decide the fate of a foreign investor willing to pump in precious foreign investment into India. This was resulting more of red tapism, thus affecting the investment inflows.
- However, the recent Standard Operating Procedure (SOP) has explicitly provided timelines for all ministries/departments involved at different stages, there still remains scope where these timelines are not strictly binding.
- The enhancement of cap on brownfield investment in 2016 as well as the elimination of the FIPB has removed all restrictions on brownfield FDI, which seriously undermines the government’s ability to ensure access to affordable medicines and the right to health.
- The abolition of the FIPB now fully dilutes the limited safety catches put in place in case brownfield investments crossed 74 per cent in pharma. Under the old FIPB norm the government was able to incorporate appropriate conditions for brownfield investors above 74% at the time of granting approval, thus protecting the interests of domestic investors. However the abolition puts this responsibility on Department of Pharmaceuticals which is historically known for favouring FDI at any cost, which in sense undermines health security.
- These acquisitions, followed by many others, challenged the self-sufficiency and availability of affordable medicines and vaccines. Further, such acquisitions also undermined the ability to use flexibilities in the Indian Patents Act to curb patent monopoly and to ensure availability of new medicines at affordable cost. If the control of technologically advanced pharma companies were vested with such transnational companies, there would be little chance to use flexibilities such as the compulsory license.
- The reason for less inflows of Foreign Direct Investment was cumbersome rules and not the FIPB. Hence, the abolition does not ensure higher FDI inflows. For eg despite allowing 100% FDI in food retail, rules prohibit foreign players from using a small fraction of their shelf space for non-food items, affecting investment plans and also employment as this can create millions of jobs and boost farm incomes.
- While the cabinet’s decision is seen as a simplification of the existing procedure to seek clearance on FDI proposals, experts have also raised doubts whether line ministries are equipped to take such decisions on an expedited manner.
Conclusion:
- The Government should consider liberalizing norms rather than abolishing the institution itself. For e.g. the laws for land acquisition and labour continue to make it difficult for large investors to come up.
- We need institutional safeguards to block investments which may pose threat for national security and interest. In advanced countries there are some institutional mechanisms to block any foreign investment proposal that hurts national interest and security, hence India also need an agency for institutional safeguards. RBI can best play the role of investment safeguarding agency if provided adequate powers apart from collection of information for Union Govt.
http://www.newindianexpress.com/opinions/2016/dec/01/should-the-state-fund-elections-1544308.html
It is considered that the state funding of elections is expected to bring in greater transparency and reduce role of black money. Discuss the pros and cons of this proposal of state funding of elections.
Hints:
- State funding of election means the state shall provide funds (cash/kind) to political parties (Partly/fully) to contest elections and in return, there are restrictions on political parties accepting funds from public sources.
- The ongoing arguments regarding electoral reforms has once again brought this issue into focus which has also been examined by many committees such as Tarkunde committee, Indrajit Gupta committee, the Committee on Constitutional Reforms and the Law Commission (2015).
- The main concern here is to bring transparency in political parties funding as this will force the political parties to disclose their source of funding as well as their accountability. However, this is one aspect of a single coin, the other being more invisible as there will be no accountability on part of the political parties in accepting funds from state.
Pros:
- Public funding is a natural and necessary cost of democracy: Political parties and candidates need money for their electoral campaigns, to keep contacts with their constituencies, to prepare policy decisions and to pay professional staff. If a country wants to have stable political parties and/or independent candidates, the state also need to be prepared to help pay for them.
- Limiting interested money and curbing corruption: If political parties and candidates get at least a basic amount of money from the public purse this has the potential to limit the likelihood of them feeling the need to accept “interested money” from donors who want to influence their policies, rhetoric or voting behaviour in the legislature. This will ensure that the elections are issue based and not money/interest based.
- State can encourage or demand changes in for example how many women candidates a party fields: In the same way as private donations can come with demands on party or candidate behaviour, the State can use public funds to level the playing field and encourage (or force) political parties to undertake reforms, hold internal elections or field a certain number of women candidates, youth or persons from an ethnic minority on their ballots.
- Level playing functioning multi-party system: In societies where many citizens are under or just above the poverty line, they cannot be expected to donate large amounts of money to political parties or candidates. If parties and candidates receive at least a basic amount of money from the State the country could have a level playing functioning multi-party system without people having to give up their scarce resources.
- Balance Disturbance: In many countries, the support base of political parties and candidates are divided along socioeconomic lines. The support base of labour or dalit parties for example, are traditionally less wealthy than the support base of other parties. If political parties receive all their income from private donations, there is a risk that (mostly accepted) socioeconomic differences in the society will translate into (mostly not accepted) differences in representation and access to political power.
Cons:
- Increases the distance between political elites and ordinary citizens: When political parties and candidates do not depend on their supporters or members neither for monetary contributions (membership, donations) nor for voluntary labour, they might be less likely to involve them in party decisions or consult their opinions on policy issues.
- Against the will of tax payers: Through public funds, taxpayers are forced to support political parties and candidates whose views they do not share. Why the people should be forced to support political parties or candidates that they would never choose to vote for. The question acquires even more relevance now that NOTA is an option available to a voter.
- Public funds favour more to ruling parties: State funds are often allocated among political parties and candidates in the national legislature. This may make it more difficult for new political forces to gain representation. The legal framework can limit this negative influence by providing special funds for new political parties or candidates. Instead they should have the possibility to decide if and when they want to donate money to a political party or candidate.
- Complete State Funding is not feasible: State Funding of elections depends on economic condition of the country. Currently, India’s economy does not suit to state complete funding.
- Most of the committees have suggested that India should go for partial state funding. However, State funding may succeed only when it is total and not partial, because there is no guarantee that even after it was introduced, rich parties and candidates would not pump black money into campaigns to boost their chances of victory.
- State funding actually makes elections more expensive because parties pocket government funds and continue to raise private funding clandestinely (further disadvantaging the relatively newer or more honest candidates).
- State funding of elections makes little sense as long as inner-party democracy is missing in key political parties. A strong Lokpal has to be in place to ensure that corruption is reported and redressed. This will instill fear among prospective candidates who will no longer see their election as a money-making opportunity.
- The success of state funding depends on a strong regulatory framework, stringent punishments, a quick and effective judicial system, an alert and demanding electorate, a broad consensus on political ethics—all of which we woefully lack.
Conclusion:
- State funding is an exotic plant and cannot bear fruit in our imperfect conditions. By talking about state funding, the political parties are shrewdly steering the narrative away from what actually needs to be done—bringing them under the ambit of the Right to Information Act; amending the Representation of People Act to make them account for all donations, irrespective of their form, amount or source; setting up of special courts to decide election petitions within a year; debarring all candidates against whom criminal charges have been framed in a court of law (currently they have to be convicted for this provision to operate) etc. are way forward.
- It is these changes that will cleanse the Augean stables of Indian politics, not the throwing of good (or white) money after bad (or black), which is what state funding will amount to.
Hints:
- Medical stents are tiny metal tubes coated with medication which are inserted into clogged arteries to keep them flowing well. This emergency angioplasty is the treatment of choice during an acute heart attack, wherein the clot is crushed with a balloon and a stent is placed improving the chance of the patient surviving by almost 30%. These metal tubes have revolutionized modern cardiology. The devices save thousands of lives globally, every year.
- In February 2017, the National Pharmaceutical Pricing Authority slashed prices of stents by up to 85% in order to make it affordable to thousands of economically poor patients.
Implications of Price capping:
Positive implications:
- It will make affordable to even the poor section of society resulting increasing their lifespan and survival even in case of heart attack.
- It will boost the medical tourism as more and more patients will come for angioplasty due to its reduced price.
Negative implications:
- Several studies across the globe have shown that in patients with multiple blocks in all three vessels, open heart surgery is a better procedure than the use of multiple stents. However, with lower stent prices, ill-informed patients often choose multi-vessel angioplasty as it is cheaper (even with three stents) than open heart surgery.
- In case of multiple stents with the increasing use of the tiny metal tubes, the chances of a stent blocking with consequent damage to the heart muscle will only increase.
- Even before the price control move was instituted, only 40 per cent of the stents used in the country were indigenously manufactured; the rest were imported. With prices of imported stents and Indian stents now being the same, doctors and patients could prefer the imported devices. This will hit the financial viability of Indian stent manufacturer and will affect their quality research. Lack of government funding for clinical research in India only aggravates the issue.
- Ultimately, lack of indigenous research and development will make the country dependent on imported stents. But that is not all. As future generation stents come into clinical use, multinational companies may choose not to release their latest products in India because of the country’s price control regime. In fact, such an alarming scenario might pertain not only to stent technology but also to research and marketing of other implantable devices.
- This will also hit the medical tourism as it will become apparent that Indian hospitals do not have the latest generation stents.
- With time, paradoxically, patients who were the intended benefactors of this price control measure may actually turn out to be losers.
Government policy to support indigenous medical device manufacturers:
- The best long-term solution is to encourage and support Indian stent manufacturers and medical device research so that we do no need to depend on imported stents. All aspects involving medical device development (clinical research, animal testing, and human trials) must be fast-tracked and should be as transparent as possible. There must be a system to make sure that the latest medical devices, including stents, are priced differently.
- Banks in India should be allowed to finance the research projects for long term in order to attract increased number of entrepreneur in medical field and also for advance research in the field of medical.
- Once such a level of competency is achieved, India could actually export stents making Prime Minister Narendra Modi’s Make in India viable for medical devices.
Ethics Questions
This statement denotes the extent upto which ethics have an impact on the individual. A law is an external check to a person’s actions, ethics on the other hand is an internal guide. One would be held guilty if he violates the laws related to the vulnerable sections of the society like children, women, elders, backwards classes, Divyang persons, minorities. For that there should be enough evidence based on the actions of the person, but in ethical terms the person has committed the sin the moment he thought of taking that shameful step.
Ethics goes beyond the distinction of law and violation and mere intent of killing anyone is sufficient to prove the guilt. Thus, a law starts to come to fore when our actions appear on ground, but ethics has the power to shold back the evil intentions at the thinking stage, where one’s character starts to reveal itself.
(a) What are the various options available to ‘X’?
(b) Suppose ‘X’ comes to you with all his options, what suggestion you would give him along with justifications.
Y has wrong intentions of adding the ingredients to the baby food. He merely wants to earn more money and for doing so, he is ready to compromise with health of children. The various options before X are-
- He can request MD and tell him it is unethical and can harm children. The company may lose its credibility if the news comes in public.
- He can ask chemist not to dilute the ingredients and try to convince him that it is wrong.
The chemist may however go to the MD and tell about him.
- He can inform the Independent Director (representing the interest of consumer) directly or through some member. It is possible that the board after coming to know about the situation will look into the matter.
(b) There are various options available to X. Disclosing the matter might pose a threat to his job.
However, if he keeps mute on the issue, it is liable to bring bad name to the enterprise.
- He should first try to convince his boss that it is unethical to carry such wrong practice just to earn more money.
- He can go to the chemist and seek his cooperation in ensuring that the important ingredients in the food are not diluted.
- Even it the above options do not bring fruitful results, the last resort should be to have enough sacrifice capacity for the good of the children even if it involves quitting job. Just to save his job, he should not compromise with the life of the children otherwise he would also be equally responsible for supporting the MD in his wrong deeds.
