Health
Health Ministry Releases “National Policy for Rare Diseases 2021”
What is the News?
The caretakers of patients with ‘rare diseases’ are not satisfied with the National Policy for Rare Diseases 2021. The Union Health Ministry recently released the policy.
Rare Diseases: WHO defines a rare disease as a lifelong disease or disorder that often highly weakens an individual. It has a prevalence of 1 or less per 1000 population. Example: Haemophilia, Thalassemia, Sickle cell anaemia, auto-immune diseases among others.
- However, every country has its own definition for rare diseases.
- The US defines rare diseases as a disease or condition that affects fewer than 200,000 patients in the country.
- Likewise, the EU defines rare diseases as life-threatening or chronically debilitating (weakening) condition. It should affect no more than 5 in 10,000 people.
About National Policy For Rare Diseases,2021:
- Aim: The policy aims to lower the incidence and prevalence of rare diseases based on an integrated and comprehensive preventive strategy. The strategy includes awareness generation, counselling programmes, providing affordable Health Care among others.
Key Features of the National Policy For Rare Diseases,2021:
- Categorisation: The policy categorizes rare diseases into three groups:
- Group 1: Disorders amenable to one-time curative treatment;
- Group 2: Diseases requiring long term or lifelong treatment; and
- Group 3: Diseases for which definitive treatment is available, but challenges are to make an optimal patient selection for benefit.
- Government Support:
- The government will provide Financial support of up to Rs. 20 lakh under the Umbrella Scheme of Rashtriya Arogya Nidhi for treatment of those rare diseases listed under Group 1.
- Moreover, Beneficiaries for such financial assistance would not be limited to BPL families. About 40% of the population, eligible under Pradhan Mantri Jan Arogya Yojana, will also be eligible for assistance.
- Further, for group 2, the State Governments can consider supporting specific patients. It includes a rare disease that can be managed with special diets or hormonal supplements or other relatively low-cost interventions (Diseases listed under Group 2).
- Voluntary Crowdfunding: The government has said that it will assist in voluntary crowd-funding for the treatment of Group 3. It is because it will be difficult to fully finance the treatment of high-cost rare diseases of Group 3.
Objections to the Policy:
- The policy offers no support to patients awaiting treatment since the earlier National Policy for Treatment of Rare Diseases 2017 was kept on hold.
- The policy has left patients with Group 3 rare diseases to fend for themselves. It has absolutely no consideration for Group 3 patients who require lifelong treatment support.
Rashtriya Arogya Nidhi scheme:
It provides financial assistance to patients living below the poverty line and who are suffering from major life-threatening diseases, to receive medical treatment.
Source: The Hindu
Ministry of Health and Family Welfare launches “Tribal TB Initiative”
What is the News?
Union Health Minister launches the Tribal TB Initiative to achieve the goal of TB Mukt Bharat.
About Tribal TB Initiative:
- Aim: Firstly, Tribal TB Initiative aims to address the problem of Tuberculosis in Tribal Population.
- Secondly, the initiative will initially focus on 161 districts across 18 identified States. It will focus on vulnerability mapping, active case finding, and promote behavioral change at the ground level.
- Thirdly, TB Mukt Bharat initiative aims at the elimination of TB by 2025.
Why was this initiative launched?
- Over 104 million tribal populations live in India. It spreads across 705 tribes and accounts for 8.6 % of India’s population.
- This tribal population is highly vulnerable to TB due to physical remoteness, malnutrition, poor living conditions, and lack of awareness. Hence, the initiative is launched to focus on these areas.
Note:
- Lakshadweep and the district of Badgam in Jammu and Kashmir have been declared TB Free on World TB Day 2021.
- The Government of India has increased the Budget allocation for TB in India four-fold in the last 5 years.
Other Tribal Health-Related Initiatives:
- ALEKH: It is an e-newsletter that is to be released on a quarterly basis. It will showcase the works of different stakeholders involved in improving the health and nutrition of tribals.
- Swasthya Portal: It aims to provide health and nutrition-related information to the tribal population of India.
Source: AIR
Health Minister Appointed as Chairman of “Stop TB Partnership Board”
“Double Mutant” COVID Virus Variant Found
What is the News?
Indian SARS-CoV-2 Consortium on Genomics (INSACOG) has been doing genome sequencing of Covid-19 Variants. It has found a unique “double mutant” virus variant in India. This variant has a unique combination of mutations, not seen anywhere else in the world.
What is Double Mutation?
- Double Mutation is when two mutated strains of a virus come together and form a third strain.
- The one reported in India is the result of the combination of E484Q, and L452R strains. The L452R strain is found in California in the United States, while, the E484Q strain is indigenous.
Is this double Mutant COVID Variant Harmful?
- Mutation in the virus is a normal process. But some mutations help the virus in defending itself from vaccines or antibodies or linking to a spike in cases.
- However, the capability of double mutant coronavirus variant in increased infectivity or in making COVID-19 more severe is still uncertain.
- Hence, INSACOG will submit details of this variant to a global repository called GISAID. If it qualifies, it will be classified as a “variant of concern”(VOC).
- Variant of concerns requires appropriate public health actions, such as
- Notification to WHO under the International Health Regulations,
- reporting to CDC,
- local or regional efforts to control spread,
- increased testing, or research to determine the effectiveness of vaccines and treatments against the variant
Note: So far, only three global Variants of Concern (VOCs) have been identified: the U.K. variant (B.1.1.7), the South African (B.1.351) and the Brazilian (P.1) lineage.
About INSACOG:
- Indian SARS-CoV-2 Consortium on Genomics(INSACOG) is a grouping of 10 National Laboratories. It was established by the Ministry of Health and Family Welfare(MoH&FW).
- Aim:
- Firstly, to monitor the genomic variations in the SARS-CoV-2 on a regular basis through a multi-laboratory network.
- Secondly, to ascertain the status of a new variant of SARS-CoV-2 in the country.
- Furthermore, to establish a surveillance system for early detection of genomic variants and determine the genomic variants in the unusual events/trends.
- Coordinated by: The Department of Biotechnology (DBT) along with MoH&FW, ICMR, and CSIR coordinate it.
- Significance: The knowledge generated through this vital research consortium assists in developing diagnostics and potential therapeutics and vaccines in the future.
Global Initiative on Sharing All Influenza Data(GISAID) Initiative
- The GISAID Initiative was launched on the occasion of the 61st World Health Assembly in 2008.
- In 2010, Germany became the official host of the GISAID Initiative through a public-private partnership.
- Aim: It aims to promote rapid sharing of data of all influenza and COVID virus sequences globally. Moreover, it helps to understand, how the viruses evolve, spread, and potentially become pandemics.
- Headquarters: Munich, Germany.
Source: The Hindu
What is “Parosmia”?
What is the News?
The most common symptoms of Covid-19 are anosmia and ageusia. However, several people are also experiencing parosmia. It is characterized by a change in perception of odours.
Anosmia: It is the partial or complete loss of the sense of smell. This loss may be temporary or permanent.
Ageusia: It is a condition, characterized by a complete loss of taste function of the tongue.
About Parosmia:
- Firstly, Parosmia is a medical term. It describes a condition in which affected individuals experience distortions in the sense of smell.
- Secondly, a person with parosmia is able to detect certain odours. But they might experience the smell of certain things as different and often unpleasant. For example, coffee may smell like burnt toast.
- Thirdly, Causes: People who are recovering their sense of smell following a loss from a virus or an injury typically experience parosmia.
- And lastly, Parosmia is a temporary condition and is not harmful in itself.
Source: Indian Express
Deadly drug-resistant superbug “Candida Auris or C.Auris” found in Andamans
What is the News?
Candida Auris (deadly hospital pathogen) identified for the first time in the Andaman and Nicobar Islands.
About Candida Auris:
- Candida Auris or C.auris is a multidrug-resistant fungus. It presents a serious global threat to human health.
Origin of Candida Auris:
- Candida Auris was first identified in 2009 in a patient in Japan. The fungus emerged in more than 40 countries across five continents in the last decade.
- The fungus is mostly found in tropical marshes and marine environments, outside hospital environments.
- However, it is an emerging pathogen, thus very little is known about the Candida Auris so far.
Symptoms of C.Auris:
- C.Auris infections can show no symptoms before turning into a fever and chills. These symptoms don’t go away despite the use of medicines and can lead to death.
- C.auris survives on the skin before entering the body through wounds. Once in the bloodstream, it causes severe illness and can lead to death.
Why C.Auris is harmful? C.Auris is considered dangerous because of three reasons:
- Fisrtly, C.Auris is often multidrug-resistant. It means that it is resistant to multiple antifungal drugs commonly used to treat Candida infections.
- Secondly, it can survive and persist within the hospital environment for prolonged periods. It is capable to survive on dry environmental surfaces for prolonged periods. It means that it adapts well to survival outside human host settings as well.
- Lastly, C.Auris is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
Vulnerable Population:
- C.Auris can get deadly for immunocompromised patients. The incidence of deaths from this fungal infection is high in countries such as the US and the UK, but its prevalence is less in Indian hospitals.
Treatment:
- Echinocandins, a class of antifungal drugs, can treat most of the C.auris infections. However, some C. auris infections have been resistant to antifungal medications making them more difficult to treat.
Source: Indian Express
Public trust is key to successful vaccination programmes
Synopsis- Need transparency and timely data sharing to build public trust in the COVID-19 vaccination programme.
Introduction-
- Major European countries, including Germany, France, Italy, and Spain have halted the use of AstraZeneca’s COVID-19 vaccine. This is followed by the warnings of harmful blood clots in some recipients.
- However, the World Health Organization (WHO) and the European Medicines Agency have ruled out any correlation between AstraZeneca’s vaccine and blood clots.
Data on Blood Clot:
According to a study based on the U.S. population, about 1,000 to 2,000 blood clots occurs every single day in the human body.
In the recent AstraZeneca’s COVID-19 vaccine case, there are only 40 blood clot cases reported due to that.
But people are reluctant to get the vaccine due to these types of events. Further, it would lead to a negative effect on the vaccination push.
What are the reasons behind the impediments to vaccination programmes?
- No proper vaccine efficacy data available – There is uncertainty and suspicion regarding the side effects of the Covid-19 vaccine.
- The risks associated with COVID-19 vaccines have not been fully investigated as these vaccines were issued under the Emergency Use Authorizations.
- The National Committee on Adverse Events Following Immunization has no proper details about the serious adverse events following immunization.
- Transparency and prompt data sharing: There is lack of transparency and data sharing in vaccination programmes. It could lead to a lack of trust in the vaccine.
Suggestions to improve vaccination programmes
- Firstly, transparency and timely data sharing about the vaccine, and open public health communication will win public trust and faith in vaccines.
- Secondly, like the U.S. Centers for Disease Control and Prevention, India should also create data on adverse vaccine effects.
- Lastly, vaccine hesitancy is the main obstruction in the smooth vaccination drive. And so, it must resolve immediately.
Source- The Hindu
Health Minister Appointed as Chairman of “Stop TB Partnership Board”
What is the News?
Union Minister for Health and Family Welfare appointed as the Chairman of the Stop TB Partnership Board. The Minister will serve a 3-year term commencing July 2021.
About Stop TB Partnership:
- Stop TB Partnership was established in the Year 2000.
- Aim: The aim is to eliminate tuberculosis as a public health problem.
- Significance: It is a unique international body as it aligns all countries in the world to fight against TB.
- Amsterdam Declaration: In 2000, Stop TB Partnership gave a call for collaborative action from ministerial delegations of 20 countries with the highest burden of TB.
- Partner organizations: It has 1500 partner organizations. It includes international, non-governmental, and governmental organizations and patient groups.
- Secretariat: Geneva, Switzerland.
India’s Initiatives against Tuberculosis:
- Firstly, India has committed to eliminating TB in the country by 2025, five years ahead of the global deadline of 2030.
- Secondly, National Strategic Plan (NSP) for TB Elimination (2017-2025): It is a framework to provide guidance for the activities of various stakeholders to reduce the burden of TB mortality and morbidity. It aims to work towards the elimination of TB in India by 2025.
- Thirdly, Nikshay Poshan Yojana: It is a direct benefit transfer (DBT) scheme to provide nutritional support to TB patients.
- Lastly, TB Harega Desh Jeetega’ Campaign: This campaign aims to improve and expand the reach of Tuberculosis care services across the country by 2022.
Source: PIB
WHO Announced “Global Breast Cancer Initiative”
What is the News?
The World Health Organization (WHO) announced an initiative called the “Global Breast Cancer Initiative”.
About Global Breast Cancer Initiative:
- Aim: The initiative aims to reduce global breast mortality by 2.5% by 2040.
- The initiative will particularly focus on reducing deaths in low-income countries. There the progress to tackle the disease is relatively slow.
- Key Features of the Initiative:
- Guidance to Governments: Under the initiative, WHO will work with other UN agencies. They will provide guidance to governments on how to strengthen systems for diagnosing and treating breast cancer. It is expected to improve capacities to manage other types of cancer.
- Evidence-based Technical Package: An evidence-based technical package will also be provided to countries as part of the initiative. It will incorporate existing WHO cancer tools and products.
About Breast Cancer:
- Breast cancer is the most common form of cancer in women. It is responsible for one in six cancer deaths among women and has overtaken lung cancer as the world’s most commonly diagnosed cancer.
- Survival Rates: Breast cancer survives for five years after diagnosis exceeds 80% in most high-income countries. However, it is 66% in India and 40% in South Africa.
Source: Down To Earth
Increasing Cases of Gestational Diabetes in India
Synopsis: India registers a high number of gestational diabetes cases, which are bound to increase in the future. This coupled with low awareness and poor testing potential calls for immediate action.
Background:
- Diabetes is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy.
- If a person is having diabetes, the body either doesn’t make enough insulin or can’t effectively use the insulin it makes.
- India has 7 crore cases of diabetes and almost 3.5 crore prediabetes cases.
- Further, Type 2 diabetes is most common, it is preventable with some lifestyle changes. However, very less focus is placed on Gestational diabetes.
About Gestational Diabetes:
- It is a transitory form of diabetes occurring in pregnant women.
- South Asian women are at higher risk of development as shown by data from the International Diabetes Federation. It estimates that 25% of south Asian women would develop it.
- In India, it is assumed to be more prevalent in urban areas (30%) than rural areas (10%). Further, assuming a 10% rate of development, the figure for gestational diabetes comes around 27-30 lakh women every year.
Impact of Gestational Diabetes:
- First, it enhances complications during pregnancy. This includes preeclampsia (fits during pregnancy), prolonged and obstructed labor, need for assisted delivery, postpartum hemorrhage, etc.
- Second, the above complications can cause a spike in maternal and neonatal mortality rates.
- Third, if not death, then the probability of developing other problems is quite high.
- Type 2 diabetes gets developed in almost 50% of women.
- Children also are at high risk of obesity, type 2 diabetes, and cardiovascular diseases.
Challenges in Managing Gestational Diabetes:
- First, there is a lack of awareness regarding gestational diabetes due to which, it gets noticed after the complication has occurred.
- Second, our health system also lacks the capacity for providing robust and timely testing.
Way Forward:
- There should be a prompt and adequate implementation of national guidelines on the diagnosis and management of gestational diabetes.
- The single test procedure suggested by Dr. V. Seshiah (a pioneer in the field of diabetes and pregnancy) and subsequently approved by the World Health Organisation should be adopted for better diagnosis.
- In order to spread awareness, the 10th march can be celebrated as National Gestational Diabetes Awareness Day.
- The Diabetes Study Group of India recommended this step as it would be an act to recognize Dr V. Seshiah’s contribution to the field of diabetes and pregnancy for more than 40 years.
Source: The Hindu
Prerequisites for Developing Digital Health Data
Synopsis: National Digital Health Mission aims to build digital health infrastructure in India. But there are many hurdles in developing comprehensive digital health data.
Introduction:
Recently on Independence Day, our Prime Minister announced National Digital Health Mission. The Mission aims to develop the backbone for integrated digital health infrastructure in India. Developing countries with significant health challenges like India critically need such an infrastructure.
The NDHM will help in developing the diagnostics and management of health services. Apart from that, the NDHM will also help in achieving broader public health monitoring, research, socio-economic studies, prioritizing resource allocation and policy interventions, etc.
Digitization can make healthcare more organized, effective, and efficient. But we must know that Digitization can’t substitute the fundamentals like an investment in nutrition and welfare, primary healthcare services and healthcare professionals, etc.
What is the prerequisite to digital health infrastructure?
Before going completely digital, certain things are essential to achieve the desired social objectives. They are,
- India needs to carefully develop various ways to fulfil the “health needs of the public”. India needs to carefully examine the following things and their improvement with digitization. Such as,
- Ways of facilitating better diagnosis and management,
- Understanding of the data structures for effective health services
- Alleviate health problems with digitization such as malnutrition and child stunting, etc.
- Challenges with Privacy: It may also create tensions between a collection of digital health data and individual rights to privacy. For example, many countries like UK, Sweden, the US, etc. attempted to build digital health infrastructures they were not successful due to serious privacy-related controversies.
- Linking the digital health data to other sectors: This data may be linked to other sectors such as banking and services with adequate access to data. This creates two types of challenges.
- Not linking the digital health data with other sectors will make the potential uses of digital health data very limited.
- Complete interlinking of digital health data will create various problems such as privacy violation, the vulnerability of data to profit-motivated pharma companies, etc.
- Design of Digital health data operations: Access to digital data requires identifying and understanding the complexity in various data sources such as immunisation records, data in government and private hospitals, diagnostic centres, etc. The design should also include an understanding of data generation frequency, error models, sharing and other operational requirements, etc.
- Building an effective system that can generate people’s trust requires building a transparent process. That process should have openness and public consultations in all spheres of development. This includes avoiding “crony expertise”, rejecting poorly-conceived designs and ideas, etc.
So, developing a comprehensive digital health infrastructure not only depends on the health sector alone. Instead, it also depends on e-governance and the administration of digitisation in India.
Issues associated with the launch of Coronil
Synopsis: Coronil Launch event is in controversy again. Ministers and public figures must not be seen as endorsing drugs whose efficacy is in doubt
Background
At a recent event, Haridwar-based Patanjali announced that its Coronil Ayurveda medicine recognized as a “supporting measure in COVID-19” by Ayush Ministry. Ministry awarded the Certificate of Pharmaceutical Product (CoPP) as per the WHO certification scheme.
After receiving certification, the export of medicine has become possible. This event was presided by Union Health Minister Harsh Vardhan and Transport Minister Nitin Gadkari.
The company claimed that it is the first evidence-based medicine to fight COVID-19.
This event attracted several criticisms. Indian Medical Association (IMA) criticized this promotion as unethical and a “blatant deceiving of the people of the country”.
What are the issues associated with the launch of Coronil?
- Firstly, Patanjali is a private company and coronil is the product of it. As per code of act, Doctors are barred from promoting any drugs and Dr Harsh Vardhan (health minister) is an ENT surgeon.
- Secondly, Baba Ramdev claimed at the event that WHO endorsed Coronil. Whereas, WHO South-East Asia in a tweet refused any such endorsement.
- Third, the publication of a randomized clinical trial of Coronil in a research journal was also put forward as an endorsement by that magazine. These publications are nothing but an initial requirement that put forward the report in front of subject experts.
- Fourth, the published report reveals that medicine was tested only on 95 patients. All of them were asymptomatic and mildly symptomatic but confirmed as RT-PCR positive. This number is very small. Moreover, a large population with mild or no symptoms recovers without any external intervention.
However, it is not the only case, where a drug approved without any solid research. DGCA previously approved itolizumab by Biocon, which was tested only on the sample of 30. Approval of Covaxin also was in a haste and lacked solid scientific evidences.
Integration of “Non-Alcoholic Fatty Liver Disease” with NPCDCS
What is the news?
The Ministry of Health & Family Welfare has launched operational guidelines for integration of NAFLD(Non-Alcoholic Fatty Liver Disease) under NPCDCS (National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke).
About NPCDCS (National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke):
- Launched in: It was launched in 2010. It aims to prevent and control Non-Communicable Diseases(NCDs).
- Implemented under: National Health Mission(NHM).
- Objectives: The objectives of the programme include awareness generation for the prevention of NCDs. Some important constituents of this program are screening, early detection, management and referral to an appropriate level health facility.
About Non-Alcoholic Fatty Liver Disease(NAFLD):
- It is a term for abnormal accumulation of fat in the liver despite the absence of harmful alcohol use, viral hepatitis or medications.
- Prevalence of NAFLD in India: As per studies, the prevalence of NAFLD is around 9% to 32% of the general population in India. There is a higher prevalence among overweight or obesity and those with diabetes or prediabetes.
Stages of NAFLD: The main stages of NAFLD are:
- Simple Fatty Liver Disease – It is a largely harmless build-up of fat in the liver cells. It may only be diagnosed during tests carried out for another reason.
- Non-Alcoholic steatohepatitis(NASH) – Mere deposition of fat in the liver is termed steatosis. It is characterized by inflammation of the liver.
- Fibrosis – It is where persistent inflammation causes scar tissue around the liver and nearby blood vessels. But the liver still able to function normally.
- Cirrhosis – It is the most severe stage after years of inflammation. At this stage, the liver shrinks and becomes scarred and lumpy. This damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer.
Is NAFLD Curable?
- Once the disease develops, there is no specific cure available, and health promotion and prevention aspects targeting weight reduction, healthy lifestyle can prevent the mortality and morbidity due to NAFLD.
Source: PIB
“Intensified Mission Indradhanush (IMI) 3.0”
What is the News?
Recently Union Health Minister launched Intensified Mission Indradhanush (IMI) 3.0 in India. After the launch, States and UTs have started the implementation of the IMI 3.0.
Development of Immunisation Programme in India:
- Ministry of Health and Family Welfare introduced the Immunization Programme in India in 1978. It was released in the name of ‘Expanded Programme of Immunization’ (EPI).
- In 1985, the EPI programme was modified as ‘Universal Immunization Programme’ (UIP). This was to be implemented in a phased manner to cover all districts in the country. Despite being operational for many years, UIP able to fully immunize only 65% of children in their first year of life.
- Mission Indradhanush:
- It was launched in 2014. The aim of the mission was to ensure full immunization with all available vaccines for children up to two years of age. Further, the mission aims to vaccinate pregnant women who were either unvaccinated or partially vaccinated under UIP.
- Diseases covered for Vaccines: Under the mission, vaccination is provided free of cost against 12 vaccine-preventable diseases. Such as Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, severe form of Childhood Tuberculosis, Rotavirus diarrhoea, Hepatitis B, Meningitis & Pneumonia caused by Haemophilus Influenzae type B, Pneumococcal Pneumonia and Japanese Encephalitis.
- However, under Mission Indradhanush, Vaccination against Japanese Encephalitis and Haemophilus influenza type B is provided only in selected districts of the country.
- Intensified Mission Indradhanush(IMI)
- It was launched in 2017. The aim was to vaccinate each and every child up to two years of age. Apart from that, IMI also vaccinates all those pregnant women who have been left uncovered under the routine immunisation programme/UIP.
- Special attention was given to unserved/low coverage pockets and urban slums with a migratory population.
- Special vaccination drives were conducted under IMI. These drives aimed to ensure full immunisation coverage in 90% of select districts and cities by 2018.
- Intensified Mission Indradhanush (IMI) 2.0
- It was launched in December 2019. It aimed to achieve targets of full immunization coverage in 272 districts of 27 States. Full immunization of 652 blocks in Uttar Pradesh and Bihar also targetted. Hard-to-reach and huge tribal populated region were chosen as blocks
- The mission has a focus on urban, underserved population and tribal areas.
- IMI 2.0 also had Inter-ministerial and inter-departmental coordination.
- Intensified Mission Indradhanush (IMI) 3.0
- It aims to cover children and pregnant women who missed the routine immunisation during the COVID-19 pandemic.
- Beneficiaries from migration areas and hard to reach areas will be targeted.
- The mission will follow the COVID-Appropriate Behaviour(CAB) approach during the immunisation activities.
- States have been asked to follow a “staggered approach” (Staged approach) to avoid crowding at the vaccination sites.
- The vaccination sessions will be planned in such a way that not more than 10 beneficiaries will present at the session site at one given point in time.
- Source: The Hindu
Challenges in controlling Zoonotic diseases in India
Synopsis: India can turn into a hotspot for zoonotic diseases (diseases that spread from animal to human), if not controlled now. Research must be proactive as this could be a larger crisis than the COVID pandemic.
Introduction
During the covid-19 pandemic, Scientists developed tools to study the virus more effectively. Further, they also set up channels to test the efficacy of the Food and Drug Administration (FDA) approved drugs. But the challenges of Zoonotic diseases still exist.
Vulnerability of India to Zoonotic diseases:
Global meta-analyses mention that Zoonotic diseases are likely to emerge in areas with many mammal species. As per the analysis, high land use and land cover change, and high human population density are the reasons for zoonotic diseases.
- According to Global meta-analyses, India can be a hotspot for the possible emergence of zoonotic diseases in the world.
- India’s approach to addressing zoonotic diseases has mainly been reactive. This is evident as the research and public health intervention usually begin when there is an outbreak.
Challenges in controlling Zoonotic diseases?
There are several scientific challenges that exist in zoonotic diseases. They are,
- One cannot predict the zoonotic disease pandemic. This is evident from the recent Covid pandemic.
- It is hard to collect viral and bacterial samples from biodiversity. Collecting samples is nearly impossible from wild reservoirs like bats and rodents.
- It is impossible to monitor and control biodiversity hotspots. Further, the government cannot detect the transmission of the pathogen from one hot spot to another.
- Moreover, it is difficult to predict the evolutions of pathogens and their relation with the hosts (animals). It is also evident in the COVID pandemic.
Suggestions:
Scientists have to conduct interdisciplinary research and sustained efforts to reduce challenges. So, Scientists from various domains have to come forward and work for a common cause just like they did for covid testing and vaccinations.
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Clean drinking water to all: Initiatives and challenges – Explained Pointwise
Introduction
Recently Telangana government has achieved 100% tap water connections to all schools and Angan Wadi Centres (AWCs) under 100 day Special Campaign. The other states like Andhra Pradesh, Himachal Pradesh, Goa, Haryana and Tamil Nadu also achieved this target.
Under the Jal Jeevan Mission (JJM) the central government also aims to provide Functional Household Tap Connection (FHTC) to every rural household in India by 2024. Further, the recent budget expanded the Jal Jeevan Mission to urban areas as well. But to provide clean drinking water, the government has to do much more than just providing the water connections.
Important aspects of Jal Jeevan Mission
The JJM aims to envisage a supply of 55 litres of water per person per day. Important aspects of the Jal Jeevan mission are,
- The JJM will focus on integrated demand and supply-side management of water at the local level.
- It will implement source sustainability measures to recharge and reuse through greywater management, water conservation, rainwater harvesting.
- The Mission will converge with other Central and State Government Schemes to achieve its objectives of sustainable water supply management across India.
- The JJM will generate maximum community participation in the form of ‘Jan Andolan to achieve the target.
Other schemes aimed towards providing Drinking water
- Swajal Yojana: It is a community-owned drinking water program for sustained piped drinking water supply powered by solar energy. It was launched in 115 aspirational districts of India.
- Jal Mani Programme: It aims to provide value and quality addition to the ongoing Rural Drinking Water Supply Programme to mainly address the water quality. The aim is achieved by installing Stand-Alone Purification System in rural Schools
- Atal Bhujal Yojana: It is a Central Sector Scheme aims to improve groundwater management through community participation in identified priority areas in seven States
What are the advantages of providing clean drinking water?
- India will face fewer water-borne diseases. According to a study, more than 21% of the country’s diseases are water-related. In 2015 alone, India lost over 1 lakh children under the age of five due to diarrheal diseases. It is preventable if India provides clean water to its population.
- Fulfilling SDG: By providing clean water and sanitation to all, India can achieve Sustainable Development Goal 6 (clean water and sanitation for all). Along with that, India can also achieve other SDGs as well such as good health and well-being, etc.
- Recharge of groundwater level: According to NASA (National Aeronautics and Space Administration), India’s water tables are declining at the rate of 0.3 meters per year. Clean water through wastewater management may reduce the demand for groundwater. This will improve the groundwater table.
- JJM and other schemes provide employment opportunities. Successful implementation of the National Skill Development Mission has created a pool of skilled manpower in plumbing, masonry, fitting, electricity, etc. The JJM implementation will utilize their skills and also provide employment opportunities to the migrant labours returning home.
- For example, Recently Ministry of Jal Shakti deployed labourers returning to their homes due to the COVID-19 pandemic in the Jal Jeevan Missions.
- Better local infrastructure – Apart from solving the drinking water problem, the schemes will also improve better infrastructure facilities especially in rural India. Infrastructure facilities will be in the form of water management structures, supporting infrastructures in-home, streets, etc.
What are the challenges associated with providing clean drinking water?
- Water is a state subject. So, Centre intervention in this domain is limited. The States also look into the issue of drinking water problem as their individual problem (not the problem of other states). This leads to interstate disputes for water and prevents them from enacting a holistic solution.
- India doesn’t have enough water for its population. India has 16% of the global population, but only 4% of freshwater resources. One billion people in India are living in water-scarce areas. So, providing enough drinking water to all is a great challenge with limited resources.
- Providing quality piped water will be a great challenge. In the majority of the Metro cities and Urban areas, demand for water is higher than the supply. To compensate for the deficit, local authorities mix the surface & groundwater.
- Moreover, NITI Aayog report mentions nearly 70 percent of the country’s freshwater sources are contaminated. So it is impossible to ensure that quality water alone is supplied to homes.
- The “slippage” problem in India: Wide temporal and spatial variation of monsoon result in the slippage problem. For example, India receives 75% of its total rainfall during the four months-long monsoon season alone. So, there is a higher chance that drying up of the water source or collapse of the created facilities will create the problem of drinking water again in the earlier cover areas of schemes such as Jal Jeevan Mission.
- Reducing per capita availability of water in India is also a challenge. The Per capita availability was at 1816 cubic meters in 2001. But it reduced to 1545 cubic meters in 2011. Further, It is expected to reduce to 1367 cubic meters in 2031. In such a scenario Providing 19.02 crore, pipe connections will increase the demand for drinking water and reduce the per capita availability of water.
Suggestions to improve access to drinking water
- Providing clean drinking water needs a few corrections at the ground level. Such as,
- Artificial Recharge Techniques such as Rainwater Harvesting Systems in houses and localities should be mandatory. This will increase the Groundwater level in Indian villages.
- Government has to encourage local participation in water conservation by steps such as an awareness campaign.
- The government has to enact a specific plan for water-stressed states and water-stressed areas like the Hiware Bazar model of local-level water regeneration.
- Hiware Bazar is a village in Maharashtra’s drought-prone Ahmednagar district. Within a decade it changed from the water-stressed region to one of the most prosperous villages of the country. They achieve this by regenerating their natural resources such as forests, watersheds, and soil with local Panchayat.
- The government can explore the options of Pricing water used by well-off sections and agriculture. This fund can be used in the maintenance of the pipes and drains.
- Mandatory compliance: The sources, as well as the quality of water in the country, need to be maintained on a war front basis. The government can ensure mandatory compliance of local bodies to the Bureau of Indian Standards on water quality. This will ensure quality water at the local level.
- The government has to explore technological solutions in drinking water management. Such as establishing water treatment plants in water storage facilities to remove toxic inorganic pollutants and dissolved solids.
India cannot provide clean drinking water to people at the expense of depletion of the existing resources. It will take India, a step closer to the ground-zero level. At the same time, India cannot wait till the present population depletes the water resources. So, It is high time for the government to act on water conservation along with the aim of achieving clean drinking water for all.
A study on the cost of ensuring “WASH” in healthcare facilities
What is the News?
A study was conducted to estimate the cost of ensuring WASH (water, sanitation and hygiene) in healthcare facilities for one year across India. The study was published in BMJ Global Health journal.
What is WASH?
- The term “WASH in health care facilities” refers to the provision of water, sanitation, health care waste management, hygiene and environmental cleaning infrastructure, and services across all parts of a facility.
Key Findings of the study:
- The study estimates that improving WASH across the public healthcare facilities in India and maintaining this for a year would cost $354 million in capital costs. Further, it will need $289 millions as a recurrent expense (all payments other than for capital expenses like maintenance, electricity, rent, etc).
- The most costly interventions were providing clean water, linen reprocessing, and sanitation. Similarly, the least expensive were hand hygiene, medical device reprocessing, and environmental surface cleaning.
Impact of Poor WASH Facilities:
- A 2019 joint global baseline report by WHO and UNICEF had pointed out that globally, one in four healthcare facilities lacked basic water servicing. Further, one in five health care facilities had no sanitation service and 42% had no hygiene facilities.
Significance of providing WASH facilities:
- WASH will reduce deaths: Approximately, the death of 3 lakh children under five years can be prevented each year.
- Achieving SDGs: The status of WASH in healthcare facilities is an important issue in development. Ensuring availability and sustainable management of water and sanitation is one of the 2030 sustainable development goals.
- Infection prevention and control: The WASH interventions can help reduce healthcare-associated infections. Especially among the mother and neonates across the Indian healthcare system.
- Cost-effective intervention: In 2012, the WHO report calculated ‘For every dollar invested in sanitation, there will be a $5.50 gain’. This will be in the form of lower health costs, more productivity, and fewer premature deaths, etc.
Source: The Hindu
Read also:-
Why Complete Elimination Strategy of COVID virus is not feasible?
Synopsis: The empirical evidence shows that the idea of the complete elimination of COVID viruses in a selected few countries is not feasible. Rather, it will only increase the socioeconomic disparities thereby making the goal of elimination infeasible.
Background
- A recent article published in The Lancet has advocated for “elimination strategy”, it is also known as the zero-COVID-19 strategy for eliminating the virus.
- Zero-COVID-19 strategy means that the replication of the virus will be reduced to the least so that no new cases will occur in a defined geographical area.
- The elimination strategy has the following three elements,
- Rapid reduction in the number of infections to zero.
- Creation of virus-free green zones and
- Prompt outbreak management when new cases occur occasionally.
- Rich countries are working on this strategy by vaccinating each and every citizen.
- However, this strategy of the complete elimination of the virus is not suitable for every country.
Why this strategy is not suitable for all countries?
Complete elimination of the virus by vaccination is only suitable for geographically isolated countries such as New Zealand. It can afford strict border control measures. Even here, it is difficult because of the following reasons,
- First, the virus will be in circulation in the countries from each other. So, the threat of a Virus outbreak will stay for a while.
- Second, the Virus is mutating at a very fast pace. Universal vaccination will not be helpful against new variants. It is difficult to consistently upgrade vaccines.
- Third, a zero-COVID-19 strategy will worsen global health inequities. The idea of creating green zones for free travel will benefit richer countries and alienate poorer nations.
- Fourth, the experience from the elimination of other diseases shows that the complete elimination of the COVID virus is not possible. For example,
- Measles and neonatal tetanus are present for more than 20 years. It caused nearly 25,000 newborn deaths in 2018. Despite the global efforts for vaccination it still remains a major public health challenge in the developing world.
- Polio, eradicated from Southeast Asia, is still endemic in Afghanistan and Pakistan.
- Also, according to immunologists surveyed by the science journal Nature the Covid virus will become endemic in certain countries.
What are the Solutions?
Instead of isolated strategies for a few countries, global leadership and resources to vaccinate the vulnerable population are required.
- First, disease control measures should be implemented globally. The vaccine coverage for vulnerable populations across the globe should be increased.
- Second, the current pace of vaccination needs to be increased by 4.3 times to vaccinate 6.4 million persons per day.
- Third, along with this, mapping of elderly and persons with comorbidities needs to be done on a priority basis for vaccination.
- Fourth, there is a need to strengthen epidemiological and genomic surveillance for COVID-19.
- Fifth, a plan for the goal of achieving Universal Health Coverage (UHC) is required. Because the COVID-19 pandemic has reversed the gains made in other health programmes like tuberculosis control.
Thus, the idea of eliminating virus in a selected few countries should be replaced with a pragmatic goal of controlling COVID-19, not elimination. Since the zero-COVID-19 strategy comes with zero evidence of feasibility, focusing on it will result in wastage of our attention, funds, and time.
Importance of COVID 19 learnings in fight against tuberculosis
Synopsis: The COVID 19 pandemic has given an opportunity to India for combating other respiratory diseases like Tuberculosis (TB). The learnings from the pandemic can be used to control the spread of TB.
Background:
- The first case of COVID 19 was reported on 30th January 2020. After that, the disease claimed the lives of 1,54,000 people and infected 10.7 million in India.
- However, with robust efforts, the government managed to control its spread. Due to this, the country is not facing a brutal second wave as suffered by other countries.
- The number of active cases is decreasing since mid-September and people are getting back to their normal lives.
- The focus should now be shifted to other respiratory diseases like TB.
About Tuberculosis:
- It is a contagious infection that usually attacks your lungs. But can infect other parts like your brain and spine.
- It is a bacterial disease caused by Mycobacterium tuberculosis and affecting mankind for 3000 years.
- Furthermore, it is a disease with the ability to damage multiple organs which enhances mortality risks.
Issues with Tuberculosis:
As per World Health Organisation (WHO), India has more than 10 million active cases of TB. 4 lakh lives are lost per year due to TB and shares 1/4th of the global burden.
- First, It causes a disproportionate impact on the poor who live in overcrowded spaces and lack proper nutrition.
- Second, numerous myths and stigma are associated with the disease which discourages reporting and proper treatment.
- Third, it has become very difficult to control if multi-drug resistance gets developed or a person is already suffering from diabetes or HIV.
Using COVID 19 Lessons to combat TB:
- First, the PM must take a lead to sensitize the masses about the disease. It was done by him in the case of COVID 19, to induce behaviour change.
- Second, the concept of physical distancing can be effective in curtailing the spread. The droplets from one person will not reach another if the due distance is maintained.
- Third, patients, as well as nearby family members, must wear masks to curb the spread of infection.
- Fourth, improved detection techniques developed during COVID can be used to replace the traditional sputum tests. This would ensure better diagnosis and quick results.
- Fifth, in order to improve tracking and contact tracing, the focus should be on instant notification techniques.
- Sixth, awareness is developed around respiratory diseases. It can be used to build community-led participation and burst the stigma surrounding TB.
- Lastly, the enthusiasm shown by media and coordination shown by governments in tackling COVID-19 should also be carried forward to TB.
India has set a target TB elimination by 2025 which is 5 years prior to the sustainable development goals target. This can be achieved if COVID 19 learnings are aptly adopted in combating TB.
PM suggested “Special Visa Scheme” for medical staff in South Asia
What is the News?
During an address to 9 neighboring countries, PM suggested Special Visa Scheme. The address was part of a workshop on “COVID-19 management: exchange of good practices in tackling pandemic and the way forward”.
Participation: The countries that participated in the workshop include: Afghanistan, Bangladesh, Bhutan, Maldives, Mauritius, Nepal, Pakistan, Seychelles, and Sri Lanka.
Key Takeaways from the address:
- Special Visa Scheme: PM suggested considering a special visa scheme for doctors and nurses. It will help them to travel quickly within the region during health emergencies at the request of the receiving country.
- Regional Air Ambulance: The Civil Aviation Ministries from the neighboring countries can coordinate a regional Air Ambulance agreement for medical contingencies.
- Data on COVID-19 vaccines: The countries could come together to create a regional platform for collating, compiling, and studying data about the effectiveness of COVID-19 vaccines among our populations.
Source: The Hindu
A robust ‘health and well-being budget for 2021-22’
Synopsis: The government has come up with an integrated health and well-being budget for 2021-22. It would help meet the current and upcoming challenges created by the COVID-19 pandemic.
Background:
- The pandemic struck India in March 2020 and exposed the vulnerabilities of the Indian health care system.
- Although India’s performance in tackling the pandemic was better than various developed countries. But its impact on the economy and society was significant.
- It was therefore imperative to come up with a strong health and wellbeing budget to develop resilience against the ill effects of the pandemic. The health budget was prepared in this context of Atma Nirbhar Bharat Abhiyan.
Government measures for strengthening ‘health and wellbeing’:
- A Production linked incentive scheme is announced to boost the manufacture of pharmaceutical and medical devices.
- 35000 crore rupees has been allocated for the development of COVID-19 vaccine. Mission COVID Suraksha has been launched to improve indigenous vaccine testing and development. Further coverage of pneumococcal vaccine will also be enhanced.
- Pradhan Mantri Garib Kalyan Yojana (PMGKY) was launched to provide free food grains to 800 million beneficiaries.
- One Nation One Ration Card (ONORC) will target 690 million beneficiaries covering 32 states/UTs.
- Jal Jeevan Mission (JJM) has been given substantial allocation.
- There would be an expansion of health and wellness centres under Pradhan Mantri – Atmanirbhar Swasth Bharat Yojana (PMANSBY). It would also involve using a 13,192 crore Finance Commission grant for strengthening the primary health system.
- Allocation for the Pradhan Mantri Jan Arogya Yojana (PM-JAY) has not changed in comparison to last year.
- There has been a 40% increase in Budget of the Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) ministry.
Significance:
- First, the nature of allocation strengthens the vision of making India Atma Nirbhar.
- Second, initiatives like Mission COVID Suraksha will help India sustain its position of being the vaccine hub of the world. Significant allocation towards vaccine development will also ensure all the citizens are able to get vaccinated in due time.
- Third, PMGKY and ONORC will help in ensuring food and nutritional security in the country.
- Fourth, a reduction in diseases namely Malaria, Polio and Diarrhoea would be seen due to substantial allocation towards JJM. This is explained by a report released by the Johns Hopkins Bloomberg School of Public Health in 2019.
- Fifth, focusing on capital expenditure through schemes like PMANSBY is a welcome step for strengthening the health system. Earlier the capital expenditure used to constitute only a small fraction of health allocation.
- Sixth, an improvement in AYUSH ministry’s budget will allow the country to focus more on preventive care and integrated treatment.
- Lastly, integration of health with well-being (Water, Sanitation and Nutrition) would help in improving the outcomes. Both National Health Policy, 2017 and Economic Survey have stressed the interdependence of these sectors.
Way Forward:
India’s commitment towards health has allowed it to successfully deliver 8 million doses of COVID vaccine to health and frontline workers. This is the fastest vaccination drive in the world.
- Allocation towards schemes like PM-JAY should be enhanced. A 20% decline was seen in infant mortality rate (IMR) between 2015-20 in states which adopted the scheme in comparison to a 12% in IMR decline in states which didn’t adopt it as per the economic survey.
- The states must increase their health spending to 8% of their respective budgets by 2022 as recommended by the National Health Policy and Finance Commission. This would reduce the burden on the Centre and ensure effective spending.
The Union Budget has effectively prepared the ground for tackling the upcoming challenges in the health sector. This should be coupled with other reforms so that the resilience capacity of the country gets enhanced. This would help in achieving the vision of universal health coverage by 2030 as part of sustainable development goals.
Significance of Telehealth services like Remote SMAs
Synopsis: The COVID-19 pandemic disrupted Normal health Services in India. The telehealth services like Remote Shared Medical Appointments (SMAs) should be used.
Background:
- The March 2020 lockdown reassigned healthcare professionals towards COVID-19 specific duties.
- This deviated the focus from other healthcare domains in India and across the world.
How Covid-19 disrupted normal Health care services:
- As per a survey of WHO, Essential services like immunization and childcare got disrupted in the majority of the 105 countries surveyed.
- Around 45% of low-income countries witnessed a disruption in 75% of services. While this figure for high-income countries was only 4%.
- Impacts on India:
- Fear of transmission and lockdown resulted in the fall of diagnostic services. In tuberculosis detection cases 50% fall was reported from April-December 2020. Whereas, in antenatal care visits 56% decline was observed during the first half of 2020.
- The inequalities got widened when people in rural and remote areas were not able to travel to cities for getting specialized care.
- However, the use of technology helped to mitigate the impact.
Virtual Consultation India
- The E-Sanjeevani platform of the Indian Government provides virtual consultations to patients. It includes patient-to-provider and provider-to-provider consultation.
- A hub and spoke model used for this platform. It connected smartphone-equipped rural wellness centres to specialist doctors located in cities.
- Private players and non-governmental organizations also used the technology for reaching out to patients.
However, given the scale of India’s population which is devoid of healthcare, a switch towards remote shared medical appointments is needed.
About Remote Shared Medical Appointments:
- Remote Shared Medical Appointments virtualizes the process of in-person shared medical appointments (SMAs). It is an effective practice in the US for more than 2 decades.
- Thus, It involves the virtual interaction of a doctor with multiple patients having similar issues.
- Advantages:
- Patients get more time with doctors.
- This process develops a sense of bonding among patients.
- This process provides better productivity as patients learn from each other’s questions.
Utility for India:
- SMAs have been very effective in the case of diabetes. It is notable that India is home to the largest number of diabetes patients.
- Aravind hospital in Puducherry has shown the potential of SMAs to combat glaucoma, a disease that causes gradual blindness.
- Offering this facility through the E-Sanjeevani platform can help the country meet the healthcare gap in rural India.
- SMAs will encourage people interaction and attract supplementary providers like physiotherapists and optometrists.
- The current COVID-19 vaccine drive will also be strengthened as providers can offer sessions to burst the myths related to vaccine efficacy.
Way Forward:
- The switch to a new technique of healthcare delivery will require adequate training and mentoring of both providers and patients.
- Collaboration with training platforms like ECHO is desired to encourage the adoption of virtual SMAs. It trains primary healthcare providers in multiple states.
- India is blessed to have very low data rates where 1.5 GB data/day is easily affordable for many Indians. This automatically gives the country a significant edge towards augmenting telehealthcare.
- Further, the strengthening of digital health services will also be in line with WHO’s Global strategy on Digital health. It would help in realizing the dream of ‘Health for All”.
Vaccination of manual scavengers must be prioritised
Synopsis: The government is focussing on the vaccination of frontline sanitation workers. However, the most vulnerable among them, Manual scavengers, did not gethe attention they deserve.
Introduction
India is far behind in understanding sanitation workers and their different categories. Manual scavengers belong to the lowest strata of unprotected sanitation workers.
Many people in India believe that manual scavenging is already eliminated since it is legally banned. However, the ground reality is very different.
- Sanitation workers can be categorized into Faecal sludge handlers, Sewage treatment plant sanitation workers, Toilet sanitation workers, public transportation site sanitation workers (railway, roads), Sewer and drain sanitation workers, Sanitation-waste intersection workers, Etc.
- Manual Scavengers are workers discarding human excreta manually, in any form.
The risk involved in septic cleaning among manual scavengers is the highest. One sanitation worker dies every five days. Waste recovery sanitation workers perform the work of manual scavenging as they come in regular contact with unprotected bio-medical waste, animal faeces.
Why sanitation workers should be included in priority population for vaccines?
Vaccination of sanitation workers should be prioritized due to following reasons:
- First, several laws banning this practice are not working properly on the ground. Sewer deaths continue to happen. Caste and economics have a role to play in the deprivation.
- Second, the absence of a policy for the protection of the sanitation workers resulted in the loss of many lives during the initial days of the pandemic. These cases are not even mentioned in the records of the National Commission of the Safai Karmachari (NCSK). The Safai KarmacharI Andolan (SKA) has had far better data.
- Third, there is no social security, no accountability in the actual expenses of the rehabilitation schemes. Even no definite provision for healthcare or pension is provided.
- Fourth, the representation of sanitation workers is not involved during creation of policies for them.
- Fifth, sanitation workers are prone to long-term diseases. In many cases, they don’t even live till the age of retirement. Their children suffer from malnutrition, TB, and cholera because of their habitation around the waste generated by the cities.
- Lastly, the sanitation workers worked full time to ensure safety for the people during the pandemic.
Way forward
The government must urgently prioritize vaccination for manual scavengers without giving the argument that they have already developed “herd immunity”.
“Traffic Crash Injuries and Disabilities” -World Bank report on road accidents in India
What is the News?
The World Bank released a report titled “Traffic Crash Injuries and Disabilities: The Burden on Indian Society”. It highlights the Socio-Economic impacts of road accidents in India.
About the Report:
- Published by: World Bank in collaboration with SaveLIFE Foundation.
- The report highlights the socio-economic impact of road accidents. It analyses the Medical care access and post-accident financial distress of various categories of people.
- The data was collected from Uttar Pradesh, Bihar, Tamil Nadu, and Maharashtra — a State each from northern, southern, western, and eastern regions.
Key Findings:
Road accidents in India:
- India tops the world in road crash deaths and injuries. It has 1% of the world’s vehicles but accounts for 11% of all road crash deaths. It is witnessing 53 road crashes every hour and killing 1 person every 4 minutes.
- India has seen around 4.5 lakh road accidents in the past year. It resulted in at least 1.5 lakh deaths over the past few years.
- According to a 2018 World Health Organization report, India tops the world in road crash deaths, with more than 400 fatalities per day.
Socio-Economic Impact of Road accidents in India:
- There are more fatalities from road crashes among poor families compared to rich families. The risk of a victim undergoing disability after a crash was also 2 times more likely among poor families.
- The socio-economic burden of road crashes is disproportionately borne by poor households. Accidents result in a decline of 75% of total household income among low-income groups. Whereas, the decline among high-income groups is only 54%. It underlines poor access to insurance schemes among the less privileged.
- Impact on Women: About 50% of women were severely affected by the decline in their household income after a crash. About 40% of women reported a change in their working patterns post-crash. While around 11% reported taking up extra work to deal with the financial crisis.
- Urban-Rural Divide: The severe impact of the decline in income was highest among poor households in rural areas (56%) compared to those in urban areas (29.5%).
- Insurance Coverage: There is an asymmetry in insurance coverage. About 1/4th of respondents from high-income households (24%) said that they received compensation. Whereas, among poorer respondents, only 14% received compensation.
Recommendations:
- There is a need to institutionalize post-crash emergency care and make health infrastructure and coverage more accessible and inclusive.
- The central and state governments should provide a social security net for crash victims from low-income households through state support.
- The Central government should create schemes to increase insurance coverage and penetration for low-income households.
Source: The Hindu
Budget 2020-21 didn’t address the core issues of ailing health sector
Source: Indian Express
Gs2: issues Relating to Development and Management of Social Sector/Services relating to Health.
Synopsis: Four important issues ailing the health sector did not find a place in the budget.
Background
- The budget allocation for the health sector in 2021-22 was (24 lakh crore) 137 % more than the previous year (69,000 crores).
- However, the actual share of Health and Family Welfare was only a third of the total allocation of Rs. 24 lakh crore.
- This is because, the increase in budget for ‘Health wellbeing’ also included funds for drinking water, sanitation, nutrition, AYUSH, health research, vaccination as well as grants assigned by the 15th Finance Commission.
- Also, a new centrally-sponsored scheme PM Aatmanirbhar Swasthya Bharat Yojana was announced as a part of Budget 2021-22.
- Even in this case, the funds allocated to this new scheme will be materialized only when the programmes are implemented.
What are the critical issues that have not been addressed by the Budget 2021-22 in the health sector?
Despite the above measures introduced in the Budget 2021-22, it has failed to address the four critical issues ailing the health sector. They are
- First, the Budget has failed to find a solution to bring down the costs of outpatient treatment.
- Under Aayushman Bharat, 50 crores of eligible poor people are entitled to cashless hospitalisation. However, the cost of drugs, the high cost of high-end diagnostics leads to high out-of-pocket expenditure before a patient needs hospitalisation.
- This ultimately reduces the number of people using affordable health care services. It defeats the very purpose of Aayushman Bharat.
- Second, Insurance coverage for the middle class is not adequate. Under the Ayushman Bharat health Programme, only 50-crore poor people are covered.
- Whereas another 10 per cent organised sector employees are covered by different government or employer generated medical coverage schemes.
- Still, around 30 crore Middle-Class Indians are without any state-supported medical insurance.
- Third, the Budget has failed to give effect to the 2017 National Health Policy recommendation. The Policy recommended for grading of clinical establishments to protect consumers rights. The states are not implementing the model Clinical Establishments Act 2010.
- Fourth, the need for a separate Empowered Medical Tribunal as recommended by 2017 National Health Policy, is not been addressed. The complexities of medical negligence or malpractice cannot be addressed by The Consumer Protection Act 1986. Thus, a separate health regulator on the lines of the State and Central Regulatory Commissions is critical for the health sector.
What needs to be done?
- A viable solution is required to reduce out of pocket expenditure in outpatient care services. This will make public health services affordable.
- Some international models can be analysed for health care funding:
- In Germany and France, health care is funded through mandatory contributions of both employer and employees.
- The Canadian model: The Canada Health Act of 1984 makes federal cost-sharing a government responsibility. Healthcare entitlements in Canada are also portable across the country.
- The Employees State Insurance Corporation scheme created in 1948 could also be modified and used to cover white-collar employees in the unorganized sector.
- Public health and hospitals can be brought on the concurrent list of the Constitution as recommended by the 15th Finance Commission. This will bring uniform principles and regulations throughout the state and ensures standards in consumer protection.
Men access “KIRAN mental health rehabilitation helpline” more
What is the News?
According to a report by the Ministry of Social Justice and Empowerment(SJE), 70% of callers to KIRAN (mental health rehabilitation helpline) are male.
Kiran helpline(1800-599-0019):
- Launched by: It was launched by the Department of Empowerment of Persons with Disabilities(DEPwD). The Department works under the Ministry of Social Justice and Empowerment (SJE).
- Purpose: It aims to offer support for mental health through experts. Support includes early screening, psychological support, distress management, mental wellbeing psychological crisis, and referrals to mental health experts.
- It offers this support in 13 languages for any individual, family, NGOs, parent associations, professional associations, rehabilitation institutes, hospitals, etc.
Key Findings of the report:
- The helpline received 13,550 new calls of which 70.5% were from males and 29.5% from females.
- The majority of callers (75%) were in the age group of 15 to 40 years, while others were older, in the 41 to 60 age group.
- Majorly the challenges faced by the callers were related to anxiety, depression, pandemic-related challenges, suicidal tendency, substance abuse, and miscellaneous.
- Most of the calls were from the North zone, followed by West, South, East, and North East.
Source: The Hindu
PM Atma Nirbhar Swasth Bharat Yojana
What is the News?
The Finance Minister has launched a new scheme titled “PM Atma Nirbhar Swasth Bharat Yojana”. In general, The scheme aims to develop capacities in the health care system over 6 yrs.
PM Atma Nirbhar Swasth Bharat Yojana:
- Type: It is a Centrally Sponsored Scheme
- Aim: The scheme aims to
- Improve primary, secondary, and tertiary care health systems,
- Strengthen existing national institutions in Health sector
- Create new institutions, to cater to detection and cure of new and emerging diseases.
- Duration of the Scheme: Six Years
- Features of the Scheme: The scheme will support in the setting up of
- Rural, Urban Health and Wellness Centres
- Integrated Public Health Labs
- Critical health care hospital blocks
- National institution for One Health
- Regional research platform for WHO South-East Asia Region,
- 9 Biosafety Level III laboratories and 4 regional centres of National Institutes for Virology.
- Strengthening National Centre for Disease Control (NCDC) and 5 regional branches of it
- Expanding the integrated health information panel.
Source: The Hindu
ICMR’s 3rd serological survey: Need to rethink on vaccination strategy
Synopsis: The recent findings of ICMR’s 3rd serological survey can be used to revalidate the vaccination policy of India.
Background
- The ICMR’s third serological survey findings were published at a press conference recently.
- However, the specific details of the course of the infection are not released. It will be made public later, in a peer-reviewed journal.
What is Serological Survey?A serological survey is conducted to assess the prevalence of a disease in a population. It is done by detecting the presence of specific antibodies that are produced against the virus.
What are the latest findings of ICMR’s 3rd serological survey?
- The findings show that nearly one out of five Indians (270 million) may have been infected.
- The report finds a three-fold rise in infections compared to August.
- Also, people who got infected in the age group of 10-17 years has increased 5 times (in percentage terms) compared to August.
- The serological survey of doctors, nurses, and paramedical staff reveals that nearly 25% of them had been infected. This is significantly above the national average.
- The survey findings cautioned that “Still, 80% of Indians are vulnerable”.
- But there is no information on the efficacy of antibodies against mutating virus strains.
What can be inferred from this result?
- Despite, the Experts pointing towards the declining trend in infections and increasing herd immunity among the population. We need to accept that the danger is still there.
- The survey highlights the need for vaccination and continuing with physical distancing and masking norms.
- There is also a rise in the spread of infection among teenagers and children. Rural India also facing an increase in infections. So the vaccine policy needs a course correction.
- So, it would be wise to rethink the vaccination policy to prioritize vaccination for children along with old age people, frontline workers, and peoples with morbidity.
“ICMR Serological Survey” -One in five Indians have been exposed to coronavirus,
What is the News?
Indian Council of Medical Research(ICMR) has released the third round of the Serological Survey.
Facts:
- Serological Survey: It is conducted to assess the prevalence of a disease in a population. It is done by detecting the presence of specific antibodies that are produced against the virus.
- How was the survey conducted? The survey used an antibody test. The test was designed specifically to check for antibodies produced against the spike protein.
- Spike Protein: Coronaviruses including SARS-CoV-2 get their name from the “corona” or crown shape, created by the protein “spikes” on their surface. These spike proteins bind with human proteins to initiate the process of infection.
Key Findings:
- Nearly one in five Indians which is around 21.5% had been infected by the coronavirus until December 2020.
- Urban Slums: The urban slums have reported the highest seroprevalence with 31.7% and was followed by urban non-slums(26.2%). The lowest was in rural areas at 19.1%.
- Children: The seroprevalence among children aged 10-17 years was around 25.3%.
- Health Care Workers: Nearly 26% of doctors and nurses and 25.4% of paramedical staff have coronavirus antibodies. It underlines their higher risk of being exposed to coronavirus infections than the general population.
- Women vs Men: There were more women (22.7%) as compared to men (20.3%) who were found to have antibodies against the Covid-19 virus.
Source: The Hindu
Vaccine battle among countries
Source: Click here
Syllabus: GS 2 – Health related issues
Synopsis: Countries should refrain from engaging in vaccine battles and focus on global cooperation.
Introduction
Almost all countries across the globe are in need of access to vaccines. But the developed countries are mindlessly collecting approved vaccines.
Only the countries in the global south like China and India are helping out other countries.
How are rich countries engaging in vaccine battles?
As per a few reports, the advance purchase contracts made by some countries for potential vaccine procurement are way above their need. It would vaccinate their population many times.
- For example, the EU population can be vaccinated two times, the US and the UK four times, and Canada six times.
- 82% of Pfizer’s production in 2021 and 78% of Moderna’s have already been advance purchased by leading countries.
Advanced countries are engaged in vaccine battles as they believe that an early vaccination will bring back normalcy in their countries. Concepts of Public good and global cooperation are missing from the scene.
What is India’s stance?
On the other hand, India is exporting a major percentage of the approved doses. Its initial shipment to the least developed countries will be free of cost.
Exports from India are helping other nations, especially its neighbouring countries. For example, Brazil has received 2 million doses of vaccine from India.
India’s approach supports the need for coordinated international efforts to bring COVID-19 under control.
Solutions
The COVAX project is a program based on funding from high and middle-income countries. It is a global risk-sharing mechanism for shared obtaining and fair distribution of COVID-19 vaccines.
This project aimed to deliver 2 billion doses by the end of 2021. But it is facing challenges from rich countries due to their excessive vaccine procurement, directly from suppliers.
But now as U.S. President Joe Biden has decided to join the COVAX project, expectations from the project are high. India, which is a hub of cost-effective vaccines, would be instrumental in its success. For example, Covishield, the Oxford University-AstraZeneca vaccine produced in India costs only $3 per dose; Covaxin is priced at $4.2.
The way forward
The development of vaccines should have shown global cooperation between the North and the South. But the democratic world is suffering from increasing democratic tendencies.
Medical boards for access to abortion untenable: Report
What is the News?
The Centre for Justice, Law and Society(CJLS), Jindal Global Law School has undertaken a study to analyse the feasibility of setting up Medical Boards. Boards are proposed in the Medical Termination of Pregnancy(MTP) (Amendment) Bill, 2020.
Background:
- MTP Amendment Bill,2020: The Bill seeks to amend Medical Termination of Pregnancy (MTP) Act, 1971. It was passed in the Lok Sabha in 2020 and is likely to be brought before the Rajya Sabha during the Budget Session.
- Medical Board: The Bill proposes the constitution of a Medical Board in every State and Union Territory. These boards will decide on abortions in cases of foetal abnormalities where pregnancies are over 24 weeks. Each Board will have a gynaecologist, a radiologist or sonologist, a paediatrician, and other members prescribed by the governments.
Key Findings of the study:
- It found that the constitution of a Medical Board to decide on the termination of pregnancy is unfeasible. 82% of these posts are lying vacant in the country,
- Between 2015 and 2019, the shortfall in specialists posts was between 71% and 81.8%.
- The shortfall was more in the North-East states of Sikkim, Mizoram and Manipur. Arunachal Pradesh and Meghalaya had a 100% shortage of paediatricians.
Additional Facts:
Other key Features of MTP Amendment Bill, 2020:
- Abortion: The Bill allows abortion to be done on the advice of one doctor up to 20 weeks, and two doctors in the case of certain categories of pregnancies between 20 and 24 weeks.
- Special Categories: It has enhanced the gestation limit from 20 to 24 weeks for ‘special categories’ of women. It includes survivors of rape, victims of incest and other vulnerable women like differently-abled women and minors.
- Protection of Identity: It also states that the name and other particulars of a woman whose pregnancy has been terminated shall not be revealed.
Source: The Hindu
Lessons for India after one year of first Covid case
Source: click here
Syllabus: GS 3
Synopsis: One year has been passed when the first confirmed case was reported in India. What are the lessons that India Should learn from this Pandemic?
Introduction
India’s first confirmed case of Sars-CoV-2 was reported exactly a year ago. Experts with the help of a modeling-based study predicted that the country could have hundreds of millions of cases and a few million deaths by July 2020.
What were the challenges faced by people during the pandemic?
There was a sudden decrease in economic activities, low job opportunities, slowing of the economy. Impacts further worsened due to lockdowns.
- One of the most disturbing visuals that came from the pandemic was the migrants walking back to their villages on the highways.
- People who tested positive for the virus and the frontline workers were discriminated against in society.
- An excessive amount of unreliable information i.e. “infodemic” became a major obstacle in effective response to the pandemic.
What were the steps taken to deal with the pandemic?
Pandemic highlighted the need for strengthening the Indian health system and boost public health services.
- Firstly, COVID-19 specific services which include testing, contact tracing and treatment facilities were scaled up.
- Secondly, in order to achieve self-sufficiency, the production of personal protective equipment (PPE) coverall, testing kits, and ventilators was increased in India.
- Thirdly, researchers and scientists worked together to develop new testing kits, to conduct clinical trials on treatment procedures and vaccines.
- Fourthly, two SARS CoV-2 vaccines were approved in India and vaccination started at the beginning of 2021. The COVID-19 vaccines manufactured in India are being used in other countries as well.
What are the lessons learnt from the pandemic?
India has reported nearly 10.7 million confirmed cases and 1,53,000 deaths in the last year. Five lessons which should be learnt are mentioned below:
- First, the pandemic has widened the inequalities in the society as the poor and vulnerable sections were the worst affected. The government should urgently increase investment in strengthening health systems to address inequities and reduce poverty.
- This will prepare the country for future pandemics and help in accelerating economic growth.
- Second, Stronger health infrastructure is possible by interventions in various areas, such as:
- Governance and leadership.
- Health financing and health information system.
- Providing services and delivery.
- Health infrastructure and workforce.
- Medicines, diagnostics, and vaccines.
- Third, the hospital-dominated medical care system needs to be changed to a more inclusive health system for the lower section.
- Community clinics could be set up along with a strengthened primary healthcare system in both rural and urban areas.
- Fourth, states and the union government should spend more on health care and public health services. Laboratories and disease surveillance systems should be well-developed. The provision of mental health services via teleconsultation can be effectively used.
- Fifth, sustain the three-way partnership between policymakers, technical experts, and community members which have been formed for pandemic response.
- This would help in ensuring that health policies are informed, effectively implemented, and services widely used by the community. People’s participation and community engagement was important and need to be continued post the pandemic.
Way forward
- These learnings should be used to create a stronger healthcare system in India, which will provide accessible, available, affordable, and quality healthcare services to each and every citizen of this country.
What is Covid Performance Index?
What is the News?
The COVID Performance Index has been released by the Lowy Institute, an Australian think-tank.
Facts:
- COVID Performance Index: The index aims to rank the best-performing countries in their response to the pandemic. It measures the impact of geography, political systems, population size, and economic development on COVID-19 outcomes, for a conclusion.
- Measuring Indicators: To assess the performance of countries, the index tracked six measures of COVID-19 in the 98 countries for which data was available. The six indicators are:
- Confirmed cases
- Confirmed deaths
- Confirmed cases per million people
- Confirmed deaths per million people
- Confirmed cases as a proportion of tests
- Tests per thousand people.
- An average across indicators was then calculated for individual countries in each period and normalized to produce a score from 0 (worst performing) to 100 (best performing).
Rankings:
- India: India has been ranked at 86 out of 98 countries in the index.
- Topped by: New Zealand has topped the index followed by Vietnam, Taiwan, Thailand, and Cyprus.
- Bottom Countries: The United States has been placed at 94 and Brazil at the bottom of the index.
- South Asia: Sri Lanka was the best performing nation in South Asia ranking at 10, while the Maldives was at 25, Pakistan at 69, Nepal at 70, and Bangladesh at 84.
- Region-wise: The countries in the Asia-Pacific region did a better job at controlling the pandemic while Europe and the US were quickly overburdened by the COVID-19 cases.
- China was not included in the index due to a lack of publicly available data on testing.
Factors that played the role in the Performance of countries:
- Population size: Smaller countries with fewer than 10 million people consistently outperformed their larger counterparts throughout 2020.
- Levels of economic development or differences in political systems between countries had less impact on the handling of Covid-19 outcomes.
- Democratic countries have found to be marginally more successful than other forms of government in their handling of the pandemic.
Source: The Hindu
India ranks 10th in Asia-Pacific Personalised Health Index
Why in News?
Economist Intelligence Unit (EIU) has released the ‘Asia-Pacific Personalized Health Index’.
India has been ranked 10th out of 11 Asia Pacific countries in the index.
Facts:
Asia-Pacific Personalised Health Index
- The index measures the progress of Asia Pacific countries in adopting personalised healthcare. It includes enabling the right care to be tailored for the right person at the right time.
- Countries covered: The index ranks 11 countries of Asia Pacific namely Australia, China, Japan, India, Indonesia, Malaysia, Singapore, South Korea, Taiwan, Thailand, and New Zealand.
- Indicators: It measures performance against 27 different indicators of personalised health across four categories called ‘Vital Signs’. These include:
- Health Information Indicator: It takes into account data, infrastructure, and technical expertise driving personalized healthcare.
- Health Services Indicators: It takes into account planning, organization, and delivery of services with respect to personalized healthcare.
- Personalized Technologies indicator: It takes into account the devices, applications, platforms, and reimbursement structures that will drive personalized healthcare based on the needs of stakeholders.
- Policy Context indicator: It takes into account the polities, frameworks, partnerships, people, and drivers that will facilitate personalized healthcare.
Other Takeaways from the index:
- Topped by: Singapore has topped the index followed by Taiwan (2nd), Japan (3rd), and Australia (4th).
- Bottom in the index: Indonesia was ranked 11th in the index.
Source: Indian Express
Every fourth senior citizen in India rates health as poor: LASI
Why in News?
The Ministry of Health & Family Welfare has released the Longitudinal Ageing Study of India (LASI) Wave-1 Report.
Facts:
About LASI:
- About the study: It is a full-scale national survey of scientific investigation. It investigates the health, economic and social determinants and consequences of the ageing population in India. It was commissioned in 2016.
- Conducted by: The National Programme for Health Care of Elderly, Ministry of Health & Family Welfare. It undertakes the Study through International Institute for Population Sciences(IIPS), Mumbai in collaboration with Harvard School of Public Health, University of Southern California, USA, United Nations Population Fund(UNFPA) and National Institute on Ageing.
Key Findings:
Self Rated Health:
- Every fourth Indian above the age of 60 and every fifth Indian above the age of 45, reported poor health.
- The prevalence of poor self-reported health (SRH) in those above 60 (24%) is twice than in the 45-59 age group.
- Among these age groups, a higher percentage of women and individuals from rural areas reported poor health.
Disabilities among ageing Population:
- About 8% of Indians aged 45 years and above, reported having at least one form of impairment. The prevalence is almost twice among senior citizens(10.5%) than those between 45 years and 59 years.
- A high percentage of senior citizens in rural areas had a physical or mental impairment than their urban counterparts.
- The major disabilities reported are locomotive impairments (five per cent), followed by visual (three per cent), mental (two per cent), hearing (two per cent) and speech impairments (one per cent).
- Karnataka and Dadra & Nagar Haveli have the highest proportions of senior citizens with disabilities. Meghalaya, Lakshadweep, Haryana and Himachal Pradesh reported the least.
Additional Facts:
- According to the Elderly in India: Profile and Programmes, 2016, senior citizens comprised 21% of Indians with some form of disability.
- Disability: It is an umbrella term for impairments and physical limitations hindering the smooth activity and participation in daily social life.
- A decade of Healthy Ageing: The United Nations has declared 2021-2030 as the “Decade of Healthy Ageing”. It called upon governments, civil society, international agencies, and others to come together to improve the lives of older people in their families and the communities in which they live.
Source: Down To Earth
How should India handle the new virus variants?
Source: click here
Syllabus: GS 3
Synopsis: Mutation of the coronavirus has become a new threat for the world. India must take precautionary measures to deal with it.
Introduction
New SARS-CoV-2 variants have emerged independently in several countries and the virus is changing very quickly. If it continues to change, currently available vaccines will become ineffective.
Why do viruses mutate?
All the viruses carry a genetic code in the form of RNA or DNA. The DNA is replicated as the cells multiply and this process may cause random errors in the new DNA.
Errors in DNA can be corrected by the enzymes present in the cell. However, RNA doesn’t contain enzymes, thus errors caused in RNA cannot be corrected. It causes more genetic changes (mutations)in RNA than DNA viruses.
How are vaccines tested for efficiency against emerging variants?
- Indirect tests are conducted in labs. It will find if variant virus escapes antibodies developed after natural infection or vaccination.
- Antibodies that neutralize the original virus are tested on the variant viruses.
Are the emerging variants vulnerable to vaccines?
- The emerging variants from South Africa could pose a challenge to current vaccines. Not enough information is available yet for the Brazil variant.
- However, the studies have only tested antibody responses. Vaccines also increase cellular immunity to eliminate infection which has not been tested.
The evidence currently does not suggest that vaccines are failing.
- However, Moderna and Pfizer/BioNTech have agreed that their vaccines have had reduced protection against the South African variant. Both the companies are now working on developing new vaccines to fight these variants.
What steps should India take in this situation?
There is no local transmission of the new variants in India until now. Only the UK variant viruses have been found in travellers coming to India.
- Firstly, India should strictly implement masks and limit crowds. It should also do the contact tracing of people infected with the new UK variant.
- Secondly, India should also put a ban on travel from South Africa and Brazil just like the US did. India must also be cautious of people with a history of travel to South Africa since October 2020, and Brazil since December 2020.
- Thirdly, the most efficient way to catch emerging variants is increased genomic surveillance. So far, there are only about 5,000 SARS-CoV-2 sequences from India in public databases, which accounts for only 0.05 percent of confirmed cases.
The setting up of an inter-ministerial group -Indian SARS-CoV-2 Genomics Consortium (INSACOG) to increase genomic surveillance is a step in the right direction. India should take more such steps.
“BBV154” A Bharat Biotech’s Intranasal Vaccine vaccine
What is the news?
An expert body is looking into Bharat Biotech’s application for testing its Covid-19 vaccine, BBV154. This is an Intranasal Vaccine.
What is Intranasal Vaccine?
- Vaccines are administered as injectable shots into the muscles(intramuscular). Or the tissue just between the skin and the muscles(subcutaneous).
- However, with intranasal vaccines, the solution is sprayed into the nostrils and inhaled instead of injecting it.
Benefits of Intranasal Vaccine:
- The nasal route has excellent potential for vaccination due to the organized immune systems of the nasal mucosa.
- It is non-invasive, Needle-free.
- Ease of administration – does not require trained health care workers.
- Elimination of needle-associated risks (injuries and infections).
- High compliance (Ideally suits for children and adults).
- Reduces the overall cost of a vaccination drive as for example BBV154 requires a single-dose regimen.
Potential Setbacks of Intranasal Vaccine:
- Past attempts to develop intranasal vaccines, including for measles flu, have not been very successful.
- These vaccines use live, weakened viruses, but have never cleared clinical trials.
- Only a live attenuated influenza flu vaccine has been licensed through this route of delivery.
Source: Indian Express
“Covaxin” is effective against U.K. virus variant
What is the News?
Indian Council of Medical Research (ICMR) and the National Institute of Virology(NIV) study found Covaxin effective against the new UK variant of Covid-19.
About the Study:
- The study has found that Covaxin has a good neutralization capacity against the U.K variant of the COVID-19 virus. This capacity was the same against the strain used for making the vaccine.
How were the neutralization studies carried out?
- Under this study, the virus isolated from people is grown in the lab using cell lines. When viruses successfully grow in them, the pathogenic effects of the viruses are observed in the cells.
- The sera (the protein-rich liquid separated from blood after it is clotted) taken from vaccinated people are then added to the cell line culture system and its ability to prevent the virus from causing pathogenic effects is observed.
- In this case, the sera taken from vaccinated people were able to neutralize the virus and hence prevent pathogenic effects being produced in the cell lines containing the virus.
Source: The Hindu
Co-WIN platform upgraded
Why in News?
The Ministry of Health and Family Welfare has announced the upgradation of Co-WIN software. It is to cater to more sessions per site and change in site location.
Facts:
- CoWIN App: It is a digitalised platform by the Ministry of Health and Family Welfare (MoHFW).
- It allows Indian citizens to apply for a Covid-19 vaccine shot and helps agencies in keeping a track of Covid-19 vaccination programmes.
- Modules: The Co-WIN app comes with five modules namely –
- Administrator module: The admins will be able to track the information provided by citizens of India. They will also be responsible for creating sessions. By this app, respective vaccinators and managers will receive relevant notifications and alerts on the relevant information.
- Registration Module: Citizens who are not frontline health workers can register for the vaccine via the ‘Registration Module’. Photo identity will be required for registration.
- Vaccination module: It will verify the beneficiary details and update vaccination status.
- Beneficiary Acknowledgement Module: It will send SMS to beneficiaries and also generate QR-based certificates after one gets vaccinated.
- Report Module: It will prepare reports of how many vaccine sessions have been conducted, how many people have attended those, how many people have dropped out etc.
- What are the new features in the enhanced version?
- The enhanced version allows planning and scheduling the sessions for the entire week and works for the enhanced safety of the beneficiaries. These new features are being enabled in the vaccinator module.
Vaccine Maitri: India Vaccine diplomacy exercise
Why in News?
India will officially start its vaccine diplomacy with the name “Vaccine Maitri” under its Neighborhood First policy.
- Vaccine Diplomacy: It is the use of vaccines to increase a country’s diplomatic relationship with other countries.
Key Features of Vaccine Maitri
- India will supply Made-in-India Covid-19 vaccines to its neighboring and key partner countries Under its Neighborhood First policy.
- Bhutan and Maldives will be the first to get the vaccines followed by Bangladesh, Nepal, Myanmar and Seychelles.
- Sri Lanka, Afghanistan and Mauritius will also get doses once they give necessary regulatory approvals.
- Pakistan has not been named as a neighboring country which will get the vaccine.
- Vaccine will be Supplied to the partner countries in a phased manner, keeping in mind the demand.
Earlier Diplomacy measures by India:
- India had earlier supplied Hydroxychloroquine, Remdesivir and Paracetamol tablets as well as diagnostic kits, ventilators, masks, gloves and other medical supplies to a large number of countries during the pandemic.
- Under the Partnerships for Accelerating Clinical Trials(PACT) programme, India has also provided training to several neighbouring countries to enhance and strengthen their clinical capabilities
Additional Facts:
- PACT programme: It has been launched for supporting COVID-19 vaccine development activities in partnering countries.
- The initiative is being implemented by Biotechnology Industry Research Assistance Council(BIRAC) and Clinical Development Services Agency(CDSA) under the aegis of the National Biopharma Mission and Ind-CEPI Mission of DBT.
Need and ways of Decongesting Indian prisons
Synopsis: Health Experts are calling federal prisons a “breeding grounds for uncontrolled transmission” of the virus. There is an urgent need of decongesting them. What are the ways to decongest Indian prisons?
Background
- In India there are around 1,400 prisons, ‘housing’ over 5 lakh prisoners. These prisoners are facing the threat of Covid pandemic, with no organisational support.
- Whereas, in the countries such as U.K and U.S, activists are strong enough to influence public policy and voice against human rights abuse in prison.
- Also, these Countries have accurate data over the impact of pandemic on prisoners in public domain. For example
- The data from Texas state shows that the pandemic has killed more than 230 people in prisons, 80% of whom had not been convicted of a crime.
- Similarly, The United Kingdom Ministry of Justice figures shows that prisoners testing positive in October stood at 1,529, with five deaths.
- However, India lacks such crucial data on Prison Statistics in public domain and also such statistics are not being demanded of our criminal justice system.
How a lack of effective criminal laws is affecting under-trial prisoners in India?
According to the Prisons Act of 1894, prisons come under the exclusive responsibility of State governments. Over the years, despite being upgraded to the status of correctional homes, these prisons are facing the challenge of Congestion of Under Trial Prisoners (UTPs).
- According to the National Crime Records Bureau’s report for 2019 out of 4.5 lakh prisoners, 3.3 lakh are ‘under-trial prisoners’, i.e., investigation or trial is supposed to be ‘in progress’.
- These UTPs are detained under Section 167 of the Code of Criminal Procedure (CrPC) which provides for “Procedure when investigation cannot be completed in 24 hours”.
- The original Cr.PC of 1898 specified the period of detention as 15 days. Later, through amendments, it was extended to periods that can go up to 90 days and, in some exceptions, to an indefinite period.
- Out of 3.3 lakh, about 2.2 lakh are either not likely to be even charge-sheeted, or they are likely to be acquitted.”
- This is a huge violation of the basic human rights of UTPs, who are already facing the issue of inadequate healthcare facilities and torture by other rowdy prisoners.
- Moreover, it is a huge injustice to the families of the UTPs. For example, their children are denied a normal childhood, proper education, and are exploited by a cruel section of the society and are forced to take to the path of crime.
What needs to be done?
Pandemic provides an opportunity for an immediate review of all prisoners’ vulnerability to the epidemic,
- First, we need to conduct repeated testing in all prisons, especially sub-jails. An arrangement for the isolation and hospitalization of who testing positive needs to be planned.
- Second, to de-congest prisons, the Code of Criminal Procedure (Amendment) Act, 2005, which contains the much-needed Section 436-A needs to be activated.
- it provides for an under-trial to be released on a personal bond, with or without sureties if the under-trial has spent half of the period of prescribed imprisonment in detention.
- Third, ‘Prisons’ is purely a ‘State subject’. But it is imperative of the centre to support the states as the Constitutional responsibility of handling infectious and contagious diseases listed in the Concurrent List.
It is the duty of the state to vaccinate inmates at the ‘Hospitals of Correction’. It is similar to anyone in a state hospital may rightly expect to be vaccinated on a priority against the virus.
Covaxin not to be used in certain cases
News: Bharat Biotech has come out with a fact sheet about the process involved and who should avoid taking the Covaxin vaccine.
Facts:
- Covaxin: It has been indigenously developed by Hyderabad-based Bharat Biotech in collaboration with the Indian Council of Medical Research(ICMR).
- Type of vaccine: It is an inactivated vaccine. It means it is made by using particles of the coronavirus that were inactivated by making them incapable to infect or replicate. Injecting particular doses of these particles serves to build immunity by helping the body create antibodies against the dead virus.
Who should not get the Covaxin?
- During the first phase, experts are analyzing the behaviors of vaccines among different types of patients. They have recommended not to vaccinate if a person:
- has any history of allergies
- has a fever
- has a bleeding disorder or are on a blood thinner.
- is immune-compromised or are on a medicine that affects your immune system
- is pregnant or breastfeeding.
- has received another COVID-19 vaccine
- Has Any other serious health related issues as determined by the Vaccinator/Officer.
Article Source
Over 2.24 lakh vaccinated in 2 days, 447 adverse events: Centre
News: The Ministry of Health and Family Welfare has released the data on COVID-19 vaccination.
Facts:
Key Highlights of the Data:
- India has vaccinated the highest number of persons on the first day under its COVID-19 vaccination program. This is much higher than many other countries such as the USA, the UK and France.
- Around 2.24 lakh beneficiaries have been given COVID-19 vaccines in the first two days of India’s countrywide vaccination drive against the novel coronavirus infection.
- 447 cases of AEFI (Adverse event following immunization) have been reported. Most of the cases are minor and only three of the cases required hospitalization.
- According to WHO, Any untoward medical occurrence which follows immunization and does not necessarily have a causal relationship with the usage of the vaccine is known as AEFI.
Smokers, vegetarians are at lesser risk of getting infected by COVID-19: CSIR serosurvey
News: Council of Scientific and Industrial Research(CSIR) has conducted a pan-India Sero-survey tracking nearly 10,000 employees to study the prevalence of Covid-19. The study concluded Smokers and vegetarians were found to have lower seropositivity. So they may be at a lesser risk of getting infected by the coronavirus.
Facts:
Key Highlights of the Survey:
Source: The Hindu
Presence of Antibodies: The survey took samples of 10,427 adult individuals working in its laboratories or institutions and their family members to assess the presence of antibodies to SARS-CoV-2.It found 1,058 (10.14%) had antibodies against Covid.
- However, the neutralising antibodies that protect against the virus waned after infection but were at detectable levels even after six months — a proxy for the period of effectiveness of future vaccination and general immunity.
- Symptoms: About three-fourths of the respondents could not recall having experienced a single one of the symptoms commonly associated with the disease.
- Lesser Risk Group: Smokers and vegetarians were found to have lower seropositivity indicating that they may be at a lesser risk of getting infected by coronavirus.
- Blood Group: Those with blood group ‘O’ may be less susceptible to the infection, while people with ‘B’ and ‘AB’ blood groups were at a higher risk.
- Class Bias: There was also a distinct class bias in those affected. Those who work from home and able to access private transport were nearly twice less likely to be exposed to the virus than the outsourced staff involved with sanitation and security and using public transport.
Factsheet for administration of COVID-19 Vaccine released
Synopsis: Government has released a Vaccine Fact sheet that contains guidelines for administering both vaccines (Covaxin and Covishield).
Background
- Union Health Ministry has sent a comprehensive fact sheet for both vaccines (Covaxin and Covishield) to all states and immunisation officer.
- The Centre has also asked the states and immunisation officers to disseminate the fact sheet to all programme managers, cold chain handlers, and vaccinators before the rollout.
What is this fact sheet?
The fact sheet contains the general guidelines that should be followed during the initial phase of the Covid-19 vaccination drive, while vaccinating the priority group (3 crore people).
The fact sheet contains the guidelines on the following aspects,
- Physical specifications such as dosage, cold chain storage requirements.
- Specific guidelines on contraindications (a factor due to which the vaccine is to be withheld to certain categories of people)
- Guidelines on adverse events
- Details on special precautions.
Now we will examine in detail, the exceptions, precautions, and possible adverse events that are mentioned in the fact sheet.
First, the general guidelines in the fact sheet contain the following directives to ensure that proper care is taken while administering the vaccine.
- Only people over the age of 18 years are eligible for vaccination.
- Since 2 doses of vaccines are required per person, every Person should be administered the same vaccine in both the dosage. It is to deal with the issue of possible interchangeability.
- While administering the vaccine to a person with a history of any bleeding or coagulation disorder, platelet disorder, clotting factor deficiency, or coagulopathy, it should be done with caution.
- Both Vaccines have to be stored at +2°C to +8°C and needed to be protected from light. If it is found frozen it has to be discarded.
Second, the specific guidelines on contraindications. The three categories of people for whom the vaccine should not be administered. They are,
- Persons who have shown a history of an allergic reaction.
- People who show an immediate or delayed onset of an allergic reaction to vaccines or injectable therapies, pharmaceutical products, and food items.
- Pregnant and lactating women.
Third, guidelines on temporary contraindications. 3 categories of persons for whom vaccination is to be deferred for four-eight weeks. They are,
- Persons showing active symptoms of SARS-CoV-2 infection.
- Covid-19 patients who have been treated with anti-SARS-Cov-2 monoclonal antibodies or convalescent plasma.
- Acutely unwell and hospitalised patients (with or without intensive care) due to any illness.
Fourth, the fact sheet under not contraindicated, specifically mentions that persons suffering from following health conditions can get vaccinated. However, the response to the Covid-19 vaccine may be less in these individuals. They are;
- Persons with a past history of Covid-19 infection.
- Persons with a history of chronic diseases and comorbidities (cardiac, neurological, pulmonary, metabolic, and malignancies).
- Persons with immunodeficiency or HIV, and patients on immune suppression due to “any condition” can be administered with the Covid-19 vaccine.
Fifth, the fact sheet has also separately mentioned the Possible Adverse Reactions for both the vaccines along with the required precautions to be taken during the adverse reaction.
Guidelines provide the list of mild adverse events and rare adverse events that may follow the vaccination from both Covishield and Covaxin. It also provides for the precautions and medication that will be required in the above cases.
For example; In case of Mild adverse events for Covishield like myalgia (deep muscle pain), malaise (a feeling of overall discomfort), common painkiller paracetamol may be used.
How Covid-19 vaccines administered in other countries have performed till now?
Though the overall performance is found to be safe so far, there were few adverse events recorded in a small section of the population. For example, in the case of the US,
- The US Centers for Disease Control (CDC), monitoring by the Vaccine Adverse Event Reporting System detected 21 cases of anaphylaxis (a severe, life-threatening allergic reaction that occurs rarely after vaccination) out of a reported 1,893,360 first doses of the Pfizer-BioNTech vaccine.
- Whereas in the case of Modern’s mRNA vaccine, which was authorized for emergency use in the US, the CDC said data is still limited.
Strategic guidelines for COVID vaccine program: Challenges and suggestions
Synopsis: Government has issued strategic guidelines for the effective rollout of COVID vaccine program. There are challenges in the way of the Vaccine program that should be tackled as soon possible.
Strategic guidelines for COVID vaccine programme
With limitations of Vaccine related to efficiency and efficacy in mind, government has framed strategic guidelines for COVID vaccine programme
- Guidelines were framed using the knowledge acquired over three decades of implementing the Universal Immunisation Programme. It aims to aims to cover 30 crore people by July 2021.
- It has specified involvement of 19 departments, donor organisations and NGOs at the national, state, district and block level in the roll out of COVID vaccine programme.
- The guidelines have also clearly mentioned the priority criteria. Citizens eligible for the first round of COVID vaccine programme includes the following,
- The caregivers and front-line workers working under the department of health, defense, municipalities, and transportation.
- Persons above the age of 50.
- And persons below the age of 50 who suffers from comorbidities such as diabetes, hypertension, cancers, and lung diseases are all included.
- The strategic guidelines have also clearly stated in detail,
- The skills, roles, and responsibilities of the required human resources.
- The quantum of logistics required for delivering vaccines at point of use.
- The requirement of physical infrastructure, monitoring systems based on digital platforms, and feedback systems for reporting adverse events.
However, it has been criticised that the guidelines are ideal and have failed to provide solutions for real-time issues of our health system.
What are the challenges involved in effective rollout of COVID vaccine programme?
There are many challenges to roll out COVID vaccine programme. They are,
- First, unequal distribution of cold storage facilities among states. For example, out of the 28,932 cold chain points, half are in the five southern states, Maharashtra and Gujarat.
- Whereas the eight states in the North and Odisha that account for over 40 per cent of the country’s population have only 28 per cent of the cold chain points.
- Second, pertaining issues in our health care sector such as poor human resources, a weak private sector, poor safety and hygiene standards, frequent power outages, poor infrastructure will reduce the capacity to implement the vaccine programme with speed, quality, and accuracy.
- Third, a massive immunization programme for 30 crore people can distort the routine health service delivery and affect other immunisation drives, and can lead to exhaustion of health care workers.
- Fourth, acquiring the data for under the 50s with comorbidities will be challenging though we have data for the above-50-year-olds in the electoral rolls.
- Fifth, there are also challenge of tackling Fudging, false certification, and siphoning off vaccines to private facilities in the event of vast price differences between private hospitals and public hospitals.
- Sixth, the non-availability of efficacy data could result in huge wastage and gives scope for errors and duplication during the procurement and supply of vaccines.
- Seventh, the trust among the people on COVID vaccines are decreasing leading to suspicions and fears due to various reasons such as
- Non-transparency of data on either of the two vaccines proposed for use in the program.
- Opacity with which the licenses were given etc. For example, have not completed the Phase 3 trials that confirm the safety and efficacy of the vaccine.
- Above all, India hasn’t signed the advance purchase agreements for vaccines that have completed Phase 3 trials from other countries.
What is the way forward?
- First, avoid the complexity of listing the priority groups throughout our country. It should be replaced by covering the complete area in one go, instead of sequencing them into different groups.
- The areas could be ranked on the basis of a vulnerability index based on disease burden, caseload of COVID infections, demographic profile, health-seeking behavior and availability of infrastructure, etc.
- Second, to create confidence in the community we need to establish an independent team of experts under the aegis of the WHO to ensure adherence to recruitment standards, consent conditions, adverse event record management, compensation standards.
- Third, to build trust about vaccination programme we need to plan for large–scale public education and information programme through State- and local-level networks where people are informed, sensitised and their feedback was taken.
- Fourth, People should be involved in decision-making. For this Local leader from public figures, religious leaders, self-help groups, the media, and even educational institutions need to participate to help citizens understand its importance and build trust
- Fifth, Science, evidence, and data analytics need to be extensively used for effective policymaking.
- Finally, vaccination is not a complete solution to end the epidemic. We need to adopt safe behavior through a communication strategy. For this, the government can use its experience of controlling the HIV/AIDS epidemic.
The need of the hour is a winning strategy against epidemic that has drained us economically, socially and psychologically. Government needs to understand that the effective way of improving uptake of the vaccine while reducing costs is by creating participatory frameworks of engaging experts and communities and building effective and reliable public information, and transparency.
BARC Develops India’s First Ruthenium 106 Plaque For Effective Eye Cancer Treatment
News: Bhabha Atomic Research Centre(BARC) Mumbai has developed an Eye Cancer therapy. It was the first indigenous Ruthenium 106 Plaque for the treatment of Ocular Tumors.
Facts:
- Ruthenium-106: It is a radioactive form of the rare heavy metal ruthenium. It is a “platinum group” metal similar to platinum.
- How is it produced? It is produced from the fission or splitting of uranium-235, the type of uranium used in nuclear fission reactors, so it’s found in spent nuclear fuel.
- Uses: It is used in medicine for cancer radiation therapy, especially for eye and skin tumors. It is also used in radioisotope thermoelectric generators that power satellites.
- Harmful to Humans: High doses of ruthenium are toxic and carcinogenic when ingested. The material is strongly retained in the bones.
Issues in the process of COVID Vaccine trial
Synopsis: Many issues have been highlighted in the Phase-3 trial of Bharat Biotech’s COVID-19 vaccines. Those issues could have been avoided after HPV vaccine trial controversy.
Introduction
In a previous case, Human papilloma virus (HPV) vaccine trial was carried out on nearly 23,500 girls in the 10-14 age group in Vadodara, Gujarat and Khammam without proper consent. Almost eight years later the Supreme Court of India criticized the government for its inability to take action on illegal clinical trials carried out in India by multinational countries.
Present situation of the approval process in India suggests nothing much has changed.
- The phase-3 clinical trial of Bharat Biotech’s COVID-19 vaccine resembles the HPV vaccine because it seems that the trial is suffering from serious violations.
- The ICMR which has assigned the task of promulgating research ethics guidelines is also the cosponsor of the Covaxin trial.
What are the problems in the Covaxin phase 3 trial?
After the 2013 SC order, The Indian regulator made audio-video recording of the informed consent of each individual participant mandatory in 2019. Written consent from the participant had to certainly be taken before the audio-video recording.
However, the process was not followed properly;
- Firstly, no efforts were made to explain and inform the participants about the pros and cons of taking part in the trial instead; they were deceived by the trial site to think they were getting a COVID-19 vaccine for free.
- Secondly, many participants didn’t know about their rights to get free medical care in case of any adverse events.
- Many aware participants sought medical help from private practitioners whereas some of the participants don’t possess mobile phones, thus medical follow-up was not possible.
- Thirdly, not enough time was given to discuss with the family before signing the consent form. At least in a few instances, the consent was taken after vaccination, which is a serious violation.
- Participants were not given a copy of the consent form and other documents to prove their participation.
- Fourthly, 700 participants in the trial were illiterate and there is no evidence that an impartial witness was present during the entire informed consent process to attach his/her signatures to the consent form.
- Fifthly, communities living close to the hospital have told the media that they were offered ₹750, and luring people in trial for money is unethical.
- Although the company maintained that the amount was the reimbursement for the transportation and loss of wages, an open announcement of remuneration was unethical.
- Lastly, it is not yet confirmed that institutional ethics committee approved the advertisement for inviting people to the trial, in lieu of money.
Way forward
- India has already approved 2 vaccines for restricted use and the virus spread slowing down, so enrolling participants will be more challenging. Therefore, a thorough and impartial inquiry will bring back confidence in clinical trials.
Union Minister inaugurates 5th National Kayakalp Awards
News: Union Minister of Health and family Welfare has inaugurated the 5th National Kayakalp Awards.
Facts:
- National Kayakalp awards: It was launched by the Ministry of Health and Family Welfare in 2015 as part of the Swachh Bharat Abhiyan to ensure hygiene, sanitation and cleanliness in Public Health Facilities in India.
- Aim: The award recognises and facilitates those District Hospitals, Sub-divisional hospitals, Community Health Centres, Primary Health Centres and Health & Wellness Centres in the public healthcare system who have achieved high levels of cleanliness, hygiene and infection control.
- Parameters: The parameters on which the performance of the facility would be judged are as follows: 1) Hospital/Facility Upkeep 2) Sanitation and hygiene 3) Waste Management 4) Infection control 5) Support Services and 6) Hygiene Promotion.
- Assessment: The assessment of these parameters are done sequentially through a three tier system – internal assessment followed by peer assessment and then external assessment.
- Significance: The success of Kayakalp has been internationally applauded during the 72nd World Health Assembly, held on 20-28th May 2019. The success of Kayakalp was also duly recognized in Global Baseline Report 2019 published by WHO, UNICEF and JMP.
Additional Facts:
- Swachh Swasth Sarvatra: It was instituted by the Ministry of Health & Family Welfare (MoHFW) & Ministry of Drinking Water and Sanitation (MDWS) in 2016 under Swachh Bharat Mission.
- Aim: To strengthen Community Health Centres in open defecation free (ODF) blocks across the country along with behavioural change to enable them achieve higher levels of cleanliness and hygiene with the goal of making India free of open defecation.
- Objectives: The Three broad objectives of this scheme are:-
- Enabling Gram Panchayat where Kayakalp awarded PHCs are located to become ODF.
- Strengthening Community Health Centre (CHC) in ODF blocks to achieve higher level of cleanliness to meet Kayakalp standards through a support of Rs 10 Lakh under NHM.
- Build capacity through training in Water, Sanitation and Hygiene (WASH) Of nominees from covered PHC and CHC.
Formalising the work of community workers
Synopsis: Government should strive to formalise the work of community workers such as Anganwadi, ASHA and National Health Mission workers to make them accessible for various social security benefits such as safety, insurance, risk allowance and fixed wages etc.
Background
- In India, there are about a lakh ASHA worker, 1.3 million Anganwadi workers and another 1.2 million Anganwadi helpers. (Community workers)
- At present, community workers are classified as “honorary workers” and are denied of minimum wages, leave and other conditions that is available to formal workers.
- Even in the best paid states, this honorarium is not even close to the government-mandated minimum wages offered to workers doing comparable jobs.
- Also, the state by preferring to call them as “volunteers “denies the opportunity to recognise their crucial work as care service providers.
- This led to the two-day nationwide strike by Anganwadi, ASHA and National Health Mission workers demanding safety, insurance, risk allowance and fixed wages during the pandemic
What is the importance of community workers to society?
- Firstly, during the COVID-19 the Accredited Social Health Activists (ASHA) and Anganwadi workers, women “volunteers” functioned as the frontline warriors in the battle against the pandemic.
- Second, these community workers serve as the connecting link between the community and the state machinery. This was very much visible when there was uncertainty and fear of the virus.
- Third, the services of community workers are essential to facilitate localised approaches to problems as they have robust contacts at the grass roots.
What is the way forward?
- Firstly, there is an urgent need to recognise Community workers as workers. It can be done by Implementing the recommendation of Parliamentary Standing Committee on Labour to formalise the work of community workers.
- Second, Recognition of care work in the public sphere could also help in settling the issue of gendered and unequal division of house work and unpaid care burden.
It is high time that the state recognises the contributions of these women and accept them as workers. The recognition of ASHA and Anganwadi volunteers as workers will be a tribute to their contribution during the pandemic and also it gives a fresh start towards the structural understanding of women’s labour and their status in the labour market leading to Gender sensitive policy making
Explained: The return of bird flu
News: After bird flu (avian influenza) was confirmed in Kerala, Rajasthan, Madhya Pradesh, Haryana, and Himachal Pradesh, high alert has been sounded in several states which have been reporting deaths of birds, including crows and migratory species.
Facts:
- Bird flu or avian influenza: It is the name used to describe a viral infection that is reported mostly in birds but has the potential to affect humans and other animals.
- Common Strain: The most common strain of the virus that causes severe respiratory disease in birds is H5N1; various other strains like H7, H8 too, cause infection.
- Origin: The virus was first reported in geese in China in 1996.Since then, outbreaks have been reported periodically across the world. India reported the presence of the virus in Nandurbar, Maharashtra, in 2006.
- Human Transmission: The H5N1 virus can jump species and infect humans from the infected bird. The first case of H5N1 infection in humans was reported in Hong Kong in 1997 when a poultry farm worker caught the infection from infected birds.
- Human-Human Transmission: The high mortality rate in humans almost 60% is the main cause of concern about the spread of bird flu. However, in its present form, human-to-human infection is not known — human infections have been reported only among people who have handled infected birds or carcasses.
- Current Situation in India: Currently, samples from Rajasthan, Madhya Pradesh, and Kerala have tested positive for the A (H5N8) strain of the virus, while samples from Himachal Pradesh have shown the presence of A (H5N1).Most infections have been reported either in wild birds, crows or migratory birds.
- Is India’s Population Vulnerable to Bird Flu? Experts have said that the chances of the H5N1 virus infecting humans is comparatively low in India as compared to South East Asian countries mainly because both meat and eggs in India are eaten well-cooked which sees them being exposed to over 100 degrees Celsius. Thus the chances of humans contracting the virus from eating chicken and eggs is extremely rare.
How to deal with Avian influenza?
Synopsis: Avian influenza must be stopped before continuous spread amongst humans.
Influenza type A viruses cause Bird flu, a highly contagious viral disease. Normally birds are carriers of this virus, takes it across the continent, though unaffected themselves, affect a large population of other birds.
These viruses mainly affect poultry birds such as chickens and turkeys. Although rare, this virus sometimes also affects mammals such as pigs, horses, cats, and dogs.
H5N8 and H5N1 are subtypes of avian influenza Virus:
- H5N8 has been found in crows in Madhya Pradesh and Rajasthan.
- H5N1 strains have been found in ducks in Kerala and migratory birds in Himachal.
Introduction
The highly pathogenic avian influenza subtypes named as H5N1 and H5N8, have been reported in Rajasthan, Madhya Pradesh, Himachal Pradesh, and Kerala.
- Death count of poultry birds in Haryana is in thousands followed by Jharkhand and Gujarat. The cause of death in these three States is still unidentified.
- Crows in Rajasthan and Madhya Pradesh, migratory birds in Himachal Pradesh, and poultry in Kerala have been targeted by the two subtypes of the virus.
- Tests have confirmed H5N1 is responsible for the deaths of over 2,000 migratory birds in Himachal Pradesh.
- H5N8 has been recognized as the cause of deaths of thousands of poultry in Kerala, and hundreds of crows in Rajasthan and Madhya Pradesh.
What is the origin of the spread of the virus and its causes?
A European Food Safety Authority report revealed that 561 avian influenza discoveries were made between August-December in 15 European countries and the U.K.
- H5N1 and H5N8 were two of three subtypes found in Europe, these were mainly found in wild birds along with a few poultry and captive birds.
- Migratory birds have been largely responsible for spread of the virus into India during winter. It spreads further through movement of local residential birds and poultry.
- Genetic analysis suggested that a tenacious transmission of this virus strain is coming from wild birds in Asia to west-central Europe.
- Movement of men and material from poultry farms has also been a cause for the further blowout.
What is being done to stop the spread?
- Firstly, more than 69,000 birds which included ducks and chickens were culled in Alappuzha and Kottayam in accordance with India’s 2015 national avian influenza plan, in an attempt to stop the spread.
- Secondly, all the states have been asked to be watchful of any unusual deaths or disease outbreak signs amongst birds, particularly migratory ones as they are considered to be one of the causes of the spread.
- Thirdly, states have been asked to disinfect and dispose of the dead birds properly, biosecurity of poultry farms needs to be strengthened.
Conclusion
- It is very rare that avian influenza viruses cross the species barrier and directly infect humans but mutations in the virus can create a new avian influenza virus which can result in continuous transmission between humans, leading to genesis of pandemic influenza.
- Hence, it is suggested to carry out genome sequencing of virus samples to track the evolution of the virus.
Preparing workforce for COVID vaccination
Introduction
The permission of two COVID-19 vaccinats for emergency use is nearing. There is now hope of an end to the pandemic. But for the administration of vaccination and treatment properly and skillfully, a trained and effective workforce is required.
Present strength of healthcare workers in India
- In India, over 4,00,000 frontline workers have been trained to respond to COVID-19.
- However, this includes people with no prior experience also. Thousands have been trained for (1) contact tracing, (2) quarantine strategies, (3) ventilator management, (4) personal protective equipment, and (5) psychological issues.
In this context, Project Echo provides a cost effective way if ncreasing our workforce – both number wise and qualitywise.
What is project ECHO?
India was a recipient of an effective global innovation called Project ECHO.
- ECHO is a low-cost way out for growing the size of health workers in underserved communities to offer patients with the best possible care and facilities.
- ECHO was utilised as a strategy for treating Hepatitis C in the beginning but now is being used for newly trained experts in HIV, malaria, tuberculosis, addiction, mental health, and many other conditions.
- Under this project, health workers, nurses and doctors are trained through video conferencing technology. They learn speciality care from subject matter experts and from each other’s community informed knowledge.
- ECHO provides the ability to spread healthcare workers in the most remote areas of the country and give them training similar to what a healthcare worker in one of our largest cities would receive.
What needs to be done before the vaccine arrives?
India is led by the Serum Institute of India which has the largest manufacturing capacity in the world. However, certain aspects need to be figured out and planned before the COVID-19 vaccine becomes widely available:
- Firstly, real skills need to be cultivated for planning out the following:
- Delivery system of these vaccines needs to be figured out.
- Storage and handling of the vaccines.
- India needs to overcome cultural and religious obstacles for those who are unwilling to accept a vaccine.
- People need to be counselled about the side-effects of the vaccine.
- Secondly, more trained health experts are required to support vaccine treatment.
- Thirdly, further preparation of the ECHO model can be done to identify new healthcare workers who can be trained to be COVID-19 experts.
NFHS-5 data suggest improvement on various social indicators
Synopsis: Overall trends of NFHS data suggest an improvement in population control, use of modern contraception, reproductive and child health, immunisation and social determinants of health.
Introduction
The National Family Health Survey-round 5 (NFHS-5) covers about 6.1 lakh sample households to provide estimates for 707 districts. In the first phase, data from 22 states and UTs has been released from the latest survey conducted in 2019-2020.
What are the major findings in the first phase of the report?
- One, the data on Total Fertility Rate (TFR) has come down to 2.1 or below (replacement level) in all states and UTs. Bihar (3), Meghalaya (2.9) and Manipur (2.2) are exceptions in this.
- Two, the data shows that the overall use of modern methods of contraception has increased in 20 out of 22 states. The most dominant method being female sterilisation.
- Three, the data confirms that the number of women marrying before the legal age has reduced in 17 out of 22 states and UTs, with Nagaland, Maharashtra, Jammu & Kashmir and Sikkim as the top performers.
- Indicators on teenage marriage and childbearing have also improved in 17 states/UTs.
- Four, 17 of 22 states/UTs saw an increase in antenatal care visits during the first trimester (Nagaland, Bihar and West Bengal saw the highest rise).
- Five, the data shows consumption of IFA tablets by pregnant women for 180 days or more has increased in almost all states/UTs (except Karnataka) albeit this has not resulted in reduction in anaemia levels among pregnant women.
- There is a need to consider adding IFA tablets which contain more natural sources of iron, folic acid and other micronutrients in the diet.
- Six, 14 out of 22 states and UTs had more than 90 percent of new-borns delivered in institutional facilities and 14 out of 22 states/UTs have seen a drop in neonatal mortality.
What does the NFHS data suggest on the indicators of women empowerment?
Women’s empowerment is a widespread concept. However, indicators like household decision making, control over personal hygiene choices and possessions like bank accounts and mobile phones are decent indirect means for evaluation.
- The data indicates that the majority of women (80 percent) participated in at least three household decisions.
- Hygienic methods of protection during menstruation are being used by more than 64 per cent of younger women in each of the 22 states/UTs, except Bihar at 59 per cent.
- Personal possessions such as mobile phone and bank account have increased to over 70 per cent across each of the 22 states/UTs of India (except Nagaland) in 2019-2020 amongst women.
What does the NFHS data indicate about the public health in India?
- All states and UTs show a drastic increase in the number of households with a constructed toilet, improved drinking water and clean cooking fuels which are the indicators critical in improving public health in India.
- There has been a rise in malnutrition rates, wasting and underweight children in half of the states which reported an increase in exclusive breastfeeding and adequacy of diets.
- Stunting can be affected by multiple factors such as indicators of the mother a child, financial situation, adequacy of diets, water and sanitation facilities, as well as interventions for nutrition promotion and health.
- NFHS-5 data also show an increase in the rates of obesity in children and risk factors for chronic diseases in adults like hypertension and blood glucose.
Conclusion
One should not simplify these results for the whole country because data from phase 2 is yet to come and summary figures may oversee how relative health and nutritional results of the population can be.
Read more : National Family Health Survey
Status of Avian Influenza(AI) in India
News: In a bid to curb the spread of the bird flu or avian flu viruses, Central Government has set up a control room in the national capital to monitor the situation and take stock on a daily basis of the preventive and control measures undertaken by the state authorities.
Facts:
- What is Bird Flu or Avian Influenza? It is a highly contagious viral disease caused by Influenza Type A viruses which generally affects poultry birds such as chickens and turkeys.
- How does the bird flu spread? Wild aquatic birds such as ducks and geese are the natural reservoir of Influenza A viruses and the central players in the ecology of these viruses.
- Many birds carry the flu without developing sickness and shed it in their droppings.Since birds excrete even while flying, they also provide a nice aerosol of influenza virus, shedding it all over the world.
- Symptoms: Unlike in birds, where it generally infects the gut, the avian influenza attacks the respiratory tract of humans and may cause severe respiratory illnesses such as pneumonia or Acute Respiratory Distress Syndrome (ARDS). Its early symptoms include fever, cough, sore throat, and sometimes abdominal pain and diarrhoea.
- Treatment: Antiviral drugs, especially oseltamivir, improve the prospects of survival in humans.
- Bird Flu in India: India notified the first outbreak of avian influenza in 2006.Infection in humans is not yet reported in India though the disease is zoonotic.There is no direct evidence that AI viruses can be transmitted to humans via the consumption of contaminated poultry products.
- In India, the disease spreads mainly by migratory birds coming into India during winter months i.e. from September – October to February – March.The secondary spread by human handling (through fomites) cannot be ruled out.
Action Plan for Prevention, Control & Containment of Avian Influenza:
- Department of Animal Husbandry and Dairying (DAHD) had prepared an action plan in 2005 which was revised in 2006, 2012 , 2015 and 2021 for guidance of State Government for prevention, control and containment of Avian Influenza in India.The action plan calls for:
- Strengthening the biosecurity of poultry farms, disinfection of affected areas, proper disposal of dead birds/carcasses
- Timely collection and submission of samples for confirmation and further surveillance
- Intensification of surveillance plan as well as the general guidelines for prevention of disease spread from affected birds to poultry and humans.
- Coordination with the forest department for reporting any unusual mortality of birds was also suggested to the States.
- To keep a vigil on any unusual mortality amongst birds and to report immediately to take necessary measures.
Pune hub to track vaccine chain across 41 key cities
News: A command and control centre has been set up at Airports Authority of India Cargo Logistics and Allied Services Company Limited(AAICLAS) to monitor the movement of COVID-19 vaccines.
Facts:
Source: The Hindu
- What will AAICLAS do? It will be the nodal body for coordinating air transportation of the vaccines across a network of 41 airports with Pune — where vaccine manufacturer Serum Institute of India is located — as the hub.
- Process of Vaccine Transportation:
- The 41 airports or cities where transportation efforts will be focused include Karnal, Mumbai, Chennai and Kolkata, each of which has a Government Medical Stores Depot (GMSD) of the Central government’s Ministry of Health and Family Welfare.
- Once vaccines dispatched by the manufacturers arrive at these four big depots, they will be further distributed across 37 State depots.
- Thereafter, they will be sent to district depots and finally to the primary health care centres.
- Each of these centres has a temperature tracker which will upload temperature data on a central server for real time monitoring.
Swasth Vayu Non-invasive Ventilator receives regulator nod
News: Swasth Vayu Ventilator has received the approval of the expert committee constituted by Director General of Health Services, Ministry of Health & Family Welfare, Government of India.
Facts:
- Swasth Vayu: It is a ‘Made in India’ non-invasive (involves use of masks or similar device) ventilator developed by the National Aerospace Laboratories(NAL),Bengaluru.
- Key Features:
- It is a microcontroller based precise closed-loop adaptive control system with a built-in biocompatible 3D printed manifold and coupler with HEPA filter (Highly Efficient Particulate Air Filter).
- It also has several advanced features like Bi-level mode(BiPAP), Continuous Positive Airway Mode(CPAP) and Spontaneous modes with provision to connect Oxygen concentrator or Enrichment unit externally.
Read Also : current affairs for upsc
- Significance:
- The ventilator is ideal for treating Covid-19 patients in wards, makeshift hospitals, dispensaries and homes.
- The major advantage of this machine is also that it is simple to use without any specialized nursing, cost effective, compact and configured with majority of indigenous components.
Kerala on alert after bird flu in two districts
News: Kerala was placed on high alert after an outbreak of bird flu was confirmed in Kottayam and Alappuzha districts.
Facts:
Source: The Hindu
- Bird Flu: It refers to the disease caused by infection with avian (bird) influenza(flu) Type A viruses.These viruses occur naturally among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species.
Read more:-UPSC Syllabus 2021
- Can it infect Humans? It can occasionally infect humans as well, although human-to-human transmission is unusual.
- How does it spread to Humans? By close contact with a) Infected Poultry b) Pigs and c) Surfaces Contaminated by Infected Birds and their droppings.
- Common Symptoms of Bird Flu in Humans: Fever, Sore Throat, Cough, Muscle Aches, Difficulty in Breathing, Pneumonia, Pain in abdomen, diarrhoea among others.
National Medicinal Plants Board launches consortia of medicinal plants
News: National Medicinal Plants Board (NMPB), Ministry of AYUSH has launched a Consortia of Medicinal Plants.
Facts:
- Why was the NMPB Consortium launched? The NMPB Consortia aims to address/deliberate on the following issues: Quality planting material, Research & Development, Cultivation and Trade of medicinal plants/market linkage.
- Medicinal Plant Species Covered: In the first phase NMPB consortia is proposed for following medicinal plant species:
- Ashwagandha (Withaniasomnifera)
- Pippali(Piper longum)
- Aonla (Phyllanthus Emblica)
- Guggulu (Commiphorawightii)
- Shatavari (Asparagus racemosus).
- Seed to Shelf Approach: To establish the linkage between the farmers and manufacturers, a ‘Seed to Shelf’ approach is also being introduced. Wherein, aspects related to Quality Planting Materials(QPM), Good Agricultural Practices(GAP’s), Good Post Harvest Practices (GPHP’s) would be addressed.
Additional Facts:
- National Medicinal Plants Board(NMPB): It was established in 2000 under the Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homoeopathy).
- Aim: Its main objective is the development of the medicinal plants sector through developing a strong coordination between various ministries/ departments/ organizations for implementation of policies / programs on medicinal plants.
India approves two COVID-19 vaccines for emergency use
News: Central Drugs and Standards Committee(CDSCO) has approved the COVID-19 vaccines COVISHIELD and COVAXIN for restricted use in emergency situations. Initially, the 3 crore medical personnel considered at the highest risk for COVID-19, would be given the vaccine for free.
Facts:
Source: The Hindu
COVISHIELD:
- It is a vaccine developed by the Serum Institute of India based on the Oxford AstraZeneca vaccine named ChAdOx1 vaccine (also christened AZD1222) i
- Type of vaccine: It is made from a weakened version of a common cold adenovirus that causes infections in chimpanzees.
- Effectiveness: The overall efficacy of the vaccine was found to be 70.42% — well below vaccines from Pfizer and Moderna but above the 50% threshold set by many regulators.
- Dosage, protection duration and storage: The vaccine has been recommended for the approval of two full doses administered around 4-6 weeks apart. Immune response could last at least a year. The vaccine can be stored at temperatures between 2°C and 8°C.
COVAXIN:
- It has been indigenously developed by Hyderabad-based Bharat Biotech in collaboration with the Indian Council of Medical Research(ICMR).
- Type of vaccine: It is an inactivated vaccine and is made by using particles of the coronavirus that were killed making them unable to infect or replicate. Injecting particular doses of these particles serves to build immunity by helping the body create antibodies against the dead virus.
- Effectiveness: The vaccine is safe and provides a robust immune response. The vaccine is yet to complete late-stage human clinical trials in India and no efficacy rate has yet been made public.
- Dosage, protection duration and storage: The vaccine will be administered in two doses and stored at 2-8° degrees Celsius. The efficacy of the vaccine is to be determined only after 14 days post the second dose.
Approval to Covaxin, and Covishield Vaccines: Concerns and way forward
This article has been developed based on the Indian Express article “Turning point”.
Synopsis- The Drug Controller General of India (DCGI) approved two vaccines — the indigenously developed Covaxin, and Covishield. There are several concerns associated with the hasty approval of vaccines.
About Vaccines
COVISHIELD:
- This vaccine is incubated in the laboratories of Oxford University and Swedish-British pharma firm, AstraZeneca. It is manufactured by the Serum Institute of India.
- Type of vaccine: It is made from a weakened version of a common cold adenovirus that causes infections in chimpanzees.
COVAXIN:
- It has been indigenously developed by Hyderabad-based Bharat Biotech in collaboration with the Indian Council of Medical Research (ICMR).
- Approval of this vaccine has raised many concerns as the Vaccine was still undergoing phase-3 clinical trials.
As per the regulators, Phase I and Phase II clinical trials were conducted on approximately 800 subjects and the results have demonstrated that the vaccine is safe and provides a robust immune response.
An efficacy trial of this vaccine was initiated in India on 25,800 volunteers, and the data provided till now has been found to be safe, according to regulators.
However, there is no clarity about the type of data available.
Conditions associated with approval
- The emergency use approval is conditional on the vaccine developers submitting details of any adverse effect to the drug regulator, every 15 days.
- A factsheet with safety details will also be provided to those receiving the first lot of vaccines.
Accelerated approval process in India
The term “Emergency Use Authorisation (EUA)” has been used mainly by regulatory agencies like FDA in the US and some other countries.
The term Emergency Use Authorisation (EUA) has not been used anywhere in rules in India. However, 2019 rules provide for an “Accelerated Approval Process” for granting approval to a drug that is still in clinical trials. The definition of a new drug in the 2019 Rules includes a vaccine.
Conditions for Accelerated Approval Process
- There should be a prima facia case that the drug is of Therapeutic benefits.
- “Accelerated approval may also be granted to a new drug if it is intended for the treatment of a serious, or life-threatening condition, or disease of special relevance to the country, and addresses unmet medical needs,”.
- Approval can be granted even if “remarkable” effectiveness is reported even from phase-II trials.
Approval granted to drugs or vaccines that are still in clinical trials is temporary, and valid only for one year.
Read more – Emergency Use authorisation of vaccines
What are the concerns associated with the hasty approval of vaccines?
India which is regarded as a manufacturer of vaccines, has put its credibility at a stake by this hasty approval of vaccine. It has raised a wave of concerns by scientific and healthcare communities about a “public rollout of an untested product.
- First, Covaxin has been approved without clinical efficacy data. This vaccine was on the 3rd stage, which is always a key to prove its efficiency. Government’s approval to this vaccine might hurt India’s credibility in case of any adverse impacts.
- Efficacy data is an indication of how effective the vaccine is in preventing the virus attack.
- Second, As regulators have themselves evaded their rules, credibility of regulator at stake- This lack of transparency could lead to a lack of trust in the vaccine. There are several issues with the way the approval has been granted, which can lead to people losing confidence in the regulatory system.
- Third, approval an untested vaccine makes it nearly impossible to conduct a proper phase-3 trial.
- It will be unethical to expect volunteers to participate in a trial where there is only a 50% chance of being administered the actual vaccine, when they have the option of the real dose elsewhere.
- Fourth, While Pharmaceutical giants like Pfizer, Moderna, and AstraZeneca have given a go-ahead only after partial results of vaccine’s abilities in their own populations, In India Covishield has not been tested for vaccine ability among Indian population.
- As it is a possibility that vaccine response among Indian population may not be the same as among the European Population.
- Fifth, several data and reports have suggested the Vaccine hesitancy among people due to Emergency Use authorization. Approval without even base-level data will only strengthen this hesitancy among the public.
The rush to approve the COVID-19 vaccine without proper clinical trial may do more harm than good. So, it would be better to wait for the preliminary data from the phase-III trials to come in, and then grant the approval.
What is the way forward?
- Government needs to strengthen its vaccine distribution and administration mechanism to meet the need of 1/4th of the population it is looking to vaccinate in the first phase.
- Immunogenicity of both the vaccines could vary, thus there is a need to understand the adverse effects.
- Prioritising the elderly people needs to be re-examined because the elderly are less mobile and have a lower level of social interaction, they are less likely to spread the virus. So, in the long run, prioritizing the elderly people may not actually minimize the total social and economic cost inflicted by the virus.
- Surveillance and monitoring systems will require to be tweaked as per the efficiency and effectiveness data of the Vaccine.
- Vaccinators required to be educated on the finer details of the two vaccines.
Concerns of hasty approval to COVID-19 vaccine
Synopsis- Concerns regarding hasty approval granted to the COVID-19 vaccines despites the lack of adequate efficacy data.
Background-
- The Drug Controller General of India (DCGI) approved the Subject Expert Committee’s recommendation for emergency use of Serum Institute of India’s Covishieldand Bharat Biotech’s Covaxin.
- Covishieldis the same vaccine as developed by Oxford- AstraZeneca, which has got emergency use approval in the UK.
- In the case of Covaxin, concerns have been raised about the absence of efficacy data, which is generated during Phase 3 of human clinical trials.
However, experts have voiced their concerns on the approval process and the lack of publicly released efficacy data for Covaxin.
How India’s credibility as manufacturer of vaccine is at stake?
The hasty nod for Covaxin has put India’s credibility as a manufacturer of vaccines is at a stake and has raised eyebrows in the scientific and healthcare communities about a “public rollout of an untested product.
- First, Covaxinhas no clinical efficacy data- Bharat Biotch’s Covaxin vaccine is still in stage 3 clinical trials in India and the final results are yet to be released. The recommendation comes despite the lack of efficacy data for Covaxin.
- Efficacy data is an indication of how effective the vaccine is in preventing the virus attack.
- Moreover, the decision is a violation of the criteria in the draft regulatory guidelines for the development of COVID-19 vaccines published by CDSCO, in which it is clear that safety and efficacy data is required for approval of vaccine, but the indigenous vaccine from Bharat Biotech does not have efficacy details because the trials are underway.
- Second, credibility of regulator at stake-This lack of transparency could lead to a lack of trust in the vaccine. There are several issues with the way the approval has been granted, which can lead to people losing confidence in the regulatory system.
- Third, approval an untested vaccine makes it nearly impossible to conduct a proper phase-3 trial.
- It will be unethical to expect volunteers to participate in a trial where there is only a 50% chance of being administered the actual vaccine, when they have the option of the real dose elsewhere.
- Fourth, Pharmaceutical giants like Pfizer, Moderna and AstraZeneca have given a go-ahead only after partial results of vaccine’s abilities in their own populations.
- Whereas in India similar data for vaccine ability among Indian population has not been published. As it is a possibility that vaccine response among India population may not be the same as among the European Population.
The rush to approve COVID-19 vaccine without proper clinical trial may do more harm than good. So, it would be better to wait for the preliminary data from the phase-III trials to come in, and then grant the approval.
What is the way forward?
- In light of the intense concerns arising from the absence of efficacy data, the Use of Covaxinshould be treated as extended clinical trials.
- For the larger scale implementation of vaccines, Government needs to carefully monitor immune response to different vaccines and assess the efficacy across populations.
Expert panel grants emergency use authorisation for Oxford vaccine
News: The subject expert committee of Central Drugs Standard Control Organization(CDSCO) has recommended COVID-19 vaccine, Covishield for emergency use authorisation.
Facts:
- COVISHIELD: The Oxford vaccine “AZD1222” is being called Covishield in India. Serum Institute of India(SII) has entered into a manufacturing partnership with Oxford University and Pharma major AstraZeneca to produce this vaccine in India.
- Technology: Covishield is made of a weakened and modified version of adenovirus (a common cold virus) that causes infections in chimpanzees and contains the genetic material of the SARS-CoV-2 virus spike protein. After vaccination, the surface spike protein is produced, priming the immune system to attack the SARS-CoV-2 virus if it later infects the body.
- Efficacy: Researchers claimed the vaccine protected against Covid in 62% of those given two full doses and in 90% of those initially given a half dose.
- Safety: The Lancet publication, a leading medical journal has confirmed that the vaccine was well-tolerated and there were no serious safety events confirmed related to the vaccine.
- Storage: The vaccine can be stored, transported and handled at normal refrigerated conditions (2°C to 8°C) for at least six months.
Health Ministry plans communication strategy
News: Union Health Ministry has released a communication strategy to support the Covid-19 vaccine rollout in India that seeks to disseminate accurate and transparent information by alleviating apprehensions and ensuring its acceptance.
Facts:
- About the strategy: The key areas that will be addressed as part of interventions under the strategy are:
- Giving information on Covid-19 vaccines
- Addressing vaccine hesitancy
- Building vaccine eagerness along with maintaining and sustaining Covid appropriate behaviour.
Key Features of the Communication Strategy:
- Using Social Influence: The strategy focuses on using social influence or endorsements from experts and official voices to spell out the process of immunisation, emphasise on the safety and efficacy of vaccines and explain the decision to conduct the drive in a phased manner.
- National Media Rapid Response Cell(NMRRC): A Media Response Cell will be established under its ambit to ensure preparedness through media monitoring and social listening to respond in real time.It will also unfold media and public discourse through extensive monitoring of print, electronic and digital media.
- Involving Community Based Platforms: Government will involve community mobilisers and frontline workers to engage with the community at various levels to build trust and enable greater confidence in the Covid-19 vaccine.
- Adverse Effects due to immunisation: In case of any adverse effects following immunisation (AEFI), the strategy emphasises on supporting the mobilisers and health workforce in managing crisis situations by appealing to the community to stay calm while waiting for a proper diagnosis and prevent aggressive behavior against health workers.
Read Also:-CURRENT AFFAIRS 2020-2021
Government launches Indian SARS-CoV-2 Genomic Consortia(INSACOG) Group
News: Government of India has launched the Indian SARS-CoV-2 Genomic Consortia Group(INSACOG).
Facts:
- INSACOG: It has been established to monitor the genomic variations in the SARS-CoV-2 on a regular basis through a multi-laboratory network.
- Composition: It comprises 10 labs (NIBMG Kolkata, ILS Bhubaneswar, NIV Pune, CCS Pune, CCMB Hyderabad, CDFD Hyderabad, InSTEM Bengaluru, NIMHANS Bengaluru, IGIB Delhi and NCDC Delhi).
- Coordinated by: The group is coordinated by the Department of Biotechnology (DBT) along with the Ministry of Health and Family Welfare(MoH&FW), ICMR and CSIR.
- Nodal Unit for Maintaining Database: National Centre for Disease Control(NCDC) will be the nodal unit for maintaining a database of all samples of the new variants of public health significance. The data will be epidemiologically analysed, interpreted, and shared with states for investigation, contact tracing and planning response strategies.
- Other key Functions of the INSACOG:
- It will establish sentinel surveillance for early detection of genomic variants with public health implications and to determine genomic variants in unusual events or trends such as super-spreader events.
- Knowledge generated through this vital research consortium will also assist in developing diagnostics and potential therapeutics and vaccines in the future.
- The group will also closely work with NCDC on activities like SOPs, data annotation, data analysis, data release among others.
More genome sequencing to study the spread of the variants
Synopsis- There is need for more genome sequencing from samples from all over the world in order to come up with effective approaches to control and prevent COVID-19 infections.
Background-
- A new variant of the pandemic SARS-CoV-2 coronavirus is spreading rapidly in Britain and prompting high levels of concern.
- Six samples of the recent U.K. returnees have been found to be positive with a variant of SARS- CoV-2 virus.
- From 25 Nov-23 Dec, about 33,000 passengers landed at various Indian airports from the U.K. So far, only 114 have been found positive and samples have been sent to 10 INSACOG (Indian SARS-CoV-2 Genomics Consortium) labs for genome sequencing.
Thus, only through detailed epidemiological studies combined with genome sequencing data can we confirm the presence and spread of the variant in India.
What are the findings related to new stain of coronavirus and will it cause concern in India?
The genomic analysis undertaken by the COVID-19 Genomics U.K. Consortium found that-
- First. The new variant of coronavirus is named “VUI 202012/01” and is defined by a set of 23 changes or mutations. Among the 23 mutations, the two of which are particularly worrisome and specifically N501Y makes is more transmissible.
- It includes a genetic mutation in the “spike” protein that can lead to an easy and immediate spread of the virus, making it deadlier. This new variant has 17 mutations that affect the shape of the virus.
- Second, It is about 70% more transmissible- The variant has the potential to increase the number of people a person can infect by over 0.4
However, it might not be able to spread wildly in India as a sizeable percentage of people are already infected.
Read more – Mutation in Coronavirus
Why it is important to undertake more genome sequencing of the virus?
The genome sequencing study would determine if the COVID patients are carrying the existing strain of SARS-CoV-2 or the mutant strain.
- First, to understand the evolving nature of the virus–So far, we are doing very less frequent genomic sequencing compared to western nations. For instance, in England, around 10 percent of the infected virus samples are sequenced to study the nature of the virus.
- Second, to find an immune escape variant of the SARS-CoV-2, [which means a mutation in the virus that allows it to evade the immune system]
- One of the immune escape variants found in genomes from India, known as N440K variant — was found to be in 2.1 percent of the gene sequences in India.
- Third, The N501Y mutation can arise independently here in India. Hence more genome sequencing and genomic epidemiology is needed.
Steps were taken by the Indian Government regarding this-
- The genomic surveillance consortium (INSACOG) has been recommended for laboratory and epidemiological surveillance of circulating strains of the SARS-CoV-2 in India.
- Under this initiative, 5 percent of the positive cases will be tested for Whole Genome Sequencing, from all the States and UT.
Read Also : Current affairs for upsc
What is the way forward?
Genome sequencing is very much important of the higher percentage of the samples to understand the evolving nature of the virus.
Mutated virus does not cause more fatalities: report
Source: The Hindu
News: According to a study by Public Health England, the new mutated variant of the novel coronavirus does not appear to cause more severe illness than other variants.
Facts:
About the Study:
- Under the study, researchers compared 1,769 people infected with the new variant with the same number of people who had different Covid variant. The two groups were matched 1:1 on the basis of age, sex, area of residence and time of testing.
- The study found that 12 of 1,340 (0.89%) people infected with the new variant died within 28 days compared with 10 of 1,360 (0.73%) people infected with virus not belonging to the new variant. Hence, the study has concluded that the difference in case fatality between the two groups is not significant.
- However, the secondary attack rate or the proportion of contacts of confirmed cases that develop disease themselves was higher in people infected with the new variant.
Additional Facts:
- What is a mutation? A mutation means an alteration in genetic material. In an RNA virus such as SARS-CoV-2, proteins are made of a sequence of amino acids. Such a virus contains some 30,000 ‘base pairs’ which are like bricks placed next to each other to form a structure. An alteration in this base can be a mutation, effectively changing the shape and behaviour of the virus.
For Further Read on New Mutant Virus: https://blog.forumias.com/mutated-covid-19-strain-of-uk-spreads-faster/
Union Health Minister nominated to the Board of GAVI, The Vaccine Alliance
Source: PIB
News: Union Health Minister of India has been nominated by the Global Alliance for Vaccines and Immunisation(GAVI) as a member of the GAVI Board.
Facts:
- Union Health Minister will be representing the South East Area Regional Office(SEARO)/ Western Pacific Regional Office (WPRO) constituency on the GAVI Board from 1st January,2021 until 31st,December 2023.
What is GAVI?
- Gavi is an international organisation – a global Vaccine Alliance created in 2000.
- It brings together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries.
- GAVI has observer status at the World Health Assembly.
- As part of its mission to save lives, reduce poverty and protect the world against the threat of epidemics, GAVI has helped vaccinate more than 822 million children in the world’s poorest countries preventing more than 14 million future deaths.
GAVI Board:
- The GAVI Board normally meets twice a year in June and November/ December and holds an annual retreat, normally in March or April.
- The board is responsible for strategic direction and policy-making, oversees the operations of the Vaccine Alliance and monitors programme implementation.
- With membership drawn from a range of partner organisations, as well as experts from the private sector, the Board provides a forum for balanced strategic decision making, innovation and partner collaboration.
Dry Run and Challenges of Vaccines distribution in India
Synopsis: Indian is one of the world’s leading vaccine manufacturer, thus will have better access to vaccines, but the distribution of manufactured vaccine will prove to be a formidable task.
Dry run to test preparedness for the nationwide roll-out of a COVID-19 vaccine kicked off in four States — Assam, Andhra Pradesh, Gujarat and Punjab.
What is dry run of Vaccines?
- A dry run is aimed at testing the planned operations and the laid out mechanisms for Covid-19 vaccination in the state. It will provide insights into any gaps or bottlenecks so that those could be addressed before the commencement of the actual drive.
- Intended beneficiaries of each State, registered on Co-WIN’ app, have been sent text messages, containing info about the time and place of their “COVID-19 vaccination”.
Read – About Co-Win app and platform
- All the beneficiaries will have to register themselves compulsorily on Co-Win platform and provide a photo ID proof upon asking.
- Authorities will prepare a report for the STF, after conducting this dry run. STF will review the report and provide feedback and guidance to the authorities on further actions.
- The report will also be submitted to the Union Ministry of health and Family Welfare.
India’s vaccine distribution infrastructure
India has created a network of Cold Chain Infrastructure for vaccines at various levels. Presently, Vaccine distribution takes place through following process and infrastructures;
- Vaccines are produced by Manufacturers or procured by suppliers through agreements and arrangements.
- These vaccines are then delivered to 4 Government Medical Store Depots (GMSDs) in Karnal, Mumbai, Chennai and Kolkata.
- From these GMSDs vaccines are delivered to state, divisional and regional vaccine stores.
- They further distribute these vaccines to District Vaccine stores (DVCs). DVCs then deliver vaccines to PHCs, CHCs and Private facilities.
- From these centers beneficiaries can get themselves vaccinated.
All these distributions take place through insulated Vans and Vaccine carriers.
Some of the important facts and figures
- In Phase-1, Government is aiming at vaccinating 300 million most vulnerable people by August 2021 i.e. 600 million doses till August.
- At present India is having About 27000 cold chain points across the country.
- India’s present distribution capacity is 360 million doses in 8 months for both government and private facilities. It includes the Capacity of Private Cold Chain infrastructure at 200 million and government capacity at 160 million.
- The above capacity includes the infrastructure of the current immunization program, if leveraged for the covid vaccination.
- Due to the electronic vaccine intelligence network (eVIN) system, a real-time supply chain management system, India’s vaccine management has improved
What are the challenges in vaccine distribution in India?
- Firstly, to complete the aims of the first phase of the covid vaccination drive, the public sector distribution capacity will need to be expanded 2-3 times.
- Secondly, there are gaps in the vaccine distribution system. As per the Audit of health ministry in 2017-18, 26% of eVIN cold chain points reported instances of stock out during the period of assessment. More than a fifth of facilities reported wastage of vaccines.
- Third, Interstate disparity in the distribution of cold chain infrastructure across the country. For instance, roughly 4 cold chain points serve 100,000 population in Gujarat, whereas there is just one cold chain for the same number of people in Jharkhand.
- Fourth, unique requirements of the COVID-19 Pandemic such as Identifying beneficiaries, ensuring they show up on the day of vaccination, and administering a second dose after a month, provide vaccine across age groups instead of current programmes focus on particularly vulnerable sections, etc. All these require micro-level planning with a proper collaboration from the top.
- Fifth, Post-vaccination challenges such as documentation of vaccination and the tracking and investigation of vaccine safety events, all are equally important to create positive public opinion about vaccination.
- Sixth, India has performed poorly on the analysis by WHO-UNICEF in 2018, it ranked among 89 countries in 51-75 percentile range on effective vaccine management.
- Seventh, If the present infrastructure of universal immunization programme is used as planned, what will happen to the regular immunization drive, is also a big challenge in front of government.
India is one of the biggest producers of vaccines in the world. Serum Institute of India (SII) alone is a producer of more than 1.5 billion vaccine doses every year and is expected to produce 1 billion doses of the Novavax vaccine by 2021.
As now, the vaccine is being authorized by Emergency Use Authorisation method, Need is to augment the capacity of vaccine distribution on an urgent basis.
Essentiality of Dry run for COVID vaccines
Synopsis: Dry runs aimed at testing the planned operations are essential for Covid 19 vaccination process.
Background
- In the coming weeks, the Phase-3 data of two COVID-19 vaccines tested by Indian manufacturers are expected to be submitted for emergency use approval.
- A countrywide rollout to immunize the four high-risk groups will begin soon in India if any of the vaccines gets the approval.
- So, to be prepared in hand the government has rightly decided to undertake a dry run for vaccine administration. The dry run is expected to be initiated this week in four States of Andhra Pradesh, Assam, Gujarat, and Punjab.
Why the Dry run is essential?
- Though, India has been vaccinating millions of young children with a variety of vaccines each year the aspects of the COVID-19 vaccination Programme are new.
- Firstly, this is the first time a vaccine to be administered outside the universal immunisation Programme and specifically for adults belonging to specific groups.
- Second, there is a need for administering two doses of the vaccine a few weeks apart and enrolling the recipients which is different compared to our running vaccination drives.
- Third, it will allow the administrators to check the usage of the Co-WIN IT platform for management of the entire vaccination process including data entry, allocation of date and time and a drill of session sites with test beneficiaries.
- Fourth, it will also help to test the linkages between planning, implementation and reporting mechanisms.
What are the measures that needs to be ensured during Dry run exercise?
- The first task is to register the recipients of vaccine identified from the from the high-risk groups on the Co-WIN platform to avoid inclusion and exclusion errors.
- When more than one vaccine becomes available, it is essential to ensure that people receive the same vaccine twice and the exercise should confirm that the Co-WIN platform is able to generate the date and time when people can receive the second dose.
- As no COVID-19 vaccine has undergone long-term follow-up for safety during the trial it is very essential to Check and report on all adverse events after the vaccination.
- Regarding storage of vaccines, the existing facilities of the universal immunisation Programme in most districts can be used for storing the vaccines since the vaccines that are at an advanced stage of testing in India do not require ultra-low temperature for delivery and storage.
- Also, the exercise should look at creating additional storage capacity at these facilities to store millions of COVID-19 vaccines as the plan is to vaccinate 300 million people in the four high-risk groups for which it requires 600 million doses.
Examining the Strategies involved in Distributing Vaccines
Synopsis: The government must examine the principle underlying the triage scheme for optimised use of resources.
Background:
- Over the next 6-7 months, India plans to vaccinate 300 million people against COVID-19 by prioritizing healthcare workers, other front-line workers and everyone who is above 50 years of age.
- To vaccinate 300 million people, India requires 600 million doses as two doses are required per individual.
- However, government will not have problems in acquiring the required number of doses as it has already struck a deal with the Serum Institute to acquire 500 million doses of the AstraZeneca vaccine and also the availability of other vaccines such as Bharat Biotech’s Covaxin and the Russian Sputnik V are also high.
- But the strategies that they have planned for distribution of vaccines needs to be examined.
What are the Issues and dilemmas in the triage scheme?
- First, government’s strategy of prioritizing the elderly people need to be re-examined because,
- Vaccination drive should have two distinct objectives, one, providing protection to those vaccinated, and two to slow down the speed and spread of the viral transmission.
- Providing vaccination to healthcare professionals is not in conflict with the above objective because these are individuals who have high levels of exposure and they also act as active disease vectors since they interact with large numbers of people.
- But, prioritising the elderly people needs to be re-examined because the elderly is less mobile and have a lower level of social interaction, they are less likely to spread the virus. So, in the long run, prioritising the elderly people may not actually minimise the total social and economic cost inflicted by the virus.
- This suggests that densely populated areas for instance, the Dharavi slum should receive far more attention than they are likely to get under the current strategy.
- Second, the government should permit private suppliers to import and distribute the vaccine in India because,
- Currently, government’s procurement strategy relies entirely on public resources for distribution and the government plans to bear the entire cost of vaccination without involving private hospitals.
- But, allowing the private sector to provide additional supplies of the vaccine would not really be a bad policy decision if it would not decrease the availability of the vaccine to the poor.
- With more and more vaccines getting approval such as the Moderna vaccine in US, there will be a significant boost in the global supply of COVID-19 vaccines which mandates the need for involving private suppliers.
- Benefits that accrue owing to such decisions are, less waiting time for the less affluent as some of the richer individuals in the target group will opt out of the government distribution system and prefer to get vaccinated at some private outlet owing to increase in supply.
- Another potential benefit accruing to the entire population is that the larger the numbers who get vaccinated, the lower will be the speed of virus transmission amongst the non-vaccinated.
- Also, there are some cost benefits, for example, Belgian Minister has revealed that the European Union has agreed to pay for leading COVID-19 vaccines is substantially lower than the prices of Moderna and Pfizer. Given the large size of India’s market India has the bargaining power advantage
UNICEF launches the COVID-19 vaccine market dashboard
Source: UNICEF
News: As the designated COVAX procurement coordinator and procurement agent, UNICEF has launched the COVID-19 Vaccine Market Dashboard.
Facts:
- Purpose: The dashboard is an interactive tool for countries, partners and industry to follow the developments of the rapidly evolving COVID-19 vaccine market and the efforts of the COVAX Facility to ensure fair and equitable access for every country in the world.
- The dashboard will also provide a regularly updated overview of the global research and development pipeline, the projected production capacity, publicly announced bilateral and multilateral supply agreements as well as reported price points.
Additional Facts:
- COVAX: It is the vaccine pillar of the ACT-Accelerator. It is co-led by the Coalition for Epidemic Preparedness Innovation (CEPI), Gavi( the Vaccine Alliance), and the World Health Organization(WHO) – working in partnership with developed and developing country vaccine manufacturers and others.
- COVAX is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are rapidly available worldwide to economies of all financial means.
- ACT Accelerator: It is a framework for collaboration. It is not a decision-making body or a new organization. It was set up in response to a call from G20 Leaders in March 2020 and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.
- Goal: The goal of the ACT Accelerator is to end the COVID-19 pandemic as quickly as possible by reducing COVID-19 mortality and severe disease through the accelerated development, equitable allocation, and scaled-up delivery of vaccines.
The positive side of National Family Health Survey report
Synopsis: There has been a divergence in the actual NFHS data and the interpretations by the critics.
What are the features of National Family Health Survey report NHFS report 2019-20?
- The initial results of NFHS have been released for 2019-20 along with comparable data for the 2015-16 survey.
- Population coverage of approximately 700 million and 21 states have been covered under the NFHS data.
- Tabular data for 131 variables have been released for 2019-20.
- The data show that there has been significant improvement in many of these 131 indicators of social welfare.
Analysis provided by NFHS has been misinterpreted by the critics. Comment
It is important to compare India with the rest of the developing world. Trends in hunger, nutrition, inequality, and growth among others can be carefully evaluated in a comparative angle with the help of World Bank data provides. Some of the misinterpreted data is as follows:
- Firstly, Bangladesh underweight percentage in 2015 was stated as 22 per cent but the World Bank data states it to be 30.1 per cent, which makes it 4.7 percentage points (ppt) lower than India, not 12.8 ppt lower.
- Secondly, teenage pregnancies in India were 19.9 per cent in 2005 which reduced to 8.7 per cent in 2015 and further got 1 ppt lower in 2019. Hence, net improvement was about 12 ppt in 15 years.
- Whereas the level was 10 ppt higher constantly in the developing world during the same period. Even then some editorials claimed of worsening of teenage pregnancies in India.
- Thirdly, welfare improved between 2015 and 2019 according to a very large number of NFHS indicators. A summary of these data is as follows:
- Child Mortality: Data on three indicators (neo-natal, infant and under-five) show an improvement between 3 and 4 ppt.
- Immunizations: It improved drastically. For instance, the hepatitis B vaccine percentage (for children 12-23 months) increased from 64.8 per cent in 2015 to 83.6 per cent in 2019.
- Breast-feeding and diet of children 6-23 months: Average gain of 4 ppt for four indicators.
- Negative trend in seven young women indicators is 0: Modern birth control methods, age at marriage, teenage pregnancies, and sexual violence all show improvement. The average improvement in these seven indicators is 3.9 percentage points.
- Negative trend in 15 adult indicators is 0: Average gain is 4.1 percentage points.
- Other improvements: Some of the indicators show an increase of 9 percentage points and above in households with electricity (9.2 ppt), improved sanitation facilities (17.3 ppt), clean fuel for cooking (18 ppt) and women having a bank account that they use (29.8 ppt increase to a level of 77.2 per cent in 2019).
The points stated above show a large divergence in factual data and its interpretation. There is improvement in close to a 100 indicators and stagnation in less than 5 indicators.
What is National Family Health Survey (NFHS)?
The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted based on the representative samples collected from households throughout India.
The NFHS survey provides state and national information for India on various health parameters such as fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health, nutrition, anaemia, utilization and quality of health and family planning services.
Who releases the National Family Health Survey?
NFHS is released by the Ministry of Health and Family Welfare (MOHFW).
But the MOHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency. The IIPS is responsible for providing coordination and technical guidance for the survey.
Technical assistance for the NFHS was provided mainly by ORC Macro (USA) but various other organizations assist with specific issues.
Who will fund for National Family Health Survey (NFHS)?
The Survey of this size cannot be carried out with government funds alone. Many international agencies provide funds to carry out the NFHS. They are,
- United States Agency for International Development (USAID)
- The Bill and Melinda Gates Foundation
- Department for International Development (DFID)
- United Nations Children’s Fund (UNICEF)
- United Nations Population Fund (UNFPA)
- MOHFW, Government of India
What is the Goal of National Family Health Survey (NFHS)?
Every National Family Health Survey (NFHS) has two specific goals to fulfill. They are
- to provide essential data needed by the Ministry of Health and Family Welfare and other agencies for informed decision making and policy and programme intervention purposes.
- to provide insight regarding important emerging health and family welfare issues
Apart from these two specific objectives, NFHS also helps to monitor the progress of various Sustainable Development Goals (SDGs) especially SDG-3 (Good Health and Well-Being).
How many National Family Health Surveys (NFHS) conducted so far?
There are 5 rounds of National Family Health Surveys (NFHS) conducted so far in India. They are,
- First Round of NFHS conducted in 1992-93 (NFHS-1)
- Second Round of NFHS conducted in 1998-99 (NFHS-2)
- Third Round of NFHS conducted in 2005-06 (NFHS-3)
- Fourth Round of NFHS conducted in 2015-16 (NFHS-4)
- Fifth Round of NFHS conducted in 2019-20 (NFHS-5)
The NFHS-1, NFHS-2, NFHS-3 didn’t cover UTs except for Delhi because the objective of the survey then was to provide State-level estimates. (Source)
Since NFHS-4, the survey introduced district-level estimates for many important indicators and also included other UTs to provide holistic information.
5th round of National Family Health Survey (NFHS-5): (Source)
The MOHFW recently released Phase – I of NFHS-5 comprising data for 22 states/UTs. The Survey was earlier expected to release in July but due to the Covid-19 pandemic the release of the survey got delayed and it is finally released on 12th December 2020.
The fieldwork in the remaining 14 (Phase-II) States/UTs is currently in progress and expected to be available in May 2021.
The national-level indicators including most of the SDG health indicators are expected to be available by June/July 2021.
Important points regarding NFHS-5:
- The state factsheet released includes information on 131 key indicators.
- The district-level factsheet includes information on 104 key indicators.
- NFHS-5 uses the majority of NFHS-4 key indicators so that it would be comparable with NFHS-4 without any loss of information.
What is new in the 5th round of NFHS (NFHS-5)?
The NFHS-5 also included district-level estimates which were introduced during the NFHS-4. Apart from that NFHS-5 also included some new topics such as
- Preschool education,
- Disability,
- Access to a toilet facility,
- Death registration,
- Bathing practices during menstruation (menstrual hygiene),
- Methods and reasons for abortion.
- components of micro-nutrients to children,
- frequency of alcohol and tobacco use,
- additional components of non-communicable diseases (NCDs),
- expanded age ranges for measuring hypertension and diabetes among all aged 15 years and above etc.
What are the key findings of NFHS-5? (Source: The Hindu)
- Malnutrition: Of the 22 States and UTs, there is an increase in the prevalence of severe acute malnutrition in 16 States/UTs (compared to NFHS-4 conducted in 2015-16).
- The percentage of children under five who are underweight has also increased in 16 out of the 22 States/UTs.
- There is also an increase in the prevalence of other indicators such as adult malnutrition measured by those having a Body Mass Index of less than 18.5kg/m2 in many States/ UTs.
- Anaemia: Anaemia levels among children as well as adult women have increased in most of the States with a decline in anaemia among children being seen only in four States/UTs.
- Obesity: Most States/UTs also see an increase in overweight/obesity prevalence among children and adults, once again drawing attention to the inadequacy of diets in India both in terms of quality and quantity.
- Stunting: The data report an increase in childhood stunting in 13 of the 22 States/UTs compared to the data of NFHS-4.
- There was a 10-pp (Percentage Point) decline in stunting among children under five between 2005-06 (NFHS-3) and 2015-16 (NFHS-4), from 48% to 38%, averaging 1 pp a year. This was considered to be a very slow pace of improvement.
- Starvation: Volunteers of the Right to Food campaign have listed over 100 starvation deaths based on media and/or verified fact-finding reports since 2015.
- Food insecurity: Field surveys such as ‘Hunger Watch’ are already showing massive levels of food insecurity and decline in food consumption, especially among the poor and vulnerable households.
- In the Hunger Watch survey carried out in 11 States, two-thirds of the respondents reported that the nutritional quality and quantity of their diets worsened in September-October compared to before the lockdown.
- Jump in Vaccination: The survey has found considerable improvement in vaccination coverage among children aged 12-23 months across all States/UTs.
- Urban-Rural gender gaps in Internet use: There is an urban-rural gap as well as gender divide with respect to the use of the Internet. On average, less than 3 out of 10 women in rural India and 4 out of 10 women in urban India ever used the Internet.
- Increase in bank accounts operated by women: The number of bank accounts that women not only hold but also operate themselves has increased dramatically over the past five years.
PM to launch Ayushman Bharat PM-JAY SEHAT for J&K
Source: PIB
News: Prime Minister will launch Ayushman Bharat PM-JAY SEHAT to extend coverage to all the residents of the Union Territory of Jammu & Kashmir.
Facts:
- PM-JAY SEHAT: It aims to ensure Universal Health Coverage by providing free of cost insurance cover to all the residents of the UT of J&K.
- The scheme will cover the remaining population which has not been covered under the Ayushman Bharat Scheme.
Key Features of the PM-JAY SEHAT scheme:
- It provides financial cover up to Rs 5 lakh per family on a floater basis to all residents of the UT of J&K.
- It provides for operational extension of PM-JAY to 15 lakh (approx.) additional families.
- The scheme will operate on insurance mode in convergence with PM-JAY.
- The benefits of the scheme will be portable across the country. The hospitals empaneled under PM-JAY scheme shall provide services under this scheme as well.
- Significance: With the launch of ‘SEHAT’ Scheme, J&K will be among the first in the country to achieve Universal Health Coverage.
Additional Facts:
- Universal Health Coverage: It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care and enables everyone to access the services, protecting people from the financial consequences of paying for health services out of their own pockets and reducing the risk that people will be pushed to poverty.
- Ayushman Bharat : It was launched in 2018.It is the world’s largest health insurance/ assurance scheme fully financed by the Centre.
- It provides a cover of Rs 5 lakh per family annually for secondary and tertiary care hospitalisation for public and private enlisted hospitals in the country.
- The two flagship programmes under Ayushman Bharat programme are (a) Health and Wellness Centre and (b) Pradhan Mantri Jan Arogya Yojana (PM-JAY).
How COVID-19 revealed the limits of Political Accountability?
Context: The COVID-19 pandemic has put governance under a stress test which exposed how poorly prepared the world’s governments were.
What was the response of the world leaders to the pandemic?
The world’s most powerful leaders failed to do their duty to protect the citizens.
- In Brazil, Jair Bolsonaro irresponsibly refused to get vaccinated, even as his own government has launched a national vaccination campaign. He even remarked that the vaccine might turn people into crocodiles.
- In India, lockdowns of limited effectiveness, the sight of migrants desperately walking back to their villages and having the second largest number of cases, dented Prime Minister Modi’s popularity.
- In Russia, Vladimir Putin has hardly spoken even as the virus wraths unchecked across Russia. Further, the citizens are against a vaccine whose ability and safety are inadequately understood because of the opacity of Russia’s protocols.
Then why people of their country have not held their leaders accountable for the failure in handling this situation? Answer lies in the following propositions that shape the view of general public towards their leaders.
What are the limits of political accountability exposed during the pandemic?
Three propositions frame this analysis:
- Prospective Accountability: It is often understood that the voters vote retrospectively, i.e., give their judgement in the elections by voting based on the incumbent’s record. Instead, they vote prospectively, i.e., against candidates who the voters fear would put the opponents to a disadvantage.
- Underestimation of collective action: Second, disease, unlike war, does not offer a clear enemy to target. Public health advice that stressed the need for personal responsibility to stay home, wear a mask, washing hands. It underestimated the challenge of collective action predicted on millions of individual responses.
- It emphasises person’s responsible for own health, then getting sick is also his own fault. It absolves the govt. off the responsibilities.
- Poverty of collective empathy: Third, the coronavirus pandemic reveals our inability to empathise with what we do not see. For example, thousands of deaths due to pollution and road accidents go unnoticed, unlike thousands of deaths by COVID-19;
What is the way forward?
- Prolonged economic suffering demands government remedy more immediately as without some measure of accountability, democracy loses its power, and so do the people.
CoWIN Grand challenge, CoWIN platform and CoWIN App
Source: PIB
News: Ministry of Health and Family Welfare(MoHFW) and the Ministry of Electronics and Information Technology (MeitY) has announced its grand challenge for “CoWIN app”.
Facts:
- Aim: To strengthen the COVID-19 Vaccine Intelligence Network (CoWIN) system.
- Eligibility: Indian tech startups, MSMEs, companies and Limited Liability Partnerships(LLPs) registered in India under Companies Act can apply. Further, teams not registered as companies or startups or MSMEs can also participate in the challenge.
- Areas of Focus: The MoHFW has identified seven areas to focus on- 1) High Adherence rate; 2) Portability across India; 3) Vaccine Transportation; 4) Queue management; 5) Report adverse event following immunisation and adverse event of special interest; 6) Learning Management System; and 7) Logistic Management Information System.
Additional Facts:
- What is CoWIN Platform?
CoWIN: It is a digitalised platform launched by the Ministry of Health and Family Welfare (MoHFW) to help agencies keep a track of Covid-19 vaccination programme and allow Indian citizens to apply for a Covid-19 vaccine shot. - What is CoWIN-20 app?
- Government developed an app as part of CoWIN platform named CoWIN-20. for real-time monitoring of Covid-19 Vaccine.
- The main feature of the app is that it will send real-time data from the cold-storage facilities that store Covid-19 vaccines. This is an extension of eVIN (Electronic Vaccine Intelligence Network)
- Modules: The app is divided into five modules.These are administrator module, registration module, vaccination module, beneficiary acknowledgement module and report module.
For example, a front line worker like Health care worker can register themselves in app using the “registration module”. After the registration is done the “beneficiary acknowledgement module” will send an acknowledgement to the person - Beneficiary Acknowledgement module will provide QR based Certificate once the person is vaccinated.
Mutated’ Covid-19 strain of UK spreads faster
Context- New mutated COVID-19 strain discovered in the United Kingdom underlines the need for adherence to Non-pharmaceutical interventions.
More in news-
A new variant of the pandemic SARS-CoV-2 coronavirus is spreading rapidly in Britain and prompting high levels of concern.
Precautionary measures taken by other countries-
- The United Kingdom stood shut off from the rest of Europe after several nations decided to close borders over fears of the new coronavirus strain.
- India too has joined over two dozen countries in banning inbound travel from the UK.
What is this new strain of coronavirus?
Covid-19 mutant strain- It has been named VUI-202012/01 and is defined by a set of 23 changes or mutations. Among the 23 mutations, the two of which are particularly worrisome.
- N501Y – Has previously been shown to increase how tightly the protein binds to the angiotensin-converting enzyme 2 receptor, its entry point into human cells.
- 69-70del – leads to the loss of two amino acids in the spike protein and has been found in viruses that eluded the immune response in some immune compromised patients.
Concern with new strain-
- It is about 70% more transmissible- The variant has the potential to increase by over 0.4 the number of people a person can infect.
Mutations, or genetic changes, arise naturally in all viruses, including SARS-CoV-2, as they replicate and circulate among humans. However, these changes, can lead to a quicker spread of Covid-19 between people.
Will vaccines work against this new strain of virus?
According to scientists, Vaccines will be equally effective despite the mutation. So there is no reason to panic.
- This is because vaccines are designed to create antibodies targeting the spike protein and there is also the T-cell immunity that would come into play to clear the virus.
- However, as the virus accumulates more changes, vaccines might require little tweaking.
What needs to be done?
- The emergence of the new variant underlines the compulsion to undertake surveillance following vaccination to track vaccine effectiveness and to look for the appearance of vaccine escape mutants.
- Non-pharmaceutical interventions, including quarantine and social distancing have significantly helped in curbing the transmission of coronavirus and should be followed strictly.
Impact of New Welfarism approach of government on nutrition
Context: The New welfarism approach followed by the present government can better explain the reason for the overall rise in stunting rates.
Background
- The 5th round of the National Family Health Survey (NFHS-5) that covers dimensions such as health, nutrition, and the overall quality of lives, has been recently released.
- It provides reliable and independent evidence to assess micro-development performance under this government.
- NFHS-5 has highlighted the dismal performance of country in reducing the malnutrition specifically stunting.
- The findings of NFHS-5 show, how the government policy has consciously adopted the New Welfarism approach providing Tangibles services, instead of providing Intangibles social benefits i.e., improving nutrition level.
What is New welfarism approach?
- The New Welfarism approach is more similar to the Basic Needs approach to development but a very distinctive approach to redistribution and inclusion.
- It does not prioritise the supply of Intangible public services such as basic health, primary education and safety security net.
- Instead, it focuses on tangible essential goods and services, normally provided by the private sector, such as bank accounts, cooking gas, toilets, electricity, housing, water and cash.
What are the findings that supports New Welfarism approach?
- Firstly, Increase in Bank accounts leading to women’s financial inclusion and empowerment: As of 2019, 72 per cent of all women had bank or savings accounts that they report as being able to use themselves.
- Secondly, increase in electricity connections, sanitation facilities, clean fuel: Ninety-eight per cent of all households had access to electricity, nearly 70 per cent to improved sanitation, and 60 per cent to clean cooking fuel.
- Third, increase in beneficiaries: Also, the percentage of households that have gained access to these goods and services each year, has accelerated since 2015
- Fourth, increase in child Stunting rates: The improvements towards child stunting, an intangible service has been disappointing as the overall stunting rates are flattening rather than decreasing and urban rates are rising.
Why the New Welfarism approach focuses on tangible goods more than Intangible goods?
- Ideological dimension: The government believes that Providing tangible goods and services such as bank accounts, cooking gas, toilets, electricity, housing will make a critical difference to the lives of the poor.
- Strategic dimension: Providing tangible goods and services that are relatively easy to deliver, measure and monitor has high electoral opportunity in it. Whereas, providing intangible services such as primary education is difficult to define and less measure and hence difficult to convert into a political advantage.
Thus, the findings clearly explain that the failure on stunting is mainly due to the shift in government policies towards New welfarism approach where the tangible goods and services are prioritised rather than intangible services such as nutrition, education, child stunting etc.
Parliamentary Standing Committee recommendation on the management of COVID-19 situation
News: The Parliamentary Standing Committee on Home Affairs has submitted its report to the Rajya Sabha Chairman on the management of Covid-19 situation.
Facts:
Key Suggestions given by Panel:
Panel has given suggestion on the four aspects:
- The country’s preparedness
- Augmentation of health infrastructure
- Social impact
- Economic impact
Source: The Hindu
On Country’s preparedness
- Separate Wing: A separate wing may be formed in the National Disaster Management Authority that will specialize in handling /managing the Pandemics like COVID-19 in the future.
- Center-state coordination mechanism: For providing quick response to such crisis, an effective functional institutional mechanism is needed for coordination between the Centre, states, and Union Territories.
On country’s Health Infrastructure
- Public Health Act: A comprehensive Public Health Act preferably at the National Level with suitable legal provisions to keep checks and controls over private hospitals in times of a pandemic to
- curb black marketing of medicines
- check the malpractices like selling of hospital beds
- denial of the cashless facility
- variation in levying charges towards consumables such as PPE kits, gloves etc,
- Strengthen Public Health care System: The public sector healthcare delivery system needs to be further strengthened in all the states/ UTs and a uniform healthcare system should be established across the country to deal with the pandemic on a sustained basis in the future.
On Social Impacts
- National Database on migrant workers should be launched at the earliest as it will help in the identification of migrant workers and also in delivering ration and other benefits to them.
- Inter-state operability of ration cards: It recommended that until the One Nation, One Ration Card is implemented in all states/UTs, inter-state operability of ration cards should be allowed.
- Mid-Day Meal Scheme: Central government should coordinate with local administration through state governments to ensure rations/ allowances are delivered on time.
On Economic Impacts
- Awareness Campaigns: The Government should hold awareness campaigns on cheaper and effective repurposed medicines to prevent panic-buying of expensive drugs by the people.
- Vaccine Authorization: Any vaccine against COVID-19 should be granted emergency use authorisation only after proper consideration and conducting its trials on a sufficient sample size.
Health care in India
Context – The problems in India’s health sector.
What are the issues with healthcare sector in India?
- Low government spending – Public expenditure on health accounts for only 1.13% of the total health expenditure which is abysmally low when compared to WHO recommendation of 5%.
- High out of pocket expenditure– Out of pocket expenses account for 62% of the expenditure. This led to an increasing number of households facing catastrophic expenditures due to health costs.
- 85% of the population cannot afford high cost, corporate private health care.
- Insurance-76% of Indians does not have health insurance. Government contribution to insurance is just 32%. Low insurance penetration forces people to spend out of pocket.
- The behaviour of a private corporate hospital is skewed in favour of profitability.
- Malpractices in the healthcare sector – Selling substandard and counterfeit medicines, unnecessary hospital admissions and exploitation.
- Weak government policy– only 1.27 crore people have taken advantage of the Ayushman Bharat scheme out of 12 crore card holders.
- Dark reality of private hospitals– The insurance backup incentivizes hospitals to expand the bill but the patients do not get attended to in their best interests.
- Low health workforce density – India’s public system has a shortage of nurses. The ratio of 0.6 nurses per doctor while the World Health Organization specification is three nurses per doctor.
- 80:20 Rule – Only 20% of people can afford modern health care, 40% cannot afford it at all and the other 40%, the non-poor, pay with difficulty.
- Nearly 7 crore of the non-poor slide into poverty on a year-to-year basis.
- Under-qualified doctors– Due to this, 80% of people routinely reach Registered Medical Practitioners who are not trained to treat patients.
What needs to be done to improve healthcare sector?
- Increase the number of doctors– Ramp up the number of doctors with counterpart obligation to serve in rural areas.
- The Licentiate Medical Practitioner [LMP] – The scheme involves a three-and-a-half year course that leads to a bachelor’s degree in medicine and surgery. Doctors trained under this scheme will work in rural areas.
- Empower graduates of BSc (Nursing) to be nursing practitioners.
- Focusing of primary care– India needs to shifts focus from secondary and tertiary sectors to primary care. PHCs should be made attractive to doctors by providing incentives and making rural service mandatory for medical students.
- States should be incentivized to carry out the appointments of health workers and doctors.
Way forward-
- PHCs should be well-staffed and well-provisioned through a reasonable fee which will cover at least part of the cost.
- Focus should be shifted to preventive healthcare from curative healthcare.
- Policymakers need to focus on the larger picture with steps being taken to reclaim the space under public care.
What is Shigella Infection reported in Kerala?
Source: Click here
News: North Kerala has been put on high alert after an 11-year-old boy died and 20 suspected cases of shigella bacterial infection were reported.
Facts:
- Shigella Infection (shigellosis) is an intestinal infection caused by a family of bacteria known as shigella.
- Transmission: Contaminated food, water are the source of the infection. The bacteria spreads not only through surfaces — touching an infected surface and then touching the mouth — but also from eating food prepared by someone carrying the infection.
- Symptoms: Symptoms include diarrhoea, fever, stomach cramps which can last for seven days.
- Treatment: It is generally done through antibiotics which can shorten the duration of the illness.
- Susceptible Group: Children under age 10 are most likely to get shigella infection but it can occur at any age.
- Precautions: Doctors advise frequently washing hands with soap and running water to avoid infections such as Shigella.
Eliminating Tuberculosis (TB)
Context- The pandemic provides learning opportunity and opens up possibilities of accelerating Tuberculosis (TB) elimination venture.
More in news-
- Covid-19 has derailed the painstaking efforts of decades and diverted scientific attention from killer diseases like tuberculosis
- COVID-19 lockdowns have resulted in a 30 per cent decline in tuberculosis diagnosis and reporting.
- Researchers estimate that over the next five years, an additional 1.19 million TB cases and 3,61,000 TB deaths may occur in India.
What is Tuberculosis?
Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
- TB causes respiratory illness and spread from person to person through the air.
- Mortality rate of 13 per cent — far worse than the 1.3 per cent for COVID-19.
How combating COVID-19 pandemic can help eradicate TB?
- Raise the awareness of the general masses- The leaders and individuals have realized the devastation an infectious respiratory disease can cause.
- Behavioural changes– The changes acquired during the pandemic such as cough hygiene, use of masks, physical distancing will further help reduce the transmission of tuberculosis, which is a respiratory illness.
- Doctors and nurses will be less complacent about these measures.
- Raise investments in the healthcare sector– investments in health systems infrastructure, infection control equipment and personal protection equipment will ensure better airborne infection prevention and control.
- Boost testing scale-
- COVID-19 has changed the landscape of testing and surveillance.
- The speed of research on new COVID-19 tests and the scale at which testing was applied are lessons to be learned by TB programmes.
- Bi-directional” TB and COVID-19 testing – Greater identification of cases will lead to more persons being isolated and treated.
- Speed of vaccine development-
- The success of various COVID-19 vaccine platforms and the speed at which the vaccine has been brought to the market gives tremendous hope for TB vaccine candidates.
- Fast-tracking of research, advance purchasing, and research sharing by countries witnessed during the pandemic could apply to the TB vaccine.
- Several dedicated infectious diseases hospitals have come up as a part of the pandemic response measures, which would contribute in a major way towards tuberculosis care and management.
- The molecular diagnostic capacity has increased – These multi-platform devices based on cartridge and chip-based technology can decentralize TB diagnosis.
- COVID-19 has taught to prioritize public health as much as curative and preventive health.
- The increased uptake of telemedicine and teleconsultation during the pandemic will provide channels of consultation for tuberculosis
What is the way forward?
COVID-19 is likely to expedite the trajectory of TB elimination.
- COVID-19 pandemic has provided an opportunity to boost TB elimination activities through health system strengthening and infectious diseases control.
What are the implications of Initial NFHS-5 results?
This article on NFHS-5 results has been developed based on the Indian Express Article under the title ‘Give children weight’ that appeared in the news on 17th December 2020.
Situation of Nutrition in India as per NFHS-5 survey and other measures
- As per the National Family Health Survey 2015-16 (NFHS-4), 35.7 per cent children below five years were underweight in India compared to Bangladesh (22 per cent) and Nepal (27 per cent). 38.4 per cent were stunted.
- Now as per early estimates of National Family Health Survey 2019-20 (NFHS-5), between 2015-16 and 2019-20, in 7 out of 10 major states for which data has been released, the proportion of underweight children increased.
- Present data estimates stunting in 36 per cent of children and 34 per cent of children are underweight.
- Some improvements have been seen in determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status
- The Global Hunger Index 2020 report has given India the 94th rank among 107 countries, much behind Bangladesh, Pakistan, and Nepal.
- As per a UN-FAO report, 194 million people go hungry every day in India, comprising about 23% of the world’s undernourished population.
What are the implications of NFHS-5 Survey estimates?
- Present data suggest that child nutrition in India has not progressed in last 5 years. Particularly, stagnation of stunting rates is alarming, as Height, unlike weight, cannot be reversed in short period of time and becomes permanent after a certain age.
- Stunting in childhood is associated with serious impairments later in life, including lower school achievements.
- Moreover, present data represent the picture before the advent of COVID pandemic. There is a high possibility that child nutrition has deteriorated as several surveys have pointed out severe food insecurity across India in 2020.
- As per the latest survey by Hunger Watch, 2/3rd of the respondents that are adults from India’s poorest households were eating less nutritious food today than before the lockdown.
- Mid-day meals in schools and anganwadis were discontinued after lockdown and not resumed yet. Some of the states tried to make arrangement like distribution of cash or “take-home rations”, but were not adequate.
- Prolonged closure of anganwadis and schools might have resulted in massive disruption of routine health services — including immunisation.
What are government initiatives for improving nutrition in India?
- The Integrated Child Development Services provides cooked meals and take-home rations to 100 million children under the age of six, as well as to pregnant and lactating mothers.
- The mid-day meal programme in schools takes care of the nutritional requirement of school-going children.
- POSHAN abhiyan: It is India’s flagship programme to improve nutritional outcomes for children, pregnant women, and lactating mothers.
What are the criticisms against government policies?
- Central budget for mid-day meals (Rs 11,000 crore) is lower than what it was in 2014-15 (Rs 13,000 crore). Central allocation for ICDS is also lower today than it was six years ago.
- Poshan Abhiyaan, government’s flagship programme for child nutrition, has been allocated a minuscule budget of Rs 3,700 crore.
- In many states, on the one hand, political parties opposedinclusion of eggs in mid-day meals and take-home rations, on another hand, maternity benefit were restricted to one child per family and Rs 5,000 per child against Rs. 6,000 per child under the NFSA 2013.
What should be done?
The present government needs to allocate more resources for improving the nutrition level among children. The budget should have been increased or kept at the same level.
- Revival of present structure: The forthcoming Budget, for 2021-22 should have adequate provision for increasing nutrition level in the country and Mid-day meals in schools and Anganwadi centers must be revived as soon as possible.
- Nutritious products such as eggs with a fruit option or such for vegetarians should be included in mid-day meals and take-home rations for young children and pregnant women.
- Maternity benefits must be extended to all children with an increase in benefits beyond outdated Rs 6,000 per child.
- Upgradation of anganwadis: ICDS programme must be upgraded and the manpower of 14 lakh anganwadis should be utilised in a way to transform anganwadis into vibrant child development centers at the village level as been done in some southern states along with states like Himachal Pradesh and Odisha.
- Inclusion of pulses: World Food Programme (WFP) includes 60 grams of pulses in its typical food basket, alongside cereals, oils, and sugar, and salt and according to the Global Pulse Confederation, pulses are part of a healthy, balanced diet and have been shown to have an important role in preventing illnesses such as cancer, diabetes, and heart disease. Thus, Pulses should be included in the PDS of India.
- Access to finance and innovations: Inclusive access to finance to strengthen and expand rural supply chains is also crucial. Small landholders need access to financial resources, technology, and innovation to ensure that the produced food reaches from farm to fork.
Present children are the future of our country and a healthy mind resides in a healthy body. As shown in the NFHS-5 survey, more than 1/4th of underweight children may prove to be the biggest obstacle in becoming a $5 trillion economy within a few years. Global economic and military superpower and require urgent attention.
Uttar Pradesh’s strategies to contain the pandemic
Context- Early and systematic tracking of high-risk contacts helped Uttar Pradesh step up the fight against COVID-19.
What were the measures taken by UP government to control the outbreak?
Uttar Pradesh is the largest state in the country in terms of population and hence, the battle against COVID-19 becomes more challenging. Several factors distinguish the handling of the pandemic in the state such as –
- Setting up of ‘Team 11’ – Team 11(which is a cluster of 11 committees) at the state level that comprises top officials and report on a daily basis to the chief minister on the corona situation. The daily review meeting has kept the state machinery on its toes.
- Ministers in charge of Health and Medical Education are also present at these meetings.
- This committee tasked with managing different aspects like –
- ICCC set up in every district– Integrated COVID Command and Control Centre (ICCC), This is the nerve centre of pandemic management in the district which helps in-
- Sending testing teams to different areas as per plan.
- Ensuring surveillance and contact tracing.
- Sending positive patients to different Covid hospitals or placing them under home isolation.
- Integrated data management portal– UP government launched an integrated Covid-19 portal (upcovid19tracks.in), set up a digital mechanism that can help the state government combat the pandemic while controlling community transmission of the virus.
- It provides us with the ability to crunch and analyse data on a daily basis.
- Also cajole the districts lagging behind to improve their performance.
- Provide test results to citizens.
- Informs citizens about the nearest COVID-19 test centres where they can get themselves tested free of cost.
- Widespread use of the drug, Ivermectin – The Uttar Pradesh government has issued a government order for not only use of Ivermectin drug to treat COVID-19 patients but also as prevention too.
- The state government provides free medicines to all patients.
- The combination of ivermectin and doxycyclin to successfully treat over three lakh home-isolated patients with mild symptoms so far.
- Target testing- The strategy of testing of selected groups helped assess the level of infection in the general population and identify and isolate super-spreaders.
- For example- Before festive season, the administration tested mehndi artists, sweet shop workers, jewelers, those working at places of worship, roadside cracker vendors and were able to isolate more than 12,500 infected persons.
Way forward-
Heavy testing, strategic containment, new innovative ideas and management ideas and Government relied measures helped Uttar Pradesh to keep the positivity rate below 5 per cent throughout the pandemic.
- Continuous monitoring of patients in home quarantine has been an extremely helpful step.
- A combination of government policies and technology-based solutions has been put in place to ensure the safety and well-being of people along with the smooth functioning of the state.
India and UK launches Virtual Vaccines Hub
Source: Click here
News: India and the UK Government has launched a Virtual Vaccines Hub.
Facts:
- Objective: To distribute vaccines for Covid-19 and other deadly viruses by sharing knowledge on clinical trials and regulatory approvals and get vaccines to people who need them most in a safe, secure and energy-efficient way.
Previous such collaboration with the UK:
- This Serum Institute and Oxford University partnership demonstrates the UK-India relationship at its best: a vaccine developed in the UK and made in India
- According to the British High Commission, India supplies over 50 per cent of the world’s vaccines and 25 per cent of the Britain’s National Health Service’s (NHS) generic drugs.
Need for Collaboration:
- The new hub will enable both country experts to share knowledge on clinical trials and regulatory approvals.
- A global pandemic requires a global solution. Scientific cooperation has made breakthroughs on corona virus vaccines at record-breaking pace
- The UK-India Vaccine Hub will now build on innovations, to bring COVID crisis and also to an end and protect against future pandemics
- A closer UK-India cooperation on medicines and vaccines approvals will ensure speedy access for the UK to Indian-produced pharmaceuticals and help safeguard future supplies to the National Health Services of Britain.
- A closer UK-India relationship is a part of a wider UK Programme to focus on partnerships in the Indo-Pacific region.
Global COVAX initiative:
Millions of doses made will be distributed to the world’s poorest people through the global COVAX initiative, in partnership with World Health Organization (WHO) and Gavi, the vaccine alliance.
India’s plan for Vaccination
Context: Recently unveiled India’s COVID-19 vaccine policy, should make adequate allowances for ground realities.
What is India’s plan on vaccinating people?
- Strategy to slow the virus spread: With a definitive cure not yet available for COVID-19, vaccines present the world with the best strategy to slow the virus down.
- India’s plan: The U.K. and the U.S. began vaccinating their people, India has announced its plan and proposed line-up for COVID-19 vaccination.
- Priority population: As per the government’s strategy, the vaccination is to be given first to health-care workers and then to people over the age of 50, with those over 60 given priority, based on the situation. This will amount to about 30 crore people.
- Verifying document: The voters’ list for the Lok Sabha and Assembly election polls has been set as the verifying document for the process.
- Co-WIN: A new digital platform, Co-WIN, will be used for COVID-19 vaccination delivery, and about 1.54 lakh Auxiliary Nurse Midwives working on Universal Immunisation Programmes will be roped in as vaccinators, with more such field staff to be mobilised in collaboration with the States.
- Cold chain systems: Cold chain systems are to be strengthened across the country to deliver multiple doses.
What are the steps to be taken?
- Perception management: They need to clear the fog on vaccine safety and efficacy among the people.
- Detailed plan: A detailed plan must be prepared for vaccinating children and a breakdown of tasks down to the lowest governance rung, as counties in the U.S. have been doing.
- Unless the latter is done, a proper estimate of the true challenges of administering vaccines in the field will not be available.
- Tackling vaccine hesitancy: Vaccine hesitancy is a reality and the only way to counter that is to be open and honest about adverse effects and make available relevant information in the public realm.
- In the past, in some States, vaccination programmes have suffered temporarily because of misinformation about adverse events following shots.
Way forward
- In this case, a long-term follow up of all who receive the vaccine is absolutely essential. For, therein lies the assurance that everyone in the global line list is waiting for.
Mucormycosis Fungal Infection
Source: Click here
News: Doctors have witnessed more than 12 cases of Covid-19 triggered Mucormycosis fungus infection.
Facts:
- Black Fungus or Mucormycosis: It is a serious but rare fungal infection caused by a group of molds called mucormycetes which exist in the environment.
- Symptoms: The symptoms are face numbness, one-side nose obstructions or swelling of eyes or pain.
- Vulnerable Group: Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness.
- Transmission: It is acquired when spores produced by the mold are inhaled or much less commonly when they enter the body through a cut or other break in the skin.It does not spread between people or between people and animals.
- Diagnosis: Healthcare providers consider medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis.
- Treatment: It needs to be treated with prescription antifungal medicine. Often, mucormycosis also requires surgery to cut away the infected tissue.
NITI Aayog releases ‘Vision 2035: Public Health Surveillance in India’
News: NITI Aayog has released a white paper: Vision 2035: Public Health Surveillance in India.
Facts:
- The document is a joint effort of Health Vertical, NITI Aayog and Institute for Global Public Health, University of Manitoba,Canada.
Vision of the Paper:
- To make India’s public health surveillance system more responsive and predictive to enhance preparedness for action at all levels.
- Citizen-friendly public health surveillance systems will ensure individual privacy and confidentiality, enabled with a client feedback mechanism.
- Improved data-sharing mechanism between Centre and states for better disease detection, prevention, and control.
- India aims to provide regional and global leadership in managing events that constitute a public health emergency of international concern.
Key Features of the Vision:
- The white paper lays out India’s vision 2035 for public health surveillance through the integration of the three-tiered public health system into Ayushman Bharat.
- The building blocks for this vision are an interdependent governance between the Centre and states, a new data-sharing mechanism that involves the use of new analytics, health informatics, and data science including innovative ways of disseminating ‘information for action’.
NFHS findings
Context: The Ministry of Health and Family Welfare has released data fact sheets for 22 States and Union Territories based on the findings of Phase I of the National Family Health Survey-5 (NFHS-5).
What are the worrying findings?
- Malnutrition: Of the 22 States and UTs, there is an increase in the prevalence of severe acute malnutrition in 16 States/UTs (compared to NFHS-4 conducted in 2015-16).
- The percentage of children under five who are underweight has also increased in 16 out of the 22 States/UTs.
- There is also an increase in the prevalence of other indicators such as adult malnutrition measured by those having a Body Mass Index of less than 18.5kg/m2 in many States/ UTs.
- Anaemia: Anaemia levels among children as well as adult women have increased in most of the States with a decline in anaemia among children being seen only in four States/UTs.
- Obesity: Most States/UTs also see an increase in overweight/obesity prevalence among children and adults, once again drawing attention to the inadequacy of diets in India both in terms of quality and quantity.
- Stunting: The data report an increase in childhood stunting in 13 of the 22 States/UTs compared to the data of NFHS-4.
- There was a 10 pp decline in stunting among children under five between 2005-06 (NFHS-3) and 2015-16 (NFHS-4), from 48% to 38%, averaging 1 pp a year. This was considered to be a very slow pace of improvement.
- Starvation: Volunteers of the Right to Food campaign have listed over 100 starvation deaths based on media and/or verified fact- finding reports since 2015.
- Food insecurity: Field surveys such as ‘Hunger Watch’ are already showing massive levels of food insecurity and decline in food consumption, especially among the poor and vulnerable households.
- In the Hunger Watch survey carried out in 11 States, two-thirds of the respondents reported that the nutritional quality and quantity of their diets worsened in September-October compared to before the lockdown.
What are the steps to be taken?
- Improvements: There are some improvements seen in determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status, a reduction in spousal violence and greater access of women to bank accounts.
- Interventions: Direct interventions such as supplementary nutrition, growth monitoring, and behaviour change communication through the ICDS and school meals must be strengthened and given more resources.
- Progress on maternity entitlements: Universal maternity entitlements and child care services to enable exclusive breastfeeding, appropriate infant and young child feeding, recognising women’s unpaid work burdens have been on the agenda for long, but not much progress has been made on these.
- Strategy: An employment-centred growth strategy which includes universal provision of basic services for education, health, food and social security is imperative.
- Expansion in social protection schemes: Such as the Mahatma Gandhi National Rural Employment Guarantee Scheme, the Public Distribution System, the Integrated Child Development Scheme (ICDS), and school meals have contributed to reduction in absolute poverty as well as previous improvements in nutrition indicators.
Way forward
- It is hoped that the experience of the pandemic, as well as the results of NFHS-5, serve as a wake-up call for serious rethinking of issues related to nutrition and accord these issues priority.
Fifth Edition of National Family Health Survey
News: The Ministry of Health and Family Welfare has released the fifth edition of the National Family Health Survey(NFHS).
Facts:
- NFHS: It was conducted after a gap of three years.It contains detailed information on population, health, and nutrition for India and its states and Union Territories.
- This is the Phase 1 of the survey conducted in 17 States and 5 Union Territories(UTs).Phase 2 of the survey will cover other states such as Uttar Pradesh, Punjab and Madhya Pradesh.
Key Highlights:
- Increased malnutrition among children: Several States have reversed course and recorded worsening levels of child (under 5 years of age) malnutrition parameters such as child stunting; child wasting; share of children underweight and child mortality rate.
- More Indians are obese and anaemic: The survey has reported an increased share of men and women who were overweight or obese and anaemic (condition in which a person lacks enough healthy red blood cells to carry adequate oxygen to the body tissues).
- Jump in Vaccination: The survey has found considerable improvement in vaccination coverage among children aged 12-23 months across all States/UTs.
- Better household amenities The share of households having access to some basic amenities has increased in most of the states.
- Urban-Rural gender gaps in Internet use: There is an urban-rural gap as well as gender divide with respect to the use of the Internet.On an average, less than 3 out of 10 women in rural India and 4 out of 10 women in urban India ever used the Internet.
- Increase in bank accounts operated by women: The number of bank accounts that women not only hold but also operate themselves has increased dramatically over the past five years.
Issues faced by Nursing sector in India
Context: Nursing education in India suffers poor quality of training, inequitable distribution, and non-standardised practices.
In News:
- The year 2020 has been designated as “International Year of the Nurse and the Midwife”.
- Nurses and midwives will be central to achieving universal health coverage in India.
What are the structural challenges affecting nursing sector in India?
- Low number of nurses: India’s nursing workforce is about two-thirds of its health workforce. Its ratio of 1.7 nurses per 1,000 population is 43% less than the World Health Organisation norm. it needs 2.4 million nurses to meet the norm.
- Inequal Distribution: Though the number of nursing education institutions has been increasing steadily, there are vast inequities in their distribution. Around 62% of them are situated in southern India.
- Vacancies: The faculty positions vacant in nursing college and schools are around 86% and 80%, respectively.
- Higher qualifications of postgraduate nurses are not recognised: There is a lack of job differentiation between diploma, graduate, and postgraduate nurses regarding their pay, parity, and promotion. Consequently, higher qualifications of postgraduate nurses are underutilised, leading to low demand for postgraduate courses.
- Outdated and fails to cater to the practice needs: The education, including re-training, is not linked to the roles and their career progression in the nursing practice. There are insufficient postgraduate courses to develop skills in specialties, and address critical faculty shortages both in terms of quality and quantity.
- Lack quality training: Multiple entry points to the nursing courses and lack of integration of the diploma and degree courses diminish the quality of training.
- Largely unregulated: The Indian Nursing Act primarily revolves around nursing education and does not provide any policy guidance about the roles and responsibilities of nurses in various cadres. Nurses in India have no guidelines on the scope of their practice and have no prescribed standards of care.
- Lack of accountability for nurses: The Consumer Protection Act which protects the rights and safety of patients as consumers, holds only the doctor and the hospital liable for medico-legal issues; nurses are out of the purview of the Act. This is contrary to the practices in developed countries where nurses are legally liable for errors in their work
What is the way forward?
- A common entrance exam, a national license exit exam for entry into practice, and periodic renewal of license linked with continuing nursing education would significantly streamline and strengthen nursing education.
- Transparent accreditation, benchmarking, and ranking of nursing institutions too would improve the quality.
- The Indian Nursing Council Act of 1947 must be amended to explicitly state clear norms for service and patient care, fix the nurse to patient ratio, staffing norms, and salaries.
- The exodus of qualified nurses must be contained by Incentivising to pursue advanced degrees to match their qualifications, clear career paths, the opportunity for leadership roles, and improvements in the status of nursing as a profession.
- A live registry of nurses, positions, and opportunities should be a top priority to tackle the demand-supply gap in this sector.
- The National Institution for Transforming India (NITI) Aayog has recently formulated a framework for public-private partnership in medical education that could be referred to develop a model agreement for nursing education.
The disabling environment prevalent in the system has led to the low status of nurses in the hierarchy of health-care professionals. The National Nursing and Midwifery Commission Bill currently under consideration should hopefully address some of the issues highlighted.
Plasmodium ovale and other types of malaria
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News: A not very common type of malaria, Plasmodium ovale has been identified in a jawan in Kerala.
Facts:
- Malaria: It is caused by the bite of the female Anopheles mosquito, if the mosquito itself is infected with a malarial parasite.
- Types: There are five kinds of malarial parasites — Plasmodium falciparum, Plasmodium vivax (the commonest ones), Plasmodium malariae, Plasmodium ovale and Plasmodium knowlesi.
- Is P Ovale different from other Parasites? P ovale is very similar to P vivax and the treatment modality is the same as it is for a person infected with P vivax.
- Prevalence of P Ovale: P ovale malaria is endemic to tropical Western Africa.It is relatively unusual outside of Africa and where found, comprises less than 1% of the isolates.
- Which Malarial Parasite is prevalent in India? In India, out of 1.57 lakh malaria cases in the high-burden states of Odisha, Chhattisgarh, Jharkhand, Meghalaya and Madhya Pradesh in 2019, 1.1 lakh cases(70%) were cases of falciparum malaria.
Note: According to the World Malaria Report 2020, cases of Malaria in India dropped from about 20 million in 2000 to about 5.6 million in 2019.
India’s first indigenous vaccine HGCO19 gets nod for human trials
News: India’s first indigenous mRNA vaccine candidate HGCO19 has received approval from Indian Drug regulators to initiate Phase I/II human clinical trial.
Facts:
- HGCO19: It is a novel mRNA vaccine candidate developed by Gennova, Pune and supported with seed grant under the Ind-CEPI mission of Department of Biotechnology of Ministry of Science & Technology.
Additional Facts:
- mRNA vaccines: It is a new type of vaccine to protect against infectious diseases.It does not use the conventional model to produce immune response.mRNA vaccine carries the molecular instructions to make the protein in the body through a synthetic RNA of the virus.The host body uses this to produce the viral protein that is recognized and thereby making the body mount an immune response against the disease.
- Advantages: mRNA-based vaccines are scientifically the ideal choice to address a pandemic because of their rapid developmental timeline.The mRNA vaccine is considered safe as is non-infectious, non-integrating in nature and degraded by standard cellular mechanisms.
- Ind-CEPI mission: It is a Department of Biotechnology mission that aims to strengthen the development of vaccines for the diseases of epidemic potential in India as well as build coordinated preparedness in the Indian public health system and vaccine industry to address existing and emerging infectious threats in India.The mission is implemented by Biotechnology Industry Research Assistance Council(BIRAC).
New cross-sector initiative for universal health coverage
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News: Lancet Citizens’ Commission on Reimagining India’s Health System initiative has been launched.
Facts:
- Lancet Citizens Commission: It is a first of its kind participatory, countrywide initiative in collaboration with world’s leading health journal The Lancet and the Lakshmi Mittal and Family South Asia Institute, Harvard University.
- Objective: To develop a citizens’ roadmap to achieving universal health coverage(UHC) in India over a period of ten years.
- Principles: The Commission will be guided by four principles:
- UHC covers all health concerns;
- Prevention and long-term care are key.
- The concern is financial protection for all health costs and
- Aspiring for a health system that can be accessed by all who enjoy the same quality.
Asia Pacific Vaccine Access Facility(APVAX)
News: Asian Development Bank(ADB) has launched a $9 billion vaccine initiative—the Asia Pacific Vaccine Access Facility (APVAX).
Facts:
- Aim: To offer rapid and equitable support to its developing members as they procure and deliver effective and safe coronavirus disease (COVID-19) vaccines.
- Criteria: If a country has to obtain finances under APVAX, then it should fulfil one of the three criteria:
- It must be procured through COVAX.
- It should be prequalified by World Health Organization
- It should be authorised by a stringent regulatory authority.
Additional Facts:
- COVAX: It is an alliance co-led by Gavi, the Coalition for Epidemic Preparedness Innovations(CEPI) and WHO.It aims to accelerate the development and manufacture of COVID-19 vaccines and to guarantee fair and equitable access for every country in the world.
- Asian Development Bank(ADB): It is a regional development bank established in 1966 to promote social and economic development in Asia.
- Members: 68 members, of which 48 are from within Asia and the Pacific and 19 outside.
- Headquarters: Manila, Philippines.
WHO releases Global Health Estimates 2019
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News: World Health Organization(WHO) has released the Global Health Estimates 2019.
Facts:
- Global Health Estimates: The report provides a comprehensive and comparable assessment of mortality and loss of health due to diseases and injuries for all regions of the world.The new data of Global Health Estimates cover the period from 2000 to 2019.
Key Takeaways:
- Top Ten Causes of Death: Ischaemic heart disease, Stroke, Chronic obstructive pulmonary disease, Lower respiratory infections, Neonatal conditions, Trachea, bronchus and lung cancers, Alzheimer disease, Diarrhoeal diseases, Diabetes mellitus, Kidney diseases.
- Noncommunicable diseases make up 7 of the world’s top 10 causes of death.This is an increase from 4 of the 10 leading causes in 2000.
- Global decline in deaths from communicable diseases but still a major challenge in low- and middle-income countries.
- Heart disease caused the most deaths and was responsible for 16% of total deaths.Since 2000, it has seen the largest increase in deaths rising by more than 2 million to nearly 9 million deaths in 2019.
- Alzheimer’s disease and other forms of dementia are now among the top 10 causes of death worldwide.Globally, 65% of deaths from Alzheimer’s and other forms of dementia are women.
- Deaths from diabetes increased by 70% globally between 2000 and 2019, with an 80% rise in deaths among males.
- Life expectancy has increased by more than 6 years between 2000 and 2019 – from 66.8 years in 2000 to 73.4 years in 2019.
What is Molnupiravir?
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News: A new drug called Molnupiravir has been shown to stop the transmission of SARS-CoV-2 (COVID-19) in 24 hours.
Facts:
- Molnupiravir: It is an experimental antiviral drug which is orally active (can be taken orally) and was developed for the treatment of influenza.
- Developed by: The drug is being developed by the biotechnology firm Ridgeback Biotherapeutics in collaboration with pharmaceutical firm Merck.
- Significance: This is the first demonstration of an orally available drug to rapidly block SARS-CoV-2 transmission and it can be a game-changer
Process and Issues linked to Emergency Use Authorisation (EUA) of COVID Vaccines in India
Emergency Use Authorisation (EUA)
This article explains the process of Emergency Use authorization, based on The Indian Express Article “Three Covid-19 vaccine developers seek emergency use approval in India”
Central Drug Standard Control Organisation (CDSCO) has received applications from 3 vaccine developers seeking Emergency Use Authorisation/Approval (EUA) for their candidate Covid-19 vaccines which are still under trial. These Vaccines are COVISHIELD, COVAXIN, and BNT162b2.
None of the Vaccine developers has yet generated data about the effectiveness of their vaccine from phase-III trials conducted in India.
What is the normal process of Vaccine Development?
In normal circumstances, a Vaccines has to go through several phases, with each phase taking many months to get completed, but in the case of COVID, it is expected that vaccines would be in the market within a year from its start, after seeking Emergency Use Approval (EUA) from their respective governments.
After Pre-clinical testing of Vaccines, it is tested on the human under clinical trials before its mass production.
Clinical trials: It involves testing on humans. There are 3 phases of clinical trials;
- Phase I of a clinical trial is conducted on a small group of healthy individuals. It only indicates what is the ideal dose required to administer in the next stage, it provides evidence of the vaccine’s ability to generate an immune response and its safety.
- The vaccine is not considered safe if it develops any major complication, however little headache and fevers are expected.
- In phase II, the range of participants is expanded to a few hundred healthy participants to check the immune response system in the body and it also assesses the time period for which antibodies last to provide immunity against the virus.
- Phase-III involves a very large group of people (Thousands of individuals) to investigate its efficiency among large population groups. Half of the population is administered the actual Vaccine and the other half are administered dummy vaccines.
- Individuals administered Vaccines are checked on fixed intervals which can be months in normal conditions to see whether their immune system is responding to the virus or not.
After the Vaccine is successfully tested, it would require regulatory approval before it can be produced in bulk quantity.
Emergency Use Authorisation (EUA)
The term “Emergency Use Authorisation (EUA)” has been used mainly by the regulatory agencies like FDA in the US and some other countries with the following guidelines;
FDA has specified that it would consider an application for EUA only if phase 3 data showed
- it was at least 50% effective in preventing the disease.
- This data needed to be generated from “well over” 3,000 trial participants, “representing a high proportion of participants” enrolled.
- These participants needed to be followed up for any serious adverse effects for at least one month after all dosages had been given.
- EUA can be granted only in a declared public health emergency.
Accelerated Approval Process in India
In India, New Drugs and Clinical Trials Rules, 2019 governs Clinical trials of new drugs and vaccines and their approvals.
But the term Emergency Use Authorisation (EUA) has not been used anywhere in rules in India. However, 2019 rules provide for an “Accelerated Approval Process” for granting approval to a drug that is still in clinical trials. The definition of a new drug in the 2019 Rules includes a vaccine.
Conditions for Accelerated Approval Process
- There should be a prima facia case that the drug is of Therapeutic benefits.
- “Accelerated approval may also be granted to a new drug if it is intended for the treatment of a serious, or life-threatening condition, or disease of special relevance to the country, and addresses unmet medical needs,”.
- Approval can be granted even if “remarkable” effectiveness is reported even from phase-II trials.
Approval granted to drugs or vaccines that are still in clinical trials is temporary, and valid only for one year.
Examples of granting EUA
- FDA granted its first EUA for use of Tamiflu drug for infants and young children for the treatment of H1N1 infection for the civilian population in 2009.
- Remdesivir or faviparir, are existing drugs approved for other ailments received EUA for treatment of Covid-19, including in India.
Issues in EUA of Vaccines
- Due to tolls or public sentiments, Governments are putting pressure on regulatory bodies to fast-track the entire process of Vaccine development.
- Lack of transparency about vaccine safety and efficacy may negatively impact people’s confidence and willingness to get vaccinated.
- Some surveys have shown that there is vaccine hesitancy among a certain section of people due to the hastening of the vaccine development process.
- Whereas FDA has formulated its guidelines 50% effectiveness and no. of participants, the Indian regulator has not formulated any such guidelines.
- Another issue with EUA-approved drugs and treatments is that they can reflect and exacerbate already existing inequities in the health system if the vaccine administered is found out to be ineffective. It might create a huge burden on the pocket of poor people.
- There are examples of granting EUA to certain drugs like hydroxychloroquine, a malaria drug in haste, which later proved to be ineffective treatment, and the risks of taking it outweighed any benefits.
- If a drug proved to be ineffective later on, after its administration to a huge population, it would be very harmful to the people’s confidence, economy, and health system of the country.
Way forward
Concerns regarding use of Vaccines can be addressed when all stakeholders are transparent at every stage of development and not by merely sharing guidelines regarding vaccine safety with the States. It is important that those seeking emergency-use authorisation share the safety and efficacy data with the authorities and public immediately.
Lessons for the health sector
Context: It has been only nine months since COVID-19 was declared a pandemic on March 11, but the world has changed in previously unimaginable ways.
Discuss the challenges put forth by the pandemic.
- Health systems: The health systems in many of the wealthy countries struggled; some were overwhelmed due to inadequate beds, supplies and healthcare workers who struggled with infection, fatigue and stress, recognising their inability to care for everyone who needed it.
- Damage by virus: Outside the healthcare system, the information epidemic (termed an “infodemic”) in society led to fear, stigma and discrimination that added to the damage caused by the virus.
- Learning: The closure of schools affected the learning of children, with those from disadvantaged backgrounds struggling to cope and frequently giving up.
- Accessibility: Access to non-COVID-19 essential health services was affected, the impact of which will be fully understood in the time ahead.
- Business activities: Reduction in business activities caused massive losses of both formal and informal employment and a fall in economic growth.
How did the countries tried to cope up with the challenges?
- Health services: COVID-19 related health services including hospital beds, intensive care unit (ICU) and ventilator beds were increased even as research on drugs and vaccines kicked off at an exceptional rate.
- Vaccines: Vaccines have moved even faster than drugs with over 300 vaccine candidates being developed, nearly 40 of them undergoing clinical trials.
- The accredited social health activists: ASHA who visited hundreds of households repeatedly during the pandemic to ensure that every possible case is identified as early as possible.
What did the other countries which handled the pandemic successfully do?
- The countries which handled the pandemic best: Thailand and Vietnam have well-functioning health systems designed to deliver primary healthcare services.
- These countries also have strong preventive and promotive health services as well as a dedicated public health workforce.
- The role of community health workers: In recognising, referring and motivating individuals for therapy was remarkable.
- Community trust and participation is essential for implementation of non-pharmacological interventions.
- Dharavi in Mumbai is an example of the difference community participation can make.
- The response to the pandemic was multi-sectoral: Health staff, policy makers and technical experts in multiple domains worked together to identify and implement solutions.
- Quality data: The need for timely and quality data in a health information system was recognised again during the pandemic.
Way forward
- Investments in scientific research: The solutions that have brought us hope have come from long-term private or public investments in scientific research and developments. It is self-evident that we need to emphasise what is feasible when resources are available.
- National health policy: All we need is commitment and that is outlined in the recent National Health Policy 2017 and reiterated in the report of the Fifteenth Finance Commission, which for the first time has a dedicated chapter on health.
This is an opportunity and should use the challenge posed by the pandemic to accelerate long pending initiatives for health system reforms, accelerating towards universal health coverage, the central goal of the National Health Policy 2017.
Sanitation in India- Cultural stigma
Context- The problem with sanitation in India is not lack of infrastructure but the social and cultural stigma attached to it.
What is the state of sanitation in India?
- Lack of proper toilets– the lack of proper restrooms makes long distance journeys an ordeal for women.
- However, NHAI maintains one restroom every 40-50 Km, but their hygiene standards are not monitored.
- A high proportion of the population does not have access to “improved sanitation”.
- Improved sanitation is defined as facilities that “ensure hygienic separation of human excreta from human contact”.
- Work related discrimination-Sanitation workers are compelled to travel to their workplaces in garbage trucks, standing next to the very garbage they clean and collect.
- Neither users nor the sanitation workers feel equal.
- In spite of a well-funded programme such as the Swachh Bharat Abhiyan in operation, little attention is devoted to this aspect of sanitation.
What are the issues related to scavenging in India?
- Caste system– Caste hierarchy still exits and it reinforces the caste’s relation with occupation.
- Only country that not only differentiates spaces as pure and impure but also its people.
- The social status of this section has been permanently fixed.
- Government discussions and policies hardly address this stigma.
- Lack of physical resources– Adequate machinery to clean septic tanks, protective gears and flush toilets are not available.
What are the steps taken by the government to address this problem?
- Prohibition of Employment as Manual Scavengers and their Rehabilitation Act–
- Prohibition:The act prohibits the employment of manual scavengers, manual cleaning of sewers and septic tanks without protective equipment, and the construction of insanitary latrines.
- Rehabilitation:It seeks to rehabilitate manual scavengers and provide for their alternative employment.
- The act ensures the rehabilitation of manual scavengers to be identified through a mandatory survey.
- Mechanized cleaning of septic tanks is the prescribed norm.
- The act also directed the government to pay a compensation of 10 lakh rupees to the family members of those killed in acts of manual scavenging since 1993.
Way forward-
- Adopting technology to end manual scavenging– Government’s move to use machines is a first step towards according dignity and respect to sewer workers. However, technology’s emancipatory powers will be realized at their fullest only when the states stop living in denial about manual scavenging.
- Direct allocation of funds– Social Justice and Empowerment Ministry said that it would directly transfer funds to ‘sanitation workers’ to buy cleaning machines, instead of contractors or municipal corporations.
Authorisation of coronavirus vaccines
Context: Safety and efficacy data for the new vaccine must be known before emergency-use authorisation for vaccines.
Why in news?
- The Pune-based Serum Institute of India has approached the regulator for nod for its vaccine, Covishield, developed by Oxford University.
- AstraZeneca, which is carrying out the phase-3 trials of the Oxford vaccine in four countries, is yet to secure a nod from any of the regulatory agencies.
- AstraZeneca recently gave details of the interim safety and efficacy data involving 131 COVID-19 cases in the phase-3 trials in the U.K. and Brazil. But details of the trials in India are not out yet.
Why fast tracking of vaccine authorization is needed?
- The unprecedented speed in taking the vaccine from the development stage to approval process in less than a year is remarkable but also necessitated by the toll the virus has taken on lives and livelihoods.
- To reduce mortality and morbidity.
What are the concerns associated with authorization of vaccines?
- Regulatory bodies under pressure: to fast-track the entire process.
- Lack of transparency: Opaqueness about vaccine safety and efficacy does no good in gaining people’s confidence and willingness to get vaccinated.
- For example, Moderna, Pfizer and AstraZeneca took the extraordinary step of publicly sharing the trial protocol, the time points at which interim analysis of phase-3 trial in India will be carried out for safety and efficacy is unclear.
- No checks: the U.S. FDA has clearly spelt out at least 50% efficacy and stipulated a median follow-up duration of at least two months after completion of the full vaccination regimen to assess a vaccine’s benefit-risk profile for emergency-use approval. However, no such conditions have been mentioned by the Indian regulatory agency. The phase-3 trial of Covishield began on September 21 and completed the enrolment on November 12.
- Fear of side effects and vaccine hesitancy: ineffective or unsafe vaccine is worse than not having one.A survey by the London-based Vaccine Confidence Project revealed that though the intent to get vaccinated was 87% in India, 34% respondents were worried about side-effects while 16% were concerned about fast-moving trials.
What needs to be done?
- Need to engage all stakeholders in a transparent manner at every stage and not by merely sharing guidelines regarding vaccine safety with the States.
- It is also important that those seeking emergency-use authorisation share the safety and efficacy data immediately.
For further read about Emergency Use Authorisation : Click here
Explained: Surgery as part of Ayurveda
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News: Government of India has a notification listing out specific surgical procedures that a postgraduate medical student of Ayurveda must be practically trained to acquaint with as well as to independently perform.
Facts:
- How far is surgery part of Ayurveda? There are two branches of surgery in Ayurveda — Shalya Tantra which refers to general surgery, and Shalakya Tantra which pertains to surgeries related to the eyes, ears, nose, throat and teeth.All postgraduate students of Ayurveda study these courses and become Ayurveda surgeons.
- Earlier Regulations for Postgraduate students in Ayurveda: They are guided by the Indian Medical Central Council (Post Graduate Education) Regulations,2016.The regulations allow postgraduate students to specialise in three disciplines of surgery namely Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology).
- What is the change? Ayurveda practitioners say the notification just brings clarity to the skills that an Ayurveda practitioner possesses.The surgeries that have been mentioned are all that are already part of the Ayurveda course.But there is little awareness about these.
- Indian Medical Association’s(IMA) objections: IMA insist that they are not opposed to the practitioners of the ancient system of medicine.But the notification gives the impression that the skills or training of the Ayurveda doctor in performing modern surgeries are the same as those practising modern medicine. This is misleading and an encroachment into the jurisdiction and competencies of modern medicine.
AMR and health crisis
Context: Antimicrobial resistance (AMR), a silent pandemic, is growing at an alarming rate.
Why is AMR growing at an alarming rate?
- AMR: Globally, about 35% of common human infections have become resistant to available medicines.
- About 700,000 people die every year because available antimicrobial drugs (antibiotics, antivirals, anti-parasitic and antifungals) have become less effective at combating pathogens.
- Resistance to second- and third-line antibiotics the last lines of defence against some common diseases are projected to almost double between 2005 and 2030.
- According to a study published in The Lancet, an estimated 58,000 new-born children die annually from sepsis in India alone because antibiotics can no longer treat certain bacterial infections.
- Reasons for AMR:
- Microorganisms develop resistance to antimicrobial agents as a natural defence mechanism. Human activity has significantly accelerated the process.
- The misuse and overuse of antimicrobials for humans, livestock and agriculture is probably the biggest reason for this.
- Research points to the role of environment and pollution in AMR.
- Once consumed, up to 80% of antibiotic drugs are excreted un-metabolised, along with resistant bacteria.
- Release of effluents from households and health and pharmaceutical facilities, and agricultural run-off, is propagating resistant microorganisms. Wastewater treatment facilities are unable to remove all antibiotics and resistant bacteria.
What are the problems faced?
- Issues faced: In India, there is capacity to treat only about 37% of the sewage generated annually. The rest is discharged into natural water bodies without treatment.
- An analysis of single wastewater discharge from a treatment facility in India catering to drug manufacturers found concentrations of antibiotics high enough to treat over 40,000 people daily.
- Mode of spread: Water may be a major mode for the spread of AMR, especially in places with inadequate water supply, sanitation and hygiene.
- Wildlife that comes into contact with discharge containing antimicrobials can also become colonised with drug-resistant organisms.
What are the key initiatives to tackle AMR?
- UNEP: The United Nations Environment Programme (UNEP) identified antimicrobial resistance as one of six emerging issues of environmental concern in its 2017 Frontiers Report.
- The UN Environment Assembly pressed the need to further understand the role of environmental pollution in spreading AMR.
- GAP: UN agencies are working together to develop the One Health AMR Global Action Plan (GAP) that addresses the issue in human, animal, and plant health and food and environment sectors.
- MoEF&CC: The Ministry of Environment, Forest and Climate Change (MoEF&CC) issued draft standards which set limits for residues of 121 antibiotics in treated effluents from drug production units.
- The Ministry of Health and Family Welfare and MoEF&CC constituted the inter-ministerial Steering Committee on Environment and Health, with representation from WHO and UNEP.
Way forward
- The Centre and State governments in India can strengthen the environmental dimensions of their plans to tackle antimicrobial resistance.
- It is particularly important to promote measures that address known hotspots such as hospitals and manufacturing and waste treatment facilities.
Purpose of the vaccine
Context- The challenges vaccine poses to qualify as a ‘public health’ intervention in India.
What is the purpose of vaccination?
- Individual prevention- – The ability to develop immunity by producing antibodies among those individuals who have taken a vaccine shot.
- It builds an adaptive immune system
- To achieve herd immunity– It is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached.
- Herd immunity refers to community protection.
- The threshold coverage is estimated to be around 60% for COVID-19 vaccine to achieve population-level immunity.
- The idea of herd community is to protect the vulnerable.
What are the concerns related to vaccination?
- Safe immunization– There are three major elements of immunization safety.
- Health care providers must be concerned with the safety of vaccines themselves (their composition),
- Administration of the vaccination (handling, scheduling, and injections),
- And surveillance and evaluation of the immunization program, including documentation of vaccine efficacy and the probability of adverse events.
- Economic concern-The huge economic resources will be needed to make the vaccine available for a large population.
- Lack of infrastructure– Vaccines require cold chain infrastructure for storage. Logistical and Infrastructural issues in storage of vaccines hampering it’s penetrability in the rural hinterland.
- Cost- If open market forces determine the cost of the vaccine and affordability then, the section of society most vulnerable to the disease would get left out.
- Credibility- ears regarding safety and credibility can be almost impossible obstacles to overcome and must be addressed head-on.
What are the challenges related to population based vaccination programme?
Priority- Within the country, it is certainly not clear who should be treated first or it should be determined by need, affordability, vulnerability or some other criterion or a combination of all.
The outcome is the clear– If this process target only specific population group then its very purpose will be defeated as the pandemic can infect all groups similarly.
What is the way forward?
- It is safe to demonstrate the success of vaccination as a public health intervention in a small population, like a block or a district, before scaling it up for the national level.
- However, if herd immunity is not the focus, then the key purpose of COVID-19 vaccines will be to ensure individual immunity.
- Protect the vulnerable– Use the first limited supplies of vaccines to protect those most in need, without worrying about the more robust members of the “herd”.
World Malaria Report 2020
Source: Click here
News: World Health Organization(WHO) has released the World Malaria Report 2020.
Facts:
- Aim: To look at the 20 years of global progress and challenges in the fight against the Malaria.
Key Takeaways:
- Malaria Control: The two decades from 2000 to 2020 was a period of extraordinary success in malaria control: As many as 1.5 billion cases and 7.6 million deaths were averted.
- Burden of Malaria: At least 29 countries accounted for 95% malaria cases globally, with Africa carrying the highest burden.The continent accounted for 94% of the world’s malaria cases and deaths with an estimated 215 million cases in 2019.
- India: India is the only high endemic country which has reported a decline of 17.6% in 2019 as compared to 2018.India has contributed to the largest absolute reductions in the WHO South-East Asia Region from about 20 million cases in 2000 to about 5.6 million in 2019.
- Malaria Free: Sri Lanka was certified malaria free in 2015 and Timor-Leste reported zero malaria cases in 2018 and 2019.
- Concerns: The gains made in malaria control have levelled off in recent years and more so in the wake of COVID-19 as pandemic caused disruptions in essential malaria services.
Recommendations:
- WHO Initiatives: High burden to high impact initiative is a country-led response supported by WHO and the RBM Partnership to End Malaria to reignite the pace of progress in the global malaria fight.
- Examples to implement: The report referred to the Mass Action Against Malaria initiative in Uganda which is an example of a country-led process of political engagement at all levels and multi-sectoral and community mobilisation.
- National Plan for Insecticide Resistance: It has called on countries to develop a national plan for insecticide resistance monitoring and management and draw on the WHO Framework for a national plan for monitoring and management of insecticide resistance in malaria vectors.
Additional Facts:
- Malaria: It is a disease caused by Plasmodium parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.
INDIAN PHARMACEUTICAL SECTOR CHALLENGES AND REFORMS
Source: PIB, Indian Medicine Industry-RSTV , FDI data of Ministry, Mint,
Relevance:
- Recently PM follows up his 3 city visit by a virtual meeting with 3 more vaccine developers based in Pune and Hyderabad
- Ambassadors of 100 countries are scheduled to arrive in Pune on December 4, to visit Serum Institute of India and Gennova Biopharma.
Sweden has already acknowledged India’s role as the ‘pharmacy of the world’ and is focusing on expanding bilateral cooperation in the areas of health and life sciences in view of the Coronavirus pandemic.
How big is Indian Pharma Sector?
- From 2000-2019 Pharma sector alone contributed for FDI inflows worth $16.2bn and it is expected to rise during COVID pandemic.
- Recent Economic Survey acclaimed Pharma sector as one of the top 5 sector which reduce trade deficit of India
- More than 80% worlds Anti Retro-viral drugs depend on India
- India is the largest producer of vaccines even before COVID pandemic and controlled more than 50% of global supplies.
- Bio-Pharma is the largest sector contributing to 62% of the total revenue
- It is estimated that medical tourism in the country can grow and become a 9 billion dollars industry this year
- 20% of global generic medicine has been controlled by India.
How Indian Pharma Sector is regulated?
- Under Drugs and Cosmetics Act 1940 (For Source click here) was the central legislation that regulates India’s drug and cosmetic import, manufacture, distribution and sale.
- The Act clearly defines the spurious drugs, adulterated drugs and mis branded drugs.
- This also established the Central Drugs Standard Control Organization (CDSCO)
- The Act establishes the regulatory control over the manufacture and sale of drugs
- State Health department has to regulate the manufacturing, sales and distribution of drugs
- Drug Inspectors will control the implementation at ground level.
Central Drugs Standard Control Organization (CDSCO) Source
- Central Drug Authority for discharging functions assigned under the Drugs and Cosmetics Act
- The CDSCO works in the Directorate General of Health services, is a division in Ministry of Health and Family welfare
- The CDSCO is headed by Drug Controller General of India (DCGI).
- It was advised by Drug Technical Advisory Board and Drug Consultative Committe
Potential lead for enormous growth of Pharma Sector:
- The growing population of over a billion along with diversity among people offers An excellent centre for clinical trials
- Focus on low cost, efficient drugs lead to growth of the sector in terms of Value and Volume
- Low cost of production and Low R&D costs in India
- A huge patient base from domestic and from foreign as a medical tourist
- Improving healthcare infrastructure in India
- An increase in lifestyle-related diseases such as diabetes, cardiovascular diseases, and central nervous system.
- Penetration of health insurance is increased
- Adoption of patented products by Indian Pharma Sector.
- Patent expiration and aging population in the US, Europe, and Japan.
Challenges in the Pharma Sector:
- From regulator side
- Doing a post-mortem kind of work by inspecting the drugs after getting into market
- Low data collection on drugs coupled with insufficient training to drug inspector leading to huge malpractice among drug sellers
- From Marketing side
- Medical representatives and drug sellers inefficient training to meet the man power along with prevalence of Quack(fake doctor) increases risk of life of patients
- Pharma companies unethical pratice of providing freebies and gifts to Doctors to promote their drugs
- Quality is getting compromised due to high demand for drugs among people. This is evident by wide scale recall of drugs in India.
- Low R&D investment: India only invests 0.7% of its GDP for research and investment. This is very low compare to the demand in the sector
- International Challenges
- Global Pharma companies accuse Indian pharma companies as an abuser of Patent laws and criticise India’s Compulsory Licensing Policies.
- India nearly 90% depend on China for its Active Pharmaceutical Ingredients
Solutions:
- Implementing the recommendation of Malshekar committee on drug regulation
- Recommend a new structure for the Drug Regulatory System in the country including the setting up of a National Drug Authority
- Recommended that the State Drug Control Organisations should be urgently strengthened. (for source)
- Creating a Digital Database for patients, drug usage and risk associated with the intake of drug
- Revise the ethical code for Pharma companies to discontinue freebies and gifts
- Government need to Upgrade the quality standards and qualities of Medical representatives and drug sellers.
- Promote country specific research for R&D and increasing the R&D spending
- Rework with the IPR policies to make Indian Pharma companies for encouraging more patents.
- Government need to frame a National Plan on self-sustaining in API’s and avoid over dependence on China.
- Government need to frame a policy to Utilise the traditional Knowledge in drug manufacturing
Though the sector is highly capital intensive, the sector developed into a global leader in Pharma products. Now It is time to implement better policies in regulation and encourage the sector to produce more API’s in India to avoid over dependence.
Aspects of vaccine distribution
Context: Aspects of vaccine distribution.
Background
- The World Health Organisation (WHO) declared the COVID-19 a pandemic in march 2020 and the most optimistic prediction for a vaccine to be available was by the middle of 2021.
- Now, the labs around the world are working faster than anticipated and the first vials of a vaccine are likely to roll out in the next two months.
Why stakes in a vaccine against COVID-19 are unprecedented?
- Though, Economies have gradually opened up after lockdowns, festivals have been celebrated in a subdued manner, and polls have been conducted in several countries.
- But it’s the vaccine that can set us free, can give back the human freedom of association, and most importantly, it can relieve the anxiety and worry that has become the part of life in large parts of the planet.
How early research in Corona virus family is helping now?
- The epidemics caused by pathogens of the coronavirus family in the past 20 years, SARS and MERS, have pushed scientists to study the varied interactions between the human immune system and contagions.
- These studies have illustrated that, unlike other flu viruses, coronaviruses make use of various biological pathways in the human body. For example-opting enzymes of the host’s cells.
- Knowledge of the spike protein has made the scientific community to understand the ways in which the immune system behaves when a person contracts the novel coronavirus.
- The recent approaches targeting the spike protein whether through genetic material as in the case of the vaccines developed by Moderna and Pfizer or through a viral vector from chimpanzees as in the Oxford-AstraZeneca vaccine, have benefitted from earlier research with coronaviruses.
What are the challenges to vaccine distribution?
- India, produces 60 per cent of the world’s vaccines and is home to the largest manufacturer, the Pune-based Serum Institute.
- Yet, the country also has the largest number of unvaccinated children in the world.
- NSO data shows that less than 60 per cent children receive the entire basket of vaccines.
- Delay in acceptance or refusal of vaccines despite availability of vaccination services in more than 90 per cent countries in the world is another hurdle in immunisation programmes.
What is the Way forward?
- Securing 1.3 billion people will require a massive public policy effort at improving the country’s public health infrastructure.
- Partnership with the private sector in immunisation programme.
- Controlling the growth of black markets.
- Checking the diversion of resources from regular immunisation programmes.
- Institute transparent mechanisms at points where science and research meet public policy.
The novel coronavirus forces us to do things differently, it demands a different conception of herd from science and public policy.
Ayurveda and patient safety
Context: Efficacy of Ayurveda to incorporate surgical techniques.
What are the requirements for conducting a successful surgery?
- Apprenticeship is the key: Surgery in the present era is an interdisciplinary effort. This is one branch of medicine where knowledge can only be acquired through apprenticeship that is, the learner needs to be guided by an expert
- A well-trained anaesthesiologist keeps the patient free of pain.
- Other specialist doctors address any other illnesses that the patient has before surgery can be safely performed.
- The well-trained surgeon must have a good knowledge of the structure of the human body in health and disease.
- Clinical judgement: The surgeon needs to know when not to perform surgery, a skill commonly called clinical judgement. These skills are difficult to teach and difficult to master.
- Modern medical training: It consists of a basic degree during which the fundamentals of the functioning of humans in health and disease, and techniques to diagnose illnesses are taught. Increased knowledge in various domains is obtained through postgraduate training.
- Ayurveda and modern medicine: It is impossible for Ayurveda to incorporate surgical techniques while ignoring all the other domains of modern medicine and still perform surgery safely and effectively.
- Safe and effective health care should not become a casualty of a misguided desire to protect indigenous systems.
What are the problems?
- Data: Data from the United States suggests that up to 4,000 surgical errors occur each year despite well-considered controls on who can perform surgery.
- Efforts to reduce this rate focus on better training. Besides professional codes, legal mechanisms have been developed to ensure safe medical practice.
- Consumer protection act: In India, the Consumer Protection Act serves as an incentive to modern medical practitioners to provide high quality health care. Even this legal mechanism is not accessible to the poor.
- Deepening inequality: The quality of medical care received in India is highly dependent on personal resources. Surgical facilities manned by graduates of Ayurveda will be utilized only by the very poor who do not have the resources to access modern medical care.
- This will further root the existing grossly unequal access to health care.
Way forward
- Increase medical colleges: There is a shortage of trained medical personnel in rural areas. The only way to address this is to greatly increase the number of government medical colleges.
- The way forward is to incorporate traditional medical systems into modern medicine.
Vaccination policy
Context: India’s COVID-19 control plan of actions can be the basis for building a much-needed public health infrastructure.
How can vaccine help in eradicating a disease?
- Preventive medicines: Vaccines play a major role in human mastery over infectious diseases by inducing immunity in individuals.
- Herd immunity: When a vaccine is rolled out as a national programme and increasing proportions of people are vaccinated, ‘herd immunity’ level increases and disease frequency decreases in the vaccinated population.
- The ‘herd effect’ of vaccination: That decelerates transmission of the microbe in the whole community, resulting in decreasing disease frequency even in the unvaccinated segment of population.
- Herd immunity plus herd effect reduces the overall disease burden in the community.
- Control: In epidemiology, the common word ‘control’ has a specific meaning: ‘deliberate reduction of disease frequency to a desired level, validated with evidence’.
- For evidence, disease frequencies must be documented both at baseline and on an ongoing basis, through systematic surveillance. So, control interventions include vaccination programme and disease surveillance.
- Elimination: The extreme form of control is ‘elimination’ of transmission of the microbe in a whole country.
- For example, measles and rubella have been eliminated in Sri Lanka through sustained vaccination achieving high coverage.
- Diseases eradicated using vaccine: Eradication is global elimination of an infectious disease. So far, smallpox and cattle plague have been eradicated using their respective vaccines.
- Severe Acute Respiratory Syndrome (SARS) was eradicated in 2003 without a vaccine, using ‘non-pharmacological interventions’, or NPI, systematic case detection, contact tracing and quarantine.
What are the statuses of vaccine candidates in India?
- Protective efficacies: Three COVID-19 vaccines have claims of about 90-95% protective efficacy are BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna) and Sputnik-V (Gamaleya Institute).
- Trial phases: Sputnik-V is under phase 2-phase 3 vaccine trials in India, by Dr. Reddy’s Laboratories. Another vaccine, ChAdOx1 nCoV-19 (OxfordAstraZeneca), manufactured under licence by Serum Institute of India as Covishield, is undergoing phase 2-phase 3 trials in India.
- An indigenous vaccine candidate, Covaxin (Bharat Biotech), found safe and immunogenic in phase 1 and phase 2 trials, is now under phase 3 trial.
- Policy development: In India’s national Universal Immunisation Programme (UIP), vaccines are procured and supplied by the Union government and vaccination is implemented by State governments.
- States have the freedom to surpass policy limits if no fund is sought.
- For example, Delhi used the Measles Mumps-Rubella vaccine when the central government policy was only for Measles vaccine and Sikkim unilaterally used human papillomavirus vaccine to prevent cervical cancer in women.
What can be done to tackle the issues?
- Policy issue: An important policy issue is whether vaccination should be confined to only uninfected individuals or should it be for all people. All test results of infected subjects are available on a computer data base and that is one way to identify those who were already infected.
- Trained staff: The vaccination stations should be staffed with trained personnel and supervised by medical doctors.
- Infrastructure: The site must have a waiting area and a post-vaccination staying area to manage any untoward reaction during the first hour.
- Digital list: A computerised master list with details and mobile numbers of all vaccinated subjects needs to be maintained for the purpose of post-vaccination follow up to document rare side-effects.
- Data management: Data management has to be meticulously planned and executed.
Way forward
- This is a huge opportunity to eliminate the novel coronavirus from India, setting an example to the rest of the world. With will and wisdom we can, and should, accomplish this.
Impact of COVID-19 on tribal communities
Context – The impact of COVID-19 pandemic on forest community and their spirited efforts to tackle it.
What are the problems faced by forest community during COVID-19?
- Losses of livelihood and shelter-Due to sudden lockdown, the forest-dwelling communities who got stuck in the cities without any support system, shelter, food or water.
- The lockdown measures have badly affected wage employment for tribal communities.
- Lack of health infrastructure– The absence of healthcare facilities in tribal areas posing a serious threat to the tribal population.
- Problems accessing the PDS-poor access to public distribution system among tribal people and other traditional forest dwellers during the lockdown.
- Loss of forest products collection season– The other major challenge faced by tribal communities during the lockdown was the collection, use and sale of minor forest produce (MFP) with April-June being a peak season for generating their income.
- According to the Ministry of Tribal Affairs, around 100 million forest dwellers depend on MFP for food, shelter, medicines and having cash with them.
- Tribals were not able to get direct cash benefits as they did not have bank accounts or banks were located in remote locations.
What are the government interventions to resolve the situation?
- Revision in MSP – The Centre recently revised the minimum support price for 49 MFPs to provide relief to tribal groups amid the lockdown. It urged states to speed up procurement operations for MFP
- FRA title holders are entitled to an additional 50 days of work under employment guarantee schemes.
How forest dwelling communities are braving the pandemic?
Examples indicate that these communities have coped with the crisis with remarkable resilience.
Case studies documented– Local communities and gram sabhas better understand the local complexities than local administrations while dealing with a crisis as presented by COVID-19.
- In each village, the Community Forest Rights Management Committees (CFRMCs) members identified families that were starving due to no income and provided ration to them.
- Holistic COVID-19 governance plan– Gram sabhas encouraged local and forest-based food security, thereby preventing crowding in market places.
- Use of local knowledge– Many communities were able to survive on a diverse range of forest foods during the lockdown as they had been regenerating their natural forests for over four decades.
- Women played the leading role in the gram sabhas, organising systems to work with social distancing.
- In many tribal communities, they made face masks of leaves to cover their faces due to non-availability of protective masks in the areas.
Way forward
- The above examples lead to an understanding that community empowerment, particularly by ensuring tenure security and devolving natural resource governance and management power, can restore ecosystems, create sustainable economies and community resilience to cope with the natural and human-induced calamities such as the COVID-19 pandemic.
- Government need to learn from these stories of resilience and works towards effective implementation of the FRA.
- The Centre should provide state governments with adequate financial resources to ensure tribal communities and Other Traditional Forest Dwellers receive cash entitlements.
Vaccine nationalism
Context- Problems posed by vaccine nationalism and the possible solutions.
What is vaccine nationalism the problems posed by vaccine nationalism?
Vaccine nationalism occurs when a country manages to secure doses of vaccine for its own citizens or residents before they are made available in other countries.
- This is done through pre-purchase agreements between a government and a vaccine manufacturer.
The problems posed by vaccine nationalism-
- It undermines equitable access to vaccines.
- Issue for countries with fewer resources-The most immediate effect of vaccine nationalism is that it further disadvantages countries with fewer resources and bargaining power.
- Deprives access to public health- It deprives populations from timely access to vital public health goods.
What needs to be done?
- Global framework for equitable access– International institutions, including the WHO, should coordinate negotiations to produce a framework for equitable access to vaccines during public health crises.
- Governments should be the custodian of public goods– Governments must step in to regulate vaccine development, innovation, manufacture, sale, and supply ultimately to the public.
- Prioritization for high risk groups– The first batch of the vaccines should be made available to all frontline, health and social care workers, police and others who are at high risk of getting the infection.
- Ensuring equity-Equitable distribution and access should be ensured. Equity entails both affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
- Pre-purchase agreements and contracts should not trump equitable access to global public health goods
- It was important for WTO members to work together to ensure that intellectual property rights such as patents, industrial designs, copyright and protection of undisclosed information did not create barriers to timely access to affordable medical products.
Way forward-
- Countries around the world should stop engaging in overly nationalistic behaviors. Failure to do so will harm patient populations across the globe.
- The WTO has a role in getting pharmaceutical firms and countries to treat vaccines and life-saving medicines as a public good.
Ayush and Ayurveda
Context: Recently, the Indian Medical systems of Ayurveda, Siddha, Sowa-Rigpa and Unani Medicine have identified surgical procedures that can be performed by postgraduate Ayurvedic doctors in Shalya (surgery).
What is the history of Ayurveda and Allopathic practices in India?
- After Independence: The Indian state was faced with the difficult task of accommodating both the ascendant modern medicine brought in by the British and India’s traditional systems of medicine, notably Ayurveda.
- Options:
- One was to take the best from all systems and integrate them into one cohesive science. This was possible but not easy as the systems had certain incompatible approaches.
- For a brief period there actually existed ‘integrated’ courses, wherein both Ayurveda and Modern medicine were taught to students.
- These withered away partly due to opposition from purists in Ayurveda who were outraged by the ‘dilution’ of their science.
Discuss the issues associated with ayurvedic graduates.
- Ayurvedic graduates experienced an identity crisis: Many of them had joined the course not for the love of Ayurveda but to get a degree with the honorific ‘Dr.’ which gave them upward mobility, social status and even value in the marriage market.
- Their role: They became resident doctors, intensive care duty doctors and operation theatre assistant surgeons.
- There is an instance of a homoeopathic graduate manning and training others on the extracorporeal membrane oxygenation, or ECMO, a complex heart lung machine in the largest unit used for critically-ill COVID-19 patients.
- They work for less pay which allows hospitals to control costs and even make profits.
- The idea of Ayurvedic surgeons: In an effort to develop postgraduate programmes, Ayurveda medical colleges developed one in “Shalya’ or “surgery”.
- A procedure called ‘Kshar Sutra’ used for anal fistula was described in Ayurveda texts and has been incorporated in modern medicine.
- Procedures and complexities
- Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020: It authorises an MS (Ayurveda) Shalya Tantra, or General Surgery postgraduate degree holder on completion of his course to perform 58 surgical procedures.
- Some of the procedures in the list are rather complicated. For example, removal of the gallbladder called cholecystectomy.
What can be done?
- Proper training: Ayurveda graduates including surgeons are a large workforce in search of an identity. If they are creatively and properly trained, they can play important roles in our health-care system.
- IMA needs to be constructive: AYUSH, or Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, is a priority area for the present government. The IMA in its opposition needs to be precise and constructive.
Way forward
- Serious discussion about utilising India’s large workforce of non MBBS doctors to improve access to decent health care for our ordinary citizens is required.
One Health Approach
Context: ‘One Health’ is the optimum approach to counter the impact of antimicrobial resistance.
Discuss antimicrobial resistance.
- Antimicrobial resistance (AMR): It is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs such as antibiotics that are used to treat infections.
- Reason for AMR:
- The ingenuity and survival instinct of germs.
- The irrational use of antibiotics in humans and animals.
- The long-term impact of AMR: AMR is estimated to cause 10 million deaths annually by 2050, unless concerted actions are initiated now. It will result in 7.5 % reduction in livestock production and negatively impact the global GDP by 3.5%.
How can we tackle the AMR challenge?
- Solutions to combat the AMR threat:
- Discovery of new drugs, before the emergence of resistance in germs.
- Prudent use of available antibiotics
- Challenge in producing new antibiotics: it is an expensive and unpredictable process. No new class of antibiotics has been developed since 1984. The estimated cost for developing a new antibiotic exceeds $1 billion.
- Only one option: to use the available antibiotics carefully to ensure their efficacy for as long as possible.
- The World Health Organization Global Action Plan: it provides a road map for tackling this challenge. Almost 80 countries have developed their respective national action plans in alignment with this Plan.
Elaborate on how the one health approach supports focussed actions on the human-animal-environment interface .
- The ‘One Health’ approach: The rational use of antibiotics in humans, animals, and agriculture warrants coordinated action in all sectors. These multi-sectoral, multidisciplinary and multi-institutional actions constitute the ‘One Health’ approach.
- It is reinforced by the fact that all the epidemics in the current millennium (SARS, MERS, bird flu and COVID-19) have originated from animals because of unwanted excursion of humans into animal domains.
- The COVID-19 pandemic has emphasised the urgency of implementing One Health.
- One platform for experts: This effort utilises existing expertise and infrastructure in various sectors with a focus on inter-sectoral coordination, collaboration, and communication.
- Human-animal-environment interface: The approach supports focussed actions on the human-animal-environment interface for the prevention, detection and response to the public health events that influence global health and food security.
- Implementation of One Health: It permits a strong and continuous national narrative on zoonoses. It advocates a multi-sectoral response to public health problems, particularly pandemics, as also to address issues related to AMR.
Way forward
- There is a need to optimally utilise emerging technologies to improve human health and development. One Health has been acknowledged as the optimum approach to counter the impact of AMR and future pandemics and must be adopted expeditiously.
Controling AMR
Context: A One Health approach is necessary to control antimicrobial resistance.
More on news:
- India an important locus for the generation of resistance genes: The multi-drug resistance determinant, New Delhi Metallo-beta-lactamase-1 (NDM-1), emerged from this region and spread globally.
- The containment of antimicrobial resistance (AMR) in India: It is central to the global effort to address this threat.
- In India, over 56,000 newborn deaths each year occur due to sepsis, caused by organisms that are resistant to first line antibiotics.
How are antibiotics categorised?
- Categories: WHO has categorised antibiotics into
- “Access” which should be widely available,
- “Watch” to be limited to specific indications,
- “Reserve”, to be used as a last-resort.
- In 2015, India had the highest consumption rate worldwide for oxazolidinones, which have been defined by WHO as “Reserve” antibiotics.
What are the reasons for prevalence of AMR in India?
- Lack of formal training: Many medical practitioners lack formal training in India and 70 per cent of primary healthcare is delivered by such individuals.
- Sales companies target both doctors as well as those acting in a medical capacity without required qualifications.
- Biased information: Pharmaceutical sales representatives are a key source of updates and information for prescribers, but the information they provide may be biased and motivated by commercial considerations to promote antibiotic sales.
- Sale of antibiotics without prescription: The sale of antibiotics without a prescription is prohibited under Schedule H1, which has been supported by the red line campaign but it is not widely enforced.
- The lack of access: The lack of access, due to geographical distance or affordability, to medical professionals and prescribers, in rural areas of India, leads 50 per cent of people to buy antibiotics directly from the pharmacy as a first choice.
- Falsified, substandard or counterfeit antimicrobials: It can worsen AMR in several ways. They can leave patients under-dosed and bacteria that are only partially suppressed may be more likely to evolve resistance.
- Contamination: Effluents from multinational pharmaceutical companies contain active antibiotics, resistant bacteria and resistant genes.
- They contaminate rivers, streams and wells, including waters which are used for drinking and bathing. This increases both the emergence of resistant bacteria in local populations and also their spread.
What can be done?
- Access to basic antibiotics: An estimated 170,000 deaths from pneumonia in children under five can be prevented with timely access to effective antibiotics.
- Balance excessive and inappropriate use: It is a key driver of antibiotic resistance, while ensuring live-saving medicines are available to those who need them.
- Adequate sanitation: Half of the South Asian population lacked access to basic sanitation in 2018. The Swachh Bharat Mission in India has improved access to toilets in many areas.
- Improvement in infrastructure: Improvements in the infrastructure required for and access to clean water, adequate sanitation and quality hygiene in India could result in a reduction of 590 million diarrheal cases by 2020 that would have been treated with antibiotics.
- Vaccination coverage: Vaccination has shown to reduce the transmission of AMR infections and the volume of antibiotics consumed.
- Mission Indradhanush to address low vaccination coverage strengthened micro-planning and additional mechanisms to improve monitoring and accountability.
Way forward
- One objective of the Indian National Action Plan (NAP) on AMR is to develop standards to ensure that access to effective antibiotics.
- Sustainable antibiotic production methods need to be developed and adopted by manufacturers.
Urbanisation and pandemic
Context: Prime Minister Narendra Modi’s call for a reimagining of urban planning and development to make cities and towns healthy and liveable after COVID-19.
More on news:
- PM emphasised resetting the mindset, processes and practices for safe urban living, and acknowledged that governments actually do little for the working millions at the Bloomberg New Economy Forum.
Discuss the spread of pandemic in urban areas and associated issues.
- Spread of pandemic: The top 10 cities affected worldwide accounted for 15% of the total cases, and data for populous Indian cities later showed large spikes that radiated into smaller towns.
- Reason for the spread: Rapid transmission in Mumbai, Delhi, Bengaluru and Chennai was the unavoidable outcome of densification and an inability to practise distancing norms.
- In Dharavi, which has one of the world’s highest slum densities, epidemiologists point an apparently low viral impact to screening and herd immunity.
- Social impact: The pandemic’s full social impact, especially among the poorer people has not been adequately measured here or elsewhere.
- Housing: Good and affordable housing is the basis of a sustainable and healthy city.
- Well-designed rental housing that is the key to protecting migrant labour and other less affluent sections remains poorly funded.
- Mumbai is estimated to have added only 5% of rental housing in new residential construction (1961-2000), and that too led by private funding.
- Enforcement of laws: Laws on air pollution, municipal solid waste management and water quality are hardly enforced, and tokenism marks the approach to urban mobility.
What can be done?
- Schemes: An opportunity to make schemes such as the Centre’s Affordable Rental Housing Complexes deliver at large scale and focus on new good houses built by the state.
- Demand and supply: The Ministry of Housing could work by digitally combining and transparently publishing data on demand and supply for each city.
- Learning from the past: Past menaces such as cholera, the plague and the global flu pandemic a century ago led to change such as sewerage, waste handling, social housing and health care that reduced disease. Something on the same lines should be done about the pandemic.
- Government should show the political will to reinvent cities after the pandemic is over.
COVID-19, climate and carbon neutrality
Context: Environmental problems have profound public health consequences both in terms of morbidity and mortality and hence demand urgent actions in the post covid-19 world.
How are environment and public health inter-related ?
- Human intrusions: Evidence has gathered that loss of biodiversity and ever-increasing human intrusions into the natural world have contributed heavily to the outbreak and spread of epidemic diseases.
- The three Es: evolution, ecology and the environment will be key to identifying potential pandemics.
- COVID-19 also reinforces the need to pay far greater attention to the biosciences that underpin agriculture, health and the environment that are going to be deeply impacted by the current pandemic.
- Environmental problems such as air pollution, water pollution, chemical contamination, deforestation, waste generation and accumulation, land degradation and excessive use of pesticides all have deep public health consequences.
- The traditional ‘grow now, pay later’ model is not only unsustainable in the medium- to long-term but also dangerous to public health in the short term.
- A report of the Ministry of Earth Sciences called ‘Assessment of climate change over the Indian region’ points to the need for making our future science and technology strategy in different areas with an understanding of the impacts of climate change caused by continued emissions of greenhouse gases.
- The depletion of the ozone layer has been fixed more or less, but HFCs are a potent threat from a climate change perspective since their global warming potential is a thousand times that of carbon dioxide.
What is carbon neutrality?
- Carbon neutrality refers to that situation when carbon emissions are equal to absorptions in carbon sinks, of which forests are one.
- Carbon neutrality, is a far bolder and worthwhile goal, the attainment of which has to be consciously engineered.
- It will involve massive scientific invention and technological innovation especially when it comes to removing greenhouse gases from the atmosphere.
Way forward
- India can and should show to the world how the measurement of economic growth can take place while taking into account both ecological pluses and minuses.
Cancer treatment – Palliative care
Context- The present diversion of healthcare facilities and resources to COVID-19 has increased anxiety and confusion among people with cancer.
What are the issues with dealing in cancer in a wake of COVID-19 pandemic?
- Treatment disruption– The uncertainty about treatment continuation due to the virus spread was stressful.
- Halt in Cancer screening programmes– These programmes are so vital for picking up cancer early in order to save lives, have ground to a halt.
- Transportation- With public transportation closure and authorities questioning the reason for traveling has become a complete nightmare for patients to access any type of health-care services.
- Fear virus transmission– Patients have developed fear of the coronavirus that they are unwilling to go to hospitals.
- This is because of low immunity, often aggravated by treatments, as well as existing co-morbidities since cancer, by and large, is a disease of older people.
What are the possible solutions of dealing cancer?
- Early recognition- Early detection through vaccination and preliminary screening is very important. Cancer survivorship owes its rising numbers largely to advances in early detection and treatment.
- The majority of people who come for treatment to a cancer centre in India come with advanced disease. The figure is nearly 70 per cent.
- Awareness programmes- These programmes are required to create awareness about the dangerous effect of tobacco products and cancer causing chemicals.
- Palliative care:
- Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness.
- It is an approach that improves the quality of life of patients and their families facing the problem associated with a life-threatening illness.
- It involves prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
What is the way forward?
- Adaption of palliative care– healthcare providers must find ways to prevent cancer, screen those at heightened risk and mitigate the adverse effects of treatment by making palliative care a part of cancer treatments from the beginning and must find mention in public health policy and be integrated into clinical care from the primary health care level upwards.
Serological surveys
What are serological surveys
Context: The Indian Council of Medical Research conducted two serosurveys: May 11 to June 4 and August 17 to September 22.
What is serological survey?
- Serological surveys are used to detect the prevalence of antibodies against COVID-19/any diseases.
- Their purpose is to measure the proportion of a population already infected as evidenced by prevalence of antibody against the disease.
How serological surveys are carried out?
- Statisticians stratify the population and select a random sample from all strata so that the prevalence figure obtained is representative of the whole population.
- Random samples are tested from the entire population then, the data are extrapolated to the whole population.
Why antibody is tested?
- Antibodies are the evidence of the host’s response to virus infection.
- Their presence in the blood-serum confirms past infection.
Why the data derived from serosurveys must be interpreted with caution?
- Issue with Asymptomatic cases: Asymptomatic cases constitute more than 80% of those infected with the virus. In people with asymptomatic infections, these antibody levels decline over time and become undetectable by 60 days after proven infection.
- Swift disappearance of S2 antibodies: In a study on exposure-prone healthcare workers in Tennessee, nearly half the subjects with S2 antibodies became negative in two months.
- Inaccuracy: The latent period between infection and the appearance of a detectable antibody is about four weeks. Those who got infected recently before the survey may not be covered.
- If taken at face value, serosurveys may not reflect the true level of antibodies prevalence.
What is the way forward?
- The predicted herd immunity level needed to end the epidemic was 60%. In India, according to the serological surveys, half of the herd immunity level required to end the epidemic was already reached by mid-September.
- However, during the festival the Governments must enforce strict norms regarding crowding, especially inside buildings.
- This will ensure safety of the individuals, family members particularly senior citizens.
COVID-19 Nutrition fallout in wake of pandemic
Impact of COVID-19 Nutrition fallout in wake of pandemic
Context – The COVID-19 crisis has affected the Mid-Day Meal (MDM) Scheme, threatening the food security of children from underprivileged communities.
What are the key findings of recent Global Hunger Index (GHI) report?
Alarming situation for India-
- India has been ranked at 94 among 107 countries in the Global Hunger Index (GHI) 2020. The country’s score of 27.2 is the worst among BRICS countries, and inferior to Pakistan, Sri Lanka, Bangladesh and Nepal.
- India’s child wasting rate was extremely high at 20.8% – the highest.
- The child stunting rate in India was 37.4 %,
- The child wasting was at 17.3 %.
- The undernourishment rate of India was at 14% and child mortality at 3.7 %.
- India already far out in terms of achieving the ‘Zero Hunger’ goal.
What are the impacts of pandemic on food security of child?
Food security concerns due to pandemic-
- Loosing school meals– A real-time monitoring tool estimated that as of April 2020, the peak of school closures, 369 million children globally were losing out on school meals, majority were in India.
- For children from vulnerable households, their only proper meal is the one they get at school.
- Inefficiency in policy implementation– The Government of India announced hot-cooked mid-day meal or dry ration for eligible school-going children even during pandemic. However, States were still struggling to implement this.
- Dry ration distributions in lieu of school meals were irregular and started only in late May.
- The offtake of grains under MDMS from FCI during April and May, 2020 was 22%, lower than the corresponding offtake during April and May, 2019.
- Children engaging in labor activity to supplement the fall in family incomes in vulnerable households.
- There is a risk that some children may not even return to schools when they reopen.
What are the possible solutions required?
- Diverse diet- Nourishment through a diverse diet that includes fat, protein and micronutrients.
- Link local farmers with MDMS – Smallholder farmers can supply cereals, vegetables and eggs to local schools, which could diversify production and farming systems, transform rural livelihoods and the local economy, and fulfill the ‘Atmanirbhar Poshan’.
- Locally produced vegetables and fruits may be added to the MDMS, also providing an income to local farmers.
- New Initiatives under MDMS- School Nutrition (Kitchen) Garden under MDMS to provide fresh vegetables for mid-day meals.
- Awareness program- The adequate awareness about of the availability of the scheme related to MDMS is needed for its proper implications.
- The missed mid-day meal entitlement for April-may should be provided to children as dry ration with retrospective effect.
Way forward-
- With continuing uncertainty regarding the reopening of schools, innovation is similarly required to ensure that not just food, but nutrition is delivered regularly to children.
- Strict measures are needed to ensure that the Public Distribution System (PDS) is accessible to all, especially the vulnerable.
Ayushman Sahakar Scheme
Ayushman Sahakar Scheme
Launched by the Ministry of Agriculture and Farmers Welfare to assist cooperatives in the creation of healthcare infrastructure. Cooperatives at the present run around 52 hospitals across the country having cumulative bed strength of more than 5,000.
Read Also :ias syllabus
National Cooperative Development Corporation (NCDC)Nodal Body: The scheme has been formulated by the National Cooperative Development Corporation(NCDC).
- Aim: To extend term loans to prospective cooperatives to the tune of Rs. 10,000 Crore for the setting up of healthcare-related infrastructure, education and services.
- Eligibility: Any Cooperative Society with a suitable provision in its bylaws to undertake healthcare-related activities would be able to access the NCDC fund.
- Incentives: The scheme provides interest subvention of 1% to women majority cooperatives.
- NCDC: It is an apex level statutory autonomous institution set up by the Government of India under an Act of the Parliament in 1963. It is under the administrative control of the Ministry of Agriculture and Farmers Welfare.
Education
UGC’s new Learning Outcomes-based Curriculum Framework (LOCF) -Explained, Pointwise
Introduction
The UGC (University Grants Commission) recently released a new document on the undergraduate history curriculum. It is named “Learning Outcomes-based Curriculum Framework (LOCF), 2021″.
The LOCF aims to change the syllabus for the undergraduate history curriculum in India. Further, it aims to provide a focused, outcome-based syllabus at the undergraduate level. Further, the LOCF also has an agenda to restructure the teaching-learning experiences in a more student-centric manner. However, the changed syllabus of the undergraduate history curriculum falls short to meet its desired objectives and requires reconsideration.
Key provisions of Learning Outcomes-based Curriculum Framework (LOCF)
The Learning Outcomes-based Curriculum Framework (LOCF), 2021 for undergraduate education in history begins with the declaration: “History, as we all know, is a vital source to obtain knowledge about a nation’s soul”.
- Firstly, the document seeks to create a student body that will compete globally and be aware of its glorious past.
- Secondly, under the LOCF, the Undergraduate education qualification will be awarded on the basis of demonstrated achievement of outcomes.
- Thirdly, these outcomes are expressed in terms of knowledge, understanding, skills, attitudes and values.
- Further, it also specifies the expected known, understandable to do things for graduates completing a particular programme of study.
Overall the document is a policy directive to mould the entire undergraduate history education in India.
About New Curriculum for History under LOCF
- To acquire a degree in BA History a student must study
- Fourteen Core Courses (CC)
- Four Discipline Specific Elective Courses (DSE)
- Four interdisciplinary General Elective Courses (GE)
- Two discipline centred Skill Enhancement Courses (SEC)
- Two Ability Enhancement Courses (AEC)
- The new curriculum is based on a choice based credit system. Under this, a student has the flexibility to choose their course from a list of elective, core, and soft skill courses.
- The first paper of course is titled ‘Idea of Bharat.’ It seeks to study the primitive life and cultural status of the people of ancient India.
- The five units of this paper cover:
- The concept of Bharatvarsha
- Indian knowledge traditions, art and culture
- Indian economic traditions
- Dharma, philosophy and ‘Vasudhaiva Kutumbakam’
- Science, environment and medical sciences
- The third paper includes features of the “Indus-Saraswati Civilisation” and its continuity, fall and survival.
- Similarly, there are other changes in other papers as well.
Intended objectives the LOCF
The LOCF aims to achieve the following objectives. Such as,
- Use history as a vital source to obtain knowledge about a nation’s soul.
- Create a conscious student body that is aware of India’s glorious past and can compete at the global level.
- Build a new narrative about the nation through a dialogue between past and present.
- Bring out the best intellect of the student and also allow him/her to keep pace with the contemporary development.
Benefits of LOCF
If implemented the LOCF will yield the following benefits. Such as,
- The curriculum will break the stereotypes of History learning and also creates interest amongst students to study History.
- It provides great flexibility to students. As the curriculum offering a large amount of choice. So the students can tailor their education on the basis of their interests.
- Further, the LOCF enables a student of History to be well versed with other complementary subjects. As it offers a balanced combination of Core, Discipline Specific Electives and Skill Enhancement Courses.
- Moreover, its interdisciplinary nature would open multiple career paths for students like:
- Administrative Assignments
- Foreign Assignments for building International Relations
- Journalism and Media
- Policy Making and Governance
- Public Life and People’s Representation
Concerning Issues of LOCF
- Improper representation of Bharatvarsha: Under the unit of ‘ The concept of Bharatvarsha’, little focus is paid towards the contributions of the south, east and northeast people.
- Further, the struggle of the masses in the freedom movement is also not given its due space in the creation of Bharat.
- Regional Bias: The curriculum is biased towards the history of North India. The rich sociocultural, economic and political changes of other regions has not provided adequately. Further, some regions introduced only as political formations.
- Weakens the social fabric: The paper on medieval and the early modern India (History of India, 1206-1707) shows that Hindus and Muslims as two separate entities. This would strengthen the belief in separate nations for Hindus and Muslims which led to the country’s partition in the past.
- Violence as a Major Driver of change: The use of force is projected as the main driver of change in society. For example, the case of Aryan, Mughal or any other invasion in new curriculum. This kind of narrative portrays violence as the sole reason for the change.
- Disputed Findings: The Saraswati (a mythological river) is mentioned in the Vedas, but its existence is disputed amongst historians.
- Ignoring Multilayered Explanations: The new curriculum adopts the categorization methods of colonial historians. It ties the history to the story of dynasties and rulers who mainly operate under the force of religion.
- This undermines the Multilayered Explanations that state social, economic and cultural changes occur as long-term processes. These are hard to pin down to specific dates or years or dynasties.
Pedagogical challenges with the LOCF
- The style of pedagogy is more textbook-oriented. The book is less emphasised towards the archaeological artefacts, coins, visits to monuments and museums etc. Further, this hinders the better understanding of the subject.
- The new framework does not encourage reading a diversity of opinion. This will restrict the students only to limited sources.
- The curriculum ignores the finest writings in Indian history. The bulk of readings span from the 1900s to the 1980s, with a heavy dependence on the work of Indologists. This curtails their resource base.
- The linkage of critical 21st-century issues like climate change, democracy, social justice etc. with the historical framework is also missing.
Suggestions to improve the LOCF
- Firstly, the UGC should re-include the works by prominent historians in the curriculum. As it would ensure a better understanding of the history by the students.
- This includes R.S. Sharma’s book on ancient India and Irfan Habib’s book on medieval India.
- Secondly, the LOCF also has to include New modes of thinking especially about Big Data, digital mapping and visualisations, critical study of the environment etc.
- Thirdly, apart from that, there should be a re-adoption of inclusive and secular texts like Kautilya’s Arthashastra, the poems of Kalidas, Ayurvedic text Charak Samhita etc.
- fourthly, apart from that, the UGC can arrange a meeting with eminent persons (representing diverse sections) in order to re-examine the proposed syllabus.
Conclusion
The shortcomings of the curriculum have to address efficiently through cautious discussion. In conclusion, the LOCF should make it more rational, objective and comprehensive in order to deliver optimum outcomes.
“Lab on Wheels Programme” For Education Equality
What is the News?
Delhi Education Minister inaugurates Delhi Technological University(DTU) Lab on Wheels programme.
About Lab on Wheels Programme:
- The Programme aims to impart education in the fields of Mathematics and Science. Especially to the students from marginalised and poor economic backgrounds. The programme aims to stimulate their interests in these subjects while pursuing higher education.
- In the end, the programme becomes mutually beneficial, if some of these students decide to take admission in DTU once they finish schooling.
Key Features of the programme:
- Under the Lab on Wheels, Delhi Technological University students will travel in a bus across Delhi. Also, they will teach government school students and underprivileged children.
- The bus will comprise 16 computers, two televisions, one 3D printer, one laptop, cameras and one printer. It will also be Wi-Fi enabled with 100% power back up and fully air-conditioned.
- The Lab on Wheels programme will cover some important things. Such as basic computer training for students, regular classwork for Class 10 and 12 students, and 3D printing training.
Source: Indian Express
“DIKSHA Platform” -Visually challenged struggle with e-textbooks
What is the News? As per a study by Vidhi Centre for Legal Policy, Visually impaired students can’t access more than half of NCERT material on DIKSHA platform.
About the study:
- The study conducted a systematic review of the Digital Infrastructure for Knowledge Sharing(DIKSHA) portal. The platform is a national platform for school education.
- Purpose: It analyzed how much the DIKSHA portal is Accessible for Students with Visual Disabilities.
What are the key findings? The assessment of inaccessibility was conducted on two fronts:
Inaccessibility of the DIKSHA platform:
- The DIKSHA web platform has a variety of accessibility issues. That makes it difficult for visual disabilities persons to independently navigate it to search and access the content they are looking for.
Inaccessibility of the resources on the DIKSHA platform:
- NCERTs: All chapters sampled from NCERT e-textbooks uploaded in an appropriate e-text format. However, only 36.4% were completely accessible and 54.5% had inaccessible elements and 9.1% were completely inaccessible.
- SCERTs:
- Of the 21 SCERT chapters sampled for Tamil Nadu, 90.5% were totally inaccessible. Only one of the sampled chapters was totally accessible using a screen reader.
- Out of the 22 SCERTs chapters sampled for Telangana, none were totally inaccessible. However, 95.5% were partially inaccessible, and only one chapter was totally accessible.
- Subject wise Inaccessibility: Mathematics chapters had the highest number of inaccessible learning activities at 80%. Following that are English, Science, and Geography chapters.
About DIKSHA Platform:
- DIKSHA (Digital Infrastructure for Knowledge Sharing) is a national platform for teachers to excel in school education.
- Launched by: It is an initiative of the National Council for Education Research and Training (NCERT), Ministry of Education.
- Purpose: The DIKSHA platform offers engaging learning material, relevant to the prescribed school curriculum, to teachers, students, and parents.
- Significance: DIKSHA made it possible amid Corona Pandemic, for all states and Union Territories, to enable learning and education at home through innovative state programs.
Source: The Hindu
Government launches “SARTHAQ” plan to implement NEP at school
What is the News?
The Union Education Minister has released an implementation plan for school education called SARTHAQ. SARTHAQ stands for ‘Students’ and Teachers’ Holistic Advancement through Quality Education.
About SARTHAQ:
- The Department of School Education and Literacy, Ministry of Education, has developed SARTHAQ.
- Purpose: SARTHAQ is an indicative and suggestive implementation plan for school education.
- The plan was launched to implement the goals of the National Education Policy (NEP) 2020. Further, it will assist all the States/UTs in this task.
- Objectives:
- Firstly, to provide all-around development for the students at the primary and secondary level.
- Secondly, to establish a safe, secure, inclusive and conducive learning environment for students as well as teachers.
- Thirdly, to meet the diverse national and global challenges of the present and the future. Further, it will help the students to imbibe 21st-century skills along with India’s tradition, culture and value system.
- Key Features of the Plan:
- The plan keeps in mind the concurrent nature of education and adheres to the spirit of federalism.
- States and UTs are given the flexibility to adapt this plan with local contextualization. Also, they can modify it as per their needs and requirements.
- The implementation plan delineates the roadmap and way forward for the implementation of NEP, 2020 for the next 10 years.
The SARTHAQ plan aims to meet the following goals of NEP 2020:
- The plan will pave the way for curriculum reforms. This includes the new national and state curriculum frameworks for school education as well as early childhood care and education.
- The programme will focus on the improvement of the enrollment ratio of children at all levels. Also, it will focus on reduction in dropouts also.
- Further, It will provide access to quality and Universal Acquisition of Foundational Literacy and Numeracy by Grade 3.
- It will implement vocational education, sports, arts, knowledge of India, 21st-century skills, values of citizenship, awareness of environment conservation in the curriculum.
- Apart from that, it will focus on experiential learning and will also improve the quality of Teacher Education Programmes.
Source: Livemint
“E9 Initiative” to Accelerate Digital Learning
What is the News? The Minister of State for Education will attend a consultation meeting of Education Ministers of E9 countries called the E9 Initiative.
About the E9 Initiative:
- Theme of the Meeting: “E9 initiative: Scaling up digital learning to accelerate progress towards Sustainable Development Goal 4”
- This consultation meeting will be the 1st of the 3 phase process to co-create a Digital Learning initiative. Marginalized children and youth, especially girls, would be the target population.
- The initiative will aim to accelerate recovery and advance the Sustainable Development Goal 4 agenda by driving rapid change in education systems.
- The initiative will also focus on three of the 2020 Global Education Meeting priorities namely: (i) support to teachers; (ii) investment in skills and (iii) narrowing of the digital divide.
About E9 Partnership:
- Launched in: 1993 at the UNESCO’s Education For All (EFA) Summit in New Delhi.
- Member Countries: The United Nations is spearheading the initiative with nine countries namely Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Nigeria, and Pakistan.
- Purpose: The E9 forum aims to achieve the goals of UNESCO’s Education For All(EFA) initiative. It strengthens political will and collective effort to ensure quality education and lifelong learning opportunities for all.
- The forum represents over half of the world’s population and 70% of the world’s illiterate adults.
- Significance: E-9 Initiative has become a forum for the countries to discuss their experiences related to education, exchange best practices, and monitor EFA-related progress.
About Education For All(EFA) Summit:
- Education For All(EFA) is a global movement led by UNESCO (United Nations Educational, Scientific and Cultural Organization) with the aim to meet the learning needs of all children, youth, and adults.
- EFA was adopted by The Dakar Framework in 2000 at the World Education Forum in Senegal, Africa.
Source: PIB
Central Vista judgment: Issue of public participation in public projects
Right To Education Act still has some arbitrariness
Synopsis: The Right To Education Act evolved so much in the past. But there is still some arbitrariness in the RTE Act.
Introduction:
Right to Free and Compulsory Education Act or RTE Act is a horizontally enforceable Fundamental Right. That is, the Right is enforceable against the State and Individuals.
But the Right To Education Act have some arbitrary discrimination against private institutions and favours minority educational institutions.
Evolution of Right To Education as a Fundamental Right:
Earlier, Article 45 mentions the right to education as a part of the Directive Principles. It mentions that the state should provide free and compulsory education to children up to the age of 14. The provision also mentions a timeline for this achievement(within a decade).
Mohini Jain v. State of Karnataka case 1992: In this case, the Supreme Court held that the Right to education is a part of the right to life recognised in Article 21.
Unnikrishnan JP v. State of Andhra Pradesh case 1993: In this case, the Supreme Court held that the state was duty-bound to provide education to children up to the age of 14. Further, the SC also mentions that the state alone cannot fulfil the task. Private educational institutions, including minority institutions, have to assist the State in that.
86th constitutional amendment of 2002:The government provided a status of a fundamental right to the right to education. The government inserted Article 21A into the constitution.
Evolution of Right To Education Act:
P A Inamdar vs State of Maharastra 2005 case: In this case, the court held that there shall be no reservation in private institutions, minority and non-minority institutions.
93rd constitutional amendment of 2005: This amendment included Clause(5) to Article 15. Under this, the State can provide for admission in institutions, including private institutions for the advancement of “backward” classes. This purposefully omitted both the aided and unaided minority educational institutions.
In 2009, the government enacted the Right to Free and Compulsory Education Act or RTE Act. The Act provides for 25 per cent reservation in private institutions.
Society for Unaided Private Schools of Rajasthan v. Union of India case. Private schools challenged the 25% percent reservation in the RTE Act. The court, on the other hand, upheld the validity of the legislation. But the court exempted the unaided minority institutions from providing reservation.
The arbitrariness in Right To Education Act:
The amendment to the Right to Education Act 2012: The amendment mentions that the RTE Act will subject to Articles 29 and 30. In other words, It protected the administrative rights of both unaided and aided minority educational institutions.
But in the Pramati Educational Trust vs Union of India case 2014, the court held that the RTE Act is applicable to both non-minority aided and unaided Private schools.
This created an arbitrariness in the Act. This has the following problems in the RTE Act,
- Onus on private unaided schools is higher than the government schools
- Minority institutions both aided and unaided were exempt.
- According to Article 21, there is no discrimination between minority and non-minority institutions. But, the RTE Act has.
- There is no explicable or rational explanation for leaving minority institutions, especially the unaided ones.
Suggestions to improve the Right to Education Act
In the Sobha George v. State of Kerala case, 2016 the court held that the no-detention policy will apply to minority schools also. Further, the court also held that the minority institutions will not subject to the RTE Act. But they are subject to the fundamental rights of the Constitution. The Court demands two fundamental questions on Section 16(no-detention policy).
- Whether the provisions such as Section 16 of RTE are statutory right or Fundamental Right?
- If it is the Fundamental Right, then the minority institutions will not claim the exemption under the Pramati Educational Trust case.
So, the government has to relook the Right to Education Act to fulfil the view of the Sobha George v. State of Kerala case. Until then the Supreme court may overrule its judgement on the Pramati Educational Trust case.
Source: The Indian Express
Governance Issues facing Private Education Institutions
Synopsis: The private educational institutions are failing to deliver optimum results. Thus, the role of the state in providing accessibility in educational institutions can’t be ignored.
Background:’
- The two renowned faculties of Ashoka university (Pratap Bhanu Mehta and Arvind Subramanian) have recently resigned. Allegedly, the owners of the institution were cautious of their outspoken criticism of the government.
- This instance questions the ability of private institutions to withstand the government’s pressure and deliver optimum results in the field of education.
Rationale behind privatisation:
- They promise to possess greater academic freedom as the government plays no role in the appointment of faculty and staff. Further, they are not dependent on government aid for carrying out day-to-day activities.
- For instance, JNU’s freedom has been curtailed by the appointment of a favourable Vice-Chancellor by Govt. Stricter norms, budget cuts, and frequent student clashes have been seen after the appointment.
- They promise better academic performance of students by providing better infrastructure and good quality teachers. They use this as a crucial factor for attracting parents towards them.
- Likewise, they complement the government schools and universities that don’t have the capacity to solely accommodate the huge Indian population.
Concerns with Privatisation:
- Rising Inequalities: Private institutions create a class divide. They are costly and expensive thus beyond the scope of many people. Further gender and caste inequalities are also prevalent in them.
- The boys and students from upper-caste backgrounds are overwhelmingly represented in private institutions relative to public ones.
- Profit Motive: Many private institutions are established by Businessmen who also need to protect their business interests. This leads to moulding of the institution’s policy in line with the government’s interest or the popular sentiment in society.
- For instance, historian Ramachandra Guha had to decline to join Ahmedabad University after a religious group’s protest over his appointment.
- Overnight Closures: Many private institutions promise good quality education at low rates. Less fees results in poor infrastructure and inefficient teachers, thereby threatening their survival and leading to overnight closures. This puts many children out of the education map.
- Security of Tenure: This is not available in private institutions due to which teachers have to surrender towards the wishes of private management.
- For instance, even with frequent clashes between VC and teachers, no full-time faculty was forced to resign from JNU.
- Flawed Results: Better results are generated due to the privileged children studying in them and not the quality of resources offered by them.
Way Forward:
- There should be democratic decision-making within the private universities. This will provide greater resilience against the government’s pressure and strengthen academic freedom. For instance, Vice-Chancellors in private universities should be made part of the decision-making process.
- Recommendations of the Central Square Foundation report on private participation can be implemented. It’s recommendations includes:
- Reviewing the non-profit mandate for the education sector and existing fee regulations
- Opening corporate governance structures to private schools
- Classifying private schools as micro, small, or medium enterprises
- There should be proper implementation of the Right to Education act. So that, at least 25% of students in private institutions come from diverse backgrounds.
Apart from reforming the private sector, the role of state can’t be ignored for maintaining a just and equal educational system.
Source: Indian Express
Higher Education in India – Significance of Quality Faculties
Synopsis: The size or location of educational institutions is not a big barrier to academic excellence. The quality and strength of faculty should improve to ensure quality higher education.
Background
- Some experts are of the belief that there should be only 10 to 12 IITs. Furthermore, the location of these institutes should be in big urban areas, and they should focus on becoming “crown jewels”.
- However, other experts do not favour this belief. Instead, they believe that the size or location of campuses can not be a barrier to academic excellence.
- The success of IIT-Mandi and other international universities such as Cornell University (England) and the Okinawa Institute of Science and Technology Graduate University (Japan) favors this belief.
- Thus, the focus should be on increasing the number and quality of faculties in higher education. The recruitment parameters for faculties should be strengthened to ensure quality.
Significance of faculties in higher education
There are a few best practices that some IITs have adopted for improving the quality of education. However, not all the IITs are able to adopt these practices due to the shortage of faculties.
- First, the majority of incoming students lack language and study skills. Thus, they require extra training and confidence-building measures in using the English language.
- For this purpose, many IITs like IIT-Mandi introduced induction programs.
- This program helps to break the ice between students and faculty, making it easy for the students to get in touch with their teachers.
- However, this program is not mandatory in even some “crown jewel” IITs. One of the reasons for this is the increasing strength of the students without a proportionate increase in faculty members.
- Second, Innovative curriculums to provide students with practical work experience are very helpful in exposing students to industrial requirements.
- For example, IIT Mandi courses from a design and innovation stream include a mandatory socio-technical practicum.
- These kinds of innovative curriculums need effort from faculty members.
- Third, many IITs have scrapped the mandatory requirement to submit final year projects. But final year projects are important to test an individual’s knowledge and skills on a concrete problem. The key reason for this is that the increase in student’s strength is not in proportion to increase in faculty strength.
Issues related to the current recruitment process of faculties
There are two existing problems with recruiting and retaining faculty members.
- First, not enough faculty members are hired. The hired faculties are burdened with additional non-academic responsibilities such as: running the canteen, managing the placement cell, etc.
- Second, the issues in the current recruitment process.
- One, shortlisting process is mechanical. It creates the possibility of the elimination of quality resources.
- Second, shortlisting done on the basis of the number of papers taken and the size of grants won by faculties.
Suggestion to improve the recruitment process
- First, each applicant should be asked to provide their two best research publications and their two best pedagogic materials. It should be in addition to their full curriculum vitae.
- Second, based on the two best publications and sample pedagogic materials the external experts should prepare a shortlist. Then the local hiring committees should attempt hiring from within this shortlist.
Case Study: Remoteness will not impact Academic quality: The case of IIT Mandi
- It has as international a resident faculty body as any other IIT.
- It was seventh in the Atal innovativeness ranking published last year.
- Notably, the IIT Mandi project that developed a landslide warning system won the SKOCH award
Source: The Hindu
Education Minister inaugurates “Ānandam” – The Center for Happiness in IIM Jammu
What is the News?
The Union Minister of Education inaugurates “Ānandam: The Center for Happiness” at Indian Institute of Management (IIM) Jammu.
About Anandam: The Centre of Happiness:
- The Centre for Happiness-Anandam established with the aim to help reduce the mental pressure of students and faculty. They undergo stress due to deadlines, coursework, and teaching load.
- Origin of Name: The Center for Happiness acquires name ‘Ānandam’ from Indian wisdom tradition. There the state of pure consciousness is anandam. Thus, it doesn’t only aim for happiness but also on knowing the truth, doing good, and enjoying the beauty around.
- Categories: The Centre has five broad categories — counseling, holistic wellness, elective courses on happiness development, research and leadership, faculty development.
- At the center, students and teachers will participate in regular physical exercises. Moreover, they will be able to practice breathing exercises such as prāṇāyāma and mindfulness and practice meditation and contemplation.
Additional Facts:
What is Gross National Happiness(GNH)?
- Firstly, Gross national happiness(GNH) is a term coined by the Fourth King of Bhutan, Jigme Singye Wangchuck in the 1970s.
- Secondly, GNH measures economic and moral progress as an alternative to gross domestic product measurement in Bhutan.
- Thirdly the concept implies that sustainable development should take a holistic approach towards notions of progress. Thus, it gives equal importance to non-economic aspects of well being.
- Fourthly, in 2012, for the first time, the World Happiness Report was released by the United Nations Sustainable Development Solutions Network based on Gross Happiness Index at a global level.
What is Happiness Curriculum?
- The Happiness curriculum launched by the Delhi government in 2018.
- The curriculum aims at increasing mental health awareness among school children from classes nursery to eighth in all government schools.
- Under the curriculum, students will attend Happiness Classes. In these classes, students participate in exercises such as storytelling, meditation, and question and answer sessions.
Source: PIB
Issues of Vacancies in IIMs For Reserved Faculty Positions
Synopsis: There are larger vacancies in IIMs for reserved faculty positions from Scheduled Castes, Scheduled Tribes, and the Other Backward Classes communities. The unavailability of deserving candidates is one of the reasons for that.
Introduction:
According to an RTI, older Indian Institutes of Management(IIMs) are lagging behind the newer IIMs in enforcing the quota rule. For example, IIM-Kolkata has no SC or ST faculty member and only two OBC faculty members.
Does IIMs oppose equality?
It is not like IIMs are not trying to fill the vacancies, there are many reasons behind that. Also, IIMs have taken many steps towards ensuring equality, such as,
- The IIMs fulfill the government-mandated admission quotas for SC, ST, and OBC candidates.
- Apart from that they also implement certain own inventions towards inclusion. For example, IIM-Banglore has taken the following measures towards inclusion. Such as:
- The IIM-B provided reservations to the students with a disability even before the Persons with Disabilities Act, 1995.
- IIM-B set up a dedicated Office of Disability Services in 2009. This functions as a nodal support point for students with disability. This helps in studying the needs of each student and proactive recommendation for disabled students.
- All these steps resulted in global recognition with the NCPEDP-Mphasis Universal Design Award. The award for IIM-B highlighted the pioneering work in promoting accessibility and ensuring a life of equality and dignity.
Then, why there are large no. of vacancies on reserved positions in IIMs?
But according to the recent report the IIMs are also facing certain challenges. Such as shortage of qualified candidates from reserved categories. But this is not a simple thing to fill up. This is due to the following reasons.
- IIMs need to balance between the Central Educational Institutions (Reservation in Teachers’ Cadre) Act 2019 and the Indian Institutes of Management Act, 2017.
(The IIM Act recognizes IIMs as Institutions of National Importance and demands their fulfilment to global standards.) - Admitting potential students to doctoral programmes is a challenge. The alumni discussion reveals that the reserved category students pursue MBA programmes to employ themselves in a good job. So that, they can move up the societal ladder quickly. But they don’t want to pursue the Research and not showing interest in the faculty postings.
How the IIMs can tackle the challenge?
The IIMs have to launch a specific pre-doctoral programme to fulfil the following objectives.
- Encourage under-privileged category students to take up research and Faculty positions.
- Encourage them to do research by offering financial incentives.
This can improve the necessary talents in the long run. Further, It will also improve the social positions of the under-privileged persons. For example, IIMB in 2019 launched the N.S. Ramaswamy Pre-doctoral Programme. It is a self-funded academic and mentoring initiative.
The other Higher Educational Institutions(HEI) in India have to follow the path of IIMB. It will fulfil the large vacancies in the HEI’s.
Source: The Hindu
Issues with UGC’s New Undergraduate History Curriculum
Synopsis: Recently, the UGC (University Grants Commission) suggested a new undergraduate history curriculum. However, it falls short to meet its desired objectives and requires reconsideration.
Background:
- The UGC released a new document on the undergraduate history curriculum, named Learning Outcomes-based Curriculum Framework (LOCF), 2021.
- The document suggestes changes as per the changing domestic and international scenario.
Objectives:
- Use history as a vital source to obtain knowledge about a nation’s soul.
- Create a conscious student body that is aware about India’s glorious past and can compete at the global level.
- Build a new narrative about the nation through a dialogue between past and present.
About the curriculum:
- The five units of the course cover:
- The concept of Bharatvarsha
- Indian knowledge traditions, art, and culture
- Indian economic traditions
- Dharma, philosophy and ‘Vasudhaiva Kutumbakam’
- Science, environment, and medical sciences
- First paper of course is titled ‘Idea of Bharat.’ It seeks to study the primitive life and cultural status of the people of ancient India.
Concerning Issues:
- Firstly, the idea of Bharatvarsha is portrayed as devoid of invasions.
- The origin is associated with the pristine ancient past. No credit is associated with Kushans, Mughals, etc. invasions in shaping the idea of Bharat.
- Further little role focus is paid towards the contributions of the south, east, and northeast people towards nation-building.
- The struggle of the masses in the freedom movement is also not given its due space in the creation of Bharat.
- Secondly, the paper on medieval and the early modern India (History of India, 1206-1707) shows that Hindus and Muslims as two separate entities. This would strengthen the belief in separate nations for Hindus and Muslims which led to the country’s partition in the past.
- Thirdly, the use of force is projected as the main driver of change in society. It is shown in the case of Aryan, Mughal or any other invasion. This kind of narrative portrays violence as the sole reason for the change.
- Fourthly, it adopts the categorization methods of colonial historians. This simply undermines the efforts of historians to challenge the colonial way of history-writing.
- The colonial methods used to pose a contrast between the secular, modern Europe and the backward ‘oriental’ states (having irrational adherence to religion).
- Fifthly, the curriculum is biased towards the history of North India. The rich sociocultural, economic and political changes of other regions have been given very little room. Further, some regions are only introduced as political formations.
Pedagogical Issues:
- Firstly, the style of pedagogy is more textbook-oriented. A less emphasis is placed on archaeological artefacts, coins, visits to monuments and museums etc. that helps in better understanding.
- Secondly, the students are not encouraged to read the diversity of opinion which would have helped in a better understanding of history.
- Thirdly, the curriculum ignores the finest writings in Indian history. The bulk of readings span from the 1900s to the 1980s, with a heavy dependence on the work of Indologists. This curtails their resource base.
- Lastly, the linkage of critical 21st-century issues like climate change, democracy, social justice etc. with the historical framework is missing.
In a nutshell, the curriculum aims to make history education space for passive rote-learning of ideas which was last popularized in the 1920s.
Source: Thehindu.com
Declining Autonomy of Indian Institute of Management (IIM)
Source: Indian Express
Syllabus: GS 2 – Issues relating to development and management of Social Sector/Services relating to Education
Synopsis:
The recent attempts of intervention in the functioning of IIMs raise concerns with respect to the degree of autonomy enjoyed by them. The powers of government and board of governors to intervene in the institute’s functioning needs re-examination.
Background:
- Recently a challenge to institutional autonomy was posed in IIM Ahmedabad and IIM Calcutta.
- In IIM Ahmedabad, the institute’s director pressured by the government to re-examine a controversial Ph.D. thesis on electoral democracy. The director although refused to comply with the government’s order.
- Similarly, in IIM Calcutta, the director was stripped of its power of making appointments and taking disciplinary actions, by the board of governors.
Autonomy Prior to IIM Act 2017:
- The IIMs functioned as societies and enjoyed significant autonomy in academic matters including fee determination.
- The independence of fixing the fees in older IIMs (Ahmedabad, Calcutta, Bangalore, Lucknow, Kozhikode, Indore) ensured they are not dependent on government funds.
- However, the appointment of the director and board of governors was done by the government that reduced IIM’s autonomy. This gave them sufficient scope to intervene.
- Friction was observed in some instances, like in 2003-04, the government’s order to reduce fees in six IIMs was opposed by the IIMs.
Autonomy Post IIM act 2017:
- The act converted autonomy based on the convention to autonomy derived from legislation.
- The government needs to follow the provisions of the act and any alteration to curtail the autonomy can only be done by the legislature.
- The act reduced the power of government but enhanced the powers of the Board of Governors over the institute. Due to this, a tussle is seen between the board and the director of the institute. (IIM Calcutta Scenario)
Impact of Declining Autonomy:
- The creativity of institutes will decrease. It would in turn reduce the quality of education.
- This further culminates into lowered reputation thereby impacting the overall higher education framework in India.
Way Forward:
- The government should avoid unnecessary intervention. In the case of IIM Ahmedabad issue, a more prudent way is to go through the appropriate academic forums within the Institute to flag complaints.
- The government should support higher education institutes in multiple ways (including funding) as is done across the globe. However, the support shouldn’t be converted into intervention.
- For instance, funding gives more controlling power to the government. This happens because Parliament and the CAG have the right to know the fate of the funds approved by the government.
The Indian Institute of Management has remained the brightest jewel in the country’s higher education set-up. Maintenance of this position would definitely require a significant degree of autonomy.
Flaws in New AICTE rules
Synopsis: The new AICTE rules allow non-Physics and Non-Maths students to pursue engineering. It will impact students’ prospects in education.
Background
- Recently, the All India Council for Technical Education (AICTE) brought changes to the entry-level qualification for undergraduate engineering programmes.
- According to the new changes, students who haven’t studied either physics or mathematics (or both) in Classes 11 and 12, will be eligible for admission in undergraduate engineering programs.
- Earlier, an engineering aspirant was required to pass high school with physics and mathematics as compulsory subjects.
- Under the new norms, a candidate is expected to have scored at least 45% in any three subjects out of a list of 14 subjects. It gives choice for students to pursue engineering without opting Physics, mathematics from the listed 14 subjects.
AICTE’s rationale behind the move
- AICTE stated that the new changes are in line with the new National Education Policy’s multidisciplinary approach.
- Further, they have decided to supplement the student’s lack of knowledge in Physics and maths through a bridge course.
- This new decision by AICTE attracted criticism from Niti Aayog member and Scientific Advisor Scientist V K Saraswat.
What are the issues with the new AICTE rules?
- First, according to V K Saraswat, developing strong basics in mathematics and physics is easier during the school period. Most of the Engineering subjects require depth knowledge in physics and maths. It will be difficult for non -background students to develop these logics in a short period.
- Second, offering bridge courses to cope with Maths and physics concepts will reduce the student’s ability to excel in graduation. For example, a non-background student needs at least 2 semesters to study physics and maths through a bridge course. It will be difficult for him to cope up with both graduation subject and bridge courses simultaneously.
- Third, worldwide there has been a renewed focus on STEM subjects. Nowadays, every subject even MMBS doctors are using mathematics. In this scenario, neglecting sciences and maths at the school level will limit students’ opportunities.
Colleges need to complete bridge courses before starting formal classes so that students will be pre-equipped with the knowledge of science and maths.
Source: Indian Express
Issue of High Vacancies in Higher Educational Institutions
Synopsis – According to the Education Ministry’s committee, there is a high rate of Vacancies for faculty positions in Central institutions for higher education. State-sponsored preparatory programmes are essential to fill vacancies.
Introduction-
- The government provides reservations for faculty positions to the weaker sections under the Central Educational Institutions (Reservation in Teachers’ Cadre) Act, 2019.
- But, According to the data shared by the Education Ministry, more than half of the faculty vacancies reserved for SCs, STs, and OBCs in Central institutions of higher education are vacant.
- The situation is particularly worse in the elite Indian Institutes of Management (IIMs). Here more than 60% of SC and OBC reserved positions are unfilled, while nearly 80% of ST reserved positions remain unfilled.
- If we include Central Universities, IISERs, IIT (non-faculty), IGNOU, and Sanskrit Central Universities then the vacancies are about 38% to 52%.
This data highlights a serious mismatch between the government’s reservation goals and actual recruitment outcomes.
What are the recommendations made by an official committee?
- Exemption from a reservation in faculty hiring – The official committee suggested exempting IITs, IIMs from the reservation for SC, ST, OBC and Economically Weaker Sections.
- Vacancies to be de-reserve if no suitable candidates are found within a year– If vacancies for appropriate candidates from SC/ST/OBC/EWS applicants are not filled during a year, the vacancies may be de-reserved for the next year.
However, these recommendations are viewed as undermining the government’s goal of social equity through the reservation. The government needs to understand the education system’s shortcoming.
State-sponsored Preparatory programmes to fulfil various issues:
According to the Education Ministry’s committee, the failure for filling the reserved positions is due to a lack of qualified applicants. The issue can be resolved by-
- State-sponsored Preparatory programmes(prepare faculties for their interviews) to meet the IITs and IIMs standards. These preparatory programmes have the following advantages,
- The programme will increase the pool of aspiring candidates from the reserved sections.
- Further, this will also create research faculties among the reserved sections.
- These preparatory programmes could help to overcome the quality deficiencies in faculty preparation.
- Make higher education institutions(HEIs) more socially responsive, thus achieving the objective of ending historical caste-based discrimination.
Way forward
- Apart from state-sponsored preparatory programmes, the government must increase the funding for education at all levels. This will support the vulnerable sections on their way towards equality.
Source- The Hindu
Why India should Invest More in Research and Innovation System?
Synopsis: India could use its education policy to improve the research and innovation ecosystem in the country.
Introduction
The Government of India celebrates National Vaccination Day every year on March 16 to communicate the importance of vaccination to the people. During the COVID-19 pandemic, the significance of this day becomes even more important.
- India’s indigenous COVID-19 vaccine will help India in emerging as a global leader in the post-COVID-19 era.
What steps were taken during the pandemic?
- Most developed nations ramped up their efforts to vaccinate their respective population. However, the developing countries were far behind. It could have resulted in another year of humanitarian and economic crisis for them.
- Developed countries engaged in vaccine nationalism during this time. However, India made vaccines widely available for other developing countries. India guaranteed a universal, unbiased, and affordable supply of vaccines for developing countries.
- This firmly established India as the pharmacy of the world and sent out the message that medical products must be dealt with as global public goods.
- The country has supplied vaccines to over 70 countries while ensuring that its domestic demand is met.
Why India should invest more in Research and Innovation?
The IITs came up with significant innovations like low-cost portable ventilators, affordable AI-powered COVID-19 test kits, drones for sanitization, and cheap and effective PPE kits and masks.
These innovations helped in providing healthcare facilities to Indian citizens. Moreover, the products were exported to different countries.
Thus, India should invest more money and energy in research and innovation to make India a long-term global leader.
Steps taken to strengthen research and Innovation
The National Education Policy (NEP) 2020 is a step forward in this direction.
- Firstly, the NEP aims to improve the research and innovation landscape in India. It proposes that Higher Education Institutions (HEIs) should focus on research and innovation. This will be done by establishing start-up incubation centres, technology development centres, and interdisciplinary research.
- Secondly, the NEP also recommends setting up Multidisciplinary Education and Research Universities, which will be on the level of IITs and IIMs to achieve the highest global standards in education.
- Thirdly, the National Research Foundation (NRF) will be established under the Principal Scientific Adviser. Its aim is to transform India’s research culture. An outlay of ₹50,000 crore for the next five years has been allocated for NRF in the Budget.
Conclusion
The world will remember India for initiating the largest education reforms and emerging from the pandemic as a global leader. The Prime Minister has given a solid boost to the vaccination drive and instilled confidence in the nation after taking the vaccine himself.
Source: click here
Ministry of Housing and Urban Affairs launches “City Innovation Exchange(CiX)”
Older IIMs lag behind in enforcing “Quota rules”
What is the News?
According to an RTI, older Indian Institutes of Management(IIMs) are lagging behind the newer IIMs in enforcing the quota rule.
Data on IIMs enforcing Quota Rule:
- In older IIMs, less than 10% of the faculty are from Scheduled Castes, Scheduled Tribes, and the Other Backward Classes communities.
- However, In some newer Indian Institutes of Management(IIMs) some progress is made in hiring faculty members.
Institute wise Data:
Older Institutes:
- IIM-Kolkata: It has no SC or ST faculty member, but it does have two OBC faculty members. It makes up less than 3% of its total strength of 77.
- IIM-Bengaluru: It has 6% of its 103 faculty members from the reserved categories: 3 SC, 1 ST, and 2 OBC community members.
- IIM-Ahmedabad: It has said that it does not maintain category-wise information for faculty.
Newer Institutes:
- The Institute at Shillong has more than 30% of faculty members from the reserved categories.
- Institute of Raipur has 25% and Institute of Jammu more than 22% from the reserved categories.
- However, among newer IIMs, IIM-Nagpur does not have a single faculty member from any of the reserved categories.
Central Educational Institutions (Reservation in Teachers’ Cadre) Act,2019:
- Purpose: The act provides for the reservation of posts in appointments of Central educational institutions by direct recruitment of persons belonging to
- Scheduled Castes (SCs) (15%)
- Scheduled Tribes (STs) (7.5%)
- Socially and Educationally Backward Classes(SEBCs) (27%) and
- Economically Weaker Sections (EWSs) (10%).
- Coverage: The act will apply to ‘central educational institutions’ which include
- universities set up by Acts of Parliament
- institutions deemed to be a university
- institutions of national importance and
- institutions receiving aid from the central government.
- Exception: The act excludes
- certain institutions of excellence, research institutions, and institutions of national and strategic importance.
- It also excludes minority education institutions.
Source: The Hindu
“Vacancies in Central institutions” for higher education
What is the News?
The Union Education Minister informed the Lok Sabha about the vacancies in the faculty positions of Central institutions for higher education. He mentioned, there is a higher vacancy in the seats reserved for OBCs, Scheduled Castes, and Tribes.
What are the Vacancies in Central institutions of higher education?
- More than half of the faculty positions reserved for the OBCs in Central institutions of higher education are vacant.
- Moreover, 40% of those reserved for the Scheduled Castes and Tribes in the Central institutions of higher education also remain unfilled.
- This situation is prominent in the Indian Institutes of Management (IIMs). More than 60% of SC and OBC reserved positions are vacant, while almost 80% of positions reserved for the STs are vacant.
Vacancies in Central institutions at Professor Level:
- Vacancies in Central institutions for SCs and STs:
- In Central Universities, vacancies were higher at the level of professors and not the assistant professor level.
- Of the 709 assistant professor positions reserved for the STs more than 500 have gotten filled.
- However, when it comes to professors, only nine of the total 137 have gotten filled for the ST candidates. This means that 93% of these posts remain vacant.
- Vacancies in Central institutions for OBCs
- Similarly, 64% of the 2,206 assistant professor positions reserved for the OBCs have gotten filled in the Central Universities.
- However, less than 5% of the 378 professor positions reserved for the OBCs have gotten filled.
Source: The Hindu
Addressing Systemic Issues in Higher Education
Synopsis: There are systemic issues in higher education. They need to be addressed to strengthen our education system.
Background
- According to the recently released QS World University Rankings, India has 12 universities and institutions in the top-100 in particular subjects.
- Though it is a better achievement compared to the previous years. Still, there is room for improvement.
- We need to address the systemic issues to further strengthen our education system.
Why are the systemic issues impacting quality in higher education?
There are many systemic issues which needs to be addressed in higher education. For example,
- First, lack of relevant career opportunities diminishes the appeal of academic education among students. For example, if studying hard and critical thinking doesn’t lead to career improvement, students tend to lose academic ambition.
- Second, the lack of relevance of the core syllabus decreases students’ interest in higher education. For example, students joining IIT’s initially, work hard to secure admission, but then lose motivation owing to a lack of relevance in the actual syllabus.
- Third, lack of High-quality jobs. In India, only a few jobs exist after higher education. The Majority of jobs require lower skills and pay poorly. In such a system the Lower-ranked colleges don’t find any motivation to improve themselves.
- Fourth, prioritising top colleges and neglect of Low ranked colleges. For example, top colleges in India enjoy much state-sponsored support. They attract the best faculty and students. This makes it further difficult for low ranked colleges to make any improvement.
What needs to be done?
For the mediocre college to improve, its students must first see value in a better education. It requires system-wide growth in opportunity. To achieve this the relevant stakeholders must do the following;
- First, policymakers, they need to promote employment led -growth oriented policies to create enough jobs for 650 million Indian youths under age 25.
- Second, industry, they should focus on developing indigenous technologies. It will help in improving our Higher Education standards.
- Third, teachers, standard of teaching will improve standards of the institutions and create more competitive students.
- Fourth, Students, they need to demand for better education. Only then institutions will respond to their needs.
- Finally, students will demand better education only when the quality education is valued by society. And vice versa, it will be valued by society only when the imparted quality education is applied towards the benefits of the society.
We must teach students not only our subjects, but also how to think about both existing applications and future ones. Students must aim to relate their learning to society.
Source: Indian Express
Cabinet approves “Pradhan Mantri Swasthya Suraksha Nidhi | PMSSN”
What is the News?
The Union Cabinet approves the Pradhan Mantri Swasthya Suraksha Nidhi (PMSSN).
About Pradhan Mantri Swasthya Suraksha Nidhi(PMSSN):
This program will ensure access to universal & affordable health care through a fund that does not lapse at the end of the financial year.
Features:
- It has been set up as a single non-lapsable reserve fund for a share of Health.
- It will be made from the share of health in the proceeds of Health and Education Cess.
- The fund will be administered and maintained by the Ministry of Health & Family Welfare
Note: Finance Minister announced the 4% Health and Education Cess during the Budget 2018-19. It replaced the existing 3% Education Cess.
How will the fund be utilised? The fund will be utilized for the following flagship schemes of the Ministry of Health & Family Welfare:
- Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
- Ayushman Bharat – Health and Wellness Centres (AB-HWCs)
- National Health Mission
- Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
- Emergency & disaster preparedness and responses during health emergencies
- Any future programme/scheme that targets to achieve progress towards SDGs and the targets set out in the National Health Policy (NHP) 2017.
Source: PIB
Tap Water Shortage in Schools despite “100-day special campaign”
What is the News?
The Parliamentary Standing Committee on Water Resources provided information that only half of the government schools and anganwadis have a tap water supply. It is despite a 100-day special campaign by the Ministry of Jal Shakti.
Centre’s 100-day Special Campaign:
- Launched by: On 2nd October 2020, the Ministry of Jal Shakti had launched the 100-day Special Campaign.
- Aim: It aims to provide a 100% potable piped water supply for drinking and cooking purposes. And tap water for washing hands and in toilets in every school, Anganwadi and ashram shala, or residential tribal school.
- Why was the campaign launched? The campaign was launched as children are more susceptible to water-borne diseases. Moreover, there is also a need for repeated washing of hands as a precautionary measure during the pandemic.
- Duration: The campaign was to end on January 10, 2021. However, it has been extended till March 31, 2021, as some States/ UTs have asked for more time to complete the task.
What has been achieved so far?
- Seven States — Andhra Pradesh, Goa, Haryana, Himachal Pradesh, Tamil Nadu, Telangana, and Punjab have achieved 100% coverage.
- Around 1.82 lakh greywater management structures and 1.42 lakh rainwater harvesting structures were also constructed in schools and Anganwadi centres.
What more needs to be done?
- Tap water supply in schools and Anganwadis: Only half of the government schools(53.3%) and Anganwadi’s(48.5%) have a tap water supply.
- Tap Water Supply in States: Tap water supply is only available in less than 8% of schools in Uttar Pradesh, 11% in West Bengal, and 2-6% of Anganwadi’s in Assam, Jharkhand, Uttar Pradesh, Chhattisgarh, and Bengal.
Source: The Hindu
NEP 2020 and language policy
Synopsis- Since colonial times, efforts to introduce education policy based on mother tongue have failed. The NEP 2020 also fails to uphold a multilingual educational approach.
Introduction
- Since colonial times, all committees and commissions recognized the importance of education in the mother tongue. Its proponents include Elphinstone’s Minute of 1824, Macaulay’s Minute of 1835, and Wood’s Dispatch of 1854.
- However, they laid the foundation of India’s education system in the English language.
- UNESCO declared in 1953 to use mother tongue for the conceptual clarity and cognitive growth of students
- Even NEP 1986, plan of action 1992, NCF 2005, RTE 2009 also highlighted the importance of mother tongue in education. However, they did nothing to fill the quality gap between English-medium schools and non-English medium schools.
- Now, NEP 2020 also recommends the medium of instruction to be in the home language/mother-tongue/local language or regional language in primary classes. But again words such as “preferably” or “wherever possible” are used, making implementation uncertain.
NEP 2020 sticks to the ‘three-language formula’ while emphasizing that no language would be imposed on anyone.
What is the issue with NEP 2020 on the language front?–
- Multiplicity of languages and dialects in India – Students are better able to learn to read and write in the language that they are most familiar with. However, in a multilingual country like India, it comes across as a challenge with different states, regional and national languages.
- Just 47 of the 270 mother tongues identified in the 2011 Census used as mediums of instruction in schools.
- NEP 2020 speaks a lot about multilingualism. But it fails to recognize that children arrive in school not with “a language” but with a complex verbal repertoire.
- The NEP 2020 three-language formula is theoretically unsound and has had a disastrous history. NEP, 2020 fails to understand that people only learn another language to integrate with others or when it is an instrument of benefit.
- For example, people from South India learn Hindi for jobs and increments. People in North India learn Sanskrit because it ensures high marks without much work.
What needs to be done?
- The Government needs to ensure that every child’s voice is heard in the classroom according to the child’s own understanding.
- The Government needs to initiate an MLE model and identify the problems in implementation and the cost of change of the model. After then prepare an action plan which resolves all of such problems.
Ranking of Indian Universities in “QS World University Rankings 2021”
What is the News?
The QS World University Rankings 2021 released.
About QS World University Rankings 2021
- Released by: Global higher education consultancy Quacquarelli Symonds releases annually.
- Parameters: It calculates the performance of the universities based on the following four parameters:
- Academic reputation
- Employer reputation
- Research impact (citations per paper)
- Productivity of an institution’s research faculty
- Subjects Covered: It covers a total of 51 disciplines grouped into five broad subject areas: 1) Arts & Humanities 2) Engineering and Technology 3) Life Sciences & Medicine 4) Natural Sciences and 5) Social Sciences & Management.
Key Findings Related to India:
- Twelve Indian universities and higher education institutions have achieved top-100 positions in their subject. In total, 25 Indian programs have achieved top-100 positions – two fewer than in 2020.
- The top-ranked Indian programme globally is the IIT Madras petroleum engineering program. It is followed by mineral and mining engineering at Bombay and Kharagpur IITs.
- Engineering and Technology: Only three institutions made it to the top 100 in this category — the Bombay, Delhi, and Madras IITs. In 2020, 5 institutions were ranked in the top 100.
- Social Sciences and management: the University of Delhi is the highest-ranked Indian institution in this category. But it fell 48 places at 208.
- Life Sciences and Medicine: All India Institute of Medical Sciences remained the only institution in the top 300 in this category.
- Natural Sciences: Indian Institute of Science(IISc) has entered into the top 100 in this category.
- Arts & Humanities: Jawaharlal Nehru University(JNU) anthropology program has been ranked 159th in this category.
- Private Institute: OP Jindal Global University is the only Indian private institution in the top 100 list. It entered into the top 100 law schools of the world with a rank of 76.
Source: The Hindu
NEP 2020 and children’s right to playgrounds
Synopsis: NEP 2020 (National Education Policy) has disregarded the children’s right to playgrounds in the name of efficiency.
Background
- The Right of Children to Free and Compulsory Education Act, 2009 (RTE) guarantees essential infrastructure including playgrounds to all school-going children between the ages of 6 and 14.
- However, the New NEP 2020 is going against the RTE requirements of providing mandatory infrastructural facilities.
- This requirement is introduced with the intention to increase efficiency and optimization. It may also lead to an increase in total schools and decrease school fees.
- However, it will deprive children’s access to playgrounds. It is also a denial of their right to play in safe and adequate spaces.
What are the changes brought by NEP 2020 with respect to playground provisions?
- First, the NEP directs a review of the “practicalities of playgrounds in urban areas”, school-area, and room-size requirements. It aims to “ease” school operation by removing RTE playground requirements.
- Second, the NEP proposes that by 2025, state governments create school complexes. The school complex would be comprised of a mix of schools and anganwadis in a 5-10 kilometre radius. Schools will be encouraged to use shared resources such as playgrounds.
What are the issues?
- First, according to NEP 2020, neither the government nor private schools need to provide playgrounds. After that, private schools may charge exorbitant fees without providing playgrounds.
- Second, one school complex comprises a 5–10 KM radius, sharing playgrounds among large no. of schools and children of different ages will be difficult. Because Children of different ages have different playground needs. For instance, Anganwadi learners have different spatial needs than middle school students.
- Third, this is against the court’s directive. In 2019, the Allahabad High Court ruled that playgrounds must be provided within a school’s land area to ensure access for all children, including children with disabilities.
- Fourth, there is a growing scarcity of playgrounds due to intensive urbanization. Children’s playgrounds have increasingly been appropriated by governments and private parties for development.
- For instance, in 2019, Gujarat amended its RTE rules to reduce the minimum playground area requirements for urban and rural schools.
- Fifth, NEP provisions are contradictory in nature. Despite removing playground requirements, the NEP advocates sports-integrated education. It fails to explain how sports may be integrated without playgrounds.
- Sixth, it is against the 1989 UN Convention on the Rights of the Child. The Convention recognizes play as an indispensable right of the child as it allows for the free and true expression of one’s personality.
- Seventh, Sports is also a minuscule sub-category of the infinite varieties of children’s play. It can accommodate only a few children based on “abilities”.
- Even if specific forms of sports infrastructure are provided in well-resourced schools, these cannot substitute for large, open playgrounds.
The NEP 2020 provision will bring down the minimum standards of quality education, instead of protecting and expanding it. This is also seen as a move to prioritize neoliberal interests that prioritize market demands over societal good.
3rd Phase of “Technical Education Quality Improvement Programme(TEQIP)”
What is the News?
The third phase of the Technical Education Quality Improvement Programme (TEQIP) is coming to an end in March 2021.
About TEQIP project:
- It was launched in 2002 by the Ministry of Education. World Banks is assisting in its implementation.
- Aim: The TEQIP project aims to upscale the quality of technical education and enhance the capacities of technical institutions.
Phases under the TEQIP project:
Phase I:
- TEQIP project was first launched in 2003. It was implemented in 13 States and covered 127 Institutions including 18 Centrally Funded Institutions.
- It focussed on
- Promotion of Academic Excellence
- Networking of Institutions for quality enhancement and resource sharing
- Enhancing quality and reach of services to Community and Economy.
Phase II:
- Phase II of the TEQIP project was launched in 2010. The coverage was widened to cover 23 States/Union Territories (UTs) and 191 Institutes.
- It focussed on
- Scaling up Post – Graduate education and demand-driven Research and Development innovation
- Establishing Centres of Excellence for focussed applicable research
- Training of faculty for effective teaching.
Phase III:
- It was started in 2017 and will be completed by 2021. It focussed on improving quality and equity in engineering institutions in seven low income, eight northeastern and three hilly States.
- Under this phase, graduates from elite institutions such as NIT and IIT were recruited to teach in some of the poorest and most remote areas. They were paid salaries in accordance with the Seventh Pay Commission.
What is the next step?
- The Central Government is planning to replace the TEQIP project with a new programme called MERITE Project.
- The MERITE project will have similar objectives to improve technical education.
- However, the MERITE Project is still in the conceptual stage and has not yet received Cabinet approval.
Neither States nor Centre is willing to commit continued funding of the TEQIP project. This may leave 1,200 assistant professors out of the job. Apart from that, it would also impact the rural colleges as they would be deprived of the faculty.
Source: The Hindu
NEP’s Approach to Effective Education for Children
Synopsis: The end-of-the-year examination results do not reflect the full potential or uniqueness of a child. Thus, NEP attempts to look beyond examinations and emphasizes child-centred pedagogy.
Introduction
Gijubhai Badheka, an educationist who helped introduce Montessori methods to India, wrote in his book that the school culture in India considers several things of children’s interest. It ranges from insects to stars which is irrelevant to classroom study.
- Teachers teach students from the textbook to prepare them for examination instead of developing the child’s curiosity. The school does not provide conditions in which the teacher could focus on the overall development of children.
- Examinations should not be the final goal of a rewarding learning experience as it only rewards the power of memorisation.
- Exams are one of the multiple milestones to be crossed by a child on her path to holistic growth and development.
What does the new education policy focus on instead of examinations?
The National Education Policy, 2020, uses two interesting phrases: “No hard separations” and “elimination of silos” in the context of learning.
- First, India is now working on implementing the policy. It is important to have an understanding of these phrases and their implications.
- For example, NEP 2020 requires the achievement of common standards for high-quality education in all schools. It means removing differences between public and private schools through the setting up of a State Standard-Setting Authority (SSSA). It requires a variety of learning from pre-school to higher education.
- Second, the removal of hard separations would include removing the barrier of language. For that, the mother tongue/language spoken by the child shall be the medium to understand the subjects, especially in the foundational years.
- Third, teaching and schooling should be activity-based and experiential. It helps in cognitive growth through story-telling, art, and craft, sports, and theatre.
- Fourth, classrooms need to discard the typical seating plan. At present all the children sit, facing the board. A flexible seating plan which has students sitting in a circle or in groups shall be introduced.
- Fifth, schools will need to embrace a variety of teaching and learning materials. For that, methods such as toys, puppets, magazines, worksheets, comic and storybooks, nature walks, visits to local crafts, etc. are useful.
- Last, assessment should only be viewed as a means of learning. The NEP would help in including more in depth knowledge with fewer curriculums, less content but more proficiency, less textbooks but more diverse learning, less stress but more joy, less assessment by the teacher but more self and peer evaluation.
The way forward
- A lot of research shows that a supportive environment is one in which a child is constantly learning to collaborate, think critically, solve problems, be creative and articulate.
- NEP 2020 wants to break the belief that taking exams on the basis of what is written in textbooks is sufficient. Examination results do not reflect the full potential or uniqueness of a child.
Education ministry circular on online conferences
Synopsis: Ministry of education’s circular for regulating online conferences is not well thought out. It will discourage innovation.
What was the circular about an online conference?
- Recently, education ministry released a circular to the state-funded universities and educational institutions. A per this circular, these institutions and universities need prior official approval from external Affairs ministry for hosting online “international conferences and seminars online”.
- It also prohibits the conference topics relate to security of the state, border, the northeast, Jammu and Kashmir, Ladakh, and broadly, any “internal matters”. Not only topics, but a background check of participants will be required.
- Event organisers were required to give preference to technological tools and channels not owned or controlled by hostile countries or agencies.
- The circular was issued in consultation with the External Affairs Ministry. Indian Academy of Sciences protested this circular and triggered a rethink on it.
Importance of virtual or online conference
- Firstly, in a pandemic-hit phase virtual conferences are the only viable channel for researchers to collaborate and discuss various issues with their global peers. The circular created a new bureaucratic hurdle for scientists in public universities, colleges and organisations.
- Secondly, Online conferences were instrumental in increased participation of thousands of Scientists. It increased attendance at events by 80% in 2020 over 2019 for the Plant Biology Worldwide Summit and over 300% for the American Physical Society meeting.
- Third, Virtual conferences clear out many hurdles like visas, expensive travel, and physical disability and so on, for the scientists who don’t have resources for that. Even researchers and students in the smallest towns can attend these conferences.
- Fourth, India has also made progresses in peer-reviewed publications due to these collaborations. It reduces the concerns of bio piracy by documenting natural assets.
Thus, online conferences proved to be very beneficial for the research and technology in India. Government should adopt more liberal approach towards it.
World bank Released “Education Finance Watch(EFW) Report” 2021
What is the News?
The World Bank and UNESCO released the Education Finance Watch Report (EFW), 2021.
About the Education Finance Watch Report:
- The report is a collaborative effort between the World Bank and UNESCO’s Global Education Monitoring (GEM) Report.
- It summarizes the available information on patterns and trends in education financing around the world.
Key Findings of the Education Finance Watch Report:
- Global spending on education has increased continuously in absolute terms over the last 10 years. However, the pandemic may interrupt this upward trend.
- Education Budgets: 2/3rd of low and middle-income countries reduced their education budgets since the start of the Covid-19 pandemic. In comparison, only a third of upper-middle and high-income countries have reduced their budgets.
- Spending on Child’s Education: Before the COVID-19 pandemic, high-income countries were spending annually the equivalent of $8,501 for every child’s education. It was $48 in low-income countries. The pandemic has further widened this spending gap.
- Access to education has improved in low and middle-income countries. However, the learning poverty rate (the proportion of 10-year-olds unable to read a short, age-appropriate text) was at around 53%. It was only 9% for high-income countries. This has increased further to 63% after COVID-19-related school closures.
Global Education Monitoring Report(GEM Report):
- Published by: It is an annual report published by UNESCO. The report was formerly known as the Education for All Global Monitoring Report.
- Mandate: The report aims to monitor progress towards Sustainable Development Goal 4 (SDG 4) on education. It also targets education-related goals in the SDG agenda.
Source: Down To Earth
“IIT Council” sets up panels for more autonomy
What is the News?
The Union Education Minister has chaired the 54th meeting of the IIT Council. The council discussed the implementation of the New Education Policy (NEP) 2020.
About IIT Council:
- Headed by: The IIT Council is headed by the Union Education Minister. It also includes the directors of all IITs and the chairman of each IIT’s Board of Governors.
- Purpose: IIT Council advises on admission standards, duration of courses, degrees, and other academic distinctions. It also lays down policy regarding cadre, methods of recruitment, and conditions of service of employees.
Key Recommendations by IIT Council:
It has set up 4 committees to look into the issue of greater autonomy for the IITs, as recommended by NEP, 2020. Moreover, these committees will look into the issues like reform of the academic Senate, grooming faculty to head the IITs, and innovative funding mechanisms.
- Reducing staff strength: It has recommended a reduction in staff strength of IITs, especially non-teaching manpower. It is due to the increasing digitization and outsourcing.
- Currently, IITs have one faculty member for every 10 students. Whereas, for every 10 faculty, there are 11 staff members.
- IIT R&D Fair: The council has suggested arranging an Online IIT Research and Development (R&D) fair. It will showcase the quality research work of IITs to the industry.
- Mobility of Faculty: The IITs should develop an Institute Development Plan to improve the mobility of faculty between institution and industry.
- One IIT – One Thrust Area approach: IITs were urged to adopt ‘One IIT – One Thrust Area’ approach based on local needs.
Source: The Hindu
Impacts of School Closures and way forward
Synopsis: Policies to ensure education during COVID-led school closures has increased the disparities. Disparities need to be rectified by suitable policy measures to deliver universal education to all.
Background
- Lockdown measures to contain COVID spread has forced the government to resort to school closures.
- The governments tried to address the situation by giving a push to the digital distance learning method.
- However, studies indicate that the initiative failed to take into account existing divides such as spatial, digital, gender and class.
- The digital learning methods widened the digital divide between the rich and the poor and the urban and rural areas.
What were the steps taken by the government?
- The government used various means such as text/video/audio content through SMS, WhatsApp, radio and TV programmes to reach out to students and engage them.
- Further, the Union Ministry of Human Resource Development in March 2020 started sharing the following free e-learning platforms.
1.Diksha portal: It contains e-learning content aligned to the curriculum |
2. e-Pathshala: It is an app by the National Council of Educational Research and Training for Classes 1 to 12 in multiple languages |
3. SWAYAM: it consists of 1,900 complete courses including teaching videos, computer weekly assignments, examinations and credit transfers, aimed both at school (Classes 1 to 12) and higher education. |
4. SWAYAM Prabha: it is a group of 32 direct to home channels devoted to the telecasting of educational programmes |
What are the issues concerning the use of the digital distance learning method?
The attempts at initiating a rapid transition to digital learning following the pandemic have many lessons,
- First, according to a recent UNICEF report, the massive school closures exposed the uneven distribution of technology required for remote learning. It reduced the chances of social and economic mobility through education.
- Second, it also disrupted the significant school programmes that resulted in high enrolment as well as regular attendance. (The mid-day meal scheme, the school health Programme and pre-metric scholarships to girl children).
- Third, the abilities of the families and communities to support their children’s education reduced. For example, A survey promoted by the Centre for Budget and Policy Studies found that in families which faced cash and food shortages, only 50% of the boys and girls were confident of returning to school.
- Fourth, students with lesser access to digital connectivity forced them to share the burden of household chores. Also, their educational routine disrupted. In many cases, students don’t remember what they learnt earlier.
- Fifth, apart from the above issues the education sector faces many challenges. Such as delivery of pedagogical processes, classroom assessment frameworks, students’ support and teacher-student engagement.
Case study of Rajasthan:
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What needs to be done?
- First, Education planning should be made context-specific, gender-responsive and inclusive.
- Second, the government should take enabling measures even when schools are closed. Such as;
- providing access to online education,
- removal of barriers in pre-matric scholarships and
- ensuring the provision of mid-day meals, iron and folic acid tablets and
- provision of personal hygiene products to girl students
- Third, currently, there are around 300 million children reported to be out of school in India across all age groups. This number can increase once schools are reopened.
- Hence, the authorities should establish the re-enrolment of children as mandated by the National Education Policy 2020. Mass outreach programmes should be developed with civil society to encourage re-enrollment.
- Fourth, to retain the poorest at schools’ remedial tuitions and counselling along with scholarships, targeted cash transfers and other entitlements are advisable.
- Fifth, we can also think about making secondary education for girls free.
- Finally, to implement all these measures we need to support the education sector with adequate budgetary resources. Hence, it is important to increase the share of education to 6% of GDP, as emphasized by the President of India.
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Overexpansion of IITs will reduce its standards
Synopsis: The recent decision by UGC to allow IITs to open branches abroad will jeopardize the Institution’s brand. This overexpansion of IITs will reduce their quality.
Background
- The Indian Institutes of Technology (IITs) are India’s premier institutes with world-class quality standards. They are among few Indian higher education institutions that perform well in the global rankings.
- However, in the last decade, the IIT institutes have expanded beyond their capacity. This accelerated expansion is likely to affect its quality standards. For example, Currently, there are 23 IITs compared to 5 IIT’s in the early 1960s.
- Moroever, recently, the University Grants Commission permitted select IITs under the ‘Institutions of Eminence’ category to set up campuses abroad. This decision could further weaken the quality standards of IITs.
- So, we need to rethink the changing role and mandate of IITs in order to ensure that quality and focus are maintained.
How the expansion of IITs is affecting the quality standards of the premier institutions?
- In recent years, the government expanded the number of IITs throughout the country. This has the following consequences.
- Most of the new IITs are located in smaller towns. Mandi (Himachal Pradesh), Palakkad (Kerala), Dharwad (Karnataka), and others.
- It will be difficult for IITs in small locations to attract top-quality faculty and staff. For example, IIT Dhanbad is approved to hire 781 instructors, but only 301 positions were filled as of January 2021.
- Also, it will be difficult to provide world-class facilities and infrastructure for IITs that are located in smaller towns.
- Thus, inevitably it will lead to quality decline and the dilution of “IIT brand”.
What are the other issues hampering the growth of IIT’s?
- First, IIT’s are unable to attract a sufficient number of young faculty to fill vacancies resulting from retirements.
- Because the salaries offered by IIT’s are relatively less compared to the salaries offered by the industries.
- Also, bright minds are getting attracted to universities and industries in other countries.
- Second, exclusive focus on technology and engineering and very less importance given to the humanities and social sciences.
- Recently, the 2020 National Education Policy emphasized that the IITs should focus more on “holistic and multidisciplinary education”.
- Third, lack of correlation between the local needs and IITs. Only a few State governments are effectively utilizing the presence of IITs for community outreach programmes through knowledge-sharing networks.
- An effective approach for local area development through IITs could have prevented the resistance of local groups for setting up new IIT in their region. For example, Goa.
What needs to be done?
- First, rather than creating new IIT’s we need to prioritise limited “IIT system”. It should be funded at “world-class” levels and staffed by “world class” faculty. Only, 10 to 12 “real” IITs located near major cities are practical for India.
- Whereas, the newly established institutes can be renamed. After that, they can be provided with sufficient resources to produce high-quality graduates and good research.
- The recent decision to liberalise the recruitment rules to attract more foreign faculty is a good step in the right direction.
- Second, IITs need to pay attention to internationalization by collaborating with the best global universities and hiring foreign faculty. Rather than starting overseas branches we need robust policies to attract international students.
- This move will produce excellent results and build the IIT’s international brand. For instance, IIT Bombay-Monash Research Academy and University of Queensland-IIT Delhi Academy of Research (UQIDAR), are promising examples.
- Third, adequate and sustained funding is mandatory from both the government and the philanthropy to ensure high-quality standards.
Data on participation of marginalised Communities in leading IITs
What is the News?
The Hindu Newspaper has published the data obtained through the RTI queries. Data provides info. on the representation of marginalized communities such as OBCs, SCs, and STs in the leading IITs of the country.
About the data:
- The RTI query data covers Ph.D. admissions made in the five-year period from 2015 to 2019. IITs covered are of Madras, Bombay, Delhi, Kanpur, and Kharagpur.
Key Findings of the data:
- Selection of SCs and STs in PHDs: Scheduled Caste and Scheduled Tribe applicants are half as likely to get selected for a Ph.D. program at leading IITs in the country as aspirants from the General Category (GC) are.
- Acceptance Rate: The acceptance rate refers to the number of students selected for every 100 students who applied. The acceptance rate stood at 4% for students from General Category. It falls to 2.7% for OBC students and further down to just 2.16% for SCs and 2.2% for STs.
Data given by Government in Parliament:
According to the Ministry of Education’s data submitted to Parliament last year:
The following data is based on the total admissions made by all IITs from 2015 to 2019:
- Only 2.1% went to STs and 9.1% to SCs. The government’s reservation policy mandates the allocation of 7.5% seats for students from the STs and 15% from SCs.
- Similarly, 23.2% of seats went to applicants from the OBCs against the 27% mandated by reservation.
- The remaining 65.6% or roughly two-thirds of all the seats went to General Category(GC) applicants.
Source: The Hindu
2nd Phase of the “Vigyan Jyoti Programme”
What is the News?
The second phase of Vigyan Jyoti programme commenced on the occasion of International Day of Women and Girls in Science on February 11, 2021.
Vigyan Jyoti Programme:
- It was launched by the Department of Science & Technology (DST) in December 2019.
- Aim: It aims to create a level-playing field for the meritorious girls in high school. It will encourage them to pursue Science, Technology, Engineering, and Mathematics(STEM) in their higher education and make them self-reliant.
- Classes Covered: This programme started at school level for meritorious girls of Class IX to Class XII.
- Coverage: The programme had been running successfully in 50 Jawahar Navodaya Vidyalayas(JNV) since 2019. It is now expanded to 50 more JNVs for the year 2021-22.
- Activities under the programme: The activities under the programme include student-parent counselling, visit to labs and knowledge centres, partners role model interactions, science camps, academic support classes, resource material distribution and tinkering activities.
- It also provides online academic support to students. It includes streaming of video classes, study materials, daily practice problems and doubt clearing sessions.
- Second Phase: The second phase of the Vigyan Jyoti aims to spread the program to 50 more districts. It will be in addition to the existing 50 districts across the country.
Other Initiatives by DST to Promote Gender Parity in STEM:
- Women Scientists Scheme: This initiative primarily aims at providing opportunities to women scientists and technologists who had a break in their career but desired to return to the mainstream. It covers women between the age group of 27-57 years.
- Consolidation of University Research for Innovation and Excellence in Women Universities(CURIE) programme: It aims for improving R&D infrastructure and establishing state-of-the-art research facilities in order to create excellence in S&T in women universities.
- Artificial Intelligence(AI) Labs: Government has established AI labs in women’s universities with the goal to foster AI innovations. It will prepare skilled manpower for AI-based jobs in the future.
- Gender Advancement for Transforming Institutions(GATI): It aims to develop a comprehensive charter and a framework for assessing gender inequality in STEM.
- Knowledge Involvement in Research Advancement through Nurturing(KIRAN): It aims to bring gender parity in the Science & Technology sector by inducting more women talent in the research & development domain through various programmes.
Source: PIB
“Foundational Abilities” of children lost due to closure of schools
What is the News?
Azim Premji University(APU) has released a study titled “loss of learning during COVID Pandemic”.
About the study:
- Focus: The study looked at the impacts of the closure of schools during COVID, on the students. It especially focussed on the students from lower classes.
- Coverage: The study was conducted on primary school children between Classes II and VI in the Government schools. It was done across five States, i.e. Chattisgarh, Karnataka, Madhya Pradesh, Rajasthan, and Uttarakhand.
Key Findings:
- Children not only missed out on the curricular learning of regular schools but are also ‘forgetting’ what they had learned in previous years.
- On average, 92% of students from Classes II to VI have lost at least one specific foundational ability in languages that they may have acquired in previous years. The corresponding figure for mathematics is 82%.
What are Foundational Abilities?
- Foundational abilities are those that form the basis for further learning. Some examples of foundational abilities include reading a paragraph with comprehension, addition, and subtraction.
- According to researchers, a grasp of foundational abilities forms the basis of a student’s further learning in all subjects.
Source: The Hindu
Finance Minister allocates funds for “National Research Foundation”
What is the News?
The Finance Minister allocated funds for the creation of a National Research Foundation(NRF).
About National Research Foundation(NRF)
- The NRF found mention in the 2019 Budget speech first. New Education Policy(NEP),2020 also proposed its formation.
- The foundation would be an autonomous body. It will fund researches across four major disciplines –Sciences; Technology; Social Sciences; and Arts and Humanities.
- Moreover, It will develop and build research capacity at universities and colleges through a formal mechanism of mentoring. Experts researchers from premier institutions of the country will assist in that.
- Thus, It will also catalyze research at universities and colleges that have until now not been big players in research.
- The funding would be cross-disciplinary. The foundation will ensure that research already being funded by Science Ministries for instance — wouldn’t be duplicated.
Source: The Hindu
Agreement for Financial Support to “STARS Project”
What is the News?
Department of Economic Affairs(DEA) and World Bank signed an agreement for the financial support on the Strengthening Teaching-Learning And Results for States(STARS) project.
STARS project:
- The project would be implemented as a new Centrally Sponsored Scheme.
- Aim: To improve the overall monitoring and measurement activities in the Indian school education system through interventions in selected states.
- Coverage: The project covers 6 States: Himachal Pradesh, Rajasthan, Maharashtra, Madhya Pradesh, Kerala, and Odisha.
- Implementation:
- At National level, Department of School Education and Literacy (DoSEL), Ministry of Education(MOE) will be the main implementing agency.
- At the State level, the project will be implemented through the integrated State Implementation Society(SIS) for Samagra Shiksha.
- World Bank Funding: The World Bank’s support is primarily in the form of a results-based financing instrument called Program for Results(PforR). This will ensure major reforms at the State level through a set of disbursement-linked indicators(DLIs).
- A State Incentive Grant(SIG) will also be used to encourage States to meet desired project outcomes.
- Verification: An independent Verification agency(IVA) will verify each result before disbursement of funds.
- Impact: The STARS project will be instrumental in the implementation of various recommendations of National Education Policy 2020 namely:
- Strengthening Early Childhood Education and Foundational Learning
- Improving Learning Assessment System
- ICT-enabled approaches in education,
- Teachers Development and Vocational education etc.
Source: PIB
Challenges in internationalisation of higher education
Synopsis: NEP, 2020 has an objective to attract International branch campuses (IBCs) of top Universities in India. But there are several challenges associated with it.
Background
- Recently, National Education Policy-2020 (NEP-2020) was introduced in India. NEP-2020, for the first time, has highlighted internationalisation of higher education as an objective.
- To achieve this, NEP-2020 allows the top 100 World-Class Universities to open international branch campuses (IBCs) in India.
- The reason behind this is to raise the standard of research and teaching to international levels and reduce the out-bound mobility of Indian students.
In this article. we will discuss the challenges that needs to be addressed at the implementational level before allowing International branch campuses (IBCs) in India.
How IBCs will help to increase the inflow of foreign students?
- In April 2018, India launched Study in India Programme with generous scholarships to increasing the inflow of foreign students. However, it did not succeed in attracting foreign students on a large scale.
- It is expected that, the establishment of IBCs in India will increase in-bound mobility of students and scholars.
- The international standards maintained by the IBCs will attract international students to explore and experience Indian education and culture.
What are the challenges that need to be addressed?
Top universities are willing to open international branch campuses (IBCs) in India. But they need clarity in areas essential for operationalisation of branch campuses in India.
First, such universities are not driven by state sponsored infrastructures. For example, the Dubai Knowledge Hub, that offered ready to move in campus, office space. IBCs wants to accumulate profits like any other business enterprise and repatriate income to their home.
Second, which subjects and areas of research to be allowed for IBCs is an area of concern. Most of the time Humanities and Social sciences are not considered due to low profits in them.
Fourth, IBCs demands for more autonomy in curriculum design, daily functioning of the institution etc. Thus, they might take decisions against the local requirement if they feel it is not profitable.
Fifth, IBCs will also expect to be treated on par with Indian institutions in matters of government funding and scholarships.
National Education Policy (NEP) 2020: Implementation Plan for School Education
News: Union Minister of Education has released details of the implementation plan of National Education Policy 2020.
Facts:
- National Education Policy 2020: It is the third in the series of National Education Policies (1968 and 1986 modified in 1992) in India and is the first education policy of the 21st century. NEP 2020 covers major reforms in wider spectrum of school education from pre-primary to senior secondary.
Implementation Plan for School Education:
- ShikshakParv was organised for discussing recommendations of NEP 2020 and its implementation strategies.
- Major portions of NEP will be covered under the new National Curriculum Framework(NCF) and centrally sponsored schemes. Groundwork for NCF is initiated and it is likely to be developed in the next academic session, that is 2021-22.
- Approval has been given for setting up the National Mission on Foundational Literacy and Numeracy Mission. A Committee has been formed for preparing a framework on FL&N, codification of learning outcomes, etc.
- E-learning has been expanded through DIKSHA.DIKSHA provides access to a large number of curriculum-linked e-content through several solutions such as QR coded Energized Textbooks(ETBs), courses for teachers, quizzes etc.
- Government has launched an initiative called ‘Manodarpan’ for mental health and wellbeing of students.It aims to provide emotional support and counselling to the students under distress.
- Learning Outcomes upto Secondary level have been notified and draft of learning outcomes for senior secondary level have been released for inviting suggestions.
- The department is also aligning its existing schemes i.e, Samagra Shiksha, Mid Day Meal and Padhna Likhna Abhiyan with the recommendations of NEP 2020.
ISRO to adopt 100 Atal Tinkering Labs for promoting Space Education
News: Atal Innovation Mission, NITI Aayog and Indian Space Research Organization (ISRO) has announced that ISRO will be adopting 100 Atal Tinkering Labs across the country to promote education in the field of STEM, Space education and space technology related Innovations for school students.
Facts:
- Atal Tinkering Labs: It is an initiative by the Atal Innovation Mission, Niti Aayog with the aim of establishing Atal Tinkering Laboratories(ATLs) in schools across India.
- Objective: To foster curiosity, creativity and imagination in young minds; and inculcate skills such as design mindset, computational thinking, adaptive learning, physical computing etc.
- Key Features of ATL:
- ATL is a work space where young minds can give shape to their ideas through hands on do-it-yourself mode and learn innovation skills.
- Young children will get a chance to work with tools and equipment to understand the concepts of STEM (Science, Technology, Engineering and Math).
- ATL would contain educational and learning ‘do it yourself’ kits and equipment on – science, electronics, robotics, open source microcontroller boards, sensors and 3D printers and computers.
- ATL can conduct different activities ranging from regional and national level competitions, exhibitions, workshops on problem solving, designing and fabrication of products, lecture series etc. at periodic intervals.
- Financial Support: AIM will provide grant-in-aid of Rs. 20 Lakh to each school that includes a one-time establishment cost of Rs. 10 lakh and operational expenses of Rs. 10 lakh for a maximum period of 5 years to each ATL.
- Eligibility: Schools (minimum Grade VI – X) managed by Government, local body or private trusts/society to set up ATL.
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Re–imagining the school education in India
Synopsis: We need to reimagine our school education system to ensure quality education for all and to make India a knowledgeable super power.
Background:
- Currently, the school as an institution has been criticised by many experts for turning into caged jails, for being run like factories, functioning like corporate enterprises and for forcing the curriculum into the child.
- In this backdrop, we will evaluate how the school system has been envisaged by great personalities, what are the drawbacks in our present schooling system and how we need to improve it to make school education inclusive, knowledgeable and as an institution for self-discovery.
How the school system has been envisaged by great personalities?
Progressive thinkers have always envisioned “free schools” for children. They always believed that school should be made to fit the child rather than the other way round. For example,
- Leo Tolstoy (Russian Novelist) himself founded a school for the children of poor peasants at his home (Yasnaya Polyana) without any strict schedule, homework or physical punishment.
- Maria Montessori (The first Italian woman to become a doctor) educational philosophy too emphasised on children’s freedom and choice.
- Rabindranath Tagore in his classical tale The Parrot’s Training (Totaakahini) has vehemently criticised the rote learning method followed in the Indian school system.
What are the issues with government schools in India?
Government schools in India faces the following challenges,
- Firstly, the poor Infrastructure in government schools leading to instances such as roof collapse.
- Second, lack of effective governance and monitoring. For example, Children’s falling sick after consuming mid-day meals.
- Third, there is a deep segregation of school systems in India, ignoring the 1966 Kothari Education Commission’s recommendation for a common school system.
- Fourth, existing inequality among children’s due to widening digital divide, the poor do not have access to mobiles, laptops and internet connectivity.
- Fifth, lack of political will to strengthen the government schools in India which can be understood from the point that government is pushing towards privatisation by handing over land and managements to private organisations.
What needs to be done?
We need to improve on the following areas to provide a healthy education to our younger generation.
- Firstly, we need to improve the schooling infrastructure by providing Clean toilets, drinking water, library, a tinkering lab, and a playground.
- Second, we need to think on having classes with mixed age groups instead of segregating children by age. This will allow children to learn at their own pace and make learning a fun activity. For example, David Horsburgh’s Neel Bagh School in Kolar, Karnataka, Here, Children’s could study Class V Telugu, Class III English and Class VII math all at the same time.
- Third, we need to identify the champions from within the government system and use them as effective resource people. This will surely motivate many teachers to perform better and achieve excellence.
- Fourth, government needs to cooperates with best NGO’s like PRATHAM to bring in best practices from all over the country.
- Fifth, we need to envision a plan to bring tens of thousands of retired professionals as teachers as they will bring years of practical experience to learning.
- Sixth, as we reimagine the school system, we must strive to bring more neighbourhood learning spaces as places for community learning. This can be done by utilising community halls in large housing societies and by creating an “activities centre” in each housing society.
- Seventh, we need to build a free archive for Indian languages such as archive.org where nearly 1.5 million people log in every day. The recent announcement by the government that it will buy bulk subscriptions of scientific journals to make them accessible for all is a step in the right direction.
- Lastly, we need to reimplement the success of Delhi government schools throughout India where government schools have become better than private ones by improving infrastructure (no stinky toilets), giving dignity to teachers, constituting school management committees and by involving many good NGOs for innovating learning methods.
We need to reimagine our school as a place where children with different backgrounds class, caste, religions, abilities can study together and learn to care and empathise. They should also be trained to excel in soft skills such as cooperation, group work, compassion, human dignity and plurality of opinions.
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Survey to enroll students, relaxing detention norm: Education Ministry to states
News: The Ministry of Education has issued guidelines to States for offering support to students during the closure of schools and when they reopen to minimize the impact of the pandemic on school education across the country,
Facts:
Key Guidelines:
- Door to Door Survey: States to conduct door-to-door surveys to identify children out of school and migrant students and prepare an action plan to prevent increased drop-outs, lower enrolments, loss of learning and deterioration in the gains made in providing universal access, quality and equity in recent years.
- Globally, the United Nations had estimated that almost 24 million school age children are at risk of dropping-out from the educational system due to COVID-19 this year.
- Relax Detention Norms: States should relax detention norms to prevent drop-outs this year as well as a slew of measures to address learning loss due to the coronavirus-induced shutdown of schools.
- Guidelines during Closure of Schools: The States have been recommended to explore the option of classroom-on-wheels and classes in small groups at the village level, increasing the access of children to online and digital resources, use of TV and radio to reduce learning losses and ensuring easy and timely access to the provisions of uniforms, textbooks and mid-day meals.
- Guidelines after Reopening of Schools:
- States should prepare and run school readiness modules and bridge courses for the initial period so that they can adjust to the school environment and do not feel stressed or left-out.
- Identify students across different grades based on their learning levels and relaxing detention norms to prevent drop out this year have also been recommended.
- Large-scale remedial programmes and learning enhancement programmes should be held to mitigate learning loss and inequality.
Dilemma of Reservation and merit system
Introduction
The year 2021 is the centenary year of the “Communal” Government Order (GO) in Madras Presidency. It introduced reservations based on castes and communities.
GO was the acknowledgment of the social inequalities prevalent in the society, by the British.
Reservation became one of the most divisive public issues, dividing them into ‘reserved’ and ‘general’ categories. The reservation was seen as the opposite of a merit system.
Reservation, the especially caste-based reservation has been established as bad, whereas the reservations in the name of ‘Merit Stream’ for the wards of employees or alumni of universities and colleges is seen as right and justified.
- For example; some of the colleges reserve postgraduate seats for the students enrolled in their own undergraduate honors programs. But officially this system is called the ‘Merit Stream’.
However, now with the EWS quota and entry of reserved category students in unreserved categories this difference is getting blurred.
Are the merit system and caste-based reservation, mutually exclusive?
- If not segregated by the ideological differences, all reservations use merit-based criteria for the selection of eligible candidates. Thus, they are not mutually exclusive.
- Even in the merit-based system, reservation like arrangements has been established that built exclusionary access. merit is achieved by a mix of ability, effort, and social capital and the social capital plays the most crucial role in it.
- For example; expensive private schools or coaching institutes are affordable for the rich only, thus ability and effort only cannot get a student admission in them.
- Most recent judgment in the Saurav Yadav vs. State of Uttar Pradesh case, reiterate the judgment of Mandal judgment, that un-reserved category must be open to all and selection should be merit-based, including for those belonging to categories entitled to reservations.
- Thus, the reserved candidates making their way into the unreserved categories by the competition with the unreserved candidates should be appreciated.
DoE circular asks teachers to check weight of school bags
News: The directorate of Education has issued a circular asking school to follow the new ‘School Bag Policy, 2020’ released by the National Council of Educational Research and Training (NCERT).
Facts:
Why is there a need for a School Bag Policy?
- Heavy school bags are a serious threat to the health and well-being of students. The heavy school bag has severe/adverse physical effects on growing children which can cause damage to their vertebral column and knees.
Key Features of the School Bag Policy,2020:
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- School Teachers should inform the students in advance about the books and notebooks to be brought to school on a particular day and frequently check their bags to ensure that they are not carrying unnecessary material.
- Weight of School Bags::The weight of the school bags should be 1.6 to 2.2 kg for students of Classes I and II, 1.7 to 2.5 kg for Classes III, IV and V, 2 to 3 kg for Classes VI and VII, 2.5 to 4 kg for Class VIII, 2.5 to 4.5 kg for Classes IX and X and 3.5 to 5 kg for Classes XI and XII.
- Responsibility of Teachers: Teachers should take the responsibility of checking the weight of school bags of the students every three months on a day selected for the whole class and any information about heavy bags should be communicated to the parents.
- Responsibility of School Management: It is the duty and the responsibility of the school management to provide quality potable water in sufficient quantities to all the students in the school so that they do not need to carry water bottles from their homes.
Policymakers must promote research under NEP
Synopsis – The policymakers that finetuned the NEP and give shape to Atmanirbhar Bharat, must also nurture institutional frameworks that enable research.
Background-
- The NEP also fosters creativity, developing employability and inviting foreign institutions to set up campuses in India.
- We are working to make India a “knowledge economy” in the 21st century and the National Education Policy (NEP) will also tackle the issues of brain drain, said Prime Minister recently.
- However, there is an absence of much required cutting edge research system. The challenges this system facing are related to funding, academic autonomy, designing robust processes for recruitment of faculty, counselling arrangements for early-career researchers, and systems to help overcome the many barriers to equality and diversity.
Why India does not have cutting edge research framework?
- First, Lack of research institutes– Only few institutions like TIFR, IITs, across the country and are outside university systems, conducting cutting edge research.
- Second, Lack of freedom– Most universities in India do not have the freedom to design courses, find creative ways to raise funds, lack of collaboration between industry and academia.
- Third, Lack of collaboration between industry and academia – India is lacking in conducting research that is both practically relevant and scientifically rigorous.
On the other hand, In US, Pfizer [premier biopharmaceutical company], and the University of California have created systems to combine academic thinking with drug development expertise.
What are the most effective strategies to generate cutting edge research ecosystem?
- First, there is need to shift university admission process for the success of New Education Policy (NEP),
- Currently, non-viable high cut-offs speak of an education system that does not encourage creative learning.
- Second, there is a need for a strong collaboration between the universities and industries to come up with innovative ideas in research along with higher investments in R&D.
Therefore, policymakers should look after the institutional framework that enables research.
Need for reform in Governance structure of public universities
Synopsis: The governance structure of public universities must be reformed on an urgent basis as it may help them become world class universities.
55 central universities, endowed with prime land and extensive central grants, are crown jewels of the Indian academic system.
However, lately, these universities are facing governance-related challenges. Six vice-chancellors (VCs) of central universities have been sacked and another five have been charge-sheeted.
Need for Public universities
- There are some important public universities, where cross-disciplinary research to solve complex modern problems take place, with the focus on all the major branches of learning.
- Locus of innovation has been switched towards innovative private universities which have failed to develop into broad-based universities with the full range of humanities, social and natural sciences and the professional disciplines.
Thus, central universities must be saved to save the academia.
What is the governance structure in public universities?
As each of the 55 central universities is governed by a separate Act, there are difference in governance structures, but broadly it is as follows:
- VC: President of India is the Visitor of the university. On his behalf, Ministry of Education appoints chancellor.
- For that purpose, Ministry appoints search committee to interview multiple candidates and to come up with the list of 3 candidates. From the list ministry appoints a VC.
- Senate or court: It is chosen through different process and constituted of nominees from various stakeholders, including the government, faculty, students, and citizens.
- Technically, this is the governing council (GC) of the university.
- Executive council: Council carry on the university work. It is chaired by VC and appoints the registrar.
- Finance committee: Finance committee is appointed to maintain financial checks and balances. It is headed by a chief finance officer.
What are the issues in governance structure in public universities?
- GC has no say in the selection of the VC and meets only once a year. In theories, it approves the annual plan of the university, presented by VC. But in reality, plan is approved without discussions or questions.
- After approval there is very minimal direction or monitoring from the GC throughout the year.
- Size of the GC is very big to organise any fruitful meeting. For example; GC of Delhi University has 475 members.
Best Practices
Example of IIM
- In contrast to the general Governance structure, IIM structure is much better version.
- It has set a limit on the members of GC at maximum of 19. All of them are expected to meet s certain standard i.e. eminent citizens with broad social representation and an emphasis on alumni.
- Functions of GC includes:
- Selection of Director,
- Providing overall strategic direction,
- Raising resources,
- Monitoring the performance of director
Example of Harvard
- Until 150 years ago, Harvard was also a government university and was on verge of collapse.
- It only became what it is today after governance reform by creating an empowered board comprising its most successful alumni. They brought dynamism, oversight, and resources with them and made it a world-class university.
Way forward
- Thus, it is apparent that the governing councils of all central universities IITs, and all other central institutions is restructured by an Act of Parliament.
- Boards of these universities should comprise of their most eminent alumni.
- Recently the billion-dollar endowment campaign announced by university is being spearheaded by its most successful alumni, many of them created Unicorns, or billion-dollar companies. If alumni like them invited to GC, they may help it become a world-class university like Harvard.
Cabinet Approves changes In Post-Matric Scholarship Scheme For Scheduled Caste Students
Source: The Hindu
News: The Cabinet Committee on Economic Affairs has approved changes to the post-matric scholarship scheme for students from the Scheduled Castes.
Facts:
- Changes are aimed to benefit more than 4 Crore SC students in the next 5 years so that they can successfully complete their higher education.
- Post Matric Scholarship scheme For Scheduled Caste Students: The Scheme aims to provide financial assistance to the Scheduled Caste students studying at post matriculation or post-secondary stage to enable them to complete their education.
- Eligibility: These scholarships are available for studies in India only and are awarded by the government of the State/Union Territory to which the applicant actually belongs i.e. permanently settled.
- Funding: It is a Centrally Sponsored scheme with a funding pattern of 60-40 for the Centre and States.
- This replaces the existing ”committed liability” system and brings greater involvement of the Central government in this scheme.
- Income Ceiling: Scholarships will be paid to the students whose parents/guardians’ income from all sources does not exceed Rs. 2,50,000/- (Rupees two lakh fifty thousand only).
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- Community Audit: The community audits of the scheme would be conducted to make sure the benefits were reaching the students.
Suitability of International Branch Campuses (IBC) in India’s education system
Context: Before allowing international branch campuses (IBC) to operate in India, their potential role and suitability in Indian Environment should be analysed .
Background:
- Although National Education Policy 2020 has recommended allowing universities in the top 100 categories of the World University Rankings to operate in India, inadequate focus has been given to the potential role and suitability of international branch campuses (IBC) in the Indian environment.
- In India, there is general perception that there exists only a single IBC model i.e., foreign universities are self-funded and establish campuses on their own without any major support from the host country. But studies suggest otherwise.
- However, recent studies have shown that there are various other models of IBCs for example, IBC that is fully or partially funded by the host government or IBC supported by private organisations or an IBC functioning in collaboration with a local partner in the partner’s campus.
- The example of Australia’s Monash university operating in South Africa from 2001 to 2019, could provide India with useful lessons in this field.
What is an IBC?
- An IBC is an entity that is owned (completely or partially) and operated by a foreign higher education provider but provides an entire academic program onsite (I.e., In the host country)
- More than 300 IBCs are functioning in around 80 countries and many of these are operated by universities from the U.S., the U.K., Australia, France and Russia.
- Indian private institutions also operate IBCs in countries such as Australia, Mauritius, Uzbekistan, Singapore, Nepal and Sri Lanka.
- Whereas Countries such as China, Malaysia, Qatar and Singapore host most of them.
Case study on the experience of Monash University in South Africa?
- SA’s regulatory framework:
- IBCs there were promoted in parallel with the pre-existing higher education system, on a dual track approach.
- The SA’s regulatory framework permits foreign universities to operate as private entities, but they need to legally register themselves as a company. Though IBC’s can offer accredited degrees and diplomas they cannot use the ‘university’ tag.
- Structural development of Monash university:
- Monash obtained registration in 2001 to operate as an IBC in Johannesburg as ‘Monash South Africa (MSA)’ and currently ranks among top 100 universities in the QS World University Ranking. It operates IBCs in China and Malaysia.
- In 2013, it started operating as a joint venture with U.S.-based majority owner Laureate Education after selling 75% of its shares.
- In 2018 both transferred the ownership to a South Africa based listed company Independent Institute of Education (IIE), a subsidiary of the ADvTech group.
What India can learn from the South African Experience?
- First, even a university that is among the top 100 could become a local private institution through mergers and acquisitions.
- Secondly, it is not necessary that the public nature of a foreign university is also reflected in its branch campus of host country. Nature may change according to the country.
- Third, ensuring parity of the programs offered at host country with the quality of programmes offered at the home campus would be a challenge.
- Fourth, domestic market demand influences course offerings, and there is dependence on contract academic staff.
- Fifth, there are limitations in substituting existing institutions.
The above experience illustrates the big gap between the state’s desired objectives and the actual reality that can be offered through IBC’s. Hence, we need to review the various delivery models existing in different national contexts to help us aid in future policy formulation process.
State of the Education Report for India: Vocational Education First
News: UNESCO has released the 2020 State of the Education Report for India: Vocational Education First.
Facts:
● The second edition of the State of Education Report focuses on technical and vocational Education reports and training(TVET).
What is TVET (Technical and Vocational Education and Training)?
TVET refers to aspects of the Education Report process involving in addition to general education, the study of technologies and related sciences and the acquisition of practical skills, attitudes, understanding and knowledge relating to occupants in various sectors of economic and social life
How to improve TVET in India?
The report outlines a set of ten recommendations that should be adopted to help achieve the stated vision for TVET in the country.
● Place learners and their aspirations at the centre of vocational education and training programs
● Create an appropriate ecosystem for teachers, trainers and assessors
● Focus on upskilling, re-skilling and lifelong learning
● Ensure inclusive access to TVET for women, differently abled and disadvantaged learners
● Massively expand the digitalization of vocational education and training
● Support local communities to generate livelihoods by engaging in the preservation of tangible and intangible cultural heritage
● Align better with the 2030 Agenda for Sustainable Development
● Deploy innovative models of financing TVET
● Expand evidence-based research for better planning and monitoring
● Establish a robust coordinating mechanism for inter-ministerial cooperation.
Additional Facts:
● United Nations Educational, Scientific and Cultural Organization (UNESCO): It is a specialized agency of the United Nations(UN) based in Paris, France. India has been a member of the UNESCO since its inception in 1946.
Issues faced by Nursing sector in India
Context: Nursing education in India suffers poor quality of training, inequitable distribution, and non-standardised practices.
In News:
- The year 2020 has been designated as “International Year of the Nurse and the Midwife”.
- Nurses and midwives will be central to achieving universal health coverage in India.
What are the structural challenges affecting nursing sector in India?
- Low number of nurses: India’s nursing workforce is about two-thirds of its health workforce. Its ratio of 1.7 nurses per 1,000 population is 43% less than the World Health Organisation norm. it needs 2.4 million nurses to meet the norm.
- Inequal Distribution: Though the number of nursing education institutions has been increasing steadily, there are vast inequities in their distribution. Around 62% of them are situated in southern India.
- Vacancies: The faculty positions vacant in nursing college and schools are around 86% and 80%, respectively.
- Higher qualifications of postgraduate nurses are not recognised: There is a lack of job differentiation between diploma, graduate, and postgraduate nurses regarding their pay, parity, and promotion. Consequently, higher qualifications of postgraduate nurses are underutilised, leading to low demand for postgraduate courses.
- Outdated and fails to cater to the practice needs: The education, including re-training, is not linked to the roles and their career progression in the nursing practice. There are insufficient postgraduate courses to develop skills in specialties, and address critical faculty shortages both in terms of quality and quantity.
- Lack quality training: Multiple entry points to the nursing courses and lack of integration of the diploma and degree courses diminish the quality of training.
- Largely unregulated: The Indian Nursing Act primarily revolves around nursing education and does not provide any policy guidance about the roles and responsibilities of nurses in various cadres. Nurses in India have no guidelines on the scope of their practice and have no prescribed standards of care.
- Lack of accountability for nurses: The Consumer Protection Act which protects the rights and safety of patients as consumers, holds only the doctor and the hospital liable for medico-legal issues; nurses are out of the purview of the Act. This is contrary to the practices in developed countries where nurses are legally liable for errors in their work
What is the way forward?
- A common entrance exam, a national license exit exam for entry into practice, and periodic renewal of license linked with continuing nursing education would significantly streamline and strengthen nursing education.
- Transparent accreditation, benchmarking, and ranking of nursing institutions too would improve the quality.
- The Indian Nursing Council Act of 1947 must be amended to explicitly state clear norms for service and patient care, fix the nurse to patient ratio, staffing norms, and salaries.
- The exodus of qualified nurses must be contained by Incentivising to pursue advanced degrees to match their qualifications, clear career paths, the opportunity for leadership roles, and improvements in the status of nursing as a profession.
- A live registry of nurses, positions, and opportunities should be a top priority to tackle the demand-supply gap in this sector.
- The National Institution for Transforming India (NITI) Aayog has recently formulated a framework for public-private partnership in medical education that could be referred to develop a model agreement for nursing education.
The disabling environment prevalent in the system has led to the low status of nurses in the hierarchy of health-care professionals. The National Nursing and Midwifery Commission Bill currently under consideration should hopefully address some of the issues highlighted.