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GS Paper: GS2-13.Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

  • [1st July 2025] The Hindu Op-ed: How do unsafe cancer drugs reach patients?

    PYQ Relevance:

    [UPSC 2014] While doctor’s prescription is a must to get drugs, many people buy them over the counter without prescription. Discuss the contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

    Linkage: The wider discussion about checking drug quality and the difficulties in doing so is very important to stop unsafe drugs, like cancer medicines, from reaching patients. This question is relevant because it looks into how drugs are monitored and the problems faced in keeping them safe.

     

    Mentor’s Comment:  A major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, has revealed that poor-quality and unsafe cancer drugs, many of them from India, have been sent to over 100 countries. These faulty medicines have caused serious health problems, including the deaths of children in Yemen, Colombia, and Saudi Arabia. The report highlights serious regulatory weaknesses in low- and middle-income countries, and shows that the WHO’s warning system only acts after harm is done. This is especially worrying because it affects cancer patients, one of the most vulnerable groups.

    Today’s editorial talks about the poor-quality and unsafe cancer drugs. This topic is important for GS Paper II (Health & Governance) in the UPSC mains exam.

    _

    Let’s learn!

    Why in the News?

    Recently, a major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, found that low-quality and unsafe cancer drugs.

    The Bureau of Investigative Journalism (TBIJ) is an independent, non-profit news organization based in the United Kingdom. It was founded in 2010 with the aim of producing in-depth, public interest journalism that holds power to account.

    What are the major quality risks in cancer drug manufacturing and distribution?

    • Contamination during manufacturing: Risk of bacterial contamination from improper disinfection, untrained staff, or poor cleanroom discipline. Even small errors like air movement or touching non-sterile items can spread bacteria.
    • Poor quality control: Failure to test raw ingredients, clean equipment, or filter water properly can make life-saving drugs toxic or lethal.
    • Distribution chain vulnerabilities: Changes in temperature, humidity, or poor handling during transport can degrade drug quality. The complex journey from raw materials to patient requires strict monitoring at each stage.

    Why are poorer countries more exposed to unsafe cancer drugs?

    • Weak Regulatory Frameworks: Many low-income countries lack strong drug regulatory authorities and legal frameworks to ensure medicine quality. Eg: In Nepal, there is no effective testing or monitoring of imported drugs due to limited institutional capacity.
    • Lack of Testing Infrastructure and Experts: These countries often do not have certified laboratories or trained personnel to check for contamination, dosage accuracy, or manufacturing faults. Eg: Nepal and similar nations lack verified experts or facilities to evaluate drug safety before market entry.
    • Inability to Track Drugs Through Supply Chains: Poor digital and logistical infrastructure leads to ineffective drug tracking, making it easier for substandard or counterfeit drugs to infiltrate the system. Eg: In countries with porous borders and no tracking systems, drugs can be repackaged or sold without oversight.
    • Corruption and Weak Enforcement: Corruption in customs, licensing, and procurement processes allows unverified drugs to enter public hospitals and pharmacies unchecked. Eg: In some regions, low-cost cancer drugs without proper quality assurance enter due to bribery and lack of regulatory follow-up.
    • Dependence on Low-Cost Imports Without Verification: Due to budget constraints, poorer nations rely heavily on cheap generic imports without adequate checks for Good Manufacturing Practices (GMP) or source validation. Eg: In Yemen (2022), at least 10 children died after receiving contaminated methotrexate, highlighting the consequences of poor import verification.

    How does WHO ensure drug safety?

    • Rapid Alert System for Dangerous Drugs: WHO operates a global Rapid Alert System to identify and inform member countries about harmful or substandard medicines. Eg: If contaminated cancer drugs are reported in one country, WHO sends out a global alert so others can take preventive action.
    • Global Benchmarking and Certification Tools: WHO uses tools like the Global Benchmarking Tool to assess national regulatory systems and ranks them from Level 1 (weakest) to Level 4 (strongest). Eg: In 2023, 70% of member countries were rated at Level 1 or 2, showing limited capacity to regulate drug safety.
    • Prequalification, GMP, and CoPP Systems: WHO runs prequalification programs to approve safe drugs, ingredients, and labs; enforces Good Manufacturing Practices (GMP); and issues the Certificate of Pharmaceutical Product (CoPP) to confirm quality of exported drugs. Eg: A CoPP acts like a passport for medicines, verifying they are approved and safely made in the exporting country.

    What are the steps taken by the Indian Government?

    • Strengthening Drug Regulatory Framework: The government has empowered the Central Drugs Standard Control Organization (CDSCO) to regulate drug approval, quality checks, and enforcement across India. CDSCO conducts inspections and sampling under the Drugs and Cosmetics Act, 1940 to detect substandard medicines.
    • Track and Trace Mechanism: India has introduced a barcode-based Track and Trace system for export of pharmaceutical products to improve transparency and traceability. Eg: The system helps monitor supply chain integrity and detect counterfeit drugs, especially in exports.
    • The Production Linked Incentive (PLI) Scheme for pharmaceuticals promotes domestic manufacturing of quality drugs and APIs while reducing import dependence. Eg: Incentives are given to firms that meet Good Manufacturing Practices (GMP) and global export standards.

    Way forward: 

    • Establish a National Drug Quality Monitoring Authority: Create a centralised, independent regulatory body to oversee real-time quality audits, enforce uniform GMP standards, and ensure accountability across manufacturing units.
    • Invest in Testing Infrastructure and Skilled Workforce: Strengthen drug testing laboratories, equip them with modern technology, and train qualified professionals to carry out rigorous inspections and batch verifications at every stage.

  • Vaccinating India: On Zero-Dose Children

    Why in the News?

    India has made significant progress in expanding vaccine coverage, with a dramatic drop in the percentage of zero-dose children from 33.4% in 1992 to 6.2% in 2023. But even though India is not affected by war or extreme poverty like some other countries, it still has the second-highest number of children without any vaccination in the world.

    What is the trend in global and Indian vaccine coverage?

    • Global Progress: Since 1980, coverage for six major diseases—including measles, polio, and tuberculosis—has doubled worldwide, and the proportion of zero-dose children has fallen to around 75% fewer globally.
    • India’s Improvement with Persistent Gaps: India has dramatically reduced zero-dose children from 33.4% in 1992 to 6.2% in 2023, yet still ranks second globally in absolute numbers, indicating significant strides amid ongoing challenges.

    What are zero-dose children?

    • Zero-dose children are those who have not received the first dose of the diphtheria, tetanus, and pertussis (DTP) vaccine.
    • They are a crucial performance marker of a country’s immunisation system and indicate inequities in vaccine coverage.

    Why are they important for assessing vaccination?

    • Reflects health system coverage and equity: A high number of zero-dose children shows that vaccination programmes are not reaching all segments of the population. NFHS-5 (2019–21) Data also showed that full immunisation coverage among children aged 12–23 months was significantly lower in rural and tribal regions compared to urban areas (e.g., Nagaland: 57.8%, compared to Tamil Nadu: 89.8%).
    • Indicates social and economic exclusion: The presence of zero-dose children highlights barriers like poverty, low maternal education, and marginalisation. Eg: Urban slums with high migrant populations tend to have more zero-dose children due to lack of awareness and access.
    • Warns of vulnerability to disease outbreaks: Areas with many zero-dose children are more likely to face outbreaks of vaccine-preventable diseases. Eg: Measles outbreaks are more common in districts with poor immunisation coverage.

    Why does India still have a high number of zero-dose children despite adequate resources?

    • High birth rate increases absolute numbers: India has the highest number of annual births globally. In 2023, India had around 23 million births, making even a small percentage of zero-dose children translate into a large number.
    • Geographical and logistical challenges: Remote tribal areas, urban slums, and migrant populations are harder to reach due to terrain, mobility, and poor infrastructure. E.g., children in parts of Meghalaya or urban Delhi, slums often miss vaccinations due to lack of access and follow-up.
    • Socio-cultural barriers and vaccine hesitancy: Low maternal education, religious beliefs, and misinformation lead to vaccine hesitancy in certain communities. Eg: In some Muslim households or among Scheduled Tribes, distrust or misinformation about vaccines limits uptake.

    How has India’s zero-dose child rate changed over time, especially post-COVID?

    • Steady decline before the pandemic: Between 1992 and 2016, India reduced the percentage of zero-dose children from 33.4% to 10.1%, showing consistent improvement in immunisation outreach.
    • Sharp rise during the COVID-19 pandemic: Disruptions in health services led to a surge in zero-dose children, increasing from 1.4 million in 2019 to 2.7 million in 2021, reversing years of progress.
    • Partial recovery after the pandemic: The number dropped to 1.1 million in 2022 but rose again to 1.44 million in 2023, indicating ongoing challenges in sustaining immunisation coverage.

    Where are zero-dose children mainly located in India?

    • High-burden states in northern and central India: Large numbers of zero-dose children are concentrated in Uttar Pradesh, Bihar, Maharashtra, Rajasthan, Madhya Pradesh, and Gujarat, which have large populations and gaps in last-mile immunisation delivery.
    • Northeastern and underserved regions: A relatively high proportion is also found in Meghalaya, Nagaland, Mizoram, and Arunachal Pradesh, where geographic inaccessibility, scattered populations, and weaker health infrastructure pose challenges.

    What actions are needed for India to meet the WHO’s 2030 immunisation target?

    • Expand and intensify targeted immunisation drives: Strengthen last-mile delivery through regular and focused vaccination campaigns in underserved regions. Eg: Mission Indradhanush and its intensified versions could increase immunisation coverage in low-performing districts.
    • Strengthen community-level engagement and awareness: Promote behavioural change and reduce vaccine hesitancy through culturally tailored IEC (Information, Education, and Communication) activities. Eg: Janani Suraksha Yojana (JSY) encourages institutional deliveries and postnatal care, which can be used to ensure timely vaccination of newborns.
    • Integrate immunisation with digital health monitoring systems: Use technology for real-time tracking of vaccine coverage and follow-up in high-birth and high-risk areas. Eg: eVIN (Electronic Vaccine Intelligence Network) monitors vaccine stocks and cold chain availability, improving efficiency and reducing wastage.

    Conclusion: India’s immunisation journey shows a mixed reality, while the country is a global leader in vaccine development, it still struggles to ensure all its children receive basic immunisation. Closing this gap is important not just for public health but also for social fairness and overall development. The need is even more urgent because India has the highest number of newborns in the world. The Immunisation Agenda 2030 should be treated as a national priority.

    Mains PYQ:

    [UPSC 2022] How do vaccines work? What approaches were adopted by the Indian vaccine manufacturers to produce COVID-19 vaccines?

    Linkage: It explicitly deals with “vaccines” and “Indian vaccine manufacturers”. While it focuses on COVID-19 vaccines, the discussion around vaccine functionality and production capacity is fundamentally linked to the broader challenge of “Vaccinating India” and reaching “zero-dose children” for various preventable diseases.

  • State- and sex-wise liver disease data hint at underlying factors

    Why in the News?

    In 2022, liver disease rose to become the eighth leading cause of death in India, marking a serious public health issue that had not occurred in the previous five years.

    What do sex- and age-wise trends reveal about liver disease deaths in India?

    • Sex-wise trend: Male deaths due to digestive diseases (especially liver-related) were 3.5 times higher than female deaths in 2022.
    • Liver diseases accounted for 70–75% of digestive disease deaths in men, while in women it ranged between 52–57%.
    • Age-wise trend:
      – For women, liver-related deaths increased with age, especially in the 65+ age group.
      – For men, the highest death rates occurred in the 35–54 age group, pointing to middle-age vulnerability.

    Why are liver disease deaths significantly higher among men than women?

    • Higher Alcohol Consumption: A major reason is the wide gender gap in alcohol use—around 19% of men consume alcohol compared to just 1% of women. This significantly increases the risk of liver disease among men. In 2022, 75% of male deaths due to digestive diseases were liver-related, compared to 57.5% in women.
    • Middle-Age Vulnerability: Most male deaths from liver disease occur in the 35–54 age group, indicating that lifestyle-related liver damage starts early. In contrast, among women, liver disease deaths are more common in the 65+ age group, often linked to age-related complications rather than lifestyle.
    • Biological and Behavioural Differences: Men may be more prone to risk-prone behaviours, including excessive alcohol and meat consumption, both of which are linked to liver damage. Data also shows men consistently have 3 to 3.5 times higher death rates from digestive diseases than women over the last decade.

    How do regional differences affect liver and digestive disease mortality?

    • Higher Burden in North-Eastern States: Five North-Eastern states recorded over 10% of certified deaths due to digestive diseases in 2022, with Sikkim leading at nearly 20%. This indicates a regional concentration of liver and digestive health issues.
    • Lifestyle Factors in the Region: The North-East has the highest combined prevalence of alcohol and meat consumption in India. This overlap may be a key factor contributing to the elevated liver disease burden in the region.
    • State-Wise Variation Highlights Public Health Gaps: No other state outside the North-East showed a double-digit share of digestive disease deaths, pointing to geographic health disparities.

    What are the steps taken by the Indian Government?

    • National Programme for Prevention and Control of NCDs (NP-NCD): The government launched NP-NCD to tackle non-communicable diseases, including liver disorders, by promoting early diagnosis, screening, and health awareness at the primary healthcare level.
    • National Action Plan and Monitoring Framework (NAP-NCD): Aims to reduce harmful alcohol use, improve dietary habits, and promote healthy lifestyles through public campaigns and community outreach, aligning with WHO targets.
    • Ayushman Bharat – Health and Wellness Centres (AB-HWCs): These centres provide comprehensive primary healthcare, including counselling on nutrition, lifestyle modification, and screening for liver and digestive diseases, especially in rural and underserved areas.

    What measures can strengthen research on lifestyle-related liver diseases? (Way forward)

    • Enhance Data Collection and Surveillance: Develop region-specific health databases that track alcohol and meat consumption, age, and liver disease trends. States like Sikkim and others in the North-East could benefit from focused public health monitoring to identify at-risk populations.
    • Promote Longitudinal and Causal Research: Support long-term studies that move beyond correlation to establish causal links between lifestyle choices and liver disease.
    • Encourage Community-Based Health Studies: Launch grassroots-level research programs involving local communities to understand dietary habits, alcohol use, and health-seeking behaviour.

    Mains PYQ:

    [UPSC 2024] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.

    Linkage: The increasing deaths due to liver diseases in India, which accounted for a substantial share of digestive system diseases and became the eighth leading cause of death in 2022, highlight a significant public health challenge. This question directly addresses the role of the public healthcare system in containing adverse health impacts and enhancing its reach at the grassroots level.

  • [pib] ‘NAVYA’ Initiative for Skilling Adolescent Girls

    Why in the News?

    The Ministry of Women and Child Development (MWCD) has launched the NAVYA initiative.

    About the ‘NAVYA’ Initiative:

    • Overview: NAVYA stands for Nurturing Aspirations through Vocational Training for Young Adolescent Girls.
    • Nodal Agencies: It is a joint pilot initiative by the Ministry of Women and Child Development (MWCD) and the Ministry of Skill Development and Entrepreneurship (MSDE).
    • Target Beneficiaries: It targets adolescent girls aged 16–18 years who have completed at least Class 10, particularly from under-served regions.
    • Implementation: The pilot phase will be implemented in 27 districts across 19 states, including Aspirational Districts and those from North-Eastern regions.
    • Objective: To build skills, confidence, and employability among young girls in sectors beyond traditional roles.

    Key Features:

    • Focus on Non-Traditional Skills: Girls will receive training in emerging fields like electronics repair, drone technology, solar energy, and more.
    • Certification Support: Beneficiaries will receive skill certificates under schemes like Pradhan Mantri Kaushal Vikas Yojana (PMKVY) and PM Vishwakarma.
    • Post-Training Pathways: Designed to ensure employment, entrepreneurship, or further education opportunities for girls.
    • Inclusive Development Goal: Empowers girls to be agents of socio-economic change, aligning with India’s growth trajectory toward Viksit Bharat by 2047.
    [UPSC 2017] Which of the following are the objectives of ‘National Nutrition Mission’?

    1. To create awareness relating to malnutrition among pregnant women and lactating mothers.

    2. To reduce the incidence of anaemia among young children, adolescent girls and women.

    3. To promote the consumption of millets, coarse cereals and unpolished rice.

    4. To promote the consumption of poultry eggs.

    Select the correct answer using the code given below:

    (a) 1 and 2 only* (b) 1, 2 and 3 only (c) 1, 2 and 4 only (d) 3 and 4 only

     

  • Integrating Rare Donor Registry of India with e-Rakt Kosh

    Why in the News?

    The ICMR has launched the Rare Donor Registry of India (RDRI). The Ministry of Health and Family Welfare is further planning to integrate the RDRI with the e-Rakt Kosh Digital platform.

    What are Rare Blood Types?

    • Rare blood groups are defined by the absence of high-frequency antigens (HFAs) or negative combinations of multiple common antigens.
    • In India, examples include Bombay (hh), P-null, Rh-null, and rare profiles like S-s-U-.

    About the Rare Donor Registry of India (RDRI):

    • Launch: It was launched by the ICMR–National Institute of Immunohaematology (NIIH) in collaboration with four regional medical institutes.
    • Purpose: It aims to address the shortage of rare blood types such as Bombay (hh), Rh-null, and P-Null, critical for patients with thalassemia, haemophilia, and sickle cell disease.
    • Uniqueness: Over 4,000 donors have been screened using multiplex PCR, suited for Indian genetic diversity, and catalogued using 300+ rare blood markers.
    • Rare Phenotypes Tracked: The registry focuses on rare phenotypes defined by the absence of high-frequency antigens; already 170 Bombay group donors have been identified.
    • Key Features:
      • DNA-Based Testing: Molecular assays are used for accurate donor typing, enabling a centralised national database accessible through a dedicated web portal.
      • Integration with e-Rakt Kosh: RDRI is designed to be integrated with e-Rakt Kosh, enabling cross-platform donor search and matching by medical professionals nationwide.
      • Real-Time Support: The platform allows secure data access, real-time requisitions, and timely transfusion support for patients requiring rare blood types.
      • Global Linkages: The initiative aims to connect with International Rare Donor Panels and develop a frozen rare blood inventory to ensure long-term availability.
    • Challenges: Key challenges include low awareness, shortage of trained personnel, and lack of antibody screening at decentralised blood banks.

    What is E-Rakt Kosh?

    • Overview: e-Rakt Kosh is a national digital platform developed by C-DAC under the National Health Mission, launched in 2016.
    • Real-Time Information: It offers live updates on blood availability, donor records, and donation camp details across India via a centralised interface.
    • National Coverage: The system covers over 3,800 blood centres across 29 states and 8 Union Territories, integrated with UMANG, e-Hospital, and the National Health Portal.
    • Notable features include:
      • Donor Safety and Tagging: It maintains traceable donor databases, including health history and rare blood group tagging, ensuring safe and verified transfusions.
      • Inventory Monitoring: e-Rakt Kosh manages stock levels, tracks expired units, and ensures safe disposal, thereby improving quality control.
      • Camp Management: It facilitates registration and scheduling of blood donation camps, sends alerts for shortages, and streamlines resource planning.
      • Critical Access Role: Once integrated with RDRI, it will allow direct access to rare blood group data, crucial during emergency transfusions.
      • Transparency and Logistics: The system enhances transparency, strengthens blood logistics, and improves communication between blood banks, hospitals, and donor groups.
    [UPSC 2001] A man whose blood group is not known meets with a serious accident and needs blood transfusion immediately. Which one of the blood groups mentioned below and readily available in the hospital will be safe for transfusion?

    Options: (a) O, Rh- * (b) O, Rh+ (c) AB, Rh- (d) AB, Rh+

     

  • Analysing Internet access and digital skills in India

    Why in the News?

    The National Sample Survey Office’s Comprehensive Annual Modular Survey (CAMS) 2022-23 is a landmark initiative that provides the first large-scale assessment of India’s digital landscape at the household and individual level.

    What does the CAMS 2022–23 reveal about digital access and skills in India?

    • Broadband Access is Widespread but Unequal: 76.3% of Indian households have broadband internet, indicating strong national reach. Eg: In urban areas like Delhi, over 90% of households are connected, while in states like Arunachal Pradesh, only 60.2% have access.
    • Social and Economic Inequalities Persist: Broadband access is higher among General category households (84.1%), but much lower among SCs (69.1%)and STs (64.8%). Eg: In the lowest income decile, 71.6% of households lack broadband, compared to just 1.9% in the top decile.
    • High Mobile Ownership But Gender and Caste Gaps Remain: Over 94% of rural households own mobile phones, but usage is skewed. Eg: Only 25.3% of rural women in the General category use mobile phones independently, and the percentage is even lower among SC/ST women.
    • Basic Digital Skills are Still Limited: While many can use mobile phones, skills like emailing and online banking are still underdeveloped. Eg: Only 20% of rural and 40% of urban people can send or receive emails; only 37.8% of all people aged 15+ can perform online banking transactions.

    Why does the digital divide still exist despite high internet penetration?

    • Economic Inequality Limits Access: While internet availability is high, affordability remains a barrier for poorer households. Eg: In the lowest income decile, 71.6% of households lack broadband, compared to only 1.9% in the top income group.
    • Social Disparities Affect Usage: Caste and gender-based inequalities reduce meaningful digital access and use. Eg: Among rural women from the General category, only 25.3% use mobile phones independently, with even lower figures among SC/ST women.
    • Low Functional Digital Literacy: Having internet access does not mean people have the skills to use it effectively for education or services. Eg: Only 20% of rural and 40% of urban populations can send or receive emails, showing a gap in practical digital usage.

    What digital skills are lacking among rural and urban populations?

    • Email Communication Skills Are Low: A large section of the population cannot use basic email services. Eg: Only 20% in rural areas and 40% in urban areas can send or receive emails.
    • Spreadsheet and Arithmetic Skills Are Poor: Most people lack the ability to perform basic digital tasks like calculations in spreadsheets. Eg: Less than 40% of Indians aged 15+ can perform arithmetic operations in spreadsheets.
    • Online Banking Proficiency Is Limited: There is limited ability to use secure digital financial services. Eg: Only 37.8% of people aged 15+ in India can perform online banking transactions, indicating low digital financial literacy.

    How can the government bridge the digital divide to meet the SDG 4 goals? (Way forward)

    • Subsidise Internet Access for Poor Households: Make broadband a basic utility, like water or electricity, to ensure universal access. Eg: Provide low-cost broadband plans or free connections for families in the bottom income deciles, where 71.6% lack connectivity.
    • Invest in Digital Skill Training: Launch nationwide programs to train youth and adults in essential digital skills. Eg: Government-backed digital literacy missions in rural areas can teach email use, spreadsheet functions, and online banking.
    • Promote Inclusive Technology Access for Women and Marginalised Groups: Ensure equal digital access for SCs, STs, OBCs, and women through targeted schemes. Eg: Initiate women-focused mobile usage schemes in rural areas, where only 25.3% of general category women use mobile phones exclusively.

    Mains PYQ:

    [UPSC 2021] Has digital illiteracy, particularly in rural areas, coupled with lack of Information and Communication Technology (ICT) accessibility hindered socio-economic development? Examine with justification.

    Linkage: The article explicitly details the disparities in “broadband Internet facilities” and “mobile or telephone connections” between rural and urban areas, and across different states, caste groups (OBCs, SCs, STs, and General), and income deciles, directly addressing “ICT accessibility. This question directly aligns with the core themes presented in the article.

  • National Polio Surveillance Network (NPSN)

    Why in the News?

    The Indian government has proposed a phased winding down of the National Polio Surveillance Network (NPSN), a WHO-established network critical to tracking and eliminating polio in India.

    About National Polio Surveillance Network (NPSN):

    • Launch : The NPSN was established in 1997 as a collaboration between the World Health Organization (WHO) and the Ministry of Health and Family Welfare (MoHFW), Government of India.
    • Objective: Its main goal is to detect and monitor the poliovirus in India to enable quick response and containment.
    • Operational Structure: The network functions under the National Polio Surveillance Project (NPSP) and includes over 200 field surveillance units across the country.
    • Methodology: The core method is Acute Flaccid Paralysis (AFP) surveillance, which tracks sudden paralysis in children under 15 — a key indicator of polio.
    • Environmental Surveillance: The NPSN also tests sewage and water samples to detect silent circulation of the virus.
    • Laboratory Support: A network of WHO-accredited laboratories confirms virus presence through testing of stool and water samples.
    • Rapid Response: Every suspected case is quickly investigated, and public health teams are deployed for control and containment.
    • Expanded Role: Over time, NPSN has also supported surveillance for measles, rubella, DPT, and helped train health workers on new vaccines.

    Polio and Its Eradication in India:

    • About: Polio is a highly infectious viral disease primarily affecting children under 5, potentially causing paralysis or death.
    • Transmission: The disease spreads via the faecal-oral route, mostly through contaminated water or food.
    • Types of Polioviruses:
      • WPV1 still exists in Pakistan and Afghanistan.
      • WPV2 and WPV3 have been eradicated globally.
    • Infection Mechanism: Once inside the body, the virus multiplies in the intestines and may attack the nervous system, causing permanent paralysis.
    • Prevention through Vaccination:
      • Oral Polio Vaccine (OPV) is given at birth, 6, 10, and 14 weeks, with a booster at 16–24 months.
      • Injectable Polio Vaccine (IPV) is administered with the third DPT dose under the Universal Immunization Programme (UIP).
    • Pulse Polio Campaign (1995): India launched the Pulse Polio Immunization Campaign, providing oral polio drops to all children under 5.
    • Eradication Milestones: The last wild polio case in India was reported in 2011, and in 2014, WHO officially declared India polio-free.
    • Role of NPSN: The success was enabled by strong surveillance, mass immunization, and dedicated work by NPSN and its partners.
    [UPSC 2016] ‘Mission Indradhanush’ launched by the Government of India pertains to:

    (a) Immunization of children and pregnant women*

    (b) Construction of smart cities across the country

    (c) India’s own search for the Earth-like planets in outer space

    (d) New Educational Policy

     

  • [30th May 2025] The Hindu Op-ed: Rewriting the script of Early Childhood Education

    PYQ Relevance:

    [UPSC 2020] National Education Policy 2020 is in conformity with the Sustainable Development Goal-4 (2030). It intends to restructure and reorient education system in India. Critically examine the statement.

    Linkage: A key focus of the NEP 2020 is the strengthening and formalization of Early Childhood Care and Education (ECCE), recognizing its foundational importance. Therefore, critically examining the NEP 2020 directly relates to the concept of “rewriting the script” for education, including ECE.

     

    Mentor’s Comment:  Lack of proper early childhood care and education (ECE) increases inequality, affecting children’s brain development, learning ability, and future income. Nobel Prize winner James Heckman’s research shows that investing in young children gives the best returns. This highlights the need for urgent systemic changes. Some states like Uttar Pradesh, Odisha, and Madhya Pradesh are already making progress with innovative ECE programmes. These small but focused steps in early childhood can help break the cycle of poverty and help India fully benefit from its young population by 2047.

    Today’s editorial will talk about the early childhood care and education (ECE) . This content would help in GS Paper II ( Policy Making & Education).

    _

    Let’s learn!

    Why in the News?

    India’s silent but urgent employment crisis is rooted not just in the lack of jobs, but in the lottery of birth that disadvantages millions of children from the outset. So, smart spending on early childhood education and involving parents will support young children in learning better.

    What is the lottery of birth? 

    • The “lottery of birth” refers to the idea that a child’s future is largely shaped by the circumstances into which they are born, such as: Family income, Geographic location, Caste, gender, or religion, Access to health, nutrition, and education.
    • These are factors beyond the child’s control but can determine their opportunities, development, and life outcomes.

    What is the significance of the “lottery of birth” in shaping a child’s future in India? 

    • Determines Access to Basic Needs Early On: A child born into poverty often lacks access to adequate nutrition, healthcare, and early learning, which are essential for cognitive and physical development. Eg: A child born in a rural poor household may suffer from malnutrition and poor school readiness, limiting long-term potential.
    • Creates Early Learning and Earning Gaps: By age 5, differences in language, numeracy, and motivation are already visible, making it harder for disadvantaged children to catch up in school and later in life. Eg: Only 15% of pre-primary children could match basic objects, and 30% could identify larger and smaller numbers, indicating early learning gaps.
    • Perpetuates Intergenerational Poverty: Children born into poverty often remain trapped in low-opportunity environments, repeating the cycle into adulthood due to limited human capital development. Eg: Without quality early education, a poor child is far less likely to complete schooling or access skilled employment, thus continuing the poverty cycle.

    Why is early childhood care and education (ECE) considered a high-return investment?

    • Highest Returns on Human Capital Investments: The Heckman Curve shows that investments in ECE yield the greatest returns compared to later stages of education or training. Eg: For every $1 spent on ECE, the return ranges between $7 to $12, through better education, health, and reduced crime.
    • Long-Term Economic and Social Benefits: Quality ECE leads to higher lifetime earnings, better employment, and improved life outcomes, helping individuals and economies thrive. Eg: Children with access to quality ECE are 4 times more likely to earn higher incomes and 3 times more likely to own a home as adults.
    • Bridges Early Learning Gaps and Boosts School Readiness: ECE helps close learning gaps caused by poverty, ensuring children enter school prepared, reducing dropouts and remedial education costs. Eg: States like Odisha are launching Shishu Vatikas to prepare 5–6-year-olds for formal schooling, improving readiness and future learning outcomes.

    Who are the key stakeholders responsible for improving ECE outcomes in India?

    • Anganwadi workers and government pre-primary school teachers are frontline educators.
    • State governments are responsible for hiring dedicated ECE teachers and creating infrastructure.
    • Parents and caregivers play a crucial role in reinforcing learning at home.
    • Supervisors and training institutions ensure quality and pedagogy through monitoring and capacity building.
    • The Government of India provides funding and policy direction, though current spending is limited (₹1,263 per child annually).

    Where are Indian states like Uttar Pradesh and Odisha making notable ECE interventions?

    • Uttar Pradesh: Hiring of ECE Educators and Teacher Training: Uttar Pradesh is recruiting nearly 11,000 Early Childhood Care and Education (ECE) educators for Balavatikas across districts. The state also held a six-day residential training for 50 master trainers from 13 districts to improve ECE pedagogy. Eg: These trained master trainers will cascade the training to other educators, ensuring quality instruction in early years.
    • Odisha: Launch of Shishu Vatikas and Jaduipedi Kits: Odisha is setting up Shishu Vatikas in all government schools to prepare children aged 5–6 for formal schooling. The state also introduced Jaduipedi Kits — play-based learning materials to enhance school readiness. Eg: These initiatives are aligned with NEP 2020 and help improve early learning outcomes through structured activities.

    How can parental involvement improve the effectiveness of early learning initiatives?

    • Strengthens Learning Continuity at Home: When parents engage in their child’s early education, it reinforces what is taught at ECE centres, ensuring consistent learning both at home and school. Eg: Providing simple worksheets or storybooks for home use helps children practice and retain concepts better.
    • Improves Child Motivation and Confidence: Active parental involvement boosts a child’s sense of security, motivation, and self-esteem, making them more eager to learn. Eg: In Madhya Pradesh, programmes like Bal Choupal involve parents in play-based activities, which positively impact children’s classroom participation.
    • Bridges Knowledge Gaps through Technology: Digital tools like WhatsApp groups or EdTech apps help parents access learning tips, track progress, and support their child’s development, especially where formal education resources are limited. Eg: Parents receiving weekly learning activities via smartphones are better equipped to support foundational skills like language and numeracy.

    What are the steps taken by the Indian government?

    • Integration of ECE in National Education Policy (NEP) 2020: The NEP 2020 recognizes early childhood education as a critical foundation and proposes a new 5+3+3+4 curriculum structure, where the first five years focus on foundational learning (ages 3–8). Eg: Introduction of the “Foundational Literacy and Numeracy” mission (NIPUN Bharat) to ensure basic learning outcomes by Grade 3.
    • Expansion and Strengthening of Anganwadi Centres: The government has focused on upgrading 14 lakh Anganwadi centres across India to serve as key delivery points for ECE, nutrition, and health services. Eg: POSHAN Abhiyaan supports capacity-building of Anganwadi workers and provides teaching-learning material to improve preschool education quality.

    Way forward: 

    • ​​Increase Investment and Improve Infrastructure in ECE: The government should significantly raise funding per child for early childhood education to ensure adequate instructional time, trained teachers, and quality learning materials. Strengthening infrastructure, including more Anganwadi centres and pre-primary schools with dedicated educators, will help bridge existing gaps and improve learning outcomes.
    • Enhance Parental Engagement and Community Participation: Empower parents with awareness, guidance, and digital tools to participate in their children’s early learning. Community-based programs like Bal Choupal should be expanded nationwide, and EdTech solutions leveraged to provide continuous support, creating a strong home-school learning ecosystem.

  • India’s first ICMR-SCD Stigma Scale 

    Why in the News?

    The Indian Council of Medical Research (ICMR) has developed the ICMR-SCD Stigma Scale for India (ISSSI) to help understand and reduce stigma faced by patients and caregivers from sickle cell disease (SCD).

    What is Sickle Cell Disease (SCD)?

    • Nature of Disease: SCD is a genetic disorder where red blood cells become sickle-shaped, reducing oxygen delivery in the body.
    • Complications: These sickle cells can block blood vessels, break easily, and cause anemia, organ damage, and painful episodes.
    • Cause: The disease is inherited, requiring one defective gene from each parent; one gene leads to sickle cell trait.
    • Symptoms: Common symptoms include fatigue, body pain, swollen limbs, frequent infections, and organ damage.
    • Treatment Options: There is no universal cure, but bone marrow transplants and gene therapy offer potential solutions; supportive care helps manage symptoms.

    Note:

    • Anaemia is a condition where the blood lacks enough healthy red blood cells (RBCs) or haemoglobin.
    • All SCD patients have anaemia, but not all anaemia is due to Sickle Cell Disease.

    About the ICMR-SCD Stigma Scale for India (ISSSI):

    • Purpose: The ISSSI is India’s first tool designed to measure stigma faced by sickle cell disease (SCD) patients and their caregivers.
    • Developing Authority: It was developed by ICMR to understand and address the social impact of SCD in India’s diverse communities.
    • Global Context: This is the fourth stigma scale worldwide and the first validated for Indian conditions.
    • Scientific Validation: The tool was validated in a study published in The Lancet (Regional Health – South-East Asia).
    • Availability: The ISSSI is now approved for use in both clinical and research settings across India.
    • Components: It includes two formats — ISSSI-Pt for patients and ISSSI-Cg for caregivers.
    • Stigma Dimensions: It captures issues related to family expectations, reproductive concerns, social disclosure, illness burden, interpersonal challenges, and negative healthcare experiences.
    • Data Sources: The scale was developed using inputs from 6 culturally diverse districts: Alluri Seetharama Raju, Anuppur, Chhoteudepur, Kandhamal, Mysuru, and Udalguri.

    India’s Strategy: Anaemia Mukt Bharat (AMB)

    • Launch Year: The AMB Mission was launched in 2018 to reduce anemia using a 6x6x6 strategy.
    • Target Groups: It covers six groups — young children, school children, adolescents, women of reproductive age, pregnant women, and lactating mothers.
    • Key Interventions: Actions include iron and folic acid supplements, deworming, nutrition education, digital health tools, IFA-fortified foods, and disease screening (including SCD).
    • Supporting Systems: It is backed by inter-ministerial coordination, state-level units, research centers, the AMB Dashboard, digital tracking, and supply chain support.
    • Reach: The mission aims to impact around 450 million people, focusing on real-time monitoring and last-mile delivery.
    [UPSC 2023] Consider the following statements in the context of interventions being undertaken under Anaemia Mukt Bharat Strategy:

    1. It provides prophylactic calcium supplementation for pre-school children, adolescents and pregnant women. 2. It runs a campaign for delayed cord clamping at the time of child-birth. 3. It provides for periodic deworming to children and adolescents. 4. It addresses non-nutritinoal causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis.

    How many of the statements given above are correct?

    Options: (a) Only one (b) Only two (c) Only three* (d) All four

     

  • [17th May 2025] The Hindu Op-ed: The ingredient to turn around nutrition outcomes

    PYQ Relevance:

    [UPSC 2024] Distinguish between gender equality, gender equity and women’s empowerment. Why is it important to take gender concerns into account in programme design and implementation?

    Linkage: Gender concerns are important in programme design, aligning with the article’s argument that nutrition programmes like POSHAN have limited impact.

     

    Mentor’s Comment: India’s free foodgrain programme, which supports 800 million people, shows a harsh truth: hunger and malnutrition are still big problems. In this fight against malnutrition, women and girls are often ignored. Even though the economy is growing and many welfare schemes exist, nutrition is still very unequal, especially for women. The government started the POSHAN Abhiyaan in 2018 to make India free of malnutrition by 2022. This scheme focuses on improving nutrition for pregnant women, new mothers, teenage girls, and young children. But, big differences in nutrition levels still remain.

    Today’s editorial discusses malnutrition among women and girls in India, despite government efforts like the POSHAN Abhiyaan. This topic is useful for GS Paper I (Women-related Issues) and GS Paper II (Welfare State).

    _

    Let’s learn!

    Why in the News?

    The government launched the POSHAN Abhiyaan to end malnutrition by 2022, but it has not achieved its goals.

    How does malnutrition in India remain deeply gendered?

    • Stark Anaemia Disparity: NFHS-5 reports 57% of women aged 15–49 are anaemic compared to 26% of men, highlighting deep nutritional inequality.
    • Underweight Burden: Nearly 1 in 5 women is underweight, a sharp contrast to men and a sign of chronic deprivation.
    • Entrenched Norms: In poorer households, women eat last and least, reinforcing invisible cultural biases that deny them basic nutritional rights.
    • Economic Disempowerment: 49% of women lack control over their own earnings, which translates into less dietary agency and poor health outcomes.
    • Nutrition as Justice: Malnutrition is framed not just as a health issue, but a social justice issue driven by patriarchal household structures.

    Why has POSHAN 2.0 failed to improve women’s nutrition significantly?

    • Underutilization of Allocated Funds: Despite a large budget, only about 69% of funds were used by December 2022, limiting the programme’s reach and effectiveness. Eg: ₹24,000 crore allocated in 2022-23, but nearly one-third remained unspent.
    • Rising Anaemia Rates Despite Investments: Anaemia prevalence among women increased from 53% to 57%between NFHS-4 and NFHS-5, showing no significant improvement. Eg: NFHS-5 data shows anaemia rates rose even after POSHAN 2.0’s interventions.
    • Focus on Awareness Over Actual Nutrition: The programme has raised awareness (Jan Andolan) but awareness alone cannot address the root causes of malnutrition such as poverty and food scarcity.
    • Ignoring Social and Economic Barriers: POSHAN 2.0 largely addresses food supply and supplementation but does not sufficiently tackle women’s economic dependence and decision-making power. Eg: 49% of women lack control over how their income is spent, limiting their ability to benefit from nutrition programmes.

    How does women’s empowerment impact nutritional outcomes?

    • Improved Spending on Nutrition: When women control income, they prioritize food and health for themselves and their families, leading to better nutrition. Eg: Nobel laureate Esther Duflo found that women’s control over extra income increases spending on children’s nutrition.
    • Greater Decision-Making Power: Empowered women can make choices about their diet, healthcare, and food allocation, reducing malnutrition risks. Eg: NFHS-5 showed that women with decision-making power over finances had better nutritional status.
    • Increased Access to Employment and Income: Economic empowerment through stable jobs helps women afford nutritious food and healthcare. Eg: Women with even modest independent income were found less likely to be undernourished in low-income communities.
    • Enhanced Health Awareness and Education: Empowered women tend to have better knowledge of nutrition and health practices, improving family nutrition. Eg: Women participating in financial literacy and health workshops show better child feeding practices.
    • Reduced Gender-Based Nutritional Inequality: Empowerment challenges social norms that deprioritize women’s nutrition, leading to more equitable food distribution. Eg: Households where women contribute economically often have less gender disparity in food consumption.

    How can inter-scheme convergence tackle gendered malnutrition?

    Note: Inter-scheme convergence is the coordinated collaboration of multiple government programmes across sectors.
    • Integrated Service Delivery: Combining nutrition, health, and livelihood schemes ensures women receive comprehensive support addressing multiple malnutrition causes. Eg: Anganwadi centres providing food supplements along with skill training and job linkages.
    • Efficient Resource Utilization: Coordination between departments reduces duplication and optimizes use of funds for women’s nutrition and empowerment. Eg: Joint budgeting for POSHAN Abhiyaan and women’s employment schemes leads to better fund utilization.
    • Holistic Empowerment of Women: Linking nutrition programmes with economic and social empowerment schemes increases women’s ability to accessand afford nutritious food. Eg: Combining POSHAN 2.0 with financial literacy and credit schemes for women.
    • Targeted Interventions in High-Risk Areas: Collaborative planning allows focused efforts in districts with severe malnutrition, addressing structural and social barriers. Eg: Health, nutrition, and livelihood departments working together in tribal districts to improve women’s nutrition.
    • Multi-dimensional Monitoring and Evaluation: Integrated monitoring tracks progress on nutrition and women’s empowerment indicators simultaneously, improving accountability. Eg: Measuring both reduction in anaemia and increase in women’s decision-making power under joint schemes.

    What steps can make women active agents in nutrition programmes? (Way forward)

    • Enhance Economic Empowerment: Provide women with access to skill training, income opportunities, and financial literacy so they can afford nutritious food and make independent decisions. Eg: Linking Anganwadi centres with local skill development and credit schemes for women.
    • Increase Decision-Making Power: Promote women’s participation in household and community decisions related to health, diet, and resource allocation. Eg: Community meetings where women lead discussions on nutrition and health interventions.
    • Strengthen Awareness and Capacity Building: Use nutrition programmes to conduct health education, nutritional counselling, and leadership training, empowering women as knowledge bearers and change-makers. Eg: Financial literacy workshops and health awareness sessions at POSHAN Abhiyaan centres.