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

  • India nears milestone with first indigenous Dengue Vaccine

    dengue

    Central Idea: Serum Institute of India and Panacea Biotec have applied to the ICMR’s call for Expression of Interest for collaborative Phase-III clinical trials for an indigenous dengue vaccine.

    What is Dengue?

    Details
    Transmission Primarily transmitted through the bite of infected Aedes mosquitoes
    Virus and Serotypes Dengue virus belonging to the Flaviviridae family

    Four distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4
    Symptoms High fever, severe headache, joint and muscle pain, rash, pain behind the eyes, mild bleeding
    Severe Dengue Progression to severe dengue can cause plasma leakage, bleeding, organ impairment
    Geographic Distribution Endemic in more than 100 countries, particularly in tropical and subtropical regions
    Incidence and Global Impact 100-400 million dengue infections occur annually globally, affecting healthcare systems and economies
    Vector and Breeding Sites Aedes aegypti mosquito breeds in stagnant water containers found near human dwellings
    Treatment No specific antiviral treatment available; supportive care, rest, fluid intake, symptom management
    Prevention and Control Reduce mosquito breeding sites, proper water storage, cleaning of water containers, use of insecticides

     

    Dengue Virus Disease and Global Impact

    • Dengue virus disease causes significant morbidity and mortality worldwide, with 2 to 2.5 lakh (200,000 to 250,000) cases reported annually in India.
    • The global incidence of dengue has increased dramatically, with over half of the world’s population at risk.
    • The World Health Organization (WHO) has identified dengue as one of the top ten global health threats in 2019.
    • Currently, there is no specific treatment for dengue, highlighting the urgent need for effective vaccines.

    Desirable Characteristics of a Dengue Vaccine

    The ICMR highlights the desirable characteristics of a dengue vaccine, including a-

    • Favorable safety profile
    • Protection against all four serotypes of dengue
    • Reduced risk of severe disease and death
    • Induction of a sustained immune response and
    • Effectiveness regardless of previous sero-status and age

     

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  • India’s G20 Presidency: Strengthening Global Health Governance for Safer and Equitable World

    Health

    Central Idea

    • India’s G20 presidency is gaining momentum, with a focus on harnessing shared responsibilities and collaborative governance to enhance global safety from pandemics. It seeks to bridge the gap between the Global North and Global South, recognizing the inclusive memberships of G20 and other plurilateral arrangements that span the global community.

    Importance of Health as a global public good

    • Interconnectedness: In today’s interconnected world, diseases can quickly spread across borders, transcending geographical boundaries. The health of individuals and communities in one part of the world can have direct implications for others. Therefore, addressing health issues becomes a shared responsibility for all nations.
    • Impact on Global Stability: Health crises, such as pandemics, can have severe social, economic, and political consequences. They can disrupt economies, strain healthcare systems, and cause social unrest. By ensuring health as a global public good, we contribute to global stability, sustainable development, and peaceful coexistence.
    • Humanitarian Imperative: Health is a fundamental human right. Everyone deserves access to quality healthcare and the opportunity to lead a healthy life. Treating health as a global public good ensures equitable access to healthcare services, regardless of an individual’s nationality or socioeconomic status.
    • Economic Productivity: Healthy populations are essential for economic productivity and growth. By investing in health as a global public good, we can create conditions for individuals to thrive, contribute to their communities, and participate actively in economic activities.
    • Prevention and Preparedness: Addressing health as a global public good requires proactive measures to prevent and prepare for health emergencies. By investing in disease surveillance, research, and robust healthcare systems globally, we can better detect and respond to outbreaks, mitigating their impact and saving lives.
    • Collaboration and Knowledge Sharing: Recognizing health as a global public good encourages collaboration among nations. By sharing knowledge, best practices, and resources, countries can collectively work towards improving public health outcomes, fostering innovation, and finding solutions to complex health challenges.
    • Achieving Sustainable Development Goals: Health is intricately linked to several Sustainable Development Goals (SDGs), including good health and well-being (SDG 3), poverty eradication (SDG 1), and gender equality (SDG 5). Treating health as a global public good support the achievement of these interconnected goals, leading to a more equitable and sustainable world.

    India’s response to Covid-19: Whole-of-society and whole-of-government approach

    • Early Measures and Nationwide Lockdown: India implemented one of the world’s largest and strictest nationwide lockdowns in March 2020 to contain the spread of the virus. This decision aimed to break the chain of transmission and provide time to strengthen healthcare infrastructure.
    • Testing and Surveillance: India significantly ramped up its testing capacity, expanding the network of testing laboratories across the country. The government implemented various testing strategies, including rapid antigen tests and RT-PCR tests, to detect and track Covid-19 cases.
    • Healthcare Infrastructure: To bolster healthcare infrastructure, the government initiated several measures such as establishing dedicated Covid-19 hospitals, increasing the number of ICU beds, ventilators, and oxygen supply, and mobilizing healthcare professionals to regions facing surges in cases.
    • Vaccine Development and Rollout: India played a crucial role in vaccine development, with its indigenous vaccine candidates receiving regulatory approval. The country launched an ambitious vaccination drive, prioritizing healthcare workers, frontline workers, and vulnerable populations. India also contributed to global vaccine supply through the export of vaccines under the Vaccine Maitri initiative.
    • Economic Relief Measures: Recognizing the socioeconomic impact of the pandemic, the government introduced economic relief measures, including financial assistance, direct benefit transfers, and welfare schemes to support vulnerable sections of society affected by lockdowns and job losses.
    • Collaborations and International Aid: India engaged in international collaborations, sharing its experiences and expertise, and cooperating with other countries in areas such as research, drug repurposing, and knowledge exchange. The country also received international assistance in the form of medical supplies and equipment.
    • Focus on Healthcare Infrastructure and Research: The government emphasized strengthening healthcare infrastructure, investing in research and development, and promoting indigenous manufacturing of medical equipment and supplies. Efforts were made to enhance testing capacity, develop innovative solutions, and support research on therapies and diagnostics.
    • Communication and Awareness: The government and health authorities prioritized public communication and awareness campaigns to disseminate accurate information, promote preventive measures, and combat misinformation related to the virus.

    Health

    What is Universal Health Coverage (UHC) by 2030?

    • UHC 2030 is a global movement and partnership that aims to accelerate progress towards achieving Universal Health Coverage (UHC) by the year 2030.
    • UHC 2030 is a collaborative initiative led by multiple stakeholders, including governments, international organizations, civil society, and the private sector, with the goal of ensuring that all individuals and communities have access to essential healthcare services without suffering financial hardship.
    • UHC 2030 builds upon the commitment made by United Nations member states in 2015 through the Sustainable Development Goals (SDGs).

    Challenges in achieving UHC by 2030?

    • Financing: Adequate and sustainable financing is crucial for UHC. Many countries struggle with limited healthcare budgets, inefficient resource allocation, and inadequate public financing. Mobilizing sufficient funds to cover the costs of expanding healthcare services and ensuring financial protection for all individuals can be a significant challenge.
    • Health Workforce: The availability, distribution, and quality of healthcare professionals pose challenges to UHC. Many countries face shortages of skilled healthcare workers, particularly in rural and remote areas. Strengthening the health workforce, ensuring equitable distribution, and improving their training and retention are critical for delivering quality healthcare services.
    • Health Infrastructure: Insufficient and inadequate healthcare infrastructure, including facilities, equipment, and technologies, can hinder the achievement of UHC. Many regions, especially in low-income countries, lack the necessary healthcare infrastructure to provide essential services to all populations. Investments in infrastructure development and strengthening are required to expand access and ensure quality care.
    • Inequities and Vulnerable Populations: UHC aims to address health inequities and reach vulnerable and marginalized populations. However, socioeconomic disparities, gender inequalities, and discrimination can hinder equitable access to healthcare services. Special attention is needed to address these inequities and ensure that UHC benefits all individuals, irrespective of their social or economic status.
    • Health Information Systems: Establishing robust health information systems is essential for effective UHC implementation. However, many countries face challenges in data collection, management, and utilization. Strengthening health information systems, including electronic health records and data analytics, is crucial for monitoring progress, making informed decisions, and improving service delivery.
    • Political Will and Governance: UHC requires strong political commitment and effective governance. Political will at the national level is necessary to prioritize UHC, allocate resources, and implement necessary policy reforms. Ensuring transparency, accountability, and efficient governance mechanisms are crucial to prevent corruption, ensure equitable service delivery, and maintain public trust.
    • Changing Disease Patterns: The evolving burden of diseases, including the rise of non-communicable diseases, poses challenges to UHC. Chronic conditions require long-term management and specialized care, placing additional strain on healthcare systems. Adapting healthcare delivery models and integrating prevention and control strategies for these diseases are essential components of UHC.
    • Global Health Security: Public health emergencies and global health security threats, as witnessed during the Covid-19 pandemic, can disrupt healthcare systems and hinder progress towards UHC. Strengthening health emergency preparedness and response capacities is vital to mitigate the impact of outbreaks and ensure continuity of healthcare services.

    health

    How India’s G20 presidency: Significant role in achieving UHC by 2030

    • Knowledge Sharing and Best Practices: As the G20 president, India can facilitate the sharing of knowledge and best practices among member countries. This includes sharing successful UHC models, innovative healthcare delivery approaches, and strategies to overcome challenges. By promoting knowledge exchange, countries can learn from each other’s experiences and accelerate progress towards UHC.
    • Advocacy for UHC: India can use its platform as G20 president to advocate for UHC as a global priority. Through diplomatic channels and international forums, India can emphasize the importance of UHC in achieving sustainable development and equitable healthcare access. This advocacy can encourage other G20 member countries to prioritize UHC and align their policies and actions accordingly.
    • Collaboration with Global Health Organizations: India’s G20 presidency can facilitate collaboration with global health organizations such as the World Health Organization (WHO), World Bank, and other relevant entities. By working closely with these organizations, India can contribute to the development and implementation of strategies and initiatives that support UHC, including capacity building, technical assistance, and funding mechanisms.
    • Promoting Innovative Financing Mechanisms: India can explore and promote innovative financing mechanisms for UHC. This includes advocating for increased public investment in healthcare, exploring public-private partnerships, and encouraging the development of social health insurance schemes. By identifying and sharing successful financing models, India can provide valuable insights to other G20 countries on sustainable funding for UHC.
    • Strengthening Primary Healthcare Systems: India’s G20 presidency can focus on strengthening primary healthcare systems, which are integral to UHC. This involves enhancing access to quality primary healthcare services, addressing health workforce shortages, improving infrastructure, and promoting preventive and promotive healthcare measures. Sharing India’s experiences and initiatives in primary healthcare can inspire other countries to invest in this essential aspect of UHC.
    • Leveraging Digital Health Technologies: India has made significant strides in adopting digital health technologies, and its G20 presidency can highlight the potential of these technologies in advancing UHC. By sharing digital health success stories and facilitating collaborations in areas such as telemedicine, health information systems, and mobile health applications, India can accelerate the adoption of digital solutions for healthcare access and delivery.
    • South-South Cooperation: India’s G20 presidency can promote South-South cooperation and collaboration among G20 member countries and other nations from the Global South. By fostering partnerships, sharing experiences, and supporting capacity-building efforts, India can facilitate collective progress towards UHC in regions that face similar challenges.

    Conclusion

    • India’s G20 presidency aims to leverage collaborative governance and shared responsibilities to create a safer world from pandemics. India’s engagement with Japan’s G7 presidency and the focus on resilient, equitable, and sustainable UHC and global health architecture development further demonstrate shared responsibilities and the commitment to addressing public health emergencies. Through collective efforts, we can heal our planet, foster harmony within our global family, and offer hope for a better future.

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    Also Read:

    Digital healthcare Services

     

  • Early Childhood Care and Education through Anganwadis

    Central Idea: The Centre is planning to promote ‘Early Childhood Care and Education’ through anganwadi centres as part of the ‘Poshan Bhi, Padhai Bhi’ slogan announced by the Women and Child Development Minister.

    What is Anganwadi scheme?

    • The scheme was started in 1975 and aims at the holistic development of children and empowerment of mother.
    • It is a Centrally-Sponsored scheme. The scheme primarily runs through the Anganwadi centre.
    • The scheme is under the Ministry of Women and Child Development.

    Moto: Poshan Bhi, Padhai Bhi

    • The focus will be on both nutrition and early learning for children under 6 years, with a particular emphasis on those under 3 years.
    • Early learning has been neglected in the Integrated Child Development Scheme (ICDS) and seen as secondary to nutrition.
    • Anganwadi centres will be repositioned as pre-schools to provide early learning access to socially and educationally backward communities.

    Why such move?

    • Two emerging trends are noted: young children shifting to private pre-schools and under-age children being admitted to Class 1 in some states.
    • The quality of services provided at Anganwadi centres is perceived as inferior, leading to the shift to private nursery schools.

    Task Force and Recommendations

    • Rebranding anganwadis: The task force recommends a “mission-mode approach” to rebranding anganwadis, including infrastructure upgrades, materials, play equipment, etc.
    • Focus on volunteer support: It suggests involving panchayat raj institutions, women’s self-help groups, local NGOs, and college volunteers to enhance the learning environment.
    • Boost to Anganwadi sisters: The task force proposes re-designating anganwadi workers as anganwadi teachers and helpers as childcare workers.
    • Nutrition boost: Infrastructure improvements, additional nutrition supplements (such as eggs and milk), extended timings, creches, and day care services are recommended.
    • MGNREGS liasion: The task force suggests leveraging funds from the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS).

    Major target: Improve Child Nutrition

    • The task force highlights that over 35% of young children in India are stunted, according to the latest NFHS data.
    • Although there has been a reduction, India still has the largest population of stunted children globally.
    • Child stunting affects developmental outcomes and the ability to learn at school.
    • NFHS-5 reveals that only 11.3% of children below 2 years receive an adequate diet.
    • The task force recommends introducing eggs as an effective intervention for nutrition.

     

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  • All India Survey on Higher Education: A Wake-up Call for the Muslim Community

    Higher

    Central Idea

    • The recently released All India Survey on Higher Education 2020–21 has shown some alarming trends. While there have been improvements in the enrollment of certain communities in higher education, there has been a drastic drop in the enrollment of Muslim students. The survey provides a grim picture of the marginalisation of the Muslim community in higher education and the need for the government to take action to address.

    Findings of the survey

    1. Enrollment overview:
    • Enrollment of Dalits, Adivasis and OBCs in higher education increased by 4.2%, 11.9%, and 4% respectively compared to 2019-20.
    • The upper castes showed the highest growth rate of 13.6%, after declining with the implementation of Mandal II in the late 2000s.
    1. Enrollment of Muslim students:
    • The enrollment of Muslim students dropped by 8% from 2019-20, by 1,79,147 students. This level of absolute decline has never happened in the recent past for any group.
    • UP accounts for 36% of the total decline in Muslim enrollment, followed by Jammu and Kashmir (26%), Maharashtra (8.5%), Tamil Nadu (8.1%), Gujarat (6.1%), Bihar (5.7%) and Karnataka (3.7%).
    • Muslims constitute about 4.6% of total enrollment in higher education while they represent about 15% of society.
    • Among major states, in 2020-21, Muslims did not do better than Dalits except in Tamil Nadu, Telangana and Delhi. Kerala tops in the percentage of Muslim youth (43%) who are currently attending higher education.

    Factors behind declining enrollment of Muslim students

    • Lack of job opportunities: Muslim students face a high unemployment rate, which means that they may not see higher education as a path to a good job.
    • Discrimination: There is discrimination in the job market against Muslim candidates. Studies have shown that Muslim candidates are less likely to be invited to job interviews compared to candidates with Brahmin or Dalit names.
    • Economic factors: Muslim students may not have the financial means to pursue higher education, and may have to work to support themselves and their families. This can lead to a high dropout rate.
    • Violence and ghettoization: Violence against Muslims has increased, which has led to a sense of fear and insecurity, and has restricted their mobility. This has resulted in a trend towards ghettoization.
    • Discriminatory policies: Some state governments have stopped providing financial support to Muslim students pursuing higher education. This has made it more difficult for them to access higher education opportunities.

    All you need to know about Sachar Committee report, 2006

    • The Sachar Committee was commissioned by the Indian government in response to concerns about the social and economic status of Muslims in India.
    • The committee surveyed the status of Muslims across various parameters, including education, employment, and access to social services.
    • The report found that Muslims in India were disproportionately affected by poverty, illiteracy, and lack of access to basic services such as healthcare and sanitation.
    • The report highlighted the need for affirmative action policies to address the marginalization of Muslims, such as reservations in education and employment.
    • The report also recommended the establishment of an Equal Opportunities Commission to address discrimination against Muslims and other minority communities in India.
    • The Sachar Committee Report sparked a national debate about the social and economic status of Muslims in India and led to increased attention on the issue of affirmative action for marginalized communities.

    Policy recommendations to address low Muslim students enrollment

    • Initiate positive discrimination policies: The government could implement policies such as sub-quotas for Muslims within the OBC quota to improve their access to higher education opportunities.
    • Provide scholarships and fellowships: The government could provide greater financial support to minority students pursuing higher education, such as scholarships and fellowships, to help them overcome economic barriers.
    • Address discrimination in the job market: The government could work to create more job opportunities for Muslims and address discrimination in the job market to help improve their economic prospects.
    • Promote social and economic equality: The overall goal should be to promote greater social and economic equality for Muslims in India, which could involve a range of policies and initiatives focused on education, employment, and other areas.

    Conclusion

    • The All-India Survey on Higher Education highlights the deepening marginalisation of the Muslim community in higher education and the need for the government to take action to address the situation. Positive discrimination in favour of Muslims, as recommended by the Sachar Committee Report, is the need of the hour to ensure equitable access to higher education for all communities. Without such efforts, India will not be able to realise its potential and contribute to the harmonious development of society.

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    Also read:

    SC quota for Dalit Muslims and Christians

  • Moving Beyond COVID-19: Need for Contextual Understanding

    COVID-19

    Central Idea

    • COVID-19 has transitioned from a population-level challenge to more of an individual health concern, and it is time for India to shift gears and apply the lessons learned from the pandemic.

    WHO Announcements on COVID-19

    • On January 30, 2020, COVID-19 was announced as a public health emergency of international concern.
    • On May 5, 2023, WHO declared that COVID-19 was no longer a public health emergency of international concern.

    Issues of misinformation during the second wave of COVID-19 in India

    • False claims about a third wave affecting children: In April-May 2021, there was a COVID-19 misinformation blitzkrieg that a third wave in India would affect children, leading to children being repeatedly asked to wear masks and deprived of schooling and learning.
    • Lack of scientific evidence: School closure and making masks mandatory for schoolchildren had their origin in nearly identical challenges of actions not being supported by scientific evidence.
    • Influencers’ impact on public discourse: Social media influencers, not necessarily subject experts, were shaping the public discourse, which was not effectively addressed by governments.
    • Disparate viewpoints: Disparate viewpoints existed among experts and influencers living in India and abroad, with the latter making more definitive and stronger arguments for school closure and mask wearing for children in India.
    • Failure to consider local context: The sub-groups of super-specialists and those staying abroad failed to factor in the local context while coming up with their opinions.
    • Dogmatic stands of self-proclaimed experts: Self-proclaimed experts and influencers have adopted a dogmatic stand and have been selectively and conveniently using emerging evidence and published literature to support their stand, often misguiding gullible followers.
    • COVID-foreverers: A group of disparate individuals and social media groups keep insisting on the enforcement of restrictions such as universal masking at ‘the drop of the hat’, often on frivolous grounds.

    What lessons were learned from the COVID-19 pandemic?

    • The importance of preparedness: The pandemic highlighted the importance of being prepared for future outbreaks and the need for robust public health infrastructure.
    • The role of misinformation: The pandemic showed how misinformation can spread rapidly and have serious consequences, highlighting the need for better education and awareness to combat misinformation.
    • The importance of local context: The pandemic demonstrated the importance of factoring in local context when making policy decisions, as different regions and countries may face different challenges and require different interventions.
    • The danger of dogmatic thinking: The pandemic showed how dogmatic thinking can be dangerous, and the need for an open-minded and evidence-based approach to decision-making.
    • The importance of nuance and context in epidemiology: The pandemic highlighted the need for nuanced understanding of epidemiology, and the importance of taking into account the broader context when interpreting scientific studies.
    • The need for a shift in focus: With COVID-19 transitioning from a population-level challenge to more of an individual health concern, there is a need to shift the focus from COVID-19 fixation to tackling other pressing health challenges.
    • The importance of integrating COVID-19 response with general health services: The pandemic showed the need for integration of COVID-19 response with general health services, and the importance of a balanced approach to public health.

    Way forward

    • Formal training courses on the principles and practice of epidemiology should be offered by the government to prepare India for more nuanced responses to outbreaks and epidemics and to curb misinformation.
    • The government needs to integrate the COVID-19 response to general health services.
    • India’s response to surges, outbreaks, and epidemics (of any infectious disease and not just COVID-19) should be guided by a nuanced understanding of epidemiology and not unduly derailed by social media influencers.
    • Schools should not be closed for a COVID-19 uptick, and wearing masks in order to attend school should never again be made mandatory, as children were never at risk from moderate to severe COVID-19.
    • It is time to drop the COVID-19 fixation and move on to tackle other more pressing health challenges in the country.

    Conclusion

    • The COVID-19 pandemic has presented numerous challenges and lessons for India and the world. The issues of misinformation and lack of context-based policy interventions have been major obstacles in effectively tackling the pandemic. It is time to apply the lessons learned and shift focus to other pressing health challenges while being prepared to respond to future outbreaks and epidemics with a nuanced understanding of epidemiology.

    Mains Question

    Q. During the COVID-19 pandemic, how did misinformation pose a significant challenge? Discuss what lessons have we learned from it?

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    Also Read:

    Covid is no longer an Emergency: what changes?

  • Govt. program for Non-Communicable Diseases renamed

    disease

    Central Idea: The article discusses the decision by the Indian Ministry of Health and Family Welfare to rename and expand its program for the control and prevention of non-communicable diseases (NCDs).

    What are Non-Communicable Diseases (NCDs)?

    • NCDs are also known as chronic diseases, which are not caused by infectious agents and are not transmissible from person to person.
    • NCDs are long-lasting and progress slowly, typically taking years to manifest symptoms.
    • Examples of NCDs include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
    • These diseases are often caused by modifiable risk factors such as unhealthy diet, lack of physical activity, tobacco and alcohol use, and environmental factors.
    • NCDs are a major cause of morbidity and mortality worldwide, accounting for around 70% of all deaths globally.

    Why in news?

    • The addition of many new diseases and health initiatives have prompted the Indian government to expand and rename its NCD program.

    Renaming of the NCD Program and Portal

    • The Ministry has renamed the NPCDCS as the “National Programme for Prevention & Control of Non-Communicable Diseases [NP-NCD].”
    • The application or software named Comprehensive Primary Healthcare Non-Communicable Disease (CPHC NCD IT) will now be renamed “National NCD Portal.”
    • The Ministry communicated this decision to the States on May 3, 2023, through a one-page letter and asked them to adhere to the changes.

    Implementation and future action

    • The NPCDCS is implemented under the National Health Mission across India.
    • The letter addressed to Principal Secretaries and Health Secretaries of all States and Union Territories advised the government to use the new names for the scheme and portal in all their future references and correspondences with the Indian government.
    • Under NPCDCS, 677 NCD district-level clinics, 187 District Cardiac Care Units, 266 District Day Care Centres and 5,392 NCD Community Health Centre-level clinics have been set up.

    Burden of NCDs in India

    • The study ‘India: Health of the Nation’s States – The India State-Level Disease Burden Initiative in 2017’ by the ICMR estimated that the proportion of deaths due to NCDs in India has increased from 37.9% in 1990 to 61.8% in 2016.
    • The four major NCDs are:
    1. Cardiovascular diseases (CVDs)
    2. Cancers
    3. Chronic respiratory diseases (CRDs) and
    4. Diabetes
    • The study shared four behavioural risk factors – unhealthy diet, lack of physical activity, and the use of tobacco and alcohol.

    Solutions to mitigate NCD burden

    • Promote healthy lifestyle: Encourage people to adopt healthy lifestyle habits such as regular physical activity, balanced and nutritious diet, avoiding tobacco and alcohol, and getting enough sleep.
    • Increase awareness and education: Increase awareness among the public about the risk factors of NCDs and educate them about ways to prevent these diseases.
    • Improve healthcare infrastructure: Increase access to healthcare facilities, especially in rural and remote areas, to ensure early detection, treatment, and management of NCDs.
    • Implement policies and regulations: Implement policies and regulations that promote healthy living, such as increasing taxes on tobacco and alcohol products, and regulating the marketing of unhealthy food products.
    • Foster public-private partnerships: Foster partnerships between the government, private sector, and civil society organizations to work collaboratively towards preventing and managing NCDs.
    • Increase research and innovation: Increase research and innovation in the prevention, early detection, and treatment of NCDs to develop new and effective interventions.

     

     

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  • Govt. to release Manual for Organ Donation & Transplantation

    organ

    Central Idea: The National Organ and Tissue Transplant Organisation (NOTTO) is working on a transplant manual as a step-by-step guide for the implementation of organ donation and transplantation programmes in hospitals and a standard course for training transplant coordinators.

    Organ transplant in India: Key statistics

    • According to data accessed from the Health Ministry, the number of organ transplants has increased by over three times from 4,990 in 2013 to 15,561 in 2022.
    • Of the 15,561 transplants, a majority — 12,791 (82%) — are from live donors and 2,765 (18%) are from cadavers (the dead).
    • Up to 11,423 of the 15,561 organ transplants are for the kidney, followed by liver (766), heart (250), lung (138), pancreas (24) and small bowel transplants (3).
    • Most of these transplants occur in private hospitals, the numbers in government hospitals are relatively lower.

    About National Organ Transplant Programme (NOTP)

    • In 2019, the GoI implemented the NOTP for promoting deceased organ donation.
    • Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994.

    Types of Organ Donations

    • The law allows both deceased and living donors to donate their organs.
    • It also identifies brain death as a form of death.
    • Living donors must be over 18 years of age and are limited to donating only to their immediate blood relatives or, in some special cases, out of affection and attachment towards the recipient.

    (1) Deceased donors:

    • They may donate six life-saving organs: kidneys, liver, heart, lungs, pancreas, and intestine.
    • Uterus transplant is also performed, but it is not regarded as a life-saving organ.
    • Organs and tissues from a person declared legally dead can be donated after consent from the family has been obtained.
    • Brainstem death is also recognized as a form of death in India, as in many other countries.
    • After a natural cardiac death, organs that can be donated are cornea, bone, skin, and blood vessels, whereas after brainstem death about 37 different organs and tissues can be donated, including the above six life-saving organs

    (2) Living donors:

    They are permitted to donate the following:

    • one of their kidneys
    • portion of pancreas
    • part of the liver

    Features of the NOTP

    • Under the NOTP a National Level Tissue Bank (Biomaterial Centre) for storing tissues has been established at National Organ and Tissue Transplant Organization (NOTTO), New Delhi.
    • Further, under the NOTP, a provision has also been made for providing financial support to the States for setting up of Bio-material centre.
    • As of now a Regional Bio-material centre has been established at Regional Organ and Tissue Transplant Organization (ROTTO), Chennai, Tamil Nadu.

    More moves for facilitation:  Green Corridors

    • Studies have suggested that the chances of transplantation being successful are enhanced by reducing the time delay between harvest and transplant of the organ.
    • Therefore, the transportation of the organ is a critical factor. For this purpose, “green corridors” have been created in many parts of India.
    • A “green corridor” refers to a route that is cleared out for an ambulance carrying the harvested organs to ensure its delivery at the destination in the shortest time possible.

    Recent amendments

    (1) No Age Bar

    • Now an individual of any age can register for organ transplant.
    • People beyond 65 years in need of an organ donation will also be eligible to get one.
    • The government has decided to do away with a clause in the National Organ and Tissue Transplant Organisation (NOTTO) guidelines as the clause violates the Right to Life.

    (2) Doing away with domicile compulsion

    • Earlier an organ recipient could register for a prospective transplant in domicile State.
    • States like Gujarat had made it mandatory for registered patients to furnish a domicile certificate to be eligible for a transplant.
    • In November last year, the Gujarat High Court quashed the discriminatory policy of the State government.

    About NOTTO

    National Organ and Tissue Transplant Organization (NOTTO) is a national level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare.

    1. National Human Organ and Tissue Removal and Storage Network
    2. National Biomaterial Centre (National Tissue Bank)

    [I] National Human Organ and Tissue Removal and Storage Network

    • This has been mandated as per the Transplantation of Human Organs (Amendment) Act 2011.
    • The network will be established initially for Delhi and gradually expanded to include other States and Regions of the country.
    • Thus, this division of the NOTTO is the nodal networking agency for Delhi and shall network for Procurement Allocation and Distribution of Organs and Tissues in Delhi.
    • It functions as apex centre for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.

    [II] National Biomaterial Centre (National Tissue Bank)

    • The Transplantation of Human Organs (Amendment) Act 2011 has included the component of tissue donation and registration of tissue Banks.
    • It becomes imperative under the changed circumstances to establish National level Tissue Bank to fulfill the demands of tissue transplantation including activities for procurement, storage and fulfil distribution of biomaterials.
    • The main thrust & objective of establishing the centre is to fill up the gap between ‘Demand’ and ‘Supply’ as well as ‘Quality Assurance’ in the availability of various tissues.

    The centre will take care of the following Tissue allografts:

    1. Bone and bone products
    2. Skin graft
    3. Cornea
    4. Heart valves and vessels

    Various issues involved

    • Lack of awareness: Lack of awareness leads to myths and misconceptions about organ donation, which further discourages people from donating organs.
    • Religious and cultural beliefs: Some religious and cultural beliefs view organ donation as a desecration of the body, which hinders organ donation.
    • Lack of infrastructure: India faces a shortage of medical infrastructure and facilities for organ donation.
    • Legal and regulatory challenges: India’s organ donation system is heavily regulated by the Transplantation of Human Organs and Tissues Act, 1994.
    • Socioeconomic factors: Poverty and lack of education can lead to reduced access to information and medical services, making it difficult for people to donate organs.
    • Organized crime: Organized criminal networks involved in organ trafficking and commercialization also create challenges for organ donation in India.
    • Stigma and Discrimination: Stigma against organ recipients, particularly those who receive transplants from other communities or castes, is also a challenge in promoting organ donation in India.

    Way forward

    • Developing a National Organ and Tissue Donation Registry: The registry could maintain a database of donors and recipients, along with their medical history and compatibility information.
    • Setting up Mobile Organ Donation Units: These units could be equipped with medical personnel and equipment to conduct donation procedures in remote areas.
    • Crowdfunding for Organ Transplant Surgeries: This could be used as a means to raise funds for organ transplant surgeries, especially for underprivileged individuals who cannot afford the cost of treatment.
    • Promoting Living Donor Transplants: Living donor transplants can help increase the number of organs available for transplantation.
    • Incentivizing for Organ Donation: Incentives could be introduced to encourage more people to donate organs. This could include tax breaks, priority access to medical treatment, and other benefits.
    • Leveraging Technology: Technology could be used to develop better donor and recipient matching algorithms, create virtual waiting lists, and streamline the donation and transplantation process.
    • International Collaboration: India could collaborate with other countries to share best practices, leverage technology, and develop new approaches to organ donation and transplantation.

     

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  • Psychedelics and its uses to treat Depression

    Central idea: The context of the article is about the use of psychedelic drugs for both recreational and medicinal purposes.

    What are Psychedelics?

    • Psychedelics are a class of drugs that alter an individual’s perception, mood, and thought processing while still allowing the individual to remain conscious and with unimpaired insight.
    • They are non-addictive and non-toxic, and cause less harm to the end user compared to illicit drugs.
    • The two most commonly used psychedelics are LSD (Lysergic acid diethylamide) and psilocybin. Researchers have also developed synthetic psychedelics.
    • In India, the Narcotic Drugs and Psychotropic Substances Act 1985 prohibits the use of psychedelic substances, except for ketamine which is used under strict medical supervision.

    History of psychedelics

    • Humans have used psilocybin and mescaline for ceremonial, healing, and spiritual rituals for millennia.
    • The modern-day use of psychedelics is commonly associated with the German chemist Arthur Heffter isolating mescaline from the peyote cactus in 1897.
    • In 1938, Swiss chemist Albert Hofmann first synthesized LSD while investigating compounds related to ergotamine.
    • LSD was widely used as a therapeutic catalyst in psychotherapy between 1947 and 1967, until it was criminalized in the US due to medical concerns and the Vietnam War.

    Experience of using psychedelic substances

    • Users of psychedelic substances report changes in perception, somatic experience, mood, thought-processing, and entheogenic experiences.
    • Perceptual distortions most commonly include the visual domain.
    • Somatic experiences may include the visceral, tactile, and interoceptive domains.
    • Mood changes may include elation, euphoria, anxiety, and paranoia.
    • Entheogenic experiences include transcendental and ineffable spiritual experiences.

    How do they work inside the body?

    • Classical psychedelics boost brain serotonin levels.
    • Psilocybin’s therapeutic effects require a ‘trip’ that is mediated by the activation of serotonin receptors.
    • Modern neuroimaging suggests that psychedelics increase the cross-talk between different brain networks, and this correlates with the subjective effects of psychedelics.

    Can psychedelic substances cause any harm?

    • Death due to direct toxicity of LSD, psilocybin, or mescaline has not been reported in the literature despite 50-plus years of recreational use.
    • Synthetic psychedelics have been associated with acute cardiac, central nervous system, and limb ischemia, as well as serotonin syndrome.

    What is Psychedelic-Assisted Psychotherapy?

    • Psychedelic-assisted psychotherapy has three types of sessions: preparatory, medication, and integration.
    • In the medication session, the patient is accompanied by a male-female co-therapist dyad and a psychedelic drug is administered in a comfortable and well-appointed room.
    • Over the next 6-8 hours, the therapists listen to the patient while maintaining a neutral therapeutic stance.
    • In the integration session, the therapists work with the patient to interpret the contents of their psychedelic experience into meaningful long-term change, based on their thoughts and ideas.

    Uses to treat Neuropsychiatric Disorders

    • Research has shown that psychedelic substances have potential therapeutic benefits in treating neuropsychiatric disorders such as treatment-resistant depression and post-traumatic stress disorder (PTSD).
    • In recent trials, a single dose of psilocybin or MDMA-assisted therapy has been shown to reduce depression scores and improve symptoms of PTSD in participants.

    Back2Basics: Narcotic Drugs and Psychotropic Substances Act, 1985

    Details
    Purpose Combat drug abuse and trafficking in India
    Scope Consolidates and amends the existing legal framework related to narcotics and psychotropic substances
    Regulations Strictly regulates and controls the production, manufacture, sale, transport, possession, and consumption of narcotic drugs and psychotropic substances
    Special Courts Establishment of special courts and appointment of special public prosecutors to handle cases related to drug trafficking and abuse
    Covered Substances Opium, heroin, cannabis, cocaine, synthetic drugs such as LSD and ecstasy
    Classification Substances classified into different schedules based on their potential for abuse and medical use
    Punishment Imposes different levels of punishment for offenses related to each schedule
    Enforcement Narcotics Control Bureau (NCB), Central Bureau of Narcotics (CBN), and state-level drug enforcement agencies
    Functions Prevention of drug abuse and trafficking, investigation and prosecution of drug offenses, rehabilitation and treatment of drug addicts

     

     

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  • India’s One Health Approach to Tackle Future Pandemics

    One Health

    Central Idea

    • The Covid-19 pandemic exposed weaknesses in the world’s health systems, including countries ranked high in the Global Health Security Index. It has also provided an opportunity to build stronger health systems to prevent and respond to future pandemics. India’s One Health approach aims to address the health of people, animals, and ecosystems together in order to prevent, prepare, and respond to pandemics.

    One Health

    What is PM Ayushman Bharat Health Infrastructure Mission (PM ABHIM)? 

    • PM ABHIM is being rolled out as India’s largest scheme to scale up health infrastructure.
    • It is aimed at ensuring a robust public health infrastructure in both urban and rural areas, capable of responding to public health emergencies or disease outbreaks.
    • Key features:
    • Health and Wellness Centres: In a bid to increase accessibility it will provide support to 17,788 rural HWC in 10 ‘high focus’ states and establish 11,024 urban HWC across the country.
    • Exclusive Critical Care Hospital Blocks: It will ensure access to critical care services in all districts of the country with over five lakh population through ‘Exclusive Critical Care Hospital Blocks’.
    • Integrated public health labs: It will also be set up in all districts, giving people access to “a full range of diagnostic services” through a network of laboratories across the country.
    • Disease surveillance system: The mission also aims to establish an IT-enabled disease surveillance system through a network of surveillance laboratories at block, district, regional and national levels.
    • Integrated Health Information Portal: All the public health labs will be connected through this Portal, which will be expanded to all states and UTs, the PMO said.

    Facts for prelims

    What is Global Health Security Index?

    • The Global Health Security Index is a tool developed to assess a country’s preparedness and ability to respond to outbreaks, pandemics, and other public health emergencies.
    • It was developed by the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security, in collaboration with The Economist Intelligence Unit (EIU).
    • The Index ranks 195 countries based on their level of preparedness across six categories: 1. Prevention, 2. Detection and reporting, 3. Rapid response, 4. Health system, 5. Compliance with international norms, and 6. Risk environment.
    • The Index aims to identify gaps in preparedness and encourage countries to take action to strengthen their health security systems, particularly in the face of global health threats such as pandemics.
    • The first edition of the Index was published in 2019, and it has since been updated to reflect the evolving global health landscape.
    • Global Health Security Index 2021: India ranked 66th.

    One Health

    What is mean by One health?

    • One Health is an interdisciplinary approach that recognizes the interconnectedness of human, animal, and environmental health.
    • It emphasizes the need for collaboration between various sectors, including public health, veterinary medicine, environmental science, and others, to achieve optimal health outcomes for all.

    key components of India’s One Health approach

    • Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): The flagship program launched in October 2021 aims to prevent, prepare, and respond to pandemics. It seeks to fill the gaps in health systems at the national and state levels.
    • National Institute for One Health: The foundation for the institute was laid recently in Nagpur. It will identify hotspots for endemic and emerging zoonotic diseases to contain their spread early on.
    • Creation of a network of institutions for genomic surveillance: During the COVID-19 pandemic, India created a formidable network of institutions that can identify new pathogens. This can now be complemented with wider testing of wastewater and samples from incoming ships and aircraft.
    • Coordination between ministries: Several ministries, including health, animal husbandry, forests, and biotechnology, have been brought under the Principal Scientific Advisor to address overlapping mandates and improve coordination.
    • Expansion of research laboratories: India is expanding its network of research laboratories, which primarily focused on influenza, to cover all respiratory viruses of unknown origin.
    • Partnerships between research bodies and manufacturers: Indian manufacturers produced vaccines, test kits, therapeutics, masks and other items at very competitive prices, both for India and other countries. The partnerships between research bodies and manufacturers will need to be sustained and enhanced to make India a global hub in the biopharma sector.
    • Clinical trial network: The clinical trial network set up under the National Biopharma Mission is a positive step toward improving access to affordable new vaccines and drugs in India and around the world.
    • Ayushman Bharat Digital Health Mission: The mission can facilitate the bringing of private hospitals and clinics under a common platform and placing data in the public domain to augment surveillance in vulnerable areas.
    • Municipal corporations mandated to provide early alerts: Municipal corporations have been mandated to identify the most vulnerable areas and provide early alerts. For this to be successful, strong partnerships with communities, dairy cooperatives, and the poultry industry will be needed to identify new infections.

    What are the potential advantages of the One Health approach?

    • Holistic approach: The One Health approach looks at the interconnectedness of human, animal, and environmental health. By taking a holistic approach, it enables a better understanding of the complex interconnections between human, animal, and environmental health, and can lead to more effective interventions and solutions
    • Early disease detection: The One Health approach emphasizes the importance of early disease detection in animals, which can serve as an early warning system for potential human outbreaks. This approach can help prevent the spread of diseases and reduce the risk of pandemics.
    • Better disease surveillance: The One Health approach facilitates better disease surveillance by enabling the sharing of information and resources between different sectors, including human health, animal health, and environmental health.
    • More effective responses: The One Health approach can lead to more effective responses to outbreaks by facilitating collaboration between different sectors and stakeholders, and ensuring a coordinated response.
    • Improved animal health: The One Health approach recognizes the importance of animal health and welfare, and can lead to improved animal health through better disease control and prevention measures.
    • Better environmental management: The One Health approach also recognizes the importance of environmental management and conservation, and can lead to more sustainable environmental practices that benefit both human and animal health.

    One Health

    Conclusion

    • India’s One Health approach is a positive step towards addressing the health of people, animals, and ecosystems together. The country’s efforts to tackle future pandemics are commendable, and the success of these efforts will be critical. The rise of new pathogens, zoonotic diseases, and antibiotic resistance highlights the need for a comprehensive approach to prevent future pandemics. India’s efforts to build stronger health systems, prevent pandemics, and respond to outbreaks will help protect its citizens and set an example for the world.

    Mains Question

    Q. What do you understand by mean One Health? Discuss the advantages of One health approach the efforts of India in this direction.

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  • Latest National Health Account figures on India’s Healthcare Sector

    national health

    Central idea: The National Health Account Estimates 2019-20 report shows an increase in government spending and a decline in out-of-pocket expenditure on healthcare.

    About National Health Account (NHA) estimates

    • The NHA estimates for India 2019-20 is the seventh consecutive report prepared by the National Health Systems Resource Centre (NHSRC).
    • NHSRC was designated as National Health Accounts Technical Secretariat (NHATS) in 2014 by the Union Health Ministry.
    • The NHA estimates use an accounting framework based on the internationally accepted standard of System of Health Accounts, 2011 developed by the WHO.
    • India now has a continuous series of NHA estimates from 2013-14 to 2019-20, making the estimates comparable internationally.
    • The estimates enable policymakers to monitor progress in different health financing indicators of the country.

    health

    Key highlights

    Description
    Government spending as % of GDP
    • Increased from 1.13% (FY 2015) to 1.35% (FY 2020)
    • Per capita health spending of the government has also increased from Rs 1,108 in FY 2015 to Rs 2,014 in FY 2020.
    • Govt share in total healthcare spending has increased from 29% in 2015 to 41.4% in 2020
    Declining out-of-pocket expenditure
    • Proportion of total healthcare spending that comes from people’s pockets has decreased from 62.6% in 2015 to 47.1% in 2020
    • Govt aims to further reduce out-of-pocket expenditure by investing in public health and insurance
    • To reduce the financial burden of healthcare on individuals and increase the utilization of healthcare services
    Government spending on primary healthcare
    • Increased from 51.3% in 2015 to 55.9% in 2020.
    • Govt. invested in creating 1.5 lakh health and wellness centres that can screen people for cancers, diabetes, and eye disease.
    Increase in social security expenditure
    • Increased from 5.7% of total healthcare spending in 2015 to 9.3% in 2020.
    • Suggests that the government is investing more in social welfare programs.
    Increase in spending on insurance
    • Privately purchased health insurance increased from 3.9% of total health expenditure in 2015 to 7.72% in 2020
    • Govt. financed health insurance spending also went up from 3.8% in 2015 to 6.37% in 2020
    Health spending by states
    • Only two big states and three smaller ones have crossed the target of 8% of their budget going towards healthcare as set by the National Health Policy 2017.

     

    Key issues

    • Marginal increase: Activists are concerned about the marginal increase in government spending.
    • Global laggard: This increase in government health expenditure as a percentage of GDP also takes into account capital spending, which puts India in 164th place out of 184 countries in terms of government health spending.
    • No proportional increase: Total spending on health as a proportion of GDP has been going down, from 3.9% in 2015 to 3.3% in 2020, indicating a decline in consumption of healthcare services.

    Conclusion

    • Overall, the report shows that government spending on healthcare has been increasing, while out-of-pocket expenditure has been declining.
    • There is a need to invest in public health and insurance and increase the contribution of states towards healthcare.

     

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