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

  • Malaria soon to be a notifiable disease across India

    malaria

    Malaria is all set to become a notifiable disease across India, which will require cases to be reported to government authorities by law.

    About Malaria

    Description
    Definition A potentially life-threatening disease caused by parasites that are transmitted through the bite of infected female Anopheles mosquitoes
    Causes Four species of plasmodium parasites, namely plasmodium vivax, plasmodium falciparum, plasmodium malariae, and plasmodium ovale
    Spread Bite of infected female Anopheles mosquitoes
    Symptoms Fever, chills, headache, muscle pain, fatigue, nausea, vomiting
    Diagnosis Blood test
    Treatment Antimalarial drugs
    Prevention Insecticide-treated bed nets, indoor residual spraying, wearing protective clothing, using mosquito repellent, avoiding mosquito bites
    Vaccine RTS,S/AS01 (Mosquirix)

     

    Why in news?

    • The move is part of India’s vision to become malaria-free by 2027 and to eliminate the disease by 2030.

    Menace of malaria in India

    • In India, 80% of malaria cases occur among 20% of its population living in the 200 high-risk districts of Andhra Pradesh, Chhattisgarh, Gujarat, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Odisha, West Bengal and the seven north-eastern states.
    • With only fewer than half of those infected reaching a clinic or hospital, the cases and deaths are much higher than recorded.

    What is Notifiable Disease?

    • A notifiable disease is a disease that is required by law to be reported to government authorities.
    • In India, the Ministry of Health and Family Welfare maintains a list of notifiable diseases under the National Health Mission.
    • This is done to track the spread of the disease and to take necessary measures to control and prevent its spread.
    • Reporting notifiable diseases is important for public health surveillance and response to outbreaks.

    Malaria as a Notifiable Disease

    • Malaria is currently a notifiable disease in 33 states and Union Territories in India.
    • Bihar, Andaman and Nicobar Islands, and Meghalaya are in the process of putting malaria in the notifiable disease category.

    Other measures to curb malaria

    • Malaria Elimination Programme: The government has launched the National Framework for Malaria Elimination in India 2016-2030 to eliminate malaria from the country by 2030.
    • Joint Action Plan: The Health Ministry has initiated a joint action plan with the Ministry of Tribal Affairs for malaria elimination in tribal areas. This plan aims to bring down malaria cases to zero in tribal areas, which are among the most vulnerable to the disease.
    • HIP-Malaria Portal: The Ministry has ensured the availability of near-real-time data monitoring through an integrated health information platform and periodic regional review meetings to keep a check on malaria growth across India.

    Vaccines developed so far

    • The WHO has approved the rollout of two first-generation malaria vaccines, RTS,S and R21, in high-transmission African countries.
    • Bharat Biotech, an Indian company, has been licensed to manufacture the RTS,S vaccine, with adjuvant provided by GSK.
    • The R21 vaccine, developed by scientists at Oxford University, has shown promising results in phase 2 clinical studies and has been approved by regulatory authorities in Ghana and Nigeria.
    • Scientists at the International Centre for Genetic Engineering and Biotechnology (ICGEB) in New Delhi have developed and produced two experimental blood-stage malaria vaccines, with Phase I clinical trials completed for one of them.

     

     

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  • Tuberculosis (TB) Should No Longer Exists in the 21st Century: India can lead the way

    TB

    Central Idea

    • At the One World TB Summit in Varanasi, Uttar Pradesh on March 24, 2023, Prime Minister Narendra Modi called for a fresh approach to the global tuberculosis (TB) elimination response, with innovation and research being central drivers of change. This is a critical step as India and the world look to redefine their TB elimination response. India’s recent progress in TB control efforts and COVID-19 response provides a good reflection point, which offers lessons to address the challenges faced in the fight against TB.

    India’s Progress in TB Control Efforts

    • Expanded reach and improved detection measures: India’s National TB Elimination Programme has introduced several measures to find, notify, and treat TB cases, resulting in expanded reach and improved detection measures. As a result, the number of TB case notifications has significantly increased, rising from 15.6 lakh in 2014 to over 24 lakh in 2022.
    • Innovative approaches: India has adopted innovative approaches to TB management, including engagement with the private sector, launch of social support provisions, and introduction of diagnostic tools and new drug regimens. These measures have improved TB management in the country.
    • Increased investment in health research and development: India has recognized the importance of investing in health research and development, especially in recent years. The Mission COVID Suraksha programme to develop vaccines was a good example of a public-private partnership, with clear goals and outcomes. The country has also established centres of excellence, which will facilitate collaboration between Indian Council of Medical Research laboratories and the private sector.
    • Expansion of diagnostic tools: India has been working on expanding access to diagnostic tools for TB. Innovations such as nasal and tongue swab-based tests for TB can be a game changer by reducing diagnostic delays, and handheld digital x-ray machines with artificial intelligence-based software can now be taken to villages and urban settlements to screen large numbers of high-risk individuals.
    • Introduction of new therapeutic molecules: India has been investing in the development and introduction of new therapeutic molecules for TB treatment. Shorter, safer, and more effective regimens, such as the 1HP regimen for latent TB infections, the four-month regimen (HPZM) for drug-susceptible TB, and the six-month regimen (BPaL/M) for drug-resistant TB, have been developed.

    Why there is a Need for Disruptive Approaches and New Tools in TB elimination response?

    • Lack of widespread awareness: Despite the progress made by India’s National TB Elimination Programme, there is still a lack of widespread awareness about the disease, which has led to delayed diagnosis and treatment.
    • Access to quality care: Many people with TB in India and other developing countries do not have access to quality care, which has led to high rates of morbidity and mortality.
    • Limited diagnostic tools: There is a need to expand access to diagnostic tools for TB, especially in rural and remote areas.
    • Drug-resistant TB: The emergence of drug-resistant TB has made treatment more difficult, requiring the development of new therapeutic molecules and regimens.
    • Need for innovative approaches: Innovative approaches are needed to change the way TB is prevented, diagnosed, and treated.
    • Rapidly evolving technology: Advances in technology, such as point-of-care tests, artificial intelligence-based software, and handheld digital x-ray machines, have made it possible to develop new tools to combat TB.
    • For example: Innovative technologies such as handheld digital x-ray machines with artificial intelligence-based software and nasal and tongue swab-based tests for TB can reduce diagnostic delays and provide rapid, low-cost diagnostics. Similarly, newer and more effective regimens and repurposed existing drugs for TB can play a crucial role in the long run.

    Importance of Prioritizing TB Vaccine Trials

    • Vaccines are key to ending the TB epidemic: Vaccines are one of the most effective ways to prevent infectious diseases. For TB, a vaccine would be a critical tool for ending the epidemic, especially for those who are at the highest risk of developing and spreading TB.
    • BCG vaccine is not effective for all: The current TB vaccine, Bacille Calmette-Guérin (BCG), is not effective for everyone, especially adolescents and adults who are at the highest risk of developing and spreading TB. Therefore, new and effective vaccines are needed to provide adequate protection.
    • Multiple TB vaccine candidates in the pipeline: There are currently over 15 TB vaccine candidates in the pipeline, which have shown promise in pre-clinical and clinical trials. Prioritizing these clinical trials will help identify the most effective vaccine candidates for various community settings and different target groups.
    • Cost-effectiveness: Vaccines are a cost-effective way to prevent diseases, and a TB vaccine would be no different. Investing in TB vaccine trials and development would save resources in the long run by reducing the burden of TB on health systems and economies.
    • Global impact: TB is a global public health issue, affecting millions of people worldwide. The development of a new TB vaccine would have a significant impact not only in India but also in other high-burden countries.

    Facts for prelims: Types of vaccine technologies

    Vaccine Technology

    		 Explanation

    Examples
    Inactivated or killed vaccines Use viruses or bacteria that have been inactivated or killed so that they can no longer cause disease Inactivated polio vaccine, hepatitis A vaccine
    Live attenuated vaccines Use viruses or bacteria that have been weakened so that they can’t cause disease in healthy people Measles, mumps, and rubella (MMR) vaccine, yellow fever vaccine
    Protein subunit vaccines Use pieces of the virus or bacteria, such as proteins or sugar molecules, to stimulate an immune response Human papillomavirus (HPV) vaccine, pertussis (whooping cough) vaccine
    Nucleic acid vaccines Use genetic material from the virus or bacteria, such as DNA or RNA, to stimulate the immune system COVID-19 mRNA vaccines from Pfizer-BioNTech and Moderna
    Viral vector vaccines Use harmless viruses, such as adenoviruses, to deliver genetic material from the target virus or bacteria into the body to stimulate an immune response Johnson & Johnson COVID-19 vaccine, Ebola vaccine developed by Merck

    How Testing and Diagnosis of TB can be improved?

    • Increased access to diagnostic tools: There is a need to increase access to diagnostic tools for TB, especially in rural and remote areas. Innovative approaches such as point-of-care tests (POCTs), including home-based tests, can provide decentralized, rapid, and low-cost diagnostics to provide results within minutes.
    • Introduction of new diagnostic tools: New innovations such as nasal and tongue swab-based tests for TB can be a game changer by reducing diagnostic delays. Further, handheld digital x-ray machines (with artificial intelligence-based software) can now be taken to villages and urban settlements to screen large numbers of high-risk individuals, safely and conveniently.
    • Strengthening the laboratory network: It is essential to strengthen the laboratory network in India to ensure quality diagnostics, especially in the private sector. Accreditation of private laboratories for TB diagnosis and linking them with the public sector is essential.
    • Integration with other healthcare services: TB testing and diagnosis need to be integrated with other healthcare services to improve access and reduce stigma. For example, TB screening can be done in conjunction with diabetes or HIV screening.
    • Empowering patients: Empowering patients with knowledge about TB symptoms and diagnostic tests can help increase awareness and improve early diagnosis. TB awareness campaigns can also help reduce stigma associated with the disease.
    • Collaboration between public and private sectors: Collaboration between the public and private sectors can improve access to diagnostic tools and reduce the time required for TB testing and diagnosis. The private sector can be leveraged to provide affordable and quality TB diagnostics and treatment.

    Need for Appropriate Policy Frameworks

    • Smoothening the rollout of proven tools: Creating regulatory and policy frameworks can smoothen the rollout of proven tools to reach people with as little delay as possible. This requires greater collaboration between policymakers, scientists, product developers, and clinical researchers across the country and even across regions.
    • Harmonization of standards and regulatory processes: Harmonization of standards and regulatory processes between countries can enable mutual recognition of evidence-based standards and licenses and save critical time towards rollout.
    • Addressing the regulatory challenges: Appropriate policy frameworks can address the regulatory challenges of introducing new tools and approaches. This can help reduce the time and cost of clinical trials and shorten the time to market for new tools and products.
    • Encouraging innovation: Policy frameworks that incentivize innovation can encourage the private sector to invest in TB research and development. This can lead to the development of new and effective tools for TB prevention, diagnosis, and treatment.
    • Supporting public-private partnerships: Appropriate policy frameworks can support public-private partnerships that can bring together the strengths of both sectors to develop and scale up innovative solutions for TB control.

    Conclusion

    • India’s scientific ingenuity during the COVID-19 pandemic has cemented its position as pioneers in innovation in the life sciences. India must use its G-20 presidency to build a global health architecture that creates equitable access for all. India must use this opportunity to call for the collaborative development of transformational tools and approaches that cater to not only India’s needs but also those of the under-represented but disproportionately affected developing world. TB should no longer be the leading infectious disease killer globally in the 21st century, and India can lead the way.

    Mains Question

    Q. At the One World TB Summit held at in Varanasi recently, Prime Minister Narendra Modi called for a fresh approach to the global tuberculosis (TB) elimination response. In this light discuss India’s Progress in TB Control Efforts and the need for disruptive approaches and new tools in TB elimination response.

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  • NCERT’s Changes On Mughal History and Sparked Heated Debate

    NCERT

    Central Idea

    • The controversy over the National Council of Educational Research and Training (NCERT) reducing the content on Mughal history in the school curriculum has sparked a heated debate in the country. While some argue that this move is part of a larger agenda to erase the Mughal legacy, others believe that it is a necessary step towards reducing the burden on students and providing a more balanced approach to teaching Indian history.

    NCERT’s changes

    • The NCERT removed overlapping material from grades 6 to 12 to reduce the burden on students.
    • Grade 12 has been designed around themes in Indian history. It is divided into three parts spanning over 2,000 years. One theme out of 12 focuses on Kings and Chronicles. It revolves around the significant policies that redefined the landscape and mindset of the people. Akbar’s policies feature in this theme in the rationalized syllabus as well.
    • This is over and above the extensive coverage they get in the middle school curricula, at the cost of the exclusion of the rest. Mughals have been overrepresented in Indian history books and were an obvious area for right-sizing.

    What NCERT has said on omitting chapters?

    • Part of rationalisation process: According to NCERT director, Chapters on Mughals have not been dropped. There was a rationalisation process last year because due to COVID, there was pressure on students everywhere.
    • Reducing the burden without affecting the knowledge: The expert committees examined the books from standards 6-12. They recommended that if some sections or this chapter is dropped, it won’t affect the knowledge of the children and an unnecessary burden can be removed.
    • Transition towards National Education Policy (NEP): NCERT working as per NEP, 2020. This is a transition phase. NEP 2020 speaks of reducing the content load. NCF (National Curriculum Framework) for school education is being formed, it will be finalised soon. Textbooks will be printed in 2024 as per NEP.

    Need for a balanced approach

    • Purpose of studying Indian history: The purpose of studying Indian history should be to understand who we are and how we got here, by understanding the demography, culture, and practices of the various components of India over the last two-and-a-half millennia.
    • Dive deep into all polities: This requires us to dive deep into all polities that have resided in the subcontinental region for significant periods.
    • Mughal history is just one part: Mughal history is just one part of just one period (medieval) of Indian history, and there is a lot more to our history that needs attention.

    Need for a more comprehensive approach

    • Rich and long history: Indian history is too rich, long, and unwieldy for any curriculum to do justice.
    • Children needs to have broader understanding: In the age of Wikipedia, we need to expose our children to the broad themes and grand sweep of history, create an understanding of their origins, and equip them with the tools and curiosity to read and research further as they grow.
    • Step is in good direction: The current reorganization is a good step in that direction.

    Conclusion

    • The real debate should be how to teach 2,500 years of Indian history to children in an engaging and informative manner. Those quibbling over the current rearrangement lack both a perspective on the scale of Indian history and an understanding of the complexities of teaching it. They would be better served by picking up a few history books themselves.

    Mains Question

    Q. The national education policy speaks of reducing the content load and ensure the understanding in this light discuss the significance of teaching history of India in more rational and comprehensive manner.

  • UGC releases National Credit Framework (NCrF)

    The University Grants Commission (UGC) released the National Credit Framework (NCrF), which will allow students to earn educational credits at all levels, irrespective of the mode of learning i.e. offline, online, or blended.

    What is National Credit Framework (NCrF)?

    • The NCrF is a meta-framework that integrates the credits earned through school education, higher education, and vocational and skill education.
    • It consists of three verticals:
    1. National School Education Qualification Framework (NSEQF)
    2. National Higher Education Qualification Framework (NHEQF) and
    3. National Skills Qualification Framework (NSQF)
    • The NCrF provides a mechanism for the integration of general academic education and vocational and skill education, ensuring equivalence within and between these two education streams.
    • Institutions would be free to notify their detailed implementation guidelines with flexibility for catering to their academic requirements.

    Key features

    (1) Credit System

    • Under the NCrF, one credit corresponds to 30 notional learning hours in a year of two semesters.
    • A student is required to earn a minimum of 20 credits every semester.
    • A student can earn more than 40 credits in a year.
    • Maximum credits a student can earn during schooling period is 160.
    • A three-year bachelor’s degree course will result in a total of 120 credits earned.
    • A Ph.D. degree is at Level 8 and earns 320 credits upon completion.

    (2) Study of Vedas:  Students can obtain credits for their proficiency in diverse areas of the Indian knowledge system, including the Puranas, Vedas, and other related components.

    (3) Indian Knowledge System (IKS): UGC notified the final report, which includes the components of the IKS. The IKS comprises 18 theoretical disciplines called vidyas and 64 practical disciplines, including vocational areas and crafts. These disciplines were the foundation of the 18 sciences in ancient India, as per the report.

    (4) Educational Acceleration: The NCrF supports educational acceleration for students with gifted learning abilities. It provides scope for crediting national/international achievers in any field, including but not limited to sports, Indian knowledge system, music, heritage, traditional skills, performing & fine arts, master artisans, etc.

    (5) International Equivalence: The international equivalence and transfer of credits shall be enabled through various multilateral/bilateral agreements between respective regulators of the countries concerned. NCrF would lend credibility and authenticity to the credits being assigned and earned under various programs in India, making these credits more acceptable and transferable internationally.

     

     

  • Healthcare: Need For Compassionate Leadership

    Central Idea

    • India’s rapid strides in health and healthcare with the help of a digital boom and the Ayushman Bharat Digital Mission, and the need for compassionate leadership to ensure respectful healthcare.

    India’s healthcare sector

    • India’s healthcare sector has shown improvement in multiple metrics due to the push for healthcare digitization, infrastructure, coverage, and other inputs.
    • However, healthcare is not just about the treatment of diseases or the availability of infrastructure but also about the overall wellness of the person.
    • Respectful healthcare that is available, affordable, accessible, and compassionate is a determinant of the quality of care.

    Importance of Compassionate leadership

    • Respectful and compassionate healthcare is essential: Healthcare is a perpetually evolving, stressful, and high-risk industry that puts a vast burden on healthcare providers. It is essential to navigate and manage the situation compassionately to deliver respectful care.
    • Compassion is a beating heart if healthcare: Compassionate leadership is required to build this type of healthcare system, as it is the quiet, beating heart of the entire healthcare system.

    Curriculum for compassionate healthcare

    • Compassionate curriculum is very necessary: To integrate compassion into the healthcare system at every stage, it is necessary to build a curriculum and deliver it to those responsible for administering healthcare respectfully.
    • Curriculum with Dalai Lama’s vision rolled out in Bihar: An eight-stage curriculum, developed by Emory University, that furthers the Dalai Lama’s vision of educating both heart and mind for the greater good of humanity is being rolled out in Bihar.
    • Impact: To date, 1,200 healthcare providers across 20 districts have been impacted by the vital components of the cognitive-based compassion training, creating compassionate leaders at every level.

    Institutionalizing compassionate healthcare

    • Institutionalizing will bring in real change: While the curriculum is a quantum leap towards building compassionate leadership, institutionalizing it will bring in real change.
    • Adopting at each level: Every academic institution and every department mandated with the responsibility to deliver health-related learning should develop and adopt compassion-based curricula.
    • Building capacity: State and regional health institutions must also be built with the capacity to deliver compassionate leadership. Partnerships with established academia and development sector organizations can enable the organizing of master coaches and master facilitators, thereby creating public goods that can be delivered by all.

    Strengthening internal systems

    • Making compassion intrinsic to the ethos: All healthcare providers are expected to carry out a wide range of tasks within the system, which often leads to burnout and impacts patient experience adversely. It is vital to strengthen systems internally to make respect and compassion intrinsic to the ethos.
    • Building a network: Building a network of compassionate practitioners in every state, district and block hospital is crucial to fan the winds of change by starting with self-compassion first and then moving to compassion for others.
    • Valuing and measuring organizational culture: Valuing and measuring organizational culture is just as critical as patient outcomes. Developing sound metrics to measure culture and employee satisfaction, self-compassion, and compassion for the team assumes greater significance to building an institution whose foundation is compassion.

    Conclusion

    • Respectful healthcare is already mentioned in the National Health Mission (NHM) guidelines, and such guidelines need to be the warp and weft of every policy and every guideline developed by public health authorities to improve patient experience. Compassionate leadership can truly realize India’s historically known values of compassion and bring alive the words of Hippocrates, the father of medicine, “Wherever the art of medicine is loved, there is also a love of humanity”.

  • Govt releases pre-draft of National Curriculum Framework

    curriculum

    The Ministry of Education has released a pre-draft version of National Curriculum Framework (NCF) for School Education.

    National Curriculum Framework (NCF)

    Features

    Details
    What is it? A comprehensive framework for school education in India

    Provides guidelines for the development of curricula and syllabi, textbooks, and teaching practices for schools in India
    Developed by National Council of Educational Research and Training (NCERT), an autonomous organization under the Ministry of Education
    Aim To promote a child-centred, activity-based approach to learning that focuses on the development of knowledge, skills, and values
    Development The first NCF was developed in 1986 and subsequently revised in 2000 and 2005.

    The latest pre-draft version of NCF for School Education was released by the Ministry of Education in April 2023.
    Coverage For age groups 3 to 18 years

    Seeks feedback from various stakeholders
    National Steering Committee Set up by the Ministry to undertake and develop NCFs under the chairmanship of K. Kasturirangan.

     

    Salient features of NCF

    (1) Values and Roots

    • A key part of the document is the inclusion of values and its “rootedness” in India.
    • The pre-draft says that the framework is deeply rooted in India in content and learning of languages, in the pedagogical approaches including tools and resources, and in philosophical basis — in the aims and in the epistemic approach.
    • The document further says that it leans towards making students acquainted with true sources of knowledge, which have been a philosophical preoccupation of ancient Indians.
    • These sources focus on six pramanas: pratyaksa, anumana, upamana, arthapatti, anupalabdhi, and sabda.

     

    Six Pramanas

    1.      Pratyaksha: Interpreted as perception through the five senses

    2.      Anumana: Uses inferences to come to new conclusions

    3.      Upamana: Knowing through analogy and comparison

    4.      Arthapatti: Involves knowing through circumstantial implication

    5.      Anupalabdhi: Includes perception of non-existence

    6.      Sabda: Something an individual can only directly know a fraction of all reality through direct experience and inference but must rely on other experts was acknowledged thousands of years ago

     

    (2) Moral Development

    • A part of the document focuses on the moral development of a child through panchakosha vikas or five-fold development.
    • The pre-draft recommends developing moral values for the child through a balanced diet, traditional games, yoga asanas, as well as a wide variety of stories, songs, lullabies, poems, and prayers to develop a love for cultural context.

    (3) Curriculum revamp

    • The pre-draft says that for Grade 10 certification, students will have to take two essential courses from humanities, maths and computing, vocational education, physical education, arts education, social science, science, and interdisciplinary areas.
    • In Grade 11 and 12, students will be offered choice-based courses in the same disciplines for more rigorous engagement.
    • Arts education will include music, dance, theatre, sculpture, painting, set design, scriptwriting, while interdisciplinary areas will include knowledge of India, traditions, and practices of Indian knowledge systems.
    • For Class 11 and 12, the document states that “Modular Board Exams will be offered as opposed to a single exam at the end of the year, and the final result will be based on the cumulative result of each exam.”
    • The framework of the social science curriculum emphasizes understanding and appreciating the feeling of Indianess, ‘bhartiyata,’ by valuing the rich cultural heritage and tradition of the country.
    • It also stresses on identifying and explaining important phases of the Indian national movement against British rule, with special reference to Gandhian and other subaltern movements.

    (4) Social Science Curriculum

    • The pre-draft emphasizes understanding and appreciating the feeling of Indianess, “bhartiyata,” by valuing the rich cultural heritage and tradition of the country.
    • The pre-draft also stresses on identifying and explaining important phases of the Indian national movement against British rule, with special reference to Gandhian and other subaltern movements.
    • It also recommends teaching concepts of Buddhism, Jainism, and Vedic and Confucian philosophies.

    (5) Follow-up processes

    • As a follow-up to the National Education Policy 2020, development of four National Curriculum Frameworks — NCF for School Education, NCF for Early Childhood Care and Education, NCF for Teacher Education, and NCF for Adult Education — have been initiated.
    • The National Steering Committee under the chairmanship of K. Kasturirangan was set up by the Ministry to undertake and develop NCFs.

    Controversy over curriculum revamp

    • The latest round of textbook rationalisation has resulted in some of the most sweeping changes in the curriculum since the NDA government came to power.
    • These changes include removing all references to the 2002 Gujarat riots, reducing content related to the Mughal era and the caste system, and dropping chapters on protests and social movements.
    • Many of these changes are seen as ‘political’, however, their earlier introduction into curriculum was also a political move.

    The furore over Mughal History

    • While some of the content on the Delhi Sultanate and the Mughal Empire has indeed been removed from the history textbook for Class 7, the Mughals have not entirely disappeared.
    • For instance, the chapter ‘The Mughal Empire’ in the Class 7 history textbook, Our Pasts – II, has undergone deletions — including a two-page table on the milestones and achievements of the reigns of the emperors Babur, Humayun, Akbar, Jahangir, Shah Jahan, and Aurangzeb.
    • However, the chapter itself has not been removed.
    • Students of Class 7 will continue to learn about the Mughals, though in lesser detail.

    Significance

    • School textbooks have always been seen as playing a crucial role in shaping national narratives, and as a tool for cultivating a desired national identity.
    • NCERT textbooks are read by more than 5 crore students in 18 states around the country, who are seen by political parties as a large captive audience with impressionable minds.
    • It’s not just school students either — candidates preparing for competitive exams such as the Civil Services Examination, SSC, JEE, and NEET, also rely on these textbooks.

  • Sodium Intake Target: Challenge of Cardiovascular Disease and Hypertension

    Sodium

    Central Idea

    • The WHO recently published the ‘Global Report on Sodium Intake Reduction’ which sheds light on the progress of its 194 member states towards reducing population sodium intake by 30% by 2025. Regrettably, progress has been lethargic, with only a few countries making considerable headway towards the objective. Consequently, there is a proposal to extend the deadline to 2030.

    The target of reducing population sodium intake

    • The target of reducing population sodium intake by 30% by 2025 was set by the World Health Organization (WHO) in its Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2013.
    • The plan aims to reduce premature deaths from non-communicable diseases, including cardiovascular diseases, by 25% by 2025, and to achieve a 30% reduction in the mean population intake of salt/sodium.
    • The target of reducing population sodium intake is aimed at reducing the burden of hypertension, which is a major risk factor for cardiovascular disease.

    Why reducing sodium intake is essential for India?

    • Reduced sodium intake and decreased blood pressure: There is a strong correlation between reduced sodium intake and decreased blood pressure, leading to a decrease in stroke and myocardial infarction incidence. Lowering sodium intake by 1 gram per day leads to a 5 mm Hg reduction in systolic blood pressure, as per a study in The BMJ.
    • Cardiovascular disease: Elevated BP is a critical risk factor for cardiovascular disease, which is the leading cause of mortality worldwide. It contributed to 54% of strokes and 47% of coronary heart diseases globally in 2001.
    • Economic impact of cardiovascular disease on LMICs: Cardiovascular disease has a staggering economic impact on LMICs, estimated at $3.7 trillion between 2011 and 2025 due to premature mortality and disability. This represents 2% of the GDP of LMICs. The Indian economy alone faces losses surpassing $2 trillion between 2012 and 2030 due to cardiovascular disease, highlighting the need for effective interventions to mitigate the economic and health consequences of the disease in LMICs.

    Sodium

    How cardiovascular disease and hypertension pose significant challenges in India?

    1. Cardiovascular diseases as primary cause of mortality and morbidity:
    • As per data from the Registrar General of India, WHO, and the Global Burden of Disease Study, cardiovascular diseases have emerged as the primary cause of mortality and morbidity. Data from the Registrar General of India, WHO, and the Global Burden of Disease Study
    • Age-adjusted cardiovascular disease mortality rate increased by 31% in the last 25 years
    • Hypertension as leading risk factor for such diseases in India
    1. Prevalence of hypertension in India:
    • More prevalent among men aged 15 and above compared to women
    • More common in southern states, particularly Kerala, while Punjab and Uttarakhand in the north also report high incidence rates
    1. Pre-hypertensive population in India
    • Defined by systolic blood pressure levels of 120-139 mmHg or diastolic blood pressure levels of 80-89 mmHg
    • 5% of women and 49.2% of men at the national level
    • Significant risks of cardiovascular disease, stroke, and premature mortality for Indians with BP readings between 130 and 139/80-89 mmHg
    • Many Indians classified as pre-hypertensive are now included in the newly defined stage-I hypertension by the American guidelines.
    1. Circulatory system diseases: The 2020 Report on Medical Certification of the Cause of Death shows that circulatory system diseases account for 32.1% of all documented deaths, with hypertension being a major risk factor.

    Global Efforts to Reduce Sodium Intake

    • The WHO aims to reduce population sodium intake by 30% by 2025
    • Only a few countries have made considerable progress towards the objective
    • India’s score of 2 on the WHO sodium score signifies the need for more rigorous efforts to address the health concern

    Sodium

    Government Initiatives

    • Voluntary programmes: The Union government has initiated several voluntary programmes aimed at encouraging Indians to decrease their sodium consumption
    • Eat Right India: The FSSAI has implemented the Eat Right India movement, which strives to transform the nation’s food system to ensure secure, healthy, and sustainable nutrition for all citizens
    • Aaj Se Thoda Kam: FSSAI launched a social media campaign called Aaj Se Thoda Kam.

    Urgent Need for a Comprehensive National Strategy

    • Despite of awareness efforts, the average Indian’s sodium intake remains alarmingly high. Evidence shows an average daily consumption of approximately 11 grams.
    • India needs a comprehensive national strategy to curb salt consumption
    • Collaboration between State and Union governments is essential to combat hypertension, often caused by excessive sodium intake

    Conclusion

    • The excessive consumption of salt can lead to severe health consequences, and India has a pressing need to reduce its sodium intake. While the government has initiated several voluntary programs, these have fallen short of the goal. India needs a comprehensive national strategy, engaging consumers, industry, and the government, to curb salt consumption. Collaboration between State and Union governments is essential to combat hypertension, often caused by excessive sodium intake.

    Mains Question

    Q. Reducing population sodium intake is a critical step towards preventing and controlling non- cardiovascular diseases and hypertension. Comment.

  • Autism Spectrum Disorders: Prevalence in India and Way Ahead

    Central Idea

    • In India, the prevalence of autism spectrum disorders (ASD) is a widely debated issue due to a lack of systematic estimates. Most estimates have been derived from studies based on school children, revealing that over one crore Indians may be on the autism spectrum. However, there are notable cultural differences in diagnosing autism between countries, which highlights the need to assess the prevalence of autism spectrum disorders specifically in the Indian context.

    What is Autism?

    • Spectrum disorder: Autism, also known as Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder that affects communication, social interaction, and behaviour. It is called a spectrum disorder because the symptoms and severity can vary widely between individuals.
    • Common symptoms: Some common symptoms of autism include difficulty with social interactions, such as maintaining eye contact or understanding nonverbal cues, delayed speech and language development, repetitive behaviors, and sensory sensitivities.
    • Cause: Autism is believed to be caused by a combination of genetic and environmental factors, but the exact cause is not yet fully understood.
    • Cure: There is currently no cure for autism, but early interventions and therapies can help individuals with autism lead fulfilling and independent lives.

    Prevalence of Autism in India

    • Lack of systematic estimates: Autism is a global issue and affects individuals of all cultures, ethnicities, and socioeconomic backgrounds. However, there is a lack of systematic estimates of autism prevalence in India.
    • Methos failed: Researchers have attempted to estimate prevalence through government hospitals, but this method failed due to the absence of central medical registries.
    • Conservative estimates: As a result, prevalence was estimated through school-based assessments. According to conservative estimates, well over one crore Indians are on the autism spectrum. This highlights the need for further research and attention to address the prevalence of ASD in India.
    • Cultural Differences and Diagnosis of Autism:
    • Notable cultural differences exist in the diagnosis of autism spectrum disorder. In the US and UK, the majority of children with autism spectrum diagnosis are verbal, with average or higher IQ, and attending mainstream schools.
    • However, in India, a significant majority of children with a clinical diagnosis of autism also have intellectual disability and limited verbal ability. This difference is driven by sociological factors, such as access to appropriate clinical expertise, provisions for inclusion in mainstream schools, and availability of medical insurance coverage.

    Challenges in Assessing Autism

    • Assessment tools: Assessment of autism spectrum disorder is primarily behavioral, and most widely used autism assessment tools are not available in Indian languages.
    • Indigenous autism assessment tools challenges: There has been a rise in the development of indigenous autism assessment tools. Despite the development of these tools, it can be challenging to compare across different assessment measures.

    Demand and Supply in India

    • Shortage of mental health professionals: Most autism assessment tools need to be administered by specialist mental health professionals. However, there is a significant shortage of mental health professionals in India, with less than 10,000 psychiatrists, a majority of whom are concentrated in big cities.
    • Delay is costly: Delay in interventions can be costly for neurodevelopmental conditions such as autism.
    • Demand and supply gap need to be met: This gap between demand and supply cannot be met directly by specialists alone, and parallel efforts to widen the reach of diagnostic and intervention services through involving non-specialists is required. Emerging evidence suggests the feasibility of involving non-specialists in autism identification and intervention through digital technology and training programs.

    Way ahead: Need for an All-India Program

    • National program on autism: The need of the hour is to develop a national program on autism in India that links researchers, clinicians, service providers to the end-users in the autism community.
    • Essential components: This program needs to have three essential components that are joined up: assessment, intervention, and awareness.
    • Assessment: Research is needed to develop appropriate assessments and design efficient implementation pathways.
    • Intervention: Clinical and support service workforce needs to be expanded by training non-specialists such that a stepped-care model can be rolled out effectively across the nation.
    • Awareness: Large-scale initiatives need to be launched to build public awareness that can reduce the stigma associated with autism and related conditions.

    Conclusion

    • There are challenges in diagnosing and assessing autism in India which highlights the need for a comprehensive and coordinated effort to address them. By expanding the clinical and support service workforce, training non-specialists, and developing appropriate assessments and interventions, India can improve outcomes for those on the autism spectrum and reduce the stigma associated with the condition. This national program needs to be informed by consultation with different stakeholders, with a primary focus on end-users within the Indian autism community.

  • Duty exemption for drugs for Rare Diseases

    rare

    Central idea: The Centre has exempted all drugs and food for special medical purposes, imported for personal use, for the treatment of rare diseases listed under the National Policy for Rare Diseases 2021 from basic customs duty.

    What are Rare Diseases?

    • Rare diseases are those medical conditions that affect a small percentage of the population.
    • In India, a disease is considered rare if it affects less than 1 in 2,000 people.
    • These diseases are often genetic and are chronic, degenerative, and life-threatening.
    • There are over 7,000 known rare diseases, and it is estimated that about 70 million people in India are affected by them.
    • Many of these diseases do not have a cure, and the treatment can be expensive and difficult to access.

    Need for duty exemption

    • This decision has been taken to help reduce the burden of the cost of treatment for patients and families.
    • The drugs and food required for the treatment of these rare diseases are often expensive and need to be imported.
    • This exemption will result in substantial cost savings and provide much-needed relief to patients with rare diseases.

    Key medicines under this exemption

    • The central government has fully exempted Pembrolizumab (Keytruda), a drug used in the treatment of various types of cancer, from basic customs duty.
    • Previously, the GST rate for Keytruda was cut to 5 per cent from 12 per cent in a meeting held in September 2021 by the GST Council.
    • Life-saving drugs Zolgensma and Viltepso used in the treatment of spinal muscular atrophy were exempted from GST when imported for personal use.

    How the new duty exemption works?

    • The exemption has been granted by the Central Board of Indirect Taxes and Customs (CBIC) by substituting “Drugs, Medicines or Food for Special Medical Purposes (FSMP)” instead of “drugs or medicines”.
    • To avail of this exemption, the individual importer has to produce a certificate from the central or state director health services or district medical officer/civil surgeon of the district.

    How are life-saving medicines taxed?

    • Drugs/medicines generally attract basic customs duty of 10 per cent, while some categories of lifesaving drugs/vaccines attract a concessional rate of 5 per cent or nil.
    • In its meeting in September 2021, the GST Council had reduced tax rates for several life-saving drugs.

     

  • Public Policy Education: Essential For Developing Effective Policies

    Central Idea

    • Government policies play a crucial role in determining the future of a country. They not only impact economic growth and public welfare but also improve the ease of living for citizens. Unfortunately, there is a lack of interest in public policy education in India, with only a small percentage of policymakers having formal education in public policy and administration.

    Public policy education

    • Public policy education refers to the study and teaching of the principles, theories, and methods involved in the development, implementation, and evaluation of policies that address societal issues.
    • This field of education aims to equip students with the knowledge and skills necessary to analyze, create, and manage public policies effectively.

    How the government policies, economic growth, and public welfare are closely interconnected?

    • Government policies: Governments create and implement policies to guide economic activities, maintain social order, and promote the welfare of their citizens. These policies cover a wide range of areas, such as fiscal and monetary policy, trade policy, education, healthcare, social security, and infrastructure development. The effectiveness of these policies can have a direct impact on economic growth and public welfare.
    • Economic growth: Economic growth is the increase in a country’s output of goods and services over time, usually measured by the growth rate of gross domestic product (GDP). A growing economy typically leads to higher employment, increased income, and improved living standards for citizens. Government policies play a crucial role in stimulating or hindering economic growth by influencing factors such as investment, consumption, trade, and innovation.
    • Public welfare: Public welfare refers to the overall well-being of a society, encompassing aspects such as income distribution, access to essential services, health, education, and environmental quality. Government policies can significantly impact public welfare by determining the allocation of resources, setting priorities, and providing social safety nets.

    Paucity of Programs

    • As per the All-India Council for Technical Education, there are 3,182 institutions with an approved intake of 4.22 lakh in business management programs, but only about 130 universities that offer public administration programs and only 29 institutes that offer public policy programs.
    • The batch size of public policy courses is 20-60, and there are few jobs available for people pursuing such courses, which disincentivizes educational institutions and students from choosing public management courses.

    Lack of Exposure to Public Management

    • Most civil servants undergo departmental induction training programs that focus on the role they play in their department and not much on how to make good public policies.
    • Consequently, very few civil servants have exposure to public management before joining service, which is critical for developing effective policies.

    Suggestions to boost public policy education in India

    1. Public Management as a Compulsory Subject in UPSC:
    • Public management should be a compulsory subject for the UPSC civil service examination, either as a substitute for one optional subject or an additional paper. This will incentivize universities and private institutions to offer public policy education, research, and case studies at the graduate or post-graduate level, leading to a major boost in public policy education.
    • Additionally, civil servants who join government would have formal education in public management before they enter service, and even those who do not make it to government jobs would develop better understanding and sensitivity towards complexities involved in public management, making them better citizens and effective private sector managers.
    1. Larger Component of Public Policy in Induction Training: Existing training institutions of the government should have a larger component of public policy as part of their induction training. Moreover, a case study bank for training should also be established.
    2. Specialized Positions of Public Policy Analysts: The government can create certain specialized positions of public policy analysts to be picked up from the market directly, thereby creating new job avenues for the graduates of public policy programs.

    Conclusion

    • The lack of formal education in public management has led to governance lagging behind private sector management in terms of efficiency and effectiveness. Public policy education is essential for developing effective policies that spur economic growth, public welfare, and improve ease of living for citizens.

    Mains Question

    Q. What is public policy education, and why is it important for policymakers in India to have formal education in public policy and administration? Suggest measures to boost public policy education in India.