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

  • ICMR releases Ethical Guidelines for AI usage in Healthcare

    health

    The Indian Council of Medical Research (ICMR) has recently released the first-ever set of ethical guidelines for the application of artificial intelligence (AI) in biomedical research and healthcare.

    Ethical Guidelines for AI usage in Healthcare

    • The guidelines aim to create “an ethics framework which can assist in the development, deployment, and adoption of AI-based solutions” in specific fields.
    • Through this initiative, the ICMR aims to make “AI-assisted platforms available for the benefit of the largest section of common people with safety and highest precision possible”.
    • It seeks to address emerging ethical challenges when it comes to AI in biomedical research and healthcare delivery.

    Key features

    • Effective and safe development, deployment, and adoption of AI-based technologies: The guidelines provide an ethical framework that can assist in the development, deployment, and adoption of AI-based solutions in healthcare and biomedical research.
    • Accountability in case of errors: As AI technologies are further developed and applied in clinical decision making, the guidelines call for processes that discuss accountability in case of errors for safeguarding and protection.
    • Patient-centric ethical principles: The guidelines outline 10 key patient-centric ethical principles for AI application in the health sector, including accountability and liability, autonomy, data privacy, collaboration, risk minimisation and safety, accessibility and equity, optimisation of data quality, non-discrimination and fairness, validity and trustworthiness.
    • Human oversight: The autonomy principle ensures human oversight of the functioning and performance of the AI system.
    • Consent and informed decision making: The guidelines call for the attainment of consent of the patient who must also be informed of the physical, psychological and social risks involved before initiating any process.
    • Safety and risk minimisation: The safety and risk minimisation principle is aimed at preventing “unintended or deliberate misuse”, anonymised data delinked from global technology to avoid cyber attacks, and a favourable benefit-risk assessment by an ethical committee among a host of other areas.
    • Accessibility, equity and inclusiveness: The guidelines acknowledge that the deployment of AI technology assumes widespread availability of appropriate infrastructure and thus aims to bridge the digital divide.
    • Relevant stakeholder involvement: The guidelines outline a brief for relevant stakeholders including researchers, clinicians/hospitals/public health system, patients, ethics committee, government regulators, and the industry.
    • Standard practices: The guidelines call for each step of the development process to follow standard practices to make the AI-based solutions technically sound, ethically justified, and applicable to a large number of individuals with equity and fairness.
    • Ethical review process: The ethical review process for AI in health comes under the domain of the ethics committee which assesses several factors including data source, quality, safety, anonymization, and/or data piracy, data selection biases, participant protection, payment of compensation, possibility of stigmatisation among others.

    Policy moves for streamlining AI in Healthcare

    • India already offers streamlining of AI technologies in various sectors, including healthcare, through the National Health Policy (2017), National Digital Health Blueprint (NDHB 2019), and Digital Information Security in Healthcare Act (2018) proposed by the Health Ministry.
    • These initiatives pave the way for the establishment of the National Data Health Authority and other health information exchanges.

    Potential applications of AI in healthcare

    Artificial Intelligence (AI) has revolutionized the healthcare industry by enabling various applications. These applications include:

    • Diagnosis and screening: AI can be used to identify diseases from medical images like X-rays, CT scans, and MRIs.
    • Therapeutics: AI can assist in the development of personalised medicines by analyzing a patient’s genetic makeup.
    • Preventive treatments: AI can predict the risk of developing a disease, helping healthcare professionals to take preventive measures.
    • Clinical decision-making: AI can analyze large amounts of data to assist healthcare professionals in making treatment decisions.
    • Public health surveillance: AI can be used to monitor disease outbreaks and inform public health policies.
    • Complex data analysis: AI can analyze large amounts of data from multiple sources to identify patterns and inform healthcare decision-making.
    • Predicting disease outcomes: AI can predict disease outcomes based on patient data, enabling early
    • Behavioural and mental healthcare: AI can help diagnose and treat mental health conditions.
    • Health management systems: AI can assist in managing patient records, appointment scheduling and reminders, and medication management.

    Various challenges for imbibing

    • Data privacy and security: With the use of AI in healthcare, there is a significant amount of personal and sensitive data is collected. This data needs to be kept secure and protected from potential cyber-attacks.
    • Regulatory and ethical issues: AI technology is still in its early stages of development and there are no clear guidelines or regulations in place for its use in healthcare. There are also ethical considerations, such as accountability, transparency, and bias that need to be addressed.
    • High cost involved: The implementation of AI in healthcare requires significant investment in terms of infrastructure, software, and training. This cost can be a major challenge for healthcare organizations, especially in developing countries.
    • Integration with existing systems: AI systems need to be integrated with existing healthcare systems and processes. This can be challenging, especially in cases where the existing systems are outdated or incompatible with AI technology.
    • Lack of trust and acceptance: AI technology is still relatively new in healthcare and there is a lack of trust and acceptance among healthcare professionals and patients. This can be a major hurdle in the widespread adoption of AI in healthcare.

    Threats posed by AI to healthcare

    • Data privacy and security: The use of AI in healthcare requires the collection and analysis of vast amounts of personal health data, which could be at risk of being stolen or misused.
    • Bias and discrimination: There is a risk that AI algorithms could perpetuate existing biases and inequalities in healthcare, such as racial or gender bias.
    • Lack of transparency: Some AI models are complex and difficult to understand, which can make it difficult to explain the reasoning behind a particular decision.
    • Medical errors: AI systems can make errors if they are trained on biased or incomplete data, or if they are used inappropriately.
    • Ethical concerns: There are several ethical concerns associated with the use of AI in healthcare, including the potential for AI to replace human doctors, the impact on patient autonomy, and the implications for informed consent.

    Way forward

    • Develop a national AI strategy for healthcare: This strategy should include policies for data sharing, privacy, and security, as well as guidelines for the ethical and responsible use of AI.
    • Invest in AI research and development: The government should invest in research and development of AI technologies that can help address the challenges in healthcare.
    • Promote collaboration between stakeholders: Collaboration between stakeholders such as healthcare providers, researchers, government agencies, and industry can help accelerate the development and adoption of AI technologies in healthcare.
    • Train healthcare professionals in AI: The government can work with academic institutions and the industry to create training programs and certifications for healthcare professionals.
    • Address regulatory challenges: The government should work to address regulatory challenges related to the use of AI in healthcare.
    • Focus on affordability and accessibility: This can be achieved by promoting innovation, encouraging competition, and ensuring that AI technologies are integrated into existing healthcare infrastructure.

     

  • Strengthening the Fight Against Tuberculosis (TB)

    Tuberculosis

    Central Idea

    • The fight against tuberculosis (TB) has been going on for over 30 years since it was declared a global health emergency, yet the goal of ending TB by 2030 is still uncertain. The fight against TB needs a renewed focus on three key areas i.e., vaccine development, newer therapeutic agents, and improved diagnostics to meet the goal of ending TB by 2030.

    Background

    • In 1993, the World Health Organization declared TB a global health emergency and the 1993 World Development Report stated that TB treatment for adults was the best buy among all developmental interventions.
    • Since then, the global response to TB has been slow and lacks urgency.

    Global Fund

    • The Global Fund to Fight AIDS, TB, and Malaria was created in response to the call for action against TB at the G7 summit in Okinawa, Japan, in 2001.
    • The Global Fund has become the single largest channel of additional funding for global TB control.
    • However, it faces constraints due to zero-sum games from donor constituents and competition between the three diseases it finances.

    Tuberculosis

    StopTB Partnership

    • The StopTB Partnership was constituted to mobilize and marshal a disparate set of actors towards the goal of ending TB.
    • It has been adapting to changes, such as using molecular diagnostic tools developed to respond to bioterrorism to diagnose TB and using social safety programs to address the poverty drivers of the TB epidemic.

    Facts for prelims: Basics of TB

    • Tuberculosis is an infectious disease caused by bacteria called Mycobacterium tuberculosis.
    • It mainly affects the lungs, but can also affect other parts of the body such as the kidneys, spine, and brain.
    • TB spreads through the air when a person with active TB disease in the lungs or throat coughs, sneezes, or speaks.
    • Symptoms of TB include coughing that lasts for three or more weeks, chest pain, coughing up blood, fatigue, fever, and weight loss.
    • TB can be treated with antibiotics, but drug-resistant forms of TB are a growing concern.

    Tuberculosis

    Three key areas that need attention

    1. Vaccine development:
    • The development of an adult TB vaccine is the first area that needs urgent attention.
    • The current vaccine is 100 years old, and the development and wide use of an adult TB vaccine are essential to ending TB.
    • COVID-19 vaccine development process provides insights into accelerating the process.
    • India’s capabilities can play a significant role in vaccine development and equitable distribution.
    1. Newer therapeutic agents for TB:
    • A few new anti-TB drugs are available but face cost and production constraints.
    • Shorter, injection-free regimens are needed to improve compliance and reduce patient fatigue.
    • A continuous pipeline of new drugs is essential to combat drug resistance.
    1. Improved diagnostics:
    • AI-assisted handheld radiology and passive surveillance of cough sounds can revolutionize TB diagnostics.
    • Incentivize biotech startups to disrupt the complexity and price barriers of molecular testing.

    Tuberculosis

    Conclusion

    • India’s leadership role in the G20 and the upcoming StopTB Partnership board meeting in Varanasi provide the perfect opportunity for India to lead the way in ending TB. With the collective will and action of leaders, it is possible to end TB sooner rather than later.
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  • Rajasthan becomes first state to guarantee Right to Health

    health

    The Rajasthan Assembly passed the Right to Health (RTH), even as doctors continued their protest against the Bill, demanding its complete withdrawal.

    Right to Health (RTH): A conceptual insight

    • RTH is a fundamental human right that guarantees everyone the right to enjoy the highest attainable standard of physical and mental health.
    • It is recognized as a crucial element of the right to an adequate standard of living and is enshrined in international human rights law.

    Scope of RTH

    • RTH covers various health-related issues, including-
    1. Access to healthcare services, clean water and sanitation, adequate nutrition, healthy living and working conditions, health education, and disease prevention.
    2. Accessible, affordable, and quality healthcare services,
    3. Eliminating barriers to healthcare access
    4. Informed consent to medical treatment and accessing information about their health.

    What is the Rajasthan Right to Health Bill?

    • Free treatment: RTH gives every resident of the state the right to avail free Out Patient Department (OPD) services and In Patient Department (IPD) services at all public health facilities and select private facilities.
    • Wider scope of healthcare: Free healthcare services will include consultation, drugs, diagnostics, emergency transport, procedures, and emergency care. However, there are conditions specified in the rules that will be formulated.
    • Free emergency treatment: Residents are entitled to emergency treatment and care without prepayment of fees or charges.
    • No delay in treatment: Hospitals cannot delay treatment on grounds of police clearance in medico-legal cases.
    • State reimbursement of charges: After emergency care and stabilisation, if patients do not pay requisite charges, healthcare providers can receive proper reimbursement from the state government.

    Existing schemes in Rajasthan

    • The flagship Chiranjeevi Health Insurance Scheme provides free treatment up to Rs 10 lakh, which has been increased to Rs 25 lakh in the latest budget.
    • The Rajasthan Government Health Scheme covers government employees, ministers, current and former MLAs, etc.
    • The Nishulk Nirogi Rajasthan scheme provides free OPD and IPD services in government hospitals and covers about 1,600 medicines, 928 surgicals, and 185 sutures.
    • The Free Test scheme provides up to 90 free tests in government hospitals and has benefited 2.93 crore persons between March-December 2022.

    Need for the RTH Scheme

    • The state prioritizes healthcare and wants Rajasthan to be a great example of good health.
    • The Health Minister has received many complaints about private hospitals asking for money from patients who have the Chiranjeevi card.
    • So, they are bringing in a new law to stop this.
    • The new law will make sure that future governments follow it and provide free healthcare to everyone.

    Controversy with the RTH Law: Emergency Care Provisions

    • Emergency care was a contentious issue in the RTH.
    • The clause states that people have the right to emergency treatment and care for accidental emergency, emergency due to snake bite/animal bite and any other emergency decided by the State Health Authority under prescribed emergency circumstances.
    • Emergency treatment and care can be availed without prepayment of requisite fee or charges.
    • Public or private health institutions qualified to provide such care or treatment according to their level of health care can offer emergency care.

    Issues raised by healthcare professionals

    • Existing burden of schemes: Doctors are protesting against the RTH because they question the need for it when there are already schemes like Chiranjeevi that cover most of the population.
    • Specialization concerns: They are also objecting to certain clauses, such as defining “emergency” and being compelled to treat patients outside their specialty as part of an emergency.
    • Unnecessary obligations: The Bill empowers patients to choose the source of obtaining medicines or tests at all healthcare establishments, which means that hospitals cannot insist on in-house medicines or tests.

    Way forward

    • Given the contentious nature of the Bill, it is important for all stakeholders to come to the table and engage in constructive dialogue to resolve the issues at hand.
    • It should involve liaison between government, doctors, patient advocacy groups, and other relevant stakeholders to discuss the concerns raised by all parties and identify potential solutions.
    • This could be followed by a revision of the Bill, incorporating feedback and suggestions from all stakeholders, and a renewed effort to build consensus and support for the legislation.
    • Additionally, greater efforts could be made to improve transparency and accountability in the healthcare system, with a focus on educating patients about their rights.

     

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  • Rising Cancer Cases in India And Economic Burden

    Central Idea

    • Cancer cases in India are predicted to cross the 15 lakh mark by 2025, highlighting concerns about the economic burden of expensive cancer treatments and the accessibility of affordable healthcare for patients.

    Cancer

    • Cancer is a group of diseases that arise when cells in the body begin to grow and divide uncontrollably, leading to the formation of tumors.
    • Normally, cells in the body grow, divide, and die in an orderly fashion, but in cancer, this process goes awry, leading to the accumulation of abnormal cells that can form a mass or tumor.
    • There are many different types of cancer, which can affect any part of the body. Some cancers, such as leukemia, do not form tumors but still involve the uncontrolled growth of abnormal cells.
    • Symptoms of cancer can vary depending on the type and location of the cancer, but common signs include unexplained weight loss, fatigue, pain, and changes in the skin or the appearance of a lump or mass.

    Economic Burden of Cancer Treatment

    1. Inaccessible and Increasing Costs:
    • The average medical expenditure per hospitalization case for cancer treatment was ₹68,259 in urban areas, according to the NSS 2017-18 report.
    • A Parliamentary Standing Committee report expressed concern about the inaccessible and increasing cost of cancer treatment.
    1. Regulatory Challenges:
    • While anti-cancer medicine costs can be regulated, the cost of radiotherapy cannot, as it has not been declared an essential service.
    • Insurance Coverage and Out-of-Pocket Expenses.
    1. Impact on Patients:
    • Cancer often strikes around the retirement age, leading to mounting debt burdens.
    • The average hospital stay for 14.1% of cancer patients is more than 30 days, further increasing bills.

    Insurance Coverage and Out-of-Pocket Expenses

    1. Poor Insurance Penetration: More than 80% of hospital bills are paid out of pocket, as per the NSS 2017-18 report.
    2. Ayushman Bharat Limitations: The Committee observed that the Ayushman Bharat insurance scheme launched in 2018 does not cover entire prescriptions, latest cancer therapies, or many diagnostic tests.
    3. State-Specific Insurance Schemes: The Committee suggested a convergence of State and Central schemes, as some State-specific insurance schemes have been highly beneficial.

    State-wise Variation in Cancer Treatment Expenditure

    • State-wise average medical expenditure per hospitalization case for cancer treatment in government hospitals varies, with the lowest in Tamil Nadu and Telangana, and the highest in northern and north-eastern India.

    Facts for Prelims: CAR T-cell therapy

    • Unlike chemotherapy or immunotherapy, which require mass-produced injectable or oral medication, CAR T-cell therapies use a patient’s own cells.
    • The treatment involves modifying a patient’s own T-cells, which are a type of immune cell, in a laboratory to target and attack cancer cells.
    • CAR stands for chimeric antigen receptor, which refers to the genetically engineered receptor that is added to the patient’s T-cells.
    • The patient’s T-cells are collected and genetically modified in a laboratory to express the CAR.
    • The modified T-cells are then infused back into the patient’s body, where they can seek out and destroy cancer cells that express the antigen targeted by the CAR.
    • The cells are even more specific than targeted agents and directly activate the patient’s immune system against cancer, making the treatment more clinically effective.
    • This is why they’re called living drugs.
    • CAR T-cell therapy has shown promising results in treating certain types of blood cancers, including leukemia and lymphoma.

    Conclusion

    • The rising number of cancer cases in India underscores the need to address the economic burden of expensive cancer treatments and improve the accessibility of affordable healthcare for patients. Converging State and Central insurance schemes, expanding insurance coverage, and exploring ways to regulate treatment costs are essential steps to ensure that patients can access life-saving treatments without facing insurmountable financial challenges.
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  • Universal Health Coverage (UHC) Must be Affordable to All

    Central Idea

    • The Universal Health Coverage (UHC) and its implementation in India raises the question of whether we believe in health as a basic human right, which India’s Constitution guarantees under the right to life. The UHC should encompass primary, secondary, and tertiary care for all who need it at an affordable cost without discrimination.

    The Definition of Health

    • The definition of health according to the World Health Organization (WHO), which includes mental and social well-being and happiness beyond physical fitness, and an absence of disease and disability.
    • We cannot achieve health in its wider definition without addressing health determinants, which necessitates an intersectoral convergence beyond medical and health departments.

    Difference between Primary health care (PHC) and Universal health care (UHC)

    • The main difference between PHC and UHC is that PHC is a level of care within the health care system, while UHC is a broader goal of ensuring access to health care for all individuals.
    • PHC is typically provided at the primary care level, while UHC includes all levels of care, from primary to secondary and tertiary care.
    • PHC is focused on basic health care services and health promotion, while UHC aims to provide comprehensive health care services to all individuals.

    Health for All by 2000

    • The slogan Health for All by 2000 proposed by Halfdan Mahler and endorsed by the World Health Assembly in 1977. It argues that universal health care/coverage (UHC) was implied as early as 1977.
    • India committed itself to the ‘Health for All’ goal by 2000 through its National Health Policy 1983.

    International Conference on PHC

    • The International Conference on Primary Health Care, at Alma Ata, 1978, which listed eight components of minimum care for all citizens.
    • Components included: It mandated all health promotion activities and the prevention of diseases, including vaccinations and treatment of minor illnesses and accidents, to be free for all using government resources, especially for the poor.
    • Components excluded: Chronic diseases, including mental illnesses, and their investigations and treatment were almost excluded from primary health care. When it came to secondary and tertiary care, it was left to the individual to seek it from a limited number of public hospitals or from the private sector by paying from their own pockets.

    Concerns around The Astana Declaration

    • The Astana declaration of 2018, which calls for partnership with the private sector. However the commercial private sector, which contributes to alcohol, tobacco, ultra-processed foods, and industrial and automobile pollution, is well established.
    • The Astana declaration never addressed poverty, unemployment, and poor livelihood, but eulogizes quality PHC only as the cornerstone for Universal Health Coverage and ignores broader Universal Health Care.

    Conclusion

    • Every individual has a right to be healed and not have complications, disability, and death. That right is guaranteed only by individualism in public health, the new global approach to UHC, where nobody is left uncounted and uncared for. The Alma Ata declaration of primary health care can be left behind as a beautiful edifice of past concepts, and we should move forward with a newer concept of UHC.
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  • Tamil Nadu’s TN-KET initiative results in reduced TB deaths

    tb

    Tamil Nadu has pioneered an initiative across the State to reduce the mortality rate among people with tuberculosis named: TN-KET (Tamil Nadu Kasanoi Erappila Thittam) meaning TB death-free project.

    What is TN-KET?

    • TN-KET aims to reduce the mortality rate among people with tuberculosis.
    • This initiative, which began in April 2022, has already achieved significant reduction in the number of early TB deaths.

    Unique features

    • Differentiated TB Care: This is at the heart of the initiative, which aims at assessing whether people with TB need ambulatory care or admission in a health facility to manage severe illness at the time of diagnosis.
    • Radiological assessment: The guidelines require comprehensive assessment of 16 clinical, laboratory and radiological parameters.
    • Triage of assessment: The preliminary assessment of patients based on just three conditions — very severe undernutrition, respiratory insufficiency, and inability to stand without support — was found to be feasible for quick identification at diagnosis.

    Outcome: Significant reduction in early TB deaths

    • Above features vastly cut down the delay and increasing the chances of saving lives.
    • The initiative has achieved the initial target of 80% triaging of patients, 80% referral, comprehensive assessment and confirmation of severe illness, and 80% admission among confirmed.
    • The State’s target is to achieve 90%-90%-90% at each district.

    Key challenges

    • The challenge is to increase the duration of admission, especially for people with very severe undernutrition, which comprises 50% of the admitted patients.

     

    Tap to read more about the topic-

    TB mukt India

     

     

  • Undernutrition: Healthy Human Capital Is The Real Wealth

    “Healthy women and children are pillars of a flourishing society”

    Central Idea

    • Undernutrition is a serious public health issue leading to adverse health consequences and affecting the economy, especially in India. Early stimulation and nutrition interventions in infants and young children lead to improved outcomes in adult life. India ranks poorly on the Human Capital Index and has high levels of stunting, anaemia, and malnutrition. Evidence suggests investing in maternal and early-life nutrition leads to high returns on investment.

    Undernutrition leads to adverse health consequences and affects the economy

    • Child deaths: Undernutrition leads to 3.1 million child deaths annually, which accounts for 45 percent of all child deaths.
    • High levels of stunting In India: India has unacceptably high levels of stunting (35.5 percent), despite marginal improvement over the years.
    • Stunting affects per capita income: Two-thirds of India’s current workforce is stunted, which has enormous economic costs in terms of a decrease in per capita income. The average reduction in per capita income for developing countries is at 7 percent, with a high of 13 percent for India due to the high rates of stunting.
    • Wasting in India: The economic losses incurred by India due to wasting are estimated at more than US $48 billion in terms of lifetime lost productivity.
    • Anaemia: Another compounding factor is anaemia among young women, at 57 percent, which has lasting effects on their future pregnancies and childbirth. The situation further worsens when infants are fed inadequate diets, and there is inadequate sanitation and hygiene.

    Investing in the well-being of women and children is an effective strategy

    • Investing in early childhood: Evidence suggests that every additional dollar invested in quality early childhood programs yields a return of between US$6 and US$17.
    • Better income in future: Early stimulation in infants is known to increase their future earnings by 25 percent. Stunting in childhood leads to impaired brain development, lower cognitive skills and education, leading to lower incomes in the future.
    • For instance: According to estimates, children who are stunted earn 20 percent less as adults than children who are not stunted.

    Increased investment in human capital brings economic growth

    • Human capital is the real wealth: The human capital is the wealth of nations and is dependent on the health, nutrition, skills, and knowledge of people.
    • Effective strategy: Evidence suggests investing in the well-being of women and children as an effective strategy for improved outcomes for children.
    • India’s ranking in Human capital Index: India ranks 116 out of 174 countries as per the Human Capital Index, with a score of 0.49 that indicates a child born in India will be 49 percent productive if provided with complete education and good health.
    • Education: Education to children plays a pivotal role in amassing human capital, improving productivity, and economic development. It has been advocated to target the 1000 days’ period from conception to two years of age for improving birth and nutrition outcomes.

    Coupling nutrition-specific interventions with nutrition-sensitive programs

    • Nutrition-sensitive interventions: Nutrition-sensitive interventions like water, sanitation, and hygiene (WASH) focus on the underlying determinants as poor sanitation can lead to stunting.
    • Integrated water and sanitation improvement program: Evidence suggests both short term and long-term reductions in diarrhoea episodes (3-50 percent) through an integrated water and sanitation improvement program in rural India. WASH can bring significant gains in tackling childhood undernutrition and are important determinants of stunting.
    • Nutrition of pregnant women and young children: Studies suggest long term benefits on adult human capital and health by improving the nutrition of pregnant women and young children.
    • For instance: The first 1000 days of life is the time for rapid growth and development, and lack of good nutrition can lead to lifelong adverse consequences. This period is a critical window of opportunity as stunting sets in during this period and aggravates by the age of two years.

    Disparities in Undernutrition Prevalence

    • Data (NFHS 5) reveals that India has more stunted children in rural areas as compared to urban areas, possibly due to socio-economic variance.
    • Stunting prevalence varies depending on mother’s education and household income,
    • There is wide variation among regions, with high rates of stunting in states of Meghalaya (46.5 percent) and Bihar (42.9 percent) while states like Sikkim and Puducherry have lowest at 22.3 percent and 20 percent respectively.
    • Notable inter-state and inter-district variation in terms of stunting prevalence.

    Way ahead

    • Investing in healthcare facilities is crucial for enhancing productivity, economic growth, and security in India.
    • Addressing undernutrition is necessary for producing and maintaining a healthy, highly skilled workforce in India.
    • Cost-effective investments in child health, nutrition, and education are necessary for improving public health and achieving economic growth in India.

    Conclusion

    • Healthy human capital is the true wealth of any nation. In India, undernutrition is a significant public health concern that not only affects the well-being of women and children but also has adverse economic implications. Therefore, addressing undernutrition is critical for creating a healthy, skilled workforce, ensuring economic growth and security in India.

    Mains Question

    Q. What is India’s ranking on the Human Capital Index, and how does investing in the well-being of women and children contribute to economic growth?

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  • Bengal is tackling fatal Adenovirus Infection

    adenovirus

    Central idea: 19 children below the age of five years have died in State-run institutions due to acute respiratory infection (ARI) caused by Adenovirus.

    What is Adenovirus Infection?

    • Adenoviruses are common viruses that typically cause mild cold or flu-like illness and are usually spread from an infected person to others by close personal contact
    • The virus is transmitted through the air by coughing and sneezing and also by touching an object or surface with adenoviruses on it
    • While the virus can affect people of any age group, children with low and compromised immunity are at a higher risk
    • Symptoms of the viral infection, other than common cold or flu-like symptoms, include acute bronchitis, pneumonia, pink eye (conjunctivitis), and acute gastroenteritis

    Reasons for outbreak in Bengal

    • Doctors claim that it is the recombinant strain which is the reason for the spike in infections and deaths.
    • Most of the children who have been infected by the virus are less than three years old and were born during the COVID-19 pandemic.
    • Children who are in the age group of six months to preschool are most susceptible to viral infection.

     

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  • Sickle Cell Anaemia screening meets only 1% of target

    anaemia

    Central idea:  The Health Ministry of India set a target to scan one crore people for sickle cell disease in 2022-23. However, with only two weeks left in the fiscal year, the Ministry has completed only 1% of the target.

    What is Sickle Cell Anaemia?

    anaemia

    • Sickle Cell Anaemia is a genetic blood disorder that affects the haemoglobin molecule in red blood cells.
    • People with sickle cell anaemia have abnormal haemoglobin that causes their red blood cells to become sickle-shaped, rigid and sticky.
    • These abnormal cells can clog small blood vessels, leading to excruciating pain, organ damage, and a higher risk of infections.
    • Sickle cell anaemia is inherited in an autosomal recessive pattern, which means that a person must inherit two copies of the mutated gene, one from each parent, to develop the disease.
    • There is no cure for sickle cell anaemia, but treatments are available to manage its symptoms and complications.

    How widespread is it in India?

    • Sickle cell anaemia is prevalent in some parts of India, particularly in tribal and rural areas.
    • According to the ICMR, sickle cell trait is present in about 20-22% of the tribal population in central India, and the disease is present in about 3-5% of the same population.
    • It is estimated that there are about 30 million carriers of the sickle cell trait in India, and around 1.5-2 lakh sickle cell disease patients.
    • The disease is most commonly found in the states of Chhattisgarh, Madhya Pradesh, Maharashtra, Odisha, and Gujarat.

    Recent discussions

    • India aims to eradicate sickle cell anaemia by 2047, Finance Minister announced during her Budget 2023 speech.
    • Under the new scheme, 70 million people up to the age of 40 years in affected tribal areas will be screened for the disease.
    • The Health Ministry has assigned tentative State-wise screening targets to the States for timely completion of the exercise.
    • The Ministry is working to create and maintain a central registry for all screened persons to prevent patients from slipping through the cracks.

    Current status of screening

    • Only 1,05,954 people have been screened so far, out of which 5959 people, or 5.62% of those screened were found to be carrying sickle cell disease traits.
    • Regular and timely screening of the population is important, as in a previous screening exercise of over 1.13 crore people in 2016, up to 9,49,057 (8.75%) tested positive for the sickle cell trait, and up to 47,311 of these ended up with full-blown sickle cell disease.

    Way forward

    • Increased screening: Achieving the goal of eliminating sickle cell anaemia would involve screening at least seven crore people under the age of 40 years in multiple phases by 2025-26.
    • Creating awareness: The Health Ministry is working to create awareness amongst those who carry the sickle cell trait to refrain from marrying another person who also carries the trait.
    • Targeted assessment: Pregnant women are a priority group for immediate screening, and in the long-term, screening of targeted population of unmarried adolescents between 10 to 25 years will be undertaken.
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  • Ayurveda Practice: Significant Challenges

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    Central Idea

    • Ayurveda graduates face significant challenges in pursuing a career in Ayurvedic practice due to widespread scepticism about the efficacy of Ayurvedic theories and practices. Despite the publicity campaigns to promote Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH), the fact is that there is a trust-deficit in these systems.

    What is National AYUSH Mission?

    • Department of AYUSH, Ministry of Health and Family Welfare, Government of India has launched National AYUSH Mission (NAM) during 12th Plan for im­plementing through States/UTs.
    • The basic objective of NAM is to promote AYUSH medical systems through cost effective AYUSH services, strengthening of educational systems, facilitate the enforcement of quality control of ASU &H drugs and sustainable availability of ASU & H raw-materials.
    • It envisages flexibility of implementation of the programmes which will lead to substantial participation of the State Governments/UT.
    • The NAM contemplates establishment of a National Mission as well as corresponding Missions in the State level.

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    What is Ayurveda?

    • Sanskrit word: Ayu means life, and Veda means knowledge or science Hence it is “The Science of Life.”
    • Ayurveda is a traditional system of medicine that originated in India more than 5,000 years ago.
    • It was taught orally from one generation to another by accomplished masters.
    • Some of this knowledge was later put into writing, but much of it remains inaccessible.
    • The principles of many natural healing systems, including Homeopathy and Polarity Therapy, have their roots in Ayurveda.

    What are the reasons for the public’s skepticism towards Ayurveda?

    • Failed to keep the pace: The Ayurveda establishment has failed to keep pace with the intellectual and scientific advances of the times.
    • Archaic theories and lack of evidence-based quality: Archaic theories that are apt to arouse suspicion in the minds of educated patients are peddled as sophisticated dogmas. Treatments are not subjected to straightforward testing as they are claimed to be based on these theories
    • Perception that Ayurvedic treatments are slow to heal: Ayurveda treatments are slow to heal is another common view that characterises the public image of Ayurveda.

    What are the challenges faced by Ayurveda graduates in pursuing a career in practice?

    • Practical usability is limited: Limited practical usability of ancient medical wisdom taught in college training
    • Lack of vibrant ecosystem of Research: Dependence on personal experimentation due to a lack of a vibrant ecosystem of science and research. The Research process involves a lot of trial and error with patients and predictably leads to an erosion of the practitioner’s reputation.
    • Necessity of complementing Ayurveda with modern medicine: Inability to treat all primary-care illnesses, necessitating complementing with modern medicine, which is prohibited in most states.
    • Unhealthy competition and advertisements: Competition from gimmickry and publicity-based practitioners.

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    How can appropriate policy-making help solve these challenges?

    • Proper training: Rejuvenating primary care by training Ayurveda graduates to become good primary-care doctors.
    • Evidence-based appraisal of Ayurveda: Conducting a vigorous evidence-based appraisal of Ayurvedic theories and practices to sift the usable from the obsolete
    • Practice modern medicines: Statutory decision to allow Ayurveda graduates to practice modern medicine in stipulated primary care areas

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    Conclusion

    • Ayurveda prioritizes patient benefit over gratification and emphasizes prevention through balance, diet, lifestyle, and herbs. Sustainable treatment requires a gradual transition to wellness. Ayurveda, science, and public welfare all stand to gain. What is needed is sincerity, straight-thinking, and some adventurism on the part of stakeholders.

    Mains Question

    Q. What is Ayurveda? Despite of the efforts to promote Ayurveda, the graduates face significant challenges in pursuing a career in Ayurvedic practice. Discuss.

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