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  • Branch campuses in India, prospects and challenges

    Context

    India, after half a century of keeping its higher education doors closed to foreigners, is on the cusp of opening itself to the world.

    Higher education reforms

    • Currently, India does not allow the entry and the operation of foreign university branch campuses.
    • The NEP 2020 was a turning point for the entry of foreign universities as it recommended allowing foreign universities ranked in the “top 100” category to operate in India — under somewhat unrealistic conditions.
    • Internationalism: The wide-ranging National Education Policy (NEP) 2020 promises higher education reforms in many areas, and internationalisation is prominent among them.
    • Strengthening India’s soft power: Among the underlying ideas is to strengthen India’s “soft power” through higher education collaboration, bringing new ideas and institutions from abroad to stimulate reform and show “best practice”, and in general to ensure that Indian higher education, for the first time, is a global player.
    • In February 2022, Finance Minister Nirmala Sitharaman, in her Budget speech, announced that “world-class foreign universities and institutions would be allowed in the planned business district in Gujarat’s GIFT City”
    •  It was reported that in April 2022, the University Grants Commission (UGC) formed a committee to draft regulations to allow foreign institutions in the “top 500” category to establish campuses in India — realising that more flexibility was needed
    • Bringing global experience to India: Establishing branch campuses of top foreign universities is a good idea as this will bring much-needed global experience to India.

    Challenges

    • Globally, branch campuses, of which there are around 300 now, provide a mixed picture.
    • Many are aimed at making money for the sponsoring university — and this is not what India wants.
    • It will not be easy to attract foreign universities to India and even more difficult to create the conditions for them to flourish.
    • Many of those top universities are already fully engaged overseas and would likely require incentives to set up in India.
    • Further, there are smaller but highly regarded universities outside the ‘top 500’ category that might be more interested.
    • Universities around the world that have academic specialisations focusing on India, that already have research or faculty ties in the country, or that have Non-Resident Indians (NRI) in senior management positions may be easier to attract.
    • What is most important is to prevent profit-seekers from entering the Indian market and to encourage foreign institutions with innovative educational ideas and a long-term commitment.
    • Many host countries have provided significant incentives, including building facilities and providing necessary infrastructure.
    • Foreign universities are highly unlikely to invest significant funds up front.
    • A big challenge will be India’s “well-known” bureaucracy, especially the multiple regulators.

    Opportunities

    • India is seen around the world as an important country and an emerging higher education power.
    • It is the world’s second largest “exporter” of students, with 4,61,792 students studying abroad (according to the UNESCO Institute for Statistics).
    • And India has the world’s second largest higher education system.
    • Foreign countries and universities will be eager to establish a “beachhead” in India and interested in providing opportunities for home campus students to learn about Indian business, society, and culture to participate in growing trade and other relations.
    • Benefits of branch campuses: International branch campuses, if allowed, could function as a structurally different variant of India’s private university sector.
    • Branch campuses, if effectively managed, could bring much needed new ideas about curriculum, pedagogy, and governance to Indian higher education — they could be a kind of educational laboratory.

    Current initiatives

    • There has been modest growth of various forms of partnerships between Indian and foreign institutions.
    • The joint PhD programmes offered by the Indian Institute of Technology Bombay-Monash Research Academy and the University of Queensland-Indian Institute of Technology Delhi Academy of Research (UQIDAR), both with Australian partners, are some examples.
    • Another example is the Melbourne-India Postgraduate Academy (MIPA). It is a joint initiative of the Indian Institute of Science Bangalore, the Indian Institute of Technology Madras, the Indian Institute of Technology Kanpur and the Indian Institute of Technology Kharagpur with the University of Melbourne.
    • MIPA provides students with an opportunity to earn a joint degree accredited both in India and Australia: from the University of Melbourne and one of the partnering Indian institutions.
    • These partnerships suggest that India could offer opportunities for international branch campuses as well.

    Challenges

    • Globally, branch campuses, of which there are around 300 now, provide a mixed picture.
    • Many are aimed at making money for the sponsoring university — and this is not what India wants.
    • It will not be easy to attract foreign universities to India and even more difficult to create the conditions for them to flourish.
    • Many of those top universities are already fully engaged overseas and would likely require incentives to set up in India.
    • Further, there are smaller but highly regarded universities outside the ‘top 500’ category that might be more interested.
    • Universities around the world that have academic specialisations focusing on India, that already have research or faculty ties in the country, or that have Non-Resident Indians (NRI) in senior management positions may be easier to attract.
    • What is most important is to prevent profit-seekers from entering the Indian market and to encourage foreign institutions with innovative educational ideas and a long-term commitment.
    • Many host countries have provided significant incentives, including building facilities and providing necessary infrastructure.
    • Foreign universities are highly unlikely to invest significant funds up front.
    • A big challenge will be India’s “well-known” bureaucracy, especially the multiple regulators.

    Conclusion

    After examining national experiences elsewhere, clear policies can be implemented that may be attractive to foreign universities. Once policies are in place, the key to success will be relationships among universities.

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  • ASHA workers earn WHO’s global plaudits

    The country’s frontline health workers or ASHAs (accredited social health activists) were one of the six recipients of the WHO’s Global Health Leaders Award 2022 which recognises leadership, contribution to the advance of global health and commitment to regional health issues.

    Who are ASHA workers?

    • ASHA workers are volunteers from within the community who are trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.
    • The role of these community health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.
    • They act as a bridge connecting marginalised communities with facilities such as primary health centres, sub-centres and district hospitals.

    Genesis & evolution

    • The ASHA programme was based on Chhattisgarh’s successful Mitanin programme, in which a Community Worker looks after 50 households.
    • The ASHA was to be a local resident, looking after 200 households.
    • The programme had a very robust thrust on the stage-wise development of capacity in selected areas of public health.
    • Many states tried to incrementally develop the ASHA from a Community Worker to a Community Health Worker, and even to an Auxiliary Nurse Midwife (ANM)/ General Nurse and Midwife (GNM), or a Public Health Nurse.

    Qualifications for ASHA Workers

    • ASHAs are primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community.
    • They must have good communication and leadership skills; should be literate with formal education up to Class 8, as per the programme guidelines.

    How many ASHAs are there across the country?

    • The aim is to have one ASHA for every 1,000 persons or per habitation in hilly, tribal or other sparsely populated areas.
    • There are around 10.4 lakh ASHA workers across the country, with the largest workforces in states with high populations – Uttar Pradesh (1.63 lakh), Bihar (89,437), and Madhya Pradesh (77,531).
    • Goa is the only state with no such workers, as per the latest National Health Mission data available from September 2019.

    What do ASHA workers do?

    • They go door-to-door in their designated areas creating awareness about basic nutrition, hygiene practices, and the health services available.
    • They focus primarily on ensuring that pregnant women undergo ante-natal check-up, maintain nutrition during pregnancy, deliver at a healthcare facility, and provide post-birth training on breast-feeding and complementary nutrition of children.
    • They also counsel women about contraceptives and sexually transmitted infections.
    • ASHA workers are also tasked with ensuring and motivating children to get immunised.
    • Other than mother and child care, ASHA workers also provide medicines daily to TB patients under directly observed treatment of the national programme.
    • They are also tasked with screening for infections like malaria during the season.
    • They also provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anaemia etc.
    • Now, they also get people tested and get their reports for non-communicable diseases.
    • The health volunteers are also tasked with informing their respective primary health centre about any births or deaths in their designated areas.

    How much are ASHA workers paid?

    • Since they are considered “volunteers/activists”, governments are not obligated to pay them a salary. And, most states don’t.
    • Their income depends on incentives under various schemes that are provided when they, for example, ensure an institutional delivery or when they get a child immunised.
    • All this adds up to only between Rs 6,000 to Rs 8,000 a month.
    • Her work is so tailored that it does not interfere with her normal livelihood.

    Success of the ASHAs

    • It is a programme that has done well across the country.
    • In a way, it became a programme that allowed a local woman to develop into a skilled health worker.
    • Overall, it created a new cadre of incrementally skilled local health workers who were paid based on performance.
    • The ASHAs are widely respected as they brought basic health services to the doorstep of households.
    • Since then ASHA continues to enjoy the confidence of the community.

    Challenges to ASHAs

    • The ASHAs faced a range of challenges: Where to stay in a hospital? How to manage mobility? How to tackle safety issues?
    • There have been challenges with regard to the performance-based compensation. In many states, the payout is low, and often delayed.
    • It has a problem of responsibility and accountability without fair compensation.
    • There is a strong argument to grant permanence to some of these positions with a reasonable compensation as sustaining motivation.
    • Ideally, an ASHA should be able to make more than the salary of a government employee, with opportunities for moving up the skill ladder in the formal primary health care system as an ANM/ GNM or a Public Health Nurse.

    Way forward

    • The incremental development of a local resident woman is an important factor in human resource engagement in community-linked sectors.
    • It is equally important to ensure that compensation for performance is timely and adequate.
    • Upgrading skill sets and providing easy access to credit and finance will ensure a sustainable opportunity to earn a respectable living while serving the community.
    • Strengthening access to health insurance, credit for consumption and livelihood needs at reasonable rates, and coverage under pro-poor public welfare programmes will contribute to ASHAs emerging as even stronger agents of change.

     

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  • [Burning Issue] Abortion Debate

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    Context

    • Around 36 million women across the US are on the verge of losing their right to legal abortion.
    • A draft document, leaked a couple of weeks ago, suggests that the Supreme Court has decided to overturn the 1973 Roe v. Wade decision which legalized abortion across the country.

    What will be the implications if Roe v Wade is struck down? How will the decision reverberate around the world? Let us analyse.

    The Roe vs. Wade case: Upholding the Right to Abortion

    • Roe, short for Jane Roe, is the pseudonym for a Texas woman who in 1970 sought to have an abortion when she was five months pregnant.
    • Texas then had ban on abortions except to save a mother’s life. The case then went to the US Supreme Court (SCOTUS).
    • The 7-2 majority opinion of the SCOTUS written in 1973, paved the way for the recognition of abortion as a constitutional right in the US considering foetal viability.

    [Foetal viability is the point at which a foetus can survive outside the womb, at the time considered to be around 28 weeks, but today is closer to 23 or 24 weeks owing to advances in medicine and technology.]

    Right to Abortion Judgment: Key takeaways

    Based on the Roe vs Wade case, the framework of regulations that applied towards the right to abortion:

    1. Almost no limitations could be placed on that right;
    2. Only limitations to abortion rights that were aimed at protecting a woman’s health were permitted; and in the third trimester,
    3. State governments had greater leeway to limit the right to abortion except for cases in which the life and health of the mother were endangered.

    What is the debate?

    The abortion debate is the ongoing controversy surrounding the moral, legal, and religious status of induced abortion.

    The sides involved in the debate are the self-described “pro-choice” and “pro-life” movements.

    1. Pro-choice emphasizes the woman’s choice whether to terminate a pregnancy.
    2. Pro-life position stresses the humanity of both the mother and foetus, arguing that a fetus is a human person deserving of legal protection.

    Ethical questions raised

    (1) The primary questions

    The moral debate about abortion deals with two separate questions:

    1. Is abortion morally wrong?
    2. Should abortion be legal or illegal?

    (2) The secondary questions

    But those two questions don’t end the debate.

    1. If we conclude that abortion is not morally wrong, that doesn’t mean that it’s right to have an abortion;
    2. We need to ask whether having an abortion is the best thing (or least bad thing) to do in each particular case.
    3. If we conclude that abortion is morally wrong, that doesn’t mean that it’s always impermissible to have an abortion; we need to ask whether having an abortion is less wrong than the alternatives.

    Why is there a possibility of the judgment being overturned?

    • Foetuses feel the pain: If the foetus is beyond 20 weeks of gestation, gynaecs assume that there will be pain caused to the foetus.
    • Biblical gospel: The Bible does not draw a distinction between foetuses and babies. By the time a baby is conceived, he or she is recognized by God.
    • Abortions cause psychological damage: Young adult women who undergo abortion may be at increased risk for subsequent depression.
    • Abortions reduce the number of adoptable babies: Instead of having the option to abort, women should give their unwanted babies to people who cannot conceive. Single parenthood is also gaining popularity in the US.
    • Cases of selective abortion: Such cases based on physical and genetic abnormalities (eugenic termination) is overt discrimination.
    • Abortion as a form of contraception: It is immoral to kill an unborn child for convenience. Many women are using abortion as a contraceptive method.
    • Morality put to question: If women become pregnant, they should accept the responsibility that comes with producing a child. People need to take responsibility for their actions and accept the consequences.
    • Abortion promotes throwaway culture: The legalization of abortion sends a message that human life has little value and promotes the throwaway culture.
    • Racial afflictions: Abortion disproportionately affects African American babies. In the US, black women are 3.3 times as likely as white women to have an abortion.

    Arguments in favour for Abortion Rights

    • Upholding individual conscience and decision-making:  The US Supreme Court has declared abortion to be a fundamental right guaranteed by the US Constitution.
    • Reproductive choice empowers women: The choice over when and whether to have children is central to a woman’s independence and ability to determine her future.
    • Foetal viability occurs post-birth:  Personhood begins after a foetus becomes “viable” (able to survive outside the womb) or after birth, not at conception. Abortion is the termination of a pregnancy, not a baby.
    • No proof of foetal pain: Most neuroscientists believe that the cortex is necessary for pain perception. The cortex does not become functional until at least the 26th week of a foetus’ development.
    • Preventing illegal abortions: Access to legal, professionally-performed abortions reduces maternal injury and death caused by unsafe, illegal abortions.
    • Mother’s health: Modern abortion procedures are safe and do not cause lasting health issues such as cancer and infertility.
    • Child’s health: Abortion gives pregnant women the option to choose not to bring fetuses with profound abnormalities to full term.
    • Prevents women’s exclusion: Women who are denied abortions are more likely to become unemployed, to be on public welfare, to be below the poverty line, and to become victims of domestic violence.
    • Reproductive choice protects women from financial disadvantage: Many women who choose abortion don’t have the financial resources to support a child.
    • Justified means of population control: Many defends abortion as a way to curb overpopulation. Malnutrition, starvation, poverty, lack of medical and educational services, pollution, underdevelopment, and conflict over resources are all consequences of overpopulation.

    Indian Case: Medical Termination of Pregnancy (MTP) Act

    • Abortion in India has been a legal right under various circumstances for the last 50 years with the introduction of Medical Termination of Pregnancy (MTP) Act in 1971.
    • The Act was amended in 2003 to enable women’s accessibility to safe and legal abortion services.
    • Abortion is covered 100% by the government’s public national health insurance funds, Ayushman Bharat and Employees’ State Insurance with the package rate for surgical abortion.

    The idea of terminating your pregnancy cannot originate by choice and is purely circumstantial. There are four situations under which a legal abortion is performed:

    1. If continuation of the pregnancy poses any risks to the life of the mother or mental health
    2. If the foetus has any severe abnormalities
    3. If pregnancy occurred as a result of failure of contraception (but this is only applicable to married women)
    4. If pregnancy is a result of sexual assault or rape

    These are the key changes that the Medical Termination of Pregnancy (Amendment) Act, 2021, has brought in:

    1. The gestation limit for abortions has been raised from the earlier ceiling of 20 weeks to 24 weeks, but only for special categories of pregnant women such as rape or incest survivors. But this termination would need the approval of two registered doctors.
    2. All pregnancies up to 20 weeks require one doctor’s approval. The earlier law, the MTP Act 1971, required one doctor’s approval for pregnancies upto 12 weeks and two doctors’ for pregnancies between 12 and 20 weeks.
    3. Women can now terminate unwanted pregnancies caused by contraceptive failure, regardless of their marital status. Earlier the law specified that only a “married woman and her husband” could do this.
    4. There is also no upper gestation limit for abortion in case of foetal disability if so decided by a medical board of specialist doctors, which state governments and union territories’ administrations would set up.

    Way forward

    • A search for the middle path perhaps the right of a woman to choose what to do with the foetus has to be balanced with the right of the foetus to survive.
    • It is only that a foetus does not have the ability to exercise an option while the person who carries it does.
    • There could be no two opinions that a victim of rape shall be allowed the choice to abort.
    • Rather than banning abortion, lawmakers must focus on counselling, employment security, social welfare, and financial support to persuade pregnant women to give birth to their children.
    • We must achieve some degree of protection for the unborn by obtaining voluntary recognition of personal responsibility and respect for the personhood of the unborn.

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  • Hyper-accumulator Plants for Soil Detox

    A study published in the JNKVV (Jawaharlal Nehru Krishi Vishwavidyalaya) research journal concluded that heavy metal pollution of soil is “emerging at a speedy rate” in India due to industrialisation.

    How does soil get contaminated?

    • Soil contamination can happen due to a variety of reasons, including manufacturing, mineral extraction, accidental spills, illegal dumping, leaking underground storage tanks, pesticide and fertiliser use etc.
    • These toxic heavy metals are then absorbed by food crops and other plants before they eventually make their way into our food chain, directly affecting human life along with ecology.

    Detoxing the soil

    • Many technologies have emerged to remediate this soil pollution.
    • But these methods have been deemed lacking in terms of sustainability as they come with a large cost and have adverse effects themselves.

    Novel technique: Hyperaccumulators

    • Turning toward more sustainable and eco-friendly technologies, scientists have developed methods of “Phytoremediation”.
    • It is a remediation method that uses living organisms like plants, microalgae, and seaweeds.
    • One particular way to remove toxic heavy metals from the soil includes the use of “hyperaccumulator” plants that absorb these substances from the soil.

    What are hyperaccumulator plants?

    • Phytoremediation refers to the usage of “hyperaccumulator” plants to absorb the toxic materials present in the soil and accumulate in their living tissue.
    • Most plants do sometimes accumulate toxic substances.
    • Hyperaccumulators have the unusual ability to absorb hundreds or thousands of times greater amounts of these substances than is normal for most plants.
    • Most discovered hyperaccumulator plants typically accumulate nickel and occur on soils that are rich in nickel, cobalt and in some cases, manganese.

    Where are they found?

    • These hyperaccumulator species have been discovered in many parts of the world.
    • They include the Mediterranean region (mainly plants of the genus Alyssum), tropical outcrops in Brazi, Cuba, New Caledonia (French territory) and Southeast Asia (mainly plants of the genus Phyllanthus).

    How can they be used to remove toxic metals from the soil?

    • Suitable plant species can be used to ‘pick up’ the pollutants from the soil through their roots and transport them to their stem, leaves and other parts.
    • After this, these plants can be harvested and either disposed or even used to extract these toxic metals from the plant.
    • This process can be used to remove metals like silver, cadmium, cobalt, chromium, copper, mercury, manganese, molybdenum, nickel, lead and zinc; metalloids such as arsenic and selenium; some radionuclides; and non-metallic components such as boron.
    • But it cannot be used to remove organic pollutants from the ground due to metabolic breakdown.

    Advantages of phytoremediation with hyperaccumulators

    • One of the primary advantages of phytoremediation is the fact that it is quite cost-effective in comparison with other remediation methods.
    • The only major costs attached are related to crop management (planting, weed control, watering, fertilisation, pruning, fencing, harvesting etc.).
    • This method is also relatively simple and doesn’t require any new kinds of specialised technology.
    • Also, no external energy source is required since the plants grow with the help of sunlight.
    • Another important advantage of this method is that it enriches the soil with organic substances and microorganisms which can protect its chemical and biological qualities.
    • Also, while the plants are growing and accumulating toxic heavy metals, they protect the soil from erosion due to wind and water.

    Limitations of hyperaccumulators

    • For all its advantages, this kind of phytoremediation with hyperaccumulators has a big drawback: it is a very slow and time-consuming process.
    • The restoration of an area with this process can take up to 10 years or more.
    • This comes with a large economic cost, proportional to the size of the area under rehabilitation.
    • The plants to conduct this rehabilitation must be carefully selected based on a large number of characteristics or they could act as an invasive species.
    • They could grow out of control and upsetting the delicate ecological balance of not just the area under rehabilitation, but also the entire region it is part of.

    What can be done for their better utilization?

    • Due to this reason, scientists only propose using species that are native to the region where the phytoremediation project is undertaken.
    • This also has other benefits: these plants will already be acclimatised to the region and there will be no legal problems concerning the procurement, transport and use of seeds.

     

     

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  • What are Look Out Circulars (LOCs)?

    The Punjab and Haryana High Court has held that a Look Out Circular (LOC), which prevents one from travelling abroad, must be supplied to the person at the time of being stopped at the airport and that the reasons should be communicated to the affected party.

    What is a Look Out Circular?

    • It is a notice to stop any individual wanted by the police, investigating agency or even a bank from leaving or entering the country through designated land, air and sea ports.
    • Immigration is tasked to stop any such individual against whom such a notice exists from leaving or entering the country.
    • There are 86 immigration check posts across the country.

    Who can issue LOCs?

    • A large number of agencies which includes the Central Bureau of Investigation (CBI), Enforcement Directorate, Directorate of Revenue Intelligence (DRI), Income Tax, State police and intelligence agencies are authorised to generate LOCs.
    • The officer should not be below the rank of a district magistrate or superintendent of police or a deputy secretary in the Union Government.

    What are the details required to generate an LOC and who issues it?

    • According to a 2010 official memorandum of the Ministry, details such as First Information Report (FIR) number, court case number are to be mandatorily provided with name, passport number and other details.
    • The BOI under the MHA is only the executing agency.
    • They generate LOCs based on requests by different agencies.
    • Since immigration posts are manned by the BOI officials they are the first responders to execute LOCs by stopping or detaining or informing about an individual to the issuing agency.
    • The LOCs can be modified; deleted or withdrawn only at the request of the originator.
    • Further, the legal liability of the action taken by immigration authorities in pursuance of LOC rests with the originating agency.

    How are banks authorized?

    • After several businessmen including liquor baron Vijay Mallya, businessmen Nirav Modi and Mehul Choksi fled the country after defaulting on loans, the MHA in 2018 brought changes to the 2010 guidelines.
    • It authorised the chairman, managing director and chief executives of all public sector banks to generate LOCs against persons who could be detrimental to economic interests of the country.

    Is there any other clause under which any individual can be stopped?

    • The 2010 Ministry guidelines give sweeping powers to police and intelligence agencies to generate LOCs in “exceptional cases” without keying in complete parameters or case details.
    • This was against suspects, terrorists, anti-national elements, etc. in larger national interest.
    • After the special status of J&K under Article 370 was abrogated in 2019, LOCs were opened against several politicians, human rights activists, journalists and social activists to bar them from flying out of the country.
    • The number of persons and the crime for which they have been placed under the list is unknown.

    Are individuals entitled to any remedial measures?

    • Many citizens have moved courts to get the LOC quashed.
    • As per norms, an LOC will stay valid for a maximum period of 12 months and if there is no fresh request from the agency then it will not be automatically revived.
    • The MHA has asserted that LOCs cannot be shown to the subject at the time of detention nor can any prior intimation be provided.
    • The Ministry recently informed the Punjab and Haryana HC that the LOC guidelines are a secret document and the same cannot be shared with the ‘accused’ or any unauthorised stakeholder.
    • It cannot be provided or shown to the subject at the time of detention by the BOI since it defeats the purpose of LOC and no accused or subject of LOC can be provided any opportunity of hearing before the issuance of the LOC.

    Precedence set by the Judiciary

    • In January this year, Delhi HC quashed an LOC against a Delhi businessman generated at the instance of the Income Tax department.
    • The court said no proceedings under any penal law had been initiated against the petitioner” and the LOC was “wholly unsustainable.”
    • It said that there cannot be any unfettered control or restriction on the right to travel and that it was part of the fundamental rights.
    • Delhi HC has also asked the Director of the CBI to tender a written apology.

     

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  • India Hypertension Control Initiative (IHCI)

    The IHCI project has demonstrated that blood pressure treatment and control are feasible in primary care settings in diverse health systems across various States in India.

    India Hypertension Control Initiative (IHCI)

    • It is a multi-partner initiative involving the Indian Council of Medical Research, WHO-India, Ministry of Health and Family Welfare, and State governments.
    • It aims to improve blood pressure control for people with hypertension.
    • The project initiated in 26 districts in 2018 has expanded to more than 100 districts by 2022.
    • More than two million patients were started on treatment and tracked to see whether they achieved BP control.

    The project was built on five scalable strategies:

    1. Simple treatment protocol with three drugs was selected in consultation with the experts and non-communicable disease programme managers.
    2. Supply chain was strengthened to ensure the availability of adequate antihypertensive drugs.
    3. Patient-centric approaches were followed, such as refills for at least 30 days and assigning the patients to the closest primary health centre or health wellness centre to make follow-up easier.
    4. The focus was on building capacity of all health staff and sharing tasks such as BP measurement, documentation, and follow-up.
    5. There was minimal documentation using either paper-based or digital tools to track follow-up and BP control.

    Prevalence of hypertension in India

    • Cardiovascular diseases (CVD) are the leading cause of death among adults in India.
    • One of the major drivers of heart attack and stroke is untreated high blood pressure or hypertension.
    • Hypertension is a silent killer as most patients do not have any symptoms.
    • India has more than 200 million people with hypertension, and only 14.5% of individuals with hypertension are on treatment.

    Success of IHCI

    • Blood pressure treatment and control were feasibly controlled in primary care settings in diverse health systems across various States in India.
    • Before IHCI, many patients travelled to higher-level facilities such as community health centres (block level) or district hospitals in the public sector for hypertension treatment.
    • Over three years, all levels of health staff at the primary health centres and health wellness centres were trained to provide treatment and follow-up services for hypertension.
    • Nearly half (47%) of the patients under care achieved blood pressure control.
    • The BP control among people enrolled in treatment was 48% at primary health centres and 55% at the health wellness centres.

    Contributing to its success: A data-driven approach

    • One of the unique contributions of the project was a data-driven approach to improving care and overall programme management.
    • The list of people who did not return for treatment was generated through a digital system or on paper by the nurse/health workers.
    • Patients were reminded either over the phone or by home visit (if feasible).
    • This strategy motivated a large number of patients to continue treatment.
    • In addition, programme managers reviewed aggregate data at the district and State levels to assess the performance of facilities in terms of follow-up and BP control.
    • Patients were provided generic antihypertensive drugs costing only ₹200 per year.
    • In addition, E-Sanjeevani, a telemedicine initiative, facilitated teleconsultations.

    Back2Basics: Hypertension

    • Hypertension also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
    • High blood pressure usually does not cause symptoms.
    • Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.
    • High blood pressure is classified as primary (essential) hypertension or secondary hypertension.
    • For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.

     

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  • [Burning Issue] Energy Transition & Challenges

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    Context

    • India has set ambitious targets towards the achievement of the dual goals of climate action and sustainable development through its nationally determined contributions and energy access commitments.
    • As India starts a new decade of energy transition, it is an opportune time to assess where India stands in achieving its targets as well as to identify the key challenges being faced during this transition.

    What is Energy Transition?

    • Energy transition refers to the global energy sector’s shift from fossil-based systems of energy production and consumption — including oil, natural gas and coal — to renewable energy sources like wind and solar, as well as lithium-ion batteries.
    • The increasing penetration of renewable energy into the energy supply mix, the onset of electrification and improvements in energy storage are all key drivers of the energy transition.
    • Regulation and commitment to decarbonization has been mixed, but the energy transition will continue to increase in importance as investors prioritize environmental, social and governance (ESG) factors.

    Ongoing Energy Trends

    • Global oil production has been basically static: Some areas are in an irreversible productive decline (e.g., the North Sea) while others, mainly the continental US, are experiencing a true renaissance in the production of petroleum liquids owing to the exploitation of oil shales.
    • Worldwide mineral production is generally static: The mining industry is facing the problem of diminishing ore grades for most minerals and the consequence is the need of more energy to maintain the same levels of production.
    • Agriculture is facing an energy problem: Agriculture is heavily dependent on fossil fuels for powering agricultural machinery, for the supply of fertilizers, pesticides, and irrigation. The increasing prices of fossil fuels are being reflected in higher prices for all agricultural products.
    • Nuclear energy faces considerable difficulties: The past decade had seen a minor renaissance in the start of the construction of new plants, although still in numbers insufficient to replace the old plants being retired.  
    • Renewable energy is seeing an explosive growth worldwide:  The energy produced by the new renewables is still a minor fraction of the total of the world primary energy production, but it has been growing at exponential rates that, so far, show no sign of abating.
    • Focus on energy efficiency: We see an evident trend towards higher efficiency in both production and end uses of energy. It is a trend particularly evident in the residential sector, with buildings that reduce energy consumption by means of better insulation, high efficiency lighting, and more.  
    • Crunches for Fossil Fuels: We are facing more and more difficult times in maintaining the current system based on fossil fuels. The combined effects of depletion and of climate change are pushing humankind in undue energy anxiety.

    India’s Energy Transition: Context- Setting

    (1) Ambitious Target

    • India’s energy transition is characterized by its ambitious targets.  By the year 2022,
    • India seeks to provide all households in the country 24×7 power.
    • By 2022, India also seeks to install 175 GW of new renewable energy (RE) in the country.

    (2) NDC Commitments

    • India in its Nationally Determined Contributions (NDCs) committed to three targets, which are to be achieved by the year 2030.
    • First, by 2030, 40% of India’s cumulative electric power installed capacity will come from non-fossil fuel-based energy sources.
    • Second, India will reduce the emission intensity of its gross domestic product (GDP) by 33–35% (vis-à-vis 2005 levels).
    • Third, India will create an additional carbon sink of 2.5–3 billion tonnes of CO2 equivalent (through additional forest and tree cover).

    (3) Current RE Capacity

    • India is world’s 3rd largest consumer of electricity and world’s 3rd largest renewable energy producer with 38% of energy capacity installed in the year 2020 (136 GW of 373 GW) coming from renewable sources.
    • Many states are still at early stages of developing their renewable energy capacity.
    • This is important to consider as India seeks to add more RE capacity in the coming months and years.

    () Leadership

    • India is also showing global clean energy leadership through initiatives such as the International Solar Alliance, which has more than 70 member countries.
    • This is yet to materialize in its full capacity.

    Various challenges

    (1) Slowdown in the RE Tendering Process

    • India’s RE growth was at the slowest pace in the past 4 years.
    • There were several reasons for this, including the trends seen during the process of auctioning RE capacity.

     (2) Renewable Purchase Obligations as a Ceiling

    • One of the mechanisms for promoting the installation of RE capacity in India has been the stipulation of targets for a mandatory minimum purchase of a certain percentage of RE by utilities.
    • This is known as a Renewable Purchase Obligation (RPO).
    • Many states has been asked by its regulator to curtail further procurement of solar energy from large-scale projects.

    (3) Financial crunches  

    • When DISCOMs face cash flow issues, this results in RE producers also facing a liquidity crisis. Public sector banks are hesitant to grant loans to RE projects.
    • Not many private sector banks are forthcoming with loans.
    • Additionally, the interest rate of existing loans to RE companies has also witnessed a rise in recent months.

    (4) Policy Uncertainty

    • Experts emphasize the importance of policy certainty for the enforcement of contracts and for the rule of law.
    • The value of the certainty of contracts and the importance of consistency and stability in rules and policy cannot be overstated in the energy sector in India.
    • Similar concerns have been raised by RE companies over the uncertainty over import duties, particularly for solar cells.

    (5) Burden of demands

    • Much like China, India is finding itself in a precarious position.
    • To meet its high electricity demands, India has had to increase its reliance on fossil fuels while still developing its national grid to cope with expected surges in power demand.

    (6) Others

    • High initial cost: While the coal-based power plants require an initial investment of about Rs. 4 crores per MW, the investments for solar and wind energy is far higher.  
    • Weather-dependency: Renewable energy sources like solar, wind, tide, etc., are dependent on weather conditions. If the favourable weather conditions are not available, it becomes inefficient and unfeasible.
    • Topographic barriers: Most renewable energy plants occupy large areas of space. This brings in the issue of the cost of the vast land area and other issues related to land acquisition.  
    • Threats to ecosystem: The turbines have caused noise pollution and are also killing birds while functioning. Ex. Decline in bustard population in Rajasthan.

    Various govt. initiatives

    • Separate ministry: India is the first country in the world to have an exclusive ministry that is involved in the promotion and development of renewables – the Ministry of New and Renewable Energy (MNRE).
    • Nation Green Corridor Programme: This project aims at synchronizing energy that is produced from renewable energy sources with conventional stations.
    • National Clean Energy Fund: It is the fund created using the carbon tax for backing research and development of innovative eco-friendly technologies.
    • Draft National Wind-Solar Hybrid Policy: Through this policy, the government seeks to promote new renewable energy projects and hybridization of the existing ones.  
    • National Offshore Wind Energy Policy: This involves the utilization of India’s Exclusive Economic Zone (EEZ) for the development of offshore wind farms up to 200 Nautical Miles from the baseline.
    • Grid Connected Solar Rooftop programme: It involves the installation of solar panel at the rooftops of the residential, commercial, industrial, and institutional buildings.
    • Small Hydropower Programme:  The potential of this programme is about 20,000 MW and it is mostly in the Himalayan States where the rivers are abundant and in States which have sufficient irrigation canals.
    • National Solar Mission: It is a part of the National Action Plan on Climate Change. It is an initiative to promote solar power in India.  .
    • Pradhan Mantri- Kisan Urja Suraksha evam Utthaan Mahabhiyan: PM- KUSUM aims at providing financial and water security to farmers by means of utilizing solar energy capacities of 25,750 MW by 2022.

    Way forward

    • Ensure equity: It must be ensured that the opportunities of India’s transition are shared fairly throughout society — and workers and communities are not left to face the challenges alone.
    • Make it people-centric: To achieve the trifecta of jobs, growth and sustainability, India must strive to put people at the centre of its energy transformation.
    • Provisions for coal-dependent regions: New jobs would need to be found over time for the coal miners affected by the changes, as well as for people who work in the fossil fuel power plants that will close down.
    • Transition funds: Policymakers must earmark special“transition funds” to help coal-dependent regions, some of which are among India’s poorest.
    • Increase investment by rationalizing energy subsidies: Energy subsidies must be rationalized and directed towards those who need them most.
    • Finance mobilization: Fiscal resources freed up through subsidy reform should then be invested in clean energy solutions, especially in underdeveloped regions and marginalised communities.
    • Community participation: While India’s energy transition will create many new jobs, the limited participation of women in the growing green workforce must be addressed.
    • Engage youth: Engaging the youth is critical to ensure that the energy transition is sustainable, inclusive and enduring.

    Conclusion

    • There is no doubt that ambitious RE and climate targets have pushed India well on its way to a clean energy future.
    • However, more needs to be done to help India achieve its potential.

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  • Structural interventions by state governments that can create higher-wage jobs

    Context

    The recent decision to deduct off-budget borrowings from state borrowing limits reminds chief ministers to be good policy ancestors.

    Financing welfare state

    • In A Brief History of Equality, economist Thomas Piketty suggests that “the world of the early 2020s, no matter how unjust it may seem, is more egalitarian than that of 1950 or 1900, which were… more egalitarian than those of 1850 or 1780”.
    • But how the welfare state is financed matters.
    • Changes in state borrowing limits: Adjusting state borrowing limits for their off-budget borrowings leads to transparency because they are routinely breached through vehicles for schemes whose bill comes due far in the future.
    • The confiscation of future spending — interest payments crowd out expenditure and revenue expenditure crowd out capex — matters because our prosperity problem is productivity, wages, not jobs.

    5 Structural interventions that can create high wage jobs

    1] Reduce regulatory hurdles

    • States control 80 per cent of India’s employers’ compliance ecosystem of 67,000+ compliances, 6,500+ filings and 26,000+ criminal provisions.
    • State governments that rationalise, decriminalise, and digitise their compliance ecosystem will reap lower corruption and higher formality.

    2] Fix government schools

    • The most powerful tool for social mobility and employability is free and quality school education.
    • State governments that undertake a significant overhaul of school performance management (the fear of falling and hope of rising for teachers) and governance (the allocation of decision rights around resources and hiring) will create an unfair advantage in human capital.

    3] Converge education and employability

    • States should set up skill universities that create qualification modularity (between certificates, diplomas, advanced diplomas, and degrees), delivery flexibility (equate online, apprenticeships, on-site and on-campus classrooms), and pray to the one god of employers.
    • Degree apprentices innovate at the intersection of employment, employability and education.
    • State governments that remove barriers in their path will see their population of employed learners exceed full-time learners.

    4] Devolution of money and power

    • Cities drive productive job creation — New York City’s GDP is higher than Russia’s.
    •  It took 70 years after 1947 for the budget of 28 states to cross the central government’s budget.
    • The combined budget of state governments now exceeds Rs 45 lakh crore, but 2.5 lakh municipalities and panchayats have a budget of only Rs 3.7 lakh crore.
    • Governments that devolve money and power from state capitals to their towns will avoid the curse of megacities and create the competition that drove China’s growth (they have 375 cities with more than a million people versus our 52).

    5] Civil service reforms

    • State governments must sell their 1,500+ loss-making public sector units, cut civil service compensation to less than 40 per cent of budget spending, and replace expenditure with capex.
    • Moving from outlays to outcomes needs a new human capital regime for civil servants via seven interventions; structure, staffing, training, performance management, compensation, culture, and HR capabilities.

    Shifting resources to protective and productive  version of states

    • Nobel Laureate James Buchanan said any state had three versions — the protective state (police, rule of law, defence, courts), the productive state (common goods like roads, power, health, education, etc.), and the redistributive state.
    • Too many state governments accept the status quo in the first two and “innovate” in the third version.
    • It’s time to shift resources to the first two.

    Conclusion

    Chief Ministers ought to create high wage jobs, and not borrow money future generations will have to repay.

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  • SC tests phones for Pegasus Spyware

    The Supreme Court has said its technical committee had so far received and tested 29 mobile devices suspected to be infected by Pegasus malware.

    Why in news?

    • It was alleged that the government used the Israel-based spyware to snoop on journalists, parliamentarians, prominent citizens and even court staff.

    What is Pegasus?

    • Pegasus is a spyware developed by NSO Group, an Israeli surveillance firm that helps spies hack into phones.
    • In 2019, when WhatsApp sued the firm in a U.S. court, the matter came to light.
    • In July 2021, Amnesty International, along with 13 media outlets across the globe released a report on how the spyware was used to snoop hundreds of individuals, including Indians.
    • While the NSO claims its spyware is sold only to governments, none of the nations have come forward to accept the claims.

    Threats created by Pegasus

    • What makes Pegasus really dangerous is that it spares no aspect of a person’s identity.
    • It makes older techniques of spying seem relatively harmless.
    • It can intercept every call and SMS, read every email and monitor each messaging app.
    • Pegasus can also control the phone’s camera and microphone and has access to the device’s location data.
    • The app advertises that it can carry out “file retrieval”, which means it could access any document that a target might have stored on their phone.

    Dysfunctions created

    • Privacy breach: The very existence of a surveillance system, whether under a provision of law or without it, impacts the right to privacy under Article 21 and the exercise of free speech under Article 19.
    • Curbing Dissent: It reflects a disturbing trend with regard to the use of hacking software against dissidents and adversaries. In 2019 also, Pegasus software was used to hack into HR & Dalit activists.
    • Individual safety: In the absence of privacy, the safety of journalists, especially those whose work criticizes the government, and the personal safety of their sources is jeopardised.
    • Self-Censorship: Consistent fear over espionage may grapple individuals. This may impact their ability to express, receive and discuss such ideas.
    • State-sponsored mass surveillance: The spyware coupled with AI can manipulate digital content in users’ smartphones. This in turn can polarize their opinion by the distant controllers.
    • National security: The potential misuse or proliferation has the same, if not more, ramifications as advanced nuclear technology falling into the wrong hands.

    Snooping in India:  A Legality check

    For Pegasus-like spyware to be used lawfully, the government would have to invoke both the IT Act and the Telegraph Act. Communication surveillance in India takes place primarily under two laws:

    1. Telegraph Act, 1885: It deals with interception of calls.
    2. Information Technology Act, 2000: It was enacted to deal with surveillance of all electronic communication, following the Supreme Court’s intervention in 1996.

    Cyber security safeguards in India

    • National Cyber Security Policy: The policy was developed in 2013 to build secure and resilient cyberspace for India’s citizens and businesses.
    • Indian Computer Emergency Response Team (CERT-In): The CERT-In is responsible for incident responses including analysis, forecasts, and alerts on cybersecurity issues and breaches.
    • Indian Cyber Crime Coordination Centre (I4C): The Central Government has rolled out a scheme for the establishment of the I4C to handle issues related to cybercrime in the country in a comprehensive and coordinated manner.
    • Budapest Convention: There also exists Budapest Convention on Cybercrime. However, India is not a signatory to this convention.

    Issues over government involvement

    • It is worth asking why the government would need to hack phones and install spyware when existing laws already offer impunity for surveillance.
    • In the absence of parliamentary or judicial oversight, electronic surveillance gives the executive the power to influence both the subject of surveillance and all classes of individuals, resulting in a chilling effect on free speech.

    Way forward

    • The security of a device becomes one of the fundamental bedrock of maintaining user trust as society becomes more and more digitized.
    • Constituting an independent high-level inquiry with credible members and experts that can restore confidence and conduct its proceedings transparently.
    • The need for judicial oversight over surveillance systems in general, and judicial investigation into the Pegasus hacking, in particular, is very essential.

    Conclusion

    • We must recognize that national security starts with securing the smartphones of every single Indian by embracing technologies such as encryption rather than deploying spyware.
    • This is a core part of our fundamental right to privacy.
    • This intrusion by spyware is not merely an infringement of the rights of the citizens of the country but also a worrying development for India’s national security apparatus.

     

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  • Project WARDEC: India’s upcoming AI-powered Wargame Centre

    The Army Training Command signed a memorandum of understanding (MoU) with Gandhinagar-based Rashtriya Raksha University (RRU) to develop a ‘Wargame Research and Development Centre (WARDEC)’ in New Delhi.

    What is Project WARDEC?

    • The project ‘WARDEC’ will be a first-of-its-kind simulation-based training centre in India that will use artificial intelligence (AI) to design virtual reality war-games.
    • The Wargame Research and Development Centre will be used by the Army to train its soldiers and test their strategies through “metaverse-enabled gameplay”.
    • The wargame models will be designed to prepare for wars as well as counter-terror and counter-insurgency operations.

    Where will the centre come up and when?

    • The centre will come up in a military zone in New Delhi, confirmed RRU officials privy to the development.
    • The RRU will join hands with Tech Mahindra to develop the centre in the coming three to four months.
    • The RRU, an institute under the Ministry of Home Affairs (MHA), specialises in national security and policing.
    • Located in Gandhinagar’s Lavad village, it is an “institute of national importance” – a status granted to it by an Act of Parliament.

    How will these simulation exercises play out?

    • Soldiers will test their skills in the metaverse where their surroundings will be simulated using a combination of virtual reality (VR) and augmented reality (AR).
    • In metaverse, the players will get a realistic experience of the actual situation.
    • If a weapon weighing 5 kg drops or the air pressure falls, they will feel it like anyone would in a live situation, real-time.
    • The game would play out player versus player, player versus computer or even computer versus computer.

    How will the centre help the Army?

    • The Army intends to use the war-game centre to train its officers in military strategies.
    • Indian Army will provide data to set the backdrop of the gameplay, so that participants get a realistic experience.
    • In Army, it is often said that the enemy can ambush you from 361 directions, where 360 sides are around the soldier, and one is above in case there is an airdrop.
    • So, wargame simulation helps the Army think of all possible scenarios.

    What promise does AI-based wargame simulation hold?

    • Apart from the armed forces, the BSF, CRPF, CISF, ITBP and SSB can also use the metaverse-enabled simulation exercises for better training.
    • The use of AI can provide a totally immersive training experience as it can simulate a battlefield close to reality and map several eventualities in the probable event of a war.

    How many countries use such wargaming drills?

    • Since the 9/11 attacks, use of information technology-enabled wargaming is preferred by several countries like the US, Israel, the UK to prepare for possibilities in case of terror attacks or war.
    • In March 2014, several world leaders, including former German chancellor Angela Merkel, former US president Barack Obama and Chinese president Xi Jinping had played a war simulation game.
    • It was during the Hague Summit about how to react in case of a nuclear attack.
    • In that case, the target of the nuclear attack was a fictional country named Brinia.

     

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