Q.1) For the complete eradication of Tuberculosis from the country, Revised National Tuberculosis Control Program (RNTCP) was introduced. In this context, discuss what are the major loopholes of the programme and how National Strategic Plan for tuberculosis 2017– 2025 would be helpful in eradication of TB? (GS-1)
What is the Revised National Tuberculosis Control Program (RNTCP)?
- Revised National Tuberculosis Control Program (RNTCP) is the state-run tuberculosis (TB) control initiative of the Government of India.
- As per the National Strategic Plan 2012–17, the program has a vision of achieving a “TB free India”.
- RNTCP provides various free of cost, quality tuberculosis diagnosis and treatment services across the country through the government health system.
- The program uses the World Health Organisation (WHO) recommended Directly Observed Treatment Short Course (DOTS) strategy and reaches over a billion people in 632 districts/reporting units.
- It is also responsible for carrying out the Government of India five year TB National Strategic Plans.
Loopholes in the program:
- Though the Revised National Tuberculosis Control Programme (RNTCP) has treated 10 million patients, the rate of decline has been slow.
- RNTCP failed on universal access to early diagnosis and treatment and improving case detection.
- Also, India is far from reaching the 2030 Sustainable Development Goals, i.e. reducing the number of deaths by 90% and TB incidence by 80% compared with 2015.
What is National Strategic Plan for tuberculosis 2017– 2025?
- The national strategic plan for tuberculosis elimination (2017-2025), has set a goal of “achieving a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB by 2025.”
- The TB control programme plans to do away with the strategy of waiting for patients to walk in to get tested and instead engage in detecting more cases, both drug-sensitive and drug-resistant.
- The emphasis will be on using highly sensitive diagnostic tests, undertaking universal testing for drug-resistant TB, reaching out to TB patients seeking care from private doctors and targeting people belonging to high-risk populations.
- The other priority is to provide anti-TB treatment irrespective of where patients seek care from, public or private and ensure that they complete the treatment.
- The TB control programme also talks of having in place patient-friendly systems to provide treatment and social support.
Q.2) Antibiotic resistance is one of the biggest threats to global health, food security, and development today. Why do you think antimicrobial resistance is a major global concern? What accelerates the emergence and spread of antimicrobial resistance? (GS-3)
Antimicrobial resistance is the ability of a microorganism like bacteria, viruses, and some parasites to stop an antimicrobial such as antibiotics, antivirals, and antimalarials from working against it.Microorganisms that develop antimicrobial resistance are referred to as “Superbugs”.
According to WHO, Antimicrobial resistance is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infectious causes against it.The medicines become ineffective and infections persist in the body, increasing the risk of spread to others. It is not a country specific issue but a global concern that is jeopardizing global health security. In India the infectious disease burden is among the highest in the world
Why is antimicrobial resistance a global concern?
- New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death.
- Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk.
- Antimicrobial resistance increases the cost of healthcare with lengthier stays in hospitals and more intensive care required.
- Antimicrobial resistance is putting the gains of the Millennium Development Goals at risk and endangers achievement of the Sustainable Development Goals.
- Spread of resistance-genes that promote life-threatening bacteria
What accelerates the emergence and spread of antimicrobial resistance?
- Antimicrobial resistance occurs naturally over time, usually through genetic changes.
- The misuse and overuse of antimicrobials is accelerating this process.
- In many places, antibiotics are overused and other misused in people and animals, and often given without professional oversight.
- Antimicrobial resistant-microbes are found in people, animals, food, and the environment in water, soil and air. They can spread between people and animals, and from person to person.
- Poor infection control and inadequate sanitary conditions and inappropriate food-handling encourage the spread of antimicrobial resistance.
- Discharge of antimicrobial waste into environment by pharmaceutical industry.
- Lack of new antibiotic being developed.
- Poor infection control in hospitals and clinics.
Q.3) The International Conference on Environment 2017 was recently conducted on November 3 and 4. The conference followed the path of a tribunal like the National Green Tribunal (NGT). Why did India set up NGT? Discuss the advantages and disadvantages of having a tribunal like NGT? (GS-3)
- There lie many reasons behind the setting up of this tribunal. After India’s move with Carbon credits, such tribunal may play a vital role in ensuring the control of emissions and maintaining the desired levels.
- This is the first body of its kind that is required by its parent statute to apply the “polluter pays” principle and the principle of sustainable development.
- This court can rightly be called ‘special’ because India is the third country following Australia and New Zealand to have such a system.
- India has now become the third country in the world to start a National Green Tribunal (NGT) which is a judicial body exclusively meant to judge environmental cases after Australia and New Zealand.
- The National Green Tribunal has been established under the National Green Tribunal Act, 2010for effective and expeditious disposal of cases relating to environmental protection and conservation of forests and other natural resources.
- The Tribunal is mandated to make and Endeavour for disposal of applications or appeals finallywithin 6 months of filing of the same.
Structure of National Green Tribunal
- Going by the enactment of the national green tribunal act, New Delhi has been chosen as the principal bench of the NGT, with regional benches in Pune (Western Zone Bench), Bhopal (Central Zone Bench), Chennai (Southern Bench) and Kolkata (Eastern Bench).
- Each Bench has a specified geographical jurisdiction covering several States in a region. There is also a mechanism for circuit benches.
Powers of National Green Tribunal
- NGT has a power to hear all civil matters which are related to environment and questions regarding the enforcement and implementation of laws which fall under the seven categories of laws namely (in order of their enactment)
- The Water (Prevention and Control of Pollution) Act, 1974;
- The Water (Prevention and Control of Pollution) Cess Act, 1977;
- The Forest (Conservation) Act, 1980;
- The Air (Prevention and Control of Pollution) Act, 1981;
- The Environment (Protection) Act, 1986;
- The Public Liability Insurance Act, 1991;
- The Biological Diversity Act, 2002
- The NGT has been given the power to regulate the procedure by itself. It does not follow the principles of civil procedure code instead it follows principles of natural justice.
- The NGT also at the time of giving orders shall apply the principals of sustainable development and also the principal that the one who pollutes shall pay.
- It will have the same power as of the civil court in deciding the matter falling within these seven legal acts.
- Even the NGT will not be bound by the rules of evidence as mentioned in the Indian evidence act.
- Anything which is not covered under these seven acts the NGT is not competent to admit the suit for that matter. The major drawback of this limitation is that a person cannot approach the NGT for every environmental issue.
Advantages of having a tribunal like NGT
- The major benefit with NGT is that it has a strong order enforcing mechanism. If the orders of NGT are not complied with than it has the power to impose both punishment as well as fine.
- The punishment is up to three years and the penalty is up to ten crore and for firms in can extend up to twenty five crores. Also the director or manager of the firm can be punished or penalized if it is found by the tribunal that the offence has been committed on the orders or with the consent of such officer of the firm.
- The act also provides various kinds of reliefs to the persons who are affected by the degradation of environment as the inhabitant of that particular area. Any person who has sustained the injury can file a suit in the National Green Tribunal.
- The government or the government agencies related to environment can file a suit in place of that person like the central or the state government or the central pollution control board or state pollution control board.
- The act also provides for fast delivery of justice and the act provides that all possible efforts will be made to dispose of the case within six months from the date of filing the suit.
- The period for filing a suit with NGT is up to 5 years from the date on which the cause for compensation arose. However if the tribunal has sufficient grounds for believing that the person has reasonable cause that prevented him from filing a suit in NGT than it can extend the period for a maximum of sixty days.
- If a person is not satisfied with the orders of the tribunal he can seek the review of the decision of NGT under rule 22 of the NGT rule. And even then if he is not satisfied with the decision of the tribunal he can file an appeal to the Supreme Court of India. But the appeal has to be filed within ninety days of the orders passed by NGT.
Criticism of National Green Tribunal
- It lacks judicial independence from the government. The rules of the NGT act allowed the bureaucrats to be appointed to the tribunal while holding their post in the government.
- This is problematic in the sense that a government official will never rule against the government because he is also a part of government and faces various kinds of pressure to not to rule against the central government.
Issue of funding
- The concept of Tribunals is in itself problematic as they are funded by the parent ministry and hence it exercises control over the tribunal and its decisions.
Need of Environmental experts
- The need for experts in the tribunal is also problematic concept because the NGT has to decide the question of law and does not have to do fact finding. The expert knowledge is not needed in granting compensation or awarding punishment. For this, there needs to be a knowledge of law.
Lack of resources
- The tribunal also faces a lack of resources for its proper functioning. The NGT was operating from a guest house earlier. Also the members of the tribunal were not given houses and were living in government guest house.
- The funds were decreased further without taking into consideration the fact that NGT is already suffering from lack of adequate funding.
No proper establishment
- The law commission report on the environmental courts suggested that one such court should be established in every state. But the NGT has only 5 benches.
- This has created problem for common citizens asking for justice as it is difficult to approach a court which is in different state and far from their home.
- The establishment of NGT also took away the right of civil courts to admit cases regarding environmental issues. So it is now compulsory to file the case before the NGT in these cases.
- Even a PIL cannot be filed in the High Court of the state for environmental issues as all environmental litigation shall be dealt only by the five benches of NGT. There is a need for environmental tribunal on district bases but present system is not even providing it on state basis.