Note4Students
From UPSC perspective, the following things are important :
Prelims level: NA
Mains level: Healthcare progress and challenges
Central Idea
- The Indian healthcare system has overcome many challenges and has made significant progress, but there are still many tough health challenges that need to be addressed. There is need to bridge the gap between the services available in metropolitan and Tier-II and Tier-III cities, provide healthcare insurance to the unorganised middle class, and use Artificial Intelligence and digital technology to improve healthcare services.
Overcoming past challenges
- The Indian healthcare system has overcome seemingly insurmountable problems, including high maternal and infant mortality rates, and low hospital delivery rates.
- The National Family Health Survey (NFHS-5) results show that even in the so-called BIMARU states, hospital deliveries have soared to 89 per cent.
Current Health Challenges
- Five interrelated challenges: The current macro picture shows at least five interrelated challenges that are pervading the population, including non-communicable diseases (NCDs), obesity, and chronic respiratory diseases.
- NCDs: The proportion of deaths due to NCDs has increased from around 38 per cent in 1990 to 62 per cent in 2016.
- Obesity: Obesity has increased from 19 per cent to 23 per cent between NFHS-4 and NFHS-5. Awareness about leading healthy lives will save millions from illness and decelerate premature death.
- Infrastructure:
- The state of infrastructure matters. Since 2018, governments at the Centre as well as the state have been trying to bolster primary healthcare by establishing health and wellness centres.
- But there are still huge variations between states, and some states have better arrangements than others. States must step up efforts to improve infrastructure in the healthcare sector.
- Bridging the gap in hospital services:
- In urban areas, the challenge is to bridge the gap in hospital services between large urban agglomerations and Tier-II and Tier-III cities.
- Large hospital chains provide only 4-5 per cent of the beds in the private sector.
- Standalone hospitals and nursing homes provide 95 per cent of private hospital beds but are unable to provide multi-specialty, leave alone tertiary and quaternary care.
- The gaps between services available in the metros and big cities and in districts must be bridged.
- Health Insurance Coverage:
- Low health insurance penetration and the very high personal outgo on healthcare remain a challenge.
- But over the past three years, more than four crore Indians have bought health insurance.
- From 2018, the Ayushman Bharat insurance scheme for 10 crore poor families has been undertaken to provide insurance against hospitalisation for up to Rs 5 lakh per year per family.
- Nearly 74 per cent of Indians are either covered or eligible for health insurance coverage.
- Use of Artificial Intelligence and digital technology:
- An emerging concern is the use of Artificial Intelligence (AI) and digital technology to improve healthcare services.
- Surgery assisted by robots, the use of genetic codes, clinical decision support systems, and telemedicine can help in making healthcare more accessible and efficient.
Conclusion
- India has shown how the impossible can be achieved, but the healthcare system needs to overcome various challenges to fully redeem its advantage of having the youngest population. The government needs to step up efforts in improving infrastructure, bridging the gap in hospital services, and providing health insurance coverage for the unorganized middle class. It is also essential to regulate the use of AI and digital technology in the healthcare sector to ensure accountability and prevent malpractice.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: WTO subsdies, Bali Peace Clause
Mains level: India-WTO row over agricultural subsidies
Central idea: India has been criticized at the World Trade Organization (WTO) for not adequately addressing questions raised by members regarding its Minimum Support Price (MSP) programs for food grain, particularly rice.
Minimum Support Price (MSP)
- MSP is the price at which the government buys crops from farmers to support them against any sharp fall in farm prices.
- It is announced by the Government of India for 23 crops ahead of each sowing season based on the recommendations of the Commission for Agricultural Costs and Prices (CACP).
- It is an important tool to protect farmers from any sharp fall in farm prices.
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Genesis of the row
- WTO members such as the US, Australia, Canada, the EU, and Thailand have alleged that India did not provide sufficient responses during consultations.
- The MSP programs have breached prescribed subsidy limits and are under scrutiny at the WTO argued these countries.
- With this, India became the first country to invoke the Bali ‘peace clause’ to justify exceeding its 10% ceiling for rice support in 2018-2019 and 2019-2020.
What is ‘Bali Peace Clause’?
- India’s minimum support price (MSP) falls under the amber box subsidies category.
- India has exceeded its limits for amber box subsidies for rice for two consecutive years, which is why it has been challenged at the WTO.
- The Bali ‘peace clause’ allows developing countries to exceed their 10% ceiling without facing legal action by other members.
- However, it is subject to numerous conditions, such as not distorting global trade and not affecting food security of other members.
- India’s MSP programs are subject to the ‘peace clause’, but some WTO members have accused India of habitually not including all required information in its notifications.
Allegations of Inadequate Reporting by India
- WTO members have been accusing India of not reporting all public stockholding programs under the ‘peace clause’.
- Some members have pointed out that India also lacks an adequate monitoring mechanism to ensure that no stocks are exported.
- India, on the other hand, argues that it is not obligated to notify any public stockholding programs other than for the crop where the subsidy limits were breached.
Impact on India’s MSP Programs
- The criticism from WTO members could have an impact on India’s MSP programs for food grain, particularly rice.
- The conditions set under the ‘peace clause’ could limit India’s ability to exceed the subsidy limits and support its farmers.
- India may have to provide more detailed notifications and monitoring mechanisms to address the concerns of other members and ensure compliance with WTO regulations.
Why is India defending its stance on MSPs?
- India faces several challenges in the agricultural sector, including climate change, soil degradation, and water scarcity.
- The country also has to deal with farmers’ distress due to low prices for their produce, which is why the MSP program was introduced in the first place.
- The challenge posed by the WTO to the MSP program could further exacerbate the problems faced by Indian farmers.
Back2Basics: WTO and its Subsidies Boxes
The World Trade Organization (WTO) is an intergovernmental organization that is responsible for regulating international trade between nations.
- Establishment: It was established on January 1, 1995, and currently has 164 member countries.
- Objective: To ensure that trade flows as smoothly, predictably, and freely as possible.
- Frameworks: Negotiating and formalizing trade agreements, resolving trade disputes between member countries, and monitoring national trade policies.
- Working principles: Non-discrimination, transparency, and fairness in international trade.
The WTO has three types of subsidy boxes – green, blue, and amber. Each box represents a different level of trade-distorting subsidies.
- Green box subsidies: These subsidies are considered non-trade-distorting and are allowed under WTO rules. They include measures such as research, disease control, and infrastructure development.
- Blue box subsidies: These subsidies are considered less trade-distorting than amber box subsidies but can still distort trade to some extent. They include measures such as direct payments to farmers to reduce production, provided that certain conditions are met, such as the use of fixed areas or yields.
- Amber box subsidies: These subsidies are considered the most trade-distorting and are subject to reduction commitments under the WTO Agreement on Agriculture. They include measures such as price support, input subsidies, and direct payments that are not subject to certain conditions.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: DPDP Bill 2022
Mains level: DPDP Bill 2022, Data Privacy and Protection
Central Idea
- India’s digital economy is growing rapidly and generating massive amounts of personal data. As citizens embrace convenience, understanding how this data is handled and protected has become critical. The Digital Personal Data Protection (DPDP) Bill 2022 aims to safeguard citizens’ information from misuse and unauthorised access but lacks specificity in certain clauses such as the interaction with sectoral data protection regulations.
The Digital Personal Data Protection (DPDP) Bill 2022
- The Digital Personal Data Protection (DPDP) Bill 2022 is a proposed legislation aimed at safeguarding the personal data of Indian citizens from misuse and unauthorized access.
- The bill aims to regulate the handling of personal data in the rapidly growing digital economy of India.
According to an explanatory note for the bill, it is based on seven principles-
- Lawful use: The first is that usage of personal data by organisations must be done in a manner that is lawful, fair to the individuals concerned and transparent to individuals.
- Purposeful dissemination: The second principle states that personal data must only be used for the purposes for which it was collected.
- Data minimisation: Bare minimum and only necessary data should be collected to fulfill a purpose.
- Data accuracy: At the point of collection. There should not be any duplication.
- Duration of storage: The fifth principle talks of how personal data that is collected cannot be stored perpetually by default, and storage should be limited to a fixed duration.
- Authorized collection and processing: There should be reasonable safeguards to ensure there is no unauthorised collection or processing of personal data.
- Accountability of users: The person who decides the purpose and means of the processing of personal data should be accountable for such processing
Challenges regarding conflicting sectoral regulations in India
- The DPDP Bill 2022 lacks specificity in certain clauses regarding the interaction with sectoral data protection regulations.
- While the Bill allows for filling regulatory gaps, conflicting sectoral regulations may create confusion.
- India already has sectoral regulations regarding data protection, such as the Reserve Bank of India’s directive on storage of payment data and the National Health Authority’s Health Data Management Policy. Any deviation from existing regulations will further require the industry to readjust their operations again at considerable cost.
Approach to regulate privacy and protect data
- The two major approaches to regulating privacy and protecting data is comprehensive legislation and sector-specific regulations
- The European Union’s General Data Protection Regulation (GDPR) as an example of comprehensive legislation with sector-specific provisions
- The American sectoral approach as a patchwork of regulations tailored to specific industries, with flaws in inconsistent protection, enforcement, and lack of federal regulation
Way ahead: Finding the right balance for India
- There is a need for greater clarity and specificity in the interaction between the DPDP Bill and sectoral regulations in India
- It is important to build on existing sectoral regulations to avoid undermining their efforts and require further costly adjustments
- The role of sectoral experts in ensuring a safer, more secure, and dynamic digital landscape for Indian citizens in the future is important.
Conclusion
- The DPDP Bill must serve as the minimum layer of protection, with sectoral regulators having the ability to build on these protections for a safer and more secure digital landscape.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Read the attached story
Mains level: Utilizing defunct mines for RE generation
Central idea: Green Gravity is an Australian renewable energy company that has developed a unique scheme to generate electricity. The company’s plan involves using defunct mines, such as the Kolar Gold Fields (KGF) in Karnataka, India, to produce reliable and cost-effective renewable energy.
The breakthrough: Gravity-Operated Weighted Blocks
- It uses a weighted block of up to 40 tonnes up to the top of a mine shaft using renewable power during the day when it is available.
- When backup power is required, the heavy block will fall under gravity, powering a generator via a connected shaft or rotor.
- The depth to which the block falls can be determined via a braking system, giving control over the amount of power produced.
Comparison to Pumped Hydropower Storage
- Green Gravity’s approach is similar to the well-established approach of “pumped hydropower” storage.
- In this approach, water is pumped upstream electrically into a reservoir and released downhill to move a turbine and produce electricity when needed.
Need for such technology
- Renewable energy, such as solar and wind power, often faces the challenge of being unreliable during nights or windless days.
- Charging a battery for backup power is very expensive and inefficient.
Advantages of Weighted Blocks over Water
- Using weighted blocks instead of water means that decommissioned mines can be put to use, and the environmental costs and challenges of moving water up can be avoided.
- This approach can also mean less reliance on coal-produced power and access to reliable power.
Potential Use in KGF
- The Kolar Gold Fields in Karnataka, India, is an iconic but defunct gold mine that has the potential to be used for renewable energy production.
- The weighted block apparatus could produce up to thousands of megawatt-hours of power from the mine’s deep shafts, some of which run nearly 3,000 metres.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Essential Medicines
Mains level: Read the attached story
Prices of 384 essential drugs and over 1,000 formulations are set to see a hike of over 11%, due to a sharp rise in the Wholesale Price Index (WPI).
Implications for customers
- Annual hikes in the prices of drugs listed in the National List of Essential Medicines (NLEM) are based on the WPI.
- The price surge will mean that consumers have to pay more for routine and essential drugs, including painkillers, anti-infection drugs, cardiac drugs, and antibiotics.
What are Essential Medicines?
- As per the World Health Organisation (WHO), Essential Medicines are those that satisfy the priority healthcare needs of the population.
- Ministry of Health and Family Welfare hence prepared and released the first National List of Essential Medicines (NLEM) of India in 1996 consisting of 279 medicines.
- The list is made with consideration to disease prevalence, efficacy, safety and comparative cost-effectiveness of the medicines.
- Such medicines are intended to be available in adequate amounts, in appropriate dosage forms and strengths with assured quality.
- They should be available in such a way that an individual or community can afford.
NLEM in India
- Drugs listed under NLEM — also known as scheduled drugs — will be cheaper because the National Pharmaceutical Pricing Authority (NPPA) caps medicine prices and changes only based on wholesale price index-based inflation.
- The list includes anti-infectives medicines to treat diabetes such as insulin — HIV, tuberculosis, cancer, contraceptives, hormonal medicines and anaesthetics.
- They account for 17-18 per cent of the estimated Rs 1.6-trillion domestic pharmaceutical market.
- Companies selling non-scheduled drugs can hike prices by up to 10 per cent every year.
- Typically, once NLEM is released, the department of pharmaceuticals under the ministry of chemicals and fertilisers adds them in the Drug Price Control Order, after which NPPA fixes the price.
Who regulates Drugs prices?
- The NPPA was set up in 1997 to fix/revise prices of controlled bulk drugs and formulations and to enforce price and availability of the medicines in the country, under the Drugs (Prices Control) Order, 1995-2013.
- Its mandate is:
- To implement and enforce the provisions of the DPCO in accordance with the powers delegated to it
- To deal with all legal matters arising out of the decisions of the NPPA
- To monitor the availability of drugs, identify shortages and to take remedial steps
- The NPPA is also mandated to collect/maintain data on production, exports and imports, market share of individual companies, profitability of companies etc., for bulk drugs and formulations and undertake and/ or sponsor relevant studies in respect of pricing of drugs/ pharmaceuticals.
How does the pricing mechanism work?
- Prices of Scheduled Drugs are allowed an increase each year by the drug regulator in line with the Wholesale Price Index (WPI) and the annual change is controlled and rarely crosses 5%.
- But the pharmaceutical players pointed out that over the past few years, input costs have flared up.
- The hike has been a long-standing demand by the pharma industry lobby.
- All medicines under the NLEM are under price regulation.
Try this MCQ
Q. Which of the following is not a mandate of the National Pharmaceutical Pricing Authority (NPPA)?
A) Fixing and revising prices of controlled bulk drugs and formulations
B) Enforcing price and availability of medicines in the country
C) Monitoring the availability of drugs and taking remedial steps
D) Regulating the import and export of pharmaceutical products
Post your answers here.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: CITES, WPA Act
Mains level: Not Much
A person in UP was booked under the Wildlife Protection Act, 1972, for “illegally” keeping and nursing an injured Sarus crane (Grus Antigone) he found in his village.
About Sarus
- The Sarus crane is usually found in wetlands and is the state bird of Uttar Pradesh.
- Standing at 152-156 centimetres, it is the world’s tallest flying bird.
What is Wildlife (Protection) Act, of 1972?
- WPA provides for the protection of the country’s wild animals, birds and plant species, in order to ensure environmental and ecological security.
- It provides for the protection of a listed species of animals, birds and plants, and also for the establishment of a network of ecologically-important protected areas in the country.
- It provides for various types of protected areas such as Wildlife Sanctuaries, National Parks etc.
There are six schedules provided in the WPA for the protection of wildlife species which can be concisely summarized as under:
| Schedule I: |
These species need rigorous protection and therefore, the harshest penalties for violation of the law are for species under this Schedule. |
| Schedule II: |
Animals under this list are accorded high protection. They cannot be hunted except under threat to human life. |
| Schedule III & IV: |
This list is for species that are not endangered. This includes protected species but the penalty for any violation is less compared to the first two schedules. |
| Schedule V: |
This schedule contains animals which can be hunted. |
| Schedule VI: |
This list contains plants that are forbidden from cultivation. |
What is the law on animals and birds under Schedule IV?
- Species mentioned under Schedules III and IV relate to the prohibition on dealings in trophy and animal articles without a license, purchase of animals by a licensee, and restriction on transportation of wildlife.
- Section 48 of the Act specifically states that any wild animal or animal article can be transported only after obtaining permission from the Chief Wildlife Warden or any other officer authorised by the state.
- Section 44 provides for issuing licenses to taxidermists, eating houses (hotels or restaurants), and dealers in animal articles, preserved animal parts or trophies, uncured trophies (whole or any unpreserved part of an animal), captive animals, and snake venom of such species.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Diabates among children
Mains level: Not Much
The National Commission for Protection of Child Rights (NCPCR) has written to Education Boards of all States/UTs, stating schools must ensure proper care/facilities for children with Type 1 diabetes (T1D).
What is Diabetes?
- Diabetes is a chronic medical condition that occurs when the body cannot regulate blood sugar levels properly.
- Blood sugar, also known as blood glucose, is the main source of energy for the body’s cells.
- Insulin, a hormone produced by the pancreas, helps the body use and store glucose from food.
- In diabetes, the body either does not produce enough insulin or cannot use the insulin it produces effectively, resulting in high blood sugar levels.
- Over time, high blood sugar levels can cause serious health problems, such as damage to the heart, blood vessels, eyes, kidneys, and nerves.
Types of Diabetes
There are two main types of diabetes: Type 1 and Type 2.
- Type 1 diabetes: It is an autoimmune disease in which the immune system attacks and destroys insulin-producing cells in the pancreas, resulting in a lack of insulin. This type of diabetes is typically diagnosed in children and young adults, although it can occur at any age. It requires insulin injections or pump therapy for survival.
- Type 2 diabetes: It is a metabolic disorder in which the body becomes resistant to the effects of insulin or doesn’t produce enough insulin to maintain normal glucose levels. This type of diabetes is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet. It is typically diagnosed in adults, but it is becoming increasingly common in children and adolescents as well. Treatment for Type 2 diabetes may include lifestyle changes, oral medications, or insulin therapy.
Menace of diabetes in India
- According to data from the International Diabetes Federation Atlas 2021, India has the world’s highest number of children and adolescents living with Type I Diabetes Mellitus (TIDM).
- There are over 2.4 lakh TID patients in the Southeast Asia region.
Measures to mitigate TID impact on students
- CBSE circular in 2017 allowed students with T1D in Classes X and XII to carry certain eatables to board exam hall to avoid low sugar episodes.
- They are permitted to carry medicines, snacks, water, a glucometer, and testing strips.
- NCPCR suggests states allow students to use smartphones to monitor sugar levels.
- Tamil Nadu has been providing free insulin to children with T1D since 1988.
Back2Basics: National Commission for Protection of Child Rights (NCPCR)
- NCPCR is a statutory body established in India under the Commissions for Protection of Child Rights Act, 2005.
- Its objective is to protect, promote and defend the rights of children in India.
- It functions as a watchdog to prevent child rights violations, as well as to take action against those responsible for such violations.
- The NCPCR also advocates for the implementation of laws, policies and programs aimed at promoting child welfare and development.
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