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

  • Tackling the Fatty Liver Disease Epidemic

    Why in the news?

    This year’s theme for International Fatty Liver Day, an awareness initiative observed annually in June, is ‘Act Now, Screen Today’. This theme holds more urgency now than ever before.

    Liver Diseases in recent times

    • Liver diseases have long been primarily linked to excessive alcohol consumption, which continues to be a major cause of advanced chronic liver disease.
    • However, in recent years, a new and quietly escalating threat to liver health has emerged: non-alcoholic fatty liver disease.

    India’s Growing Burden of Fatty Liver Disease

    Note: MASLD, or Metabolic dysfunction-associated steatotic liver disease, is a reclassification of what was previously known as non-alcoholic fatty liver disease (NAFLD). 

    • High Prevalence Rates: The global prevalence of Metabolic dysfunction-associated steatotic liver disease (MASLD) is estimated at 25-30%. In India, a 2022 meta-analysis revealed that the pooled prevalence of fatty liver among adults was 38.6%. Among obese children in India, the prevalence was around 36%.
    • Progression of Disease: The continuous damage caused by fatty liver leads to more severe conditions such as steatohepatitis and cirrhosis, often requiring liver transplants.

    Causes of Growing Burden of Fatty Liver Disease

    • Lack of Early Detection: Fatty liver disease often goes undetected in early stages due to lack of symptoms. Diagnosis usually occurs at an advanced stage, when significant liver damage has already taken place.
    • Diet and Insulin Resistance: Excessive consumption of carbohydrates, especially refined carbs and sugars, leads to metabolic problems. High carbohydrate intake results in persistently high insulin levels and insulin resistance, promoting the conversion of excess glucose into fatty acids, which are then stored in the liver.

    Initiatives Taken by the Government

    • Integration with NPCDCS: The Ministry of Health & Family Welfare launched operational guidelines for integrating NAFLD with the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in February 2021.
    • Health Promotion and Prevention: The Ayushman Bharat- Health and Wellness Centres (AB-HWCs) are being used to promote healthy living and screen for hypertension, diabetes, and other common NCDs.

    Personalization is the Key

    • Tailored Screening Tests: The selection of screening tests and their frequency should be based on individual risk factors, including family history, lifestyle, and pre-existing health conditions.
    • Avoiding Generic Assumptions: Clinicians should not rely solely on age or physical markers; instead, they should consider a comprehensive risk profile. Non-communicable diseases are increasingly affecting diverse populations, including children.
    • Integrated Health Strategies: Combining dietary modifications, regular physical activity, and effective weight management to mitigate liver disease risks.
    • Frequent Screenings: Regular monitoring of liver health through non-invasive tools like vibration-controlled transient elastography. Continuous assessment of liver stiffness to detect early stages of liver fibrosis and monitor treatment responses.
    • Active Health Management: Emphasis on the importance of individuals taking control of their health by being aware of their diet and lifestyle choices.Encouragement of frequent health screenings to detect and manage liver disease early.

    Way Forward:

    • Awareness Campaigns: Government initiatives focus on raising awareness about the importance of liver health and the risks associated with MASLD.
    • Health Screenings: Programs promoting comprehensive health screenings that include physical examinations, blood tests, and abdomen ultrasounds to detect liver diseases early.

    Mains PYQ

    Q The public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

  • The social sciences, a shelter for the ‘excluded’ student

    Why in the news?

    Persistent exclusion results in some disciplines becoming a last resort for many students with social sciences increasingly becoming a significant reservoir of the excluded in India.

    Causes of Exclusion in Higher Education:

    • Excessive Competition: Premier institutions have stringent filtering mechanisms due to high demand, which results in significant exclusion of students.
    • Financial Factors: Private institutions often have high fees not regulated by statutory norms, and public institutions, facing reduced government funding, also increase fees, making education inaccessible for many.
    • Subject and Course Availability: There is a regional disparity in the availability of courses. Certain regions offer generic courses with outdated syllabi, limiting students’ choices and leading to exclusion.

    Surge of Empirical Orientation:

    • Employability Perception: Courses with empirical and practical applications, like economics, are perceived to offer better employment opportunities compared to more theoretical courses like anthropology or sociology.
    • Policy Intervention Skills: There is a growing expectation for social science students to develop problem-solving skills similar to those of engineering students, which narrows the focus within social sciences.
    • Private Universities: The emergence of private universities catering to the affluent has led to a demand for courses that are less popular in public institutions, creating a dichotomy in course preference and quality.

    Improving Quality of Higher Education:

    • Expand Quantity and Improve Quality: Increase the number of seats to accommodate excluded students and ensure concerted efforts towards enhancing the quality of education like entry based on competitive exams.
    • Enhance Teaching Quality: Prioritize the improvement of teaching methods and the content of courses to make education more relevant and effective for example reviewing and taking feedback on learning experiences from students.
    • Address Financial Exclusion: Implement measures to reduce financial barriers and prevent the widening of educational inequalities, ensuring that quality education is accessible to a broader demographic. For example, the Government can provide loans or scholarships.
    • Update Course Content: Regularly revise and update the syllabi to keep pace with societal changes and technological advancements, such as generative artificial intelligence.
    • Focus on Inclusivity: Ensure that policies and interventions in higher education focus on inclusivity, addressing the needs of diverse student populations and reducing regional disparities in course offerings.

    Steps taken by Government 

    • All India Council for Technical Education (AICTE) Initiatives: The AICTE has undertaken various initiatives to enhance the quality of technical education, such as the establishment of Deen Dayal Upadhyay KAUSHAL Kendras and the introduction of B.Voc degree programs.
    • University Grants Commission (UGC) Regulations: The UGC has notified regulations to improve the quality of higher education, including those related to recognition, accreditation, minimum qualifications for teachers, curbing ragging, and grievance redressal.
    • Scholarship and Fellowship Schemes: The UGC has launched various scholarship and fellowship schemes, such as the PG Doctoral Fellowship for SC/ST students, to promote inclusion and equity in higher education.

    Conclusion: Efforts to enhance higher education, including expanding access, improving quality, and addressing financial barriers, are crucial for fostering inclusivity and equipping students for India’s future.

    Mains PYQ:

    Q The quality of higher education in India requires major improvement to make it internationally competitive. Do you think that the entry of foreign educational institutions would help improve the quality of technical and higher education in the country Discuss. (UPSC IAS/2015)

  • [7th June 2024] The Hindu Op-ed: Health regulations need a base-to-top approach

    [7th June 2024] The Hindu Op-ed: Health regulations need a base-to-top approach

    PYQ Relevance

    Q The public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

    Q In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss. (UPSC IAS/2020)

    Mentors comment: In the last week of May, a tragic fire at a private neonatal care nursing home in New Delhi shocked everyone. Political parties started blaming each other, and the media exaggerated by incorrectly claiming that many nursing homes in Delhi operate without a license. Despite the intense media coverage, the incident has been largely forgotten, leaving the grieving parents behind. Instead of focusing on who to blame, it’s important to recognize that such tragedies are usually the result of systemic failures—in this case, the failure of health-care regulations.

    Let’s learn–

    Why in the news?

    Health regulations are crucial, but their implementation in India needs to be thoughtful and carefully balanced.

    Regulation and standards in the Indian health care system

    • Excessive and Complex Regulations: Some states have over 50 approvals required under multiple regulations for each healthcare facility, creating a bureaucratic burden. Despite the complexity, there is a perception among officials that the private health sector is under-regulated.
    • Unrealistic Standards: Many healthcare quality standards set by the government, such as those in the Clinical Establishments (Registration and Regulation) Act, 2010, and the Indian Public Health Standards (IPHS), are considered unrealistic and difficult to implement. Only a small percentage of government primary healthcare facilities meet these standards despite their aspirational goals.

    Mixed health-care system in India 

    • Diverse Healthcare Providers: India’s healthcare system includes both government and private sector providers, ranging from single-doctor clinics and small nursing homes to large corporate hospitals, each serving different population segments.
    • Dominance of Private Sector: The private sector delivers approximately 70% of outpatient services and 50% of inpatient services, indicating a significant reliance on private facilities for health care by the Indian population.
    • Regulatory and Quality Challenges: There are disparities in regulation enforcement and quality standards between the private and government sectors, with issues such as approval delays, cost of compliance, and ensuring consistent quality care across diverse facilities.

    Challenges related to mixed health-care system

    • Regulatory Disparities: Uneven enforcement of regulations between private and government health facilities. Overzealous regulation of private facilities while government facilities face fewer consequences for similar infractions.
    • Approval Delays: Sluggish approval processes for private facilities, causing operational delays and financial strain. Long waiting periods for renewal applications, even when submitted well in advance.
    • Cost and Accessibility: High cost of services in large corporate hospitals compared to smaller clinics and nursing homes. Limited accessibility of government facilities for certain populations, despite being free or low-cost.
    • Differential Standards: Impractical to hold small clinics and nursing homes to the same standards as large hospitals. Need for a tiered approach to regulation, with essential and desirable standards based on facility type.
    • Financial Burden: High cost of compliance with regulations for smaller facilities, potentially making health services unaffordable for patients. The a need for government subsidies or funding to help smaller providers meet regulatory standards without increasing costs for patients.
    • Stakeholder Involvement: Insufficient involvement of health-care providers, facility owners, and community members in the formulation of regulations. Lack of representation from various types of facilities in regulatory processes.
    • Public Perception and Trust: Political rhetoric and sensational media coverage undermining trust in health-care providers. Potential for increased violence against health-care providers due to public mistrust.
    • Infrastructure and Safety: Inconsistent emphasis on essential safety measures like fire safety across facilities. Need for equitable implementation of safety standards in all healthcare buildings.

    Affordable care is one need

    • Role of Small Providers: Single doctor clinics and small nursing homes are crucial for providing initial access and health services, particularly for middle-income and low-income populations. These smaller providers deliver a significant portion of health services at a lower cost compared to large corporate hospitals.
    • Supportive Regulations: There is a need for regulations that support small providers to keep healthcare costs low and affordable. Guidelines should be practical and implementable, harmonizing multiple regulations and simplifying the application process with timely approval.
    • Differential Approach: Regulations should recognize the different capabilities of various health facilities. Smaller clinics and nursing homes should not be held to the same standards as large hospitals to avoid escalating costs that could be transferred to patients. Essential and desirable regulatory points should be established, with regular self-assessments and inspections to ensure compliance.
    • Government subsidies and funding should be considered to help smaller facilities adhere to necessary regulations without increasing costs for patients.

    Why do we need to Focus on the primary caregivers?

    • Accessibility and Affordability: Single-doctor clinics and small nursing homes provide essential health services at a lower cost, making health care more accessible and affordable for middle-income and low-income populations.
    • Primary Care Foundation: Promoting primary care helps manage health issues early, reducing the burden on secondary and tertiary care facilities and supporting the goals of the National Health Policy, 2017, for people-centric, accessible, and affordable health services.
    • Sustainable Support: Simplified, fair, and collaborative regulatory processes, along with government subsidies, can help primary-care providers operate effectively, ensuring quality and safety without escalating costs for patients.

    Conclusion: Primary health care is crucial for achieving the SDG goal of universal health coverage by providing accessible, affordable, and quality health services, thus reducing the burden on higher-level care facilities and promoting overall health equity.

  • Tele MANAS cell for Armed Forces

    Why in the News?

    • The Ministry of Health and Family Welfare (MoHFW) and the Ministry of Defence (MoD) have entered into a Memorandum of Understanding (MoU) to foster collaboration in operating a special cell of Tele MANAS.
      • This collaboration, spanning two years, aims to establish a pilot project at the Armed Forces Medical College in Pune.

    Suicides and Fratricides in Armed Forces: A Global Issue

    • As per information given in Parliament in April 2022, there were two cases of fratricide each year from 2019 to 2021 and one case in 2021.
    • In an older reply in Rajya Sabha on suspected suicide cases in the Army, the Government informed that during the years 2016 to 2018 there were 104, 75 and 80 cases, respectively.
    • A 2018 study correlated extended deployment to a 15% increased suicide risk in the U.S. military, the U.S. Department of Defence recorded 503 suicides among active-duty personnel in 2019.
    • Common reasons that forces an individual to take extreme steps are:
      • Family issues,
      • Family separation,
      • Prolonged deployment in difficult areas,
      • Continuous exposure to hazardous situations,
      • Traumas originated in Counter Insurgency or Counter Terrorism operations and
      • Wide range of Human Resource management issues.
    • Preventive Measures: The Army in its latest advisory issued in August 2023 stated that officers and religious teachers – at least one Pandit, Maulvi, Granthi or Pastor – are posted in each unit and selected other ranks are being trained on the nuances of counselling.

    What is the Tele MANAS Initiative?

    • Tele MANAS, or Tele Mental Health Assistance and Networking across States, stands as India’s National Tele Mental Health Programme.
    • It is envisioned as the digital extension of the District Mental Health Programme (DMHP).
    • Its announcement came in the Union Budget of 2022.
    • The Ministry of Health and Family Welfare (MoHFW) serves as the nodal agency overseeing its implementation.
    • The primary aim is to ensure universal access to equitable, accessible, affordable, and high-quality mental health care through round-the-clock tele-mental health services.
    • The International Institute of Information Technology, Bengaluru, serves as the technology partner.
    • The nodal centre for Tele MANAS operations is located at NIMHANS, Bengaluru.
    • The National Health Systems Resource Centre operates within the health system domain.
    • Helpline numbers for assistance are 14416 and 18008914416.
    • The implementation structure comprises two tiers:
    1. Tier 1: Consists of State Tele MANAS cells comprising trained counsellors and mental health specialists,
    2. Tier 2: Comprises resources from the District Mental Health Program (DMHP) and medical colleges.

    Reach and Impact

    • Nationwide Presence: Currently, 51 operational Tele MANAS cells operate across all 36 States and UTs, delivering services in 20 diverse languages.
    • Remarkable Response: Since its inception in October 2022, Tele MANAS has received over 10 lakh calls and manages a daily average of more than 3,500 calls.

    National Mental Health Programme (NMHP):

    • The NMHP was launched by the Government of India in 1982.
    • It was initiated to address the significant burden of mental disorders in the population.
    • Mental disorders affect approximately 6-7% of the population in India.
      • Objectives of NMHP: Ensuring the availability and accessibility of minimum mental healthcare to all, particularly the vulnerable and underprivileged sections of the population.
    • As part of NMHP, the District Mental Health Program (DMHP) was introduced in 1996 during the IX Five Year Plan based on the ‘Bellary Model’:
      • The Bellary Model emphasizes the importance of early detection, short-term training for physicians, and health worker training in identifying individuals with mental health issues.

     

    PYQ:

    [2023] Why suicide among young women is increasing in Indian society?

  • The delicate balancing of health-care costs    

    Why in the news?

    With growing health disparities and inconsistent access to medical services, the need for fair and sustainable healthcare policies has never been more pressing.

    Private Healthcare System in India

    • Private hospitals in India, especially those accredited by the Joint Commission International (JCI) and National Accreditation Board for Hospitals (NABH), are hubs of specialised care and innovation.
    • These institutions invest heavily in top-tier infrastructure and advanced technologies, significantly enhancing patient outcomes, particularly in complex procedures. Integration of telemedicine and remote care is common, broadening access and building patient trust.

    Price Caps, Quality, and Innovation

    • Affordability vs. Quality: The Supreme Court’s deliberation on standardising medical procedure rates across government and private sectors highlights the tension between affordability and quality. A study indicates a 15% increase in patient dissatisfaction in hospitals under financial pressure from price caps
    • Impact on Innovation: Price caps could slow the development of new treatments and technologies, particularly in high-investment fields like cancer research and robotic surgery. Value-based pricing, where payments reflect health outcomes rather than service volume, is proposed as a potential solution.
    • Economic Implications: Properly implemented rate standardisation can alleviate healthcare disparities but must avoid destabilising providers’ economic health. Dynamic pricing models, which adjust based on medical complexity and patient financial status, are recommended. Thailand’s tiered pricing system is cited as a successful example.

    Legal and regulatory challenges

    • No regulation on Rate Fixation: States like Rajasthan and Tamil Nadu have identified significant gaps in the provisions for rate fixation, indicating a need for more robust legal frameworks to ensure fair and standardised pricing across different regions.
    • Inadequate Laws as per Local Conditions: Current laws may not adequately consider local demographic and economic conditions, necessitating reforms that allow for more customised approaches to healthcare cost management.
    • Lack in uniform regulation: Moreover,” the Clinical Establishment Act of 2011″, aimed at setting standards for quality, transparency, and accountability, has been adopted by only a few states, and its implementation remains lax​​. This lack of uniform regulation allows for wide disparities in service costs and quality.

    Role of Data in Shaping Policies

    • Data-Driven Insights: Predictive analytics can foresee the long-term impacts of rate fixation on healthcare innovations, helping policymakers adjust regulations to encourage innovation and accessibility.
    • Pilot Projects: Implementing pilot projects in select districts can gauge the impact of rate caps on healthcare quality and innovation.

    Way Forward 

    • Balanced Pricing Models: Implement value-based pricing where payments are linked to health outcomes rather than the volume of services provided.
    • Supporting Innovation: Allocate government subsidies and grants for research and development in private hospitals.

    Mains PYQ

    Q Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (UPSC IAS/2018)

  • India and the ‘managed care’ promise

    PYQ Relevance

    Q Public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

    Q The increase in life expectancy in the country has led to newer health challenges in the community. What are those challenges and what steps need to be taken to meet them? (UPSC IAS/2022)

    Mentor Comment: Health insurance, now central to India’s UHC policy, is being enhanced by digital advancements, enabling reforms akin to the U.S. but with cost-effective local adaptations. A South Indian healthcare chain recently integrated insurance and care provision, forming an Indian-style MCO. This prompts reflection on MCOs’ potential to extend universal health care in India significantly.

    Let’s learn_ _ 

    Why in the news?

    Universal healthcare poses a multifaceted challenge, yet managed care organizations may offer a piece of the solution that Indian healthcare requires.

    What is a Managed Care Organization?

    • A Managed Care Organization (MCO) is a health care company or a health plan that is focused on managed care as a model to limit costs, while keeping quality of care high.

    The background of Managed Care Organizations (MCOs) in the United States and India:

    Evolution of MCOs in the United States:

    •  MCOs have their origins in rudimentary prepaid healthcare practices in the 20th century.
    • The mainstreaming of MCOs gained momentum in the 1970s due to concerns over healthcare costs.The economic slowdown post-1970s made high insurance premiums less attractive to purchasers.
    • A shift occurred towards integrating insurance and healthcare provisioning functions. Focus areas included prevention, early management, and cost control, all under a fixed premium paid by enrollees.
    • MCOs have evolved through multiple generations and forms, deeply penetrating the health insurance market. While evidence of their effectiveness in improving health outcomes and prioritizing preventive care is mixed, they have been effective in reducing costly hospitalizations and associated costs.

    Evolution of MCOs in India:

    • The first public commercial health insurance emerged in the 1980s.The focus has primarily been on indemnity insurance and covering hospitalization costs.
    • There is a significant market for outpatient consultations, valued at nearly $26 billion.
    • Health insurance in India has traditionally lagged behind life and general insurance. The sector faces issues such as lack of innovation and high, often unsustainable, operational costs.
    • As per Thomas (2011), Health insurance has played a secondary role to other forms of insurance. The industry’s operational inefficiencies and high costs have been persistent issues.

    Challenges in India:

    • Lack of Natural Incentives for Cost Control: The evolutionary trajectory of Indian health insurance has not incentivized consumer-driven cost control.
    • Target Demographic: Health insurance has mainly targeted a thin, urban, well-off segment, neglecting broader demographics.
    • Informality in Outpatient Practices: There is widespread informality among outpatient practices, complicating efforts to standardize and regulate care.
    • Lack of Clinical Protocols: The absence of widely accepted clinical protocols hampers the quality and consistency of care.
    • Economic Viability: Unprofitable operations and unaffordable premiums pose significant economic challenges, preventing sustainable growth and systemic improvement.
    • Limited Impact on UHC: Private initiatives, despite their potential, are unlikely to significantly contribute to Universal Health Coverage (UHC) without public support.
    • Insufficient Control Over Patient Journeys: Health insurers have little control over the patient’s journey before hospitalization, limiting their ability to manage early interventions and reduce costs through comprehensive outpatient care.

    Prospective Solutions and Remaining Issues:

    • Potential for Big Healthcare Brands: Large healthcare brands with loyal urban patient bases and substantial resources may initiate successful managed care projects.
    • Need for Public Patronage: Exploring managed care with cautious and incremental public patronage could be promising, indicating a need for government involvement to achieve broader impacts.
    • Underutilization of Outpatient Insurance: Given the low share of insurance in outpatient care spending and the average of three consultations per year per person, there is significant potential to reduce healthcare costs through early interventions and comprehensive outpatient care coverage.

     NITI Aayog Report:

    • Outpatient care insurance scheme: In 2021, NITI Aayog released a report advocating for an outpatient care insurance scheme based on a subscription model to enhance savings through improved care integration.
    • Yield significant benefits: A well-functioning managed care system can yield significant benefits, including consolidating practices, streamlining management protocols, and emphasizing preventive care in the private sector.
    • Catering for the beneficiaries of PMJAY: The report highlights the potential of incentives under the Ayushman Bharat Mission to encourage the establishment of hospitals in underserved areas catering to beneficiaries of the Pradhan Mantri Jan Arogya Yojana (PMJAY).

    Conclusion: While Managed Care Organizations are not a perfect solution, they can play a role in addressing the complexities of achieving Universal Health Coverage (UHC) in India by being part of a broader strategy.

  • 38% Indians consume fried snacks and processed foods, only 28% consume healthy food

    Why in the news?

    A global report highlights a significant rise in unhealthy food consumption in India, surpassing intake of vegetables, fruits, and other nutritious foods.

    • Global Food Policy Report 2024: Food Systems for Healthy Diets and Nutrition was released by “the International Food Policy Research Institute (IFPRI)”.

    About CGIAR:

    • CGIAR (formerly the Consultative Group on International Agricultural Research) is a global partnership uniting organizations engaged in research for a food-secure future.
    • Focus: Its mission focuses on reducing poverty, enhancing food and nutrition security, and improving natural resources and ecosystem services.CGIAR conducts research and partners with other organizations to transform global food systems and ensure equitable access to sustainable, healthy diets.

    Emerging Trends in India:

     

    • Increase in consumption of unhealthy food: There is a significant increase in the consumption of unhealthy foods such as salty or fried snacks compared to nutritious options like vegetables and fruits. About 38% of the population consumes unhealthy foods, while only 28% consume all five recommended food groups.

    The consumption of processed foods and ready-made convenience foods is rising. From 2011 to 2021, malnutrition in India increased from 15.4% to 16.6%.The prevalence of overweight adults rose from 12.9% in 2006 to 16.4% in 2016.

    Processed food consumption is on the rise in India 

    South Asian Highlights

    • Processed Food Consumption: Increasing intake of processed foods like chocolates, salty snacks, beverages, and ready-made meals in India and other South Asian countries.
    • Malnutrition Rates: High levels of undernutrition and micronutrient deficiencies coexist with rising rates of overweight, obesity, and diet-related noncommunicable diseases (NCDs).
    • Food Budget Trends: Packaged food spending in India’s household food budgets nearly doubled from 6.5% to 12% between 2015 and 2019.

    Issue of Double Malnutrition:

    • Double malnutrition refers to the coexistence of undernutrition and micronutrient deficiencies with overweight and obesity, or diet-related noncommunicable diseases (NCDs).
    • High levels of undernutrition (stunting and wasting) and micronutrient deficiencies persist even as overweight and obesity rates increase.
    • More than two billion people, especially in Africa and South Asia, cannot afford a healthy diet.

    Dietary Guidelines by ICMR:

    • The Indian Council of Medical Research (ICMR) released 17 dietary guidelines to promote healthy eating.
    • Guidelines emphasize reading food labels to make informed choices and minimizing the consumption of high-fat, sugar, salt, and ultra-processed foods.
    • The guidelines highlight the importance of diverse diets over cereal-centric agriculture and food policies.
    • ICMR advises against the misleading information often presented on packaged foods.

    Way forward:

    • Strengthen Nutritional Policies: Develop and enforce policies that promote the consumption of nutritious foods. Implement taxes on unhealthy foods and subsidies for fruits, vegetables, and other micronutrient-rich foods.
    • Regulate Processed Foods: Implement strict regulations on the marketing of unhealthy foods, especially targeting children.

    Mains PYQ:

    Q How far do you agree with the view that the focus on the lack of availability of food as the main cause of hunger takes the attention away from ineffective human development policies in India? (15) (UPSC IAS/2018)

  • NIMHANS bags WHO’s Nelson Mandela Award for Health Promotion for 2024

    Why in the News?

    • The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India’s premier mental health institution, has been honoured with the “Nelson Mandela Award” for Health Promotion by the World Health Organization (WHO) for 2024.

    About National Institute of Mental Health and Neuro-Sciences (NIMHANS)

    Details
    Location Bangalore, India
    Affiliation Autonomous institute under the Ministry of Health and Family Welfare, Government of India
    Ranking Ranked 4th best medical institute in India by the “National Institutional Ranking Framework (NIRF)”
    History
    • Founded in 1847 as the Bangalore Lunatic Asylum.
    • Renamed as the Mental Hospital in 1925.
    • Amalgamated with the All India Institute of Mental Health (AIIMH) in 1974 to form NIMHANS.
    • Conferred with deemed university status by the University Grants Commission in 1994.
    • Declared an Institute of National Importance by an act of parliament in 2012.
    Governance
    • Operates with academic autonomy under the “Societies Registration Act”.
    • Prioritises service, manpower development, and research in mental health and neurosciences.
    • A multidisciplinary integrated approach was adopted for translating research results into practice.
    Funding Receives resources for academic and research activities from national and international funding organisations.
    Outreach
    • Engages in mental health outreach initiatives including critiquing mental health reports and collaborating with government agencies for training and counseling.
    • Known for diagnosing and treating various mental health conditions including depression and neurobiological disorders.

     

    Back2Basics: Nelson Mandela Award for Health Promotion

    Aspect Details
    Establishment Year 1995
    Presented by World Health Organization (WHO)
    Purpose Recognizing outstanding contributions and achievements in health promotion worldwide
    Namesake Nelson Mandela, former President of South Africa
    Criteria for Recognition
    • Innovative approaches
    • Sustainable Impact
    • Dedication to health equity and social justice
    Recipients Individuals, organisations, institutions, or communities
    Selection Process
    • Based on significant strides in health promotion
    • Consideration of efforts in disease prevention and well-being improvement, especially among disadvantaged populations
    Presentation
    • Occurs during special ceremonies or events
    • Often coincides with key health promotion initiatives or milestones
    Significance
    • Symbolises recognition and encouragement for ongoing efforts in health promotion
    • Highlights the importance of collective action and collaboration in addressing health challenges and achieving public health and sustainable development goals

     

    PYQ:

    [2021] We can never obtain peace in the outer world until and unless we obtain peace within ourselves.

  • How close is the World Health Organization to agreeing on pandemic response rules?

    Why in the News?

    Health officials of the World Health Organization (WHO) aim to finalize over two years of negotiations on new pandemic response rules when they convene in Geneva next week.

    About the ‘Pandemic Treaty’

    • The pandemic treaty is a new legally binding agreement being negotiated to improve the global pandemic response. The treaty aims to address the shortcomings revealed during the COVID-19 pandemic, such as inequitable vaccine distribution.
    • Article 12, a critical and contentious part of the treaty, proposes reserving around 20% of tests, treatments, and vaccines for WHO distribution to poorer countries during emergencies.
    • The treaty would be the second major health accord after the 2003 Framework Convention on Tobacco Control.

    Convention n Tobacco Control

    • Govt. of India ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004, the first-ever international public health treaty focusing on the global public health issue of tobacco control.
    • The FCTC is a legally binding treaty that requires countries bound by the treaty — or Parties to implement evidence-based measures to reduce tobacco use and exposure to tobacco smoke.

    How will Global Health Rules Change?

    • Updates to the existing International Health Regulations (IHR) include a new alert system for different risk assessments of outbreaks, replacing the current single-level emergency declaration.
    • A new “early action alert” stage will be introduced, along with a potential “pandemic emergency” category for the most severe health threats.
    • Obligations for countries: Strengthened obligations for countries to inform the WHO about public health events, changing the language from “may” to “should”.

    How do the countries view this pact?

    • Developed Countries
        • Wealthy countries are often cautious about sharing resources such as drugs and vaccines.
        • There is significant political pressure, especially from right-wing groups, fearing that the treaty could infringe on national sovereignty.
        • These countries are concerned about the financial implications, debating whether to set up a new fund or use existing resources like the World Bank’s $1 billion pandemic fund.
    • Underdeveloped Countries
      • Poorer countries emphasize the need for equitable access to treatments and vaccines, reflecting experiences of “vaccine apartheid” during the COVID-19 pandemic.
      • They advocate for stronger commitments from wealthier nations to support global health infrastructure and emergency response capabilities.

    Future Scope of the New IHR Rules and the Pandemic Accord (Treaty):

    • More robust framework: The IHR updates and the pandemic treaty has designed to complement each other, creating a more robust framework for global health emergencies.
    • Promotes cooperation: The new rules aim to ensure faster, more transparent information sharing, and better co-operation during health crises.
    • Next steps for treaty negotiations: Next week’s World Health Assembly will focus on planning the next steps for the Treaty Negotiations, with a full agreement unlikely to be reached immediately.
    • Defenses against future pandemics: The successful implementation of both the IHR updates and the pandemic treaty could significantly strengthen the world’s defenses against future pandemics, addressing gaps exposed by COVID-19.

    Conclusion: While there is a shared understanding of the treaty’s importance, countries’ views are shaped by their National interests, Financial concerns, and Political pressures, leading to complex and protracted negotiations.

    Mains PYQ:

    Q Critically examine the role of WHO in providing global health security during the Covid-19 pandemic. (UPSC IAS/2020)

  • Spotlighting Pre-eclampsia, ensuring safe motherhood

    Why in the News?

    The prevalence of Congenital Anomalies and Neurological Challenges in newborns highlights the need for adequate Antenatal and Perinatal care to address them.

    Key observations made by the National Family Health Survey (NFHS-5):

    Perinatal mortality rates stand at 32 for 1,000 pregnancies, neonatal mortality rates at 25 for 1,000 live births, and hypertensive disorders in pregnancy remain a leading cause of maternal death.

    • Cause of Maternal and Perinatal Mortality: Preeclampsia (PE) is a significant cause of maternal and perinatal morbidity and mortality, with early onset PE posing higher risks.  
    • Combination of Maternal factors and Biomarkers: Screening based on maternal risk factors alone has suboptimal performance, while a combination of maternal factors and biomarkers like mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor can improve detection rates significantly.
    • Early Intervention with Aspirin Prophylaxis: First-trimester screening models, like the FMF prediction algorithm, have been effective in identifying high-risk pregnancies for preterm PE, allowing for early intervention with aspirin prophylaxis to reduce the incidence of preeclampsia.

    What is Pre-eclampsia?

    • Preeclampsia is a complication of pregnancy. Preeclampsia, high blood pressure, and high levels of protein in urine indicate kidney damage (proteinuria), or other signs of organ damage. 
    • Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

     

    Challenges to cure Pre-eclampsia (PE):

    • Complex Screening Protocols: Effective screening requires a combination of maternal history, demographics, color Doppler ultrasound, mean arterial pressure, and placental biomarkers, which may not be uniformly available or implemented.
    • Limited Resources: Not all healthcare facilities have access to advanced screening tools and technologies like color Doppler ultrasound and placental biomarker testing.
    • Lack of Awareness: Pregnant women may not be aware of the symptoms and risks associated with pre-eclampsia, leading to delayed presentation and diagnosis.
    • Delayed Intervention: Identifying high-risk pregnancies early is crucial, but delays in screening and diagnosis can lead to missed opportunities for timely intervention.
    • Pharmacological Challenges: Ensuring timely pharmacological intervention, such as aspirin prophylaxis, requires adherence to established protocols, which may only sometimes be followed.
    • Logistical Issues: Implementing widespread screening and management protocols involves logistical challenges, including training healthcare providers and ensuring the availability of necessary equipment.
    • Complexity of the Disorder: The systemic nature of pre-eclampsia, affecting multiple organs, complicates its management and requires a multidisciplinary approach.

    Programs in India:

    • “Samrakshan” program: The Indian Radiological and Imaging Association’s (IRIA) “Samrakshan” program aims to reduce pre-eclampsia from 8%-10% to 3% and fetal growth restriction from 25%-30% to 10% by the end of the decade.
    • The program focuses on spreading awareness, screening for pre-eclampsia and fetal growth restriction, and ensuring comprehensive care throughout pregnancy.

    Way Forward: 

    • Early Detection and Management: Early detection through regular prenatal care, including blood pressure monitoring and urine testing for protein, is crucial in managing pre-eclampsia.
      • Timely intervention can help prevent severe complications and ensure the well-being of both mother and baby.
    • Promoting Awareness and Education: Raising awareness about the signs and symptoms of pre-eclampsia among pregnant women is essential for early recognition and prompt action.
      • Education on risk factors, preventive measures, and the importance of regular antenatal check-ups can significantly impact maternal and neonatal outcomes.
    • Ensuring Access to Quality Maternal Healthcare: Access to quality maternal healthcare services, including skilled antenatal care, monitoring, and timely interventions, is vital in addressing pre-eclampsia and reducing maternal mortality rates.
      • Empowering healthcare providers with the knowledge and resources to manage pre-eclampsia effectively is key to ensuring safe motherhood.
    • Collaborative Efforts for Maternal Health: Collaboration between governments, healthcare institutions, non-profit organisations, and the private sector is essential in implementing comprehensive maternal health programs that prioritise the prevention, early detection, and management of pre-eclampsia.

    Conclusion: By spotlighting pre-eclampsia and emphasising the importance of early detection, awareness, access to quality care, and collaborative efforts, we can strive towards ensuring safe motherhood for all women, safeguarding the health and well-being of mothers and their babies.

    Mains PYQ:

    Q Identify the Millennium Development Goals (MDGs) that are related to health.Discuss the success of the actions taken by the Government for achieving the same.(UPSC IAS/2013)