💥Mains Ready By December. Smash Mains & Smash PYQ Admissions Open
Talk to Mentor

Civilsdaily

Login

GS Paper: GS2

  • ASHA workers earn WHO’s global plaudits

    The country’s frontline health workers or ASHAs (accredited social health activists) were one of the six recipients of the WHO’s Global Health Leaders Award 2022 which recognises leadership, contribution to the advance of global health and commitment to regional health issues.

    Who are ASHA workers?

    • ASHA workers are volunteers from within the community who are trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.
    • The role of these community health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.
    • They act as a bridge connecting marginalised communities with facilities such as primary health centres, sub-centres and district hospitals.

    Genesis & evolution

    • The ASHA programme was based on Chhattisgarh’s successful Mitanin programme, in which a Community Worker looks after 50 households.
    • The ASHA was to be a local resident, looking after 200 households.
    • The programme had a very robust thrust on the stage-wise development of capacity in selected areas of public health.
    • Many states tried to incrementally develop the ASHA from a Community Worker to a Community Health Worker, and even to an Auxiliary Nurse Midwife (ANM)/ General Nurse and Midwife (GNM), or a Public Health Nurse.

    Qualifications for ASHA Workers

    • ASHAs are primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community.
    • They must have good communication and leadership skills; should be literate with formal education up to Class 8, as per the programme guidelines.

    How many ASHAs are there across the country?

    • The aim is to have one ASHA for every 1,000 persons or per habitation in hilly, tribal or other sparsely populated areas.
    • There are around 10.4 lakh ASHA workers across the country, with the largest workforces in states with high populations – Uttar Pradesh (1.63 lakh), Bihar (89,437), and Madhya Pradesh (77,531).
    • Goa is the only state with no such workers, as per the latest National Health Mission data available from September 2019.

    What do ASHA workers do?

    • They go door-to-door in their designated areas creating awareness about basic nutrition, hygiene practices, and the health services available.
    • They focus primarily on ensuring that pregnant women undergo ante-natal check-up, maintain nutrition during pregnancy, deliver at a healthcare facility, and provide post-birth training on breast-feeding and complementary nutrition of children.
    • They also counsel women about contraceptives and sexually transmitted infections.
    • ASHA workers are also tasked with ensuring and motivating children to get immunised.
    • Other than mother and child care, ASHA workers also provide medicines daily to TB patients under directly observed treatment of the national programme.
    • They are also tasked with screening for infections like malaria during the season.
    • They also provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anaemia etc.
    • Now, they also get people tested and get their reports for non-communicable diseases.
    • The health volunteers are also tasked with informing their respective primary health centre about any births or deaths in their designated areas.

    How much are ASHA workers paid?

    • Since they are considered “volunteers/activists”, governments are not obligated to pay them a salary. And, most states don’t.
    • Their income depends on incentives under various schemes that are provided when they, for example, ensure an institutional delivery or when they get a child immunised.
    • All this adds up to only between Rs 6,000 to Rs 8,000 a month.
    • Her work is so tailored that it does not interfere with her normal livelihood.

    Success of the ASHAs

    • It is a programme that has done well across the country.
    • In a way, it became a programme that allowed a local woman to develop into a skilled health worker.
    • Overall, it created a new cadre of incrementally skilled local health workers who were paid based on performance.
    • The ASHAs are widely respected as they brought basic health services to the doorstep of households.
    • Since then ASHA continues to enjoy the confidence of the community.

    Challenges to ASHAs

    • The ASHAs faced a range of challenges: Where to stay in a hospital? How to manage mobility? How to tackle safety issues?
    • There have been challenges with regard to the performance-based compensation. In many states, the payout is low, and often delayed.
    • It has a problem of responsibility and accountability without fair compensation.
    • There is a strong argument to grant permanence to some of these positions with a reasonable compensation as sustaining motivation.
    • Ideally, an ASHA should be able to make more than the salary of a government employee, with opportunities for moving up the skill ladder in the formal primary health care system as an ANM/ GNM or a Public Health Nurse.

    Way forward

    • The incremental development of a local resident woman is an important factor in human resource engagement in community-linked sectors.
    • It is equally important to ensure that compensation for performance is timely and adequate.
    • Upgrading skill sets and providing easy access to credit and finance will ensure a sustainable opportunity to earn a respectable living while serving the community.
    • Strengthening access to health insurance, credit for consumption and livelihood needs at reasonable rates, and coverage under pro-poor public welfare programmes will contribute to ASHAs emerging as even stronger agents of change.

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • Centre reconstitutes Inter-State Council (ISC)

    The Inter-State Council, which works to promote and support cooperative federalism in the country, has been reconstituted with PM Modi as Chairman and CMs of all States and six Union Ministers as members.

    What is Inter-State Council (ISC)?

    Genesis of ISC

    • The Constitution of India in Article 263, provides for the establishment of Inter-State Council (ISC).
    • The objective of the ISC is to discuss or investigate policies, subjects of common interest, and disputes among states.

    Temporary or permanent?

    • The articles says that ISC may be established “if at any time it appears to the President that the public interests would be served by the establishment of a Council”.
    • Therefore, the constitution itself did not establish the ISC, because it was not considered necessary at the time the constitution was being framed, but kept the option for its establishment open.

    Establishment as permanent body

    • This option was exercised in 1990.
    • The ISC was established as a permanent body on 28 May 1990 by a presidential order on the recommendation of the Sarkaria Commission.
    • It had recommended that a permanent Inter-State Council called the Inter-Governmental Council (IGC) should be set up under Article 263.
    • It cannot be dissolved and re-established.
    • Therefore, the current status of ISC is that of a permanent constitutional body.

    Aims of the ISC

    • Decentralisation of powers to the states as much as possible
    • More transfer of financial resources to the states
    • Arrangements for devolution in such a way that the states can fulfil their obligations
    • Advancement of loans to states should be related to as ‘the productive principle’
    • Deployment of Central Armed Police Forces in the states either on their request or otherwise

    Composition

    The Inter-State Council composes of the following members:

    • Prime Minister, Chairman.
    • Chief Ministers of all states.
    • Chief Ministers of the union territories having legislative assemblies.
    • Administrators of the union territories not having legislative assemblies.
    • 6 Union Cabinet Ministers, including Home Minister, to be nominated by the Prime Minister.
    • Governors of the states being administered under President’s rule.

    Standing Committee

    • Home Minister, Chairman
    • 5 Union Cabinet Ministers
    • 9 Chief Ministers

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • Indo-Pacific Economic Framework for Prosperity (IPEF)

    India has signalled its readiness to be part of a new economic initiative led Indo-Pacific Economic Framework for Prosperity (IPEF) by the US for the region.

    What is IPEF?

    • The grouping, which includes seven out of 10 members of the Association of South East Asian Nations (ASEAN), all four Quad countries, and New Zealand, represents about 40% of global GDP.
    • The negotiations for the IPEF are expected to centre around four main pillars, including trade, supply chain resiliency, clean energy and decarbonisation, and taxes and anti-corruption measures.
    • Countries would have to sign up to all of the components within a module, but do not have to participate in all modules.
    • The “fair and resilient trade” module will be led by the US Trade Representative and include digital, labor, and environment issues, with some binding commitments.
    • The IPEF seeks to strengthen economic partnership amongst participating countries with the objective of enhancing resilience, sustainability, inclusiveness, economic growth, fairness, and competitiveness in the Indo-Pacific region.

    Features of IPEF

    • US officials made it clear that the IPEF would not be a “free trade agreement”, nor are countries expected to discuss reducing tariffs or increasing market access.
    • The IPEF will not include market access commitments such as lowering tariff barriers,
    • In that sense, the IPEF would not seek to replace the 11-nation CPTPP (Trans-Pacific Partnership) that the US quit in 2017, or the RCEP, which China, and all of the other IPEF countries (minus the US) are a part of.
    • Three ASEAN countries considered closer to China — Myanmar, Cambodia and Laos — are not members of the IPEF.

    Four pillars of IPEF

    1. Trade that will include digital economy and emerging technology, labour commitments, the environment, trade facilitation, transparency and good regulatory practices, and corporate accountability, standards on cross-border data flows and data localisations;
    2. Supply chain resiliency to develop “a first-of-its-kind supply chain agreement” that would anticipate and prevent disruptions;
    3. Clean energy and decarbonisation that will include agreements on “high-ambition commitments” such as renewable energy targets, carbon removal purchasing commitments, energy efficiency standards, and new measures to combat methane emissions; and
    4. Tax and anti-corruption, with commitments to enact and enforce “effective tax, anti-money laundering, anti-bribery schemes in line with [American] values”.

    Reasons for creation of IPEF

    • The IPEF is also seen as a means by which the US is trying to regain credibility in the region after former President Donald Trump pulled out of the Trans Pacific Partnership TPP).
    • Since then, there has been concern over the absence of a credible US economic and trade strategy to counter China’s economic influence in the region.
    • China is an influential member of the TPP, and has sought membership of its successor agreement Comprehensive and Progressive Agreement on Trans Pacific Partnership.
    • It is also in the 14-member Regional Comprehensive Economic Partnership, of which the US is not a member (India withdrew from RCEP).
    • The Biden Administration is projecting IPEF as the new US vehicle for re-engagement with East Asia and South East Asia.

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • What are Look Out Circulars (LOCs)?

    The Punjab and Haryana High Court has held that a Look Out Circular (LOC), which prevents one from travelling abroad, must be supplied to the person at the time of being stopped at the airport and that the reasons should be communicated to the affected party.

    What is a Look Out Circular?

    • It is a notice to stop any individual wanted by the police, investigating agency or even a bank from leaving or entering the country through designated land, air and sea ports.
    • Immigration is tasked to stop any such individual against whom such a notice exists from leaving or entering the country.
    • There are 86 immigration check posts across the country.

    Who can issue LOCs?

    • A large number of agencies which includes the Central Bureau of Investigation (CBI), Enforcement Directorate, Directorate of Revenue Intelligence (DRI), Income Tax, State police and intelligence agencies are authorised to generate LOCs.
    • The officer should not be below the rank of a district magistrate or superintendent of police or a deputy secretary in the Union Government.

    What are the details required to generate an LOC and who issues it?

    • According to a 2010 official memorandum of the Ministry, details such as First Information Report (FIR) number, court case number are to be mandatorily provided with name, passport number and other details.
    • The BOI under the MHA is only the executing agency.
    • They generate LOCs based on requests by different agencies.
    • Since immigration posts are manned by the BOI officials they are the first responders to execute LOCs by stopping or detaining or informing about an individual to the issuing agency.
    • The LOCs can be modified; deleted or withdrawn only at the request of the originator.
    • Further, the legal liability of the action taken by immigration authorities in pursuance of LOC rests with the originating agency.

    How are banks authorized?

    • After several businessmen including liquor baron Vijay Mallya, businessmen Nirav Modi and Mehul Choksi fled the country after defaulting on loans, the MHA in 2018 brought changes to the 2010 guidelines.
    • It authorised the chairman, managing director and chief executives of all public sector banks to generate LOCs against persons who could be detrimental to economic interests of the country.

    Is there any other clause under which any individual can be stopped?

    • The 2010 Ministry guidelines give sweeping powers to police and intelligence agencies to generate LOCs in “exceptional cases” without keying in complete parameters or case details.
    • This was against suspects, terrorists, anti-national elements, etc. in larger national interest.
    • After the special status of J&K under Article 370 was abrogated in 2019, LOCs were opened against several politicians, human rights activists, journalists and social activists to bar them from flying out of the country.
    • The number of persons and the crime for which they have been placed under the list is unknown.

    Are individuals entitled to any remedial measures?

    • Many citizens have moved courts to get the LOC quashed.
    • As per norms, an LOC will stay valid for a maximum period of 12 months and if there is no fresh request from the agency then it will not be automatically revived.
    • The MHA has asserted that LOCs cannot be shown to the subject at the time of detention nor can any prior intimation be provided.
    • The Ministry recently informed the Punjab and Haryana HC that the LOC guidelines are a secret document and the same cannot be shared with the ‘accused’ or any unauthorised stakeholder.
    • It cannot be provided or shown to the subject at the time of detention by the BOI since it defeats the purpose of LOC and no accused or subject of LOC can be provided any opportunity of hearing before the issuance of the LOC.

    Precedence set by the Judiciary

    • In January this year, Delhi HC quashed an LOC against a Delhi businessman generated at the instance of the Income Tax department.
    • The court said no proceedings under any penal law had been initiated against the petitioner” and the LOC was “wholly unsustainable.”
    • It said that there cannot be any unfettered control or restriction on the right to travel and that it was part of the fundamental rights.
    • Delhi HC has also asked the Director of the CBI to tender a written apology.

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • India Hypertension Control Initiative (IHCI)

    The IHCI project has demonstrated that blood pressure treatment and control are feasible in primary care settings in diverse health systems across various States in India.

    India Hypertension Control Initiative (IHCI)

    • It is a multi-partner initiative involving the Indian Council of Medical Research, WHO-India, Ministry of Health and Family Welfare, and State governments.
    • It aims to improve blood pressure control for people with hypertension.
    • The project initiated in 26 districts in 2018 has expanded to more than 100 districts by 2022.
    • More than two million patients were started on treatment and tracked to see whether they achieved BP control.

    The project was built on five scalable strategies:

    1. Simple treatment protocol with three drugs was selected in consultation with the experts and non-communicable disease programme managers.
    2. Supply chain was strengthened to ensure the availability of adequate antihypertensive drugs.
    3. Patient-centric approaches were followed, such as refills for at least 30 days and assigning the patients to the closest primary health centre or health wellness centre to make follow-up easier.
    4. The focus was on building capacity of all health staff and sharing tasks such as BP measurement, documentation, and follow-up.
    5. There was minimal documentation using either paper-based or digital tools to track follow-up and BP control.

    Prevalence of hypertension in India

    • Cardiovascular diseases (CVD) are the leading cause of death among adults in India.
    • One of the major drivers of heart attack and stroke is untreated high blood pressure or hypertension.
    • Hypertension is a silent killer as most patients do not have any symptoms.
    • India has more than 200 million people with hypertension, and only 14.5% of individuals with hypertension are on treatment.

    Success of IHCI

    • Blood pressure treatment and control were feasibly controlled in primary care settings in diverse health systems across various States in India.
    • Before IHCI, many patients travelled to higher-level facilities such as community health centres (block level) or district hospitals in the public sector for hypertension treatment.
    • Over three years, all levels of health staff at the primary health centres and health wellness centres were trained to provide treatment and follow-up services for hypertension.
    • Nearly half (47%) of the patients under care achieved blood pressure control.
    • The BP control among people enrolled in treatment was 48% at primary health centres and 55% at the health wellness centres.

    Contributing to its success: A data-driven approach

    • One of the unique contributions of the project was a data-driven approach to improving care and overall programme management.
    • The list of people who did not return for treatment was generated through a digital system or on paper by the nurse/health workers.
    • Patients were reminded either over the phone or by home visit (if feasible).
    • This strategy motivated a large number of patients to continue treatment.
    • In addition, programme managers reviewed aggregate data at the district and State levels to assess the performance of facilities in terms of follow-up and BP control.
    • Patients were provided generic antihypertensive drugs costing only ₹200 per year.
    • In addition, E-Sanjeevani, a telemedicine initiative, facilitated teleconsultations.

    Back2Basics: Hypertension

    • Hypertension also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
    • High blood pressure usually does not cause symptoms.
    • Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.
    • High blood pressure is classified as primary (essential) hypertension or secondary hypertension.
    • For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • Illegal fishing by China in the Indo-Pacific

    In order to check China’s illegal fishing in the Indo-Pacific region, the Quadrilateral Security Alliance (Quad) has planned to launch a satellite-based surveillance initiative.

    What is the news?

    • The leaders of Quad are reported to be getting ready to unveil a maritime surveillance initiative to protect exclusive economic zones in the Indo-Pacific against environmental damage.

    How will the proposed maritime surveillance system work?

    • The initiative will use satellite technology to connect existing surveillance centres in India, Singapore and the Pacific.
    • This will help establish a tracking system to combat illegal, unregulated and unprotected (IUU) fishing.
    • The satellite-enabled dragnet will track IUU fishing activities from the Indian Ocean and South-east Asia to the South Pacific.
    • The idea is to monitor illicit fishing vessels that have their AIS (automatic identification system) transponders turned off to evade tracking.
    • The move by the Quad security group is also seen to be aimed at reducing the small Pacific island nations’ growing reliance on China.

    Why is illegal fishing seen as such a big threat?

    • The unregulated plunder of global fishing stock poses a grave threat to the livelihood and food security of millions of people.
    • Globally, fish provide about 3.3 billion people with 20% of their average animal protein intake.
    • According to an FAO report, around 60 million people are engaged in the sector of fisheries and aquaculture.
    • While the economic loss from illegal fishing has been difficult to precisely quantify, some estimates peg it around USD 20 billion annually.

    Threats posed by IUU Fishing

    • Illegal fishing has now replaced piracy as a global maritime threat.
    • In the Indo-Pacific region, like elsewhere, the collapse of fisheries can destabilise coastal nations.
    • It poses a much bigger security risk, as it can fuel human trafficking, drug crime and terror recruiting.

    Why is China in the dock?

    • The 2021 IUU Fishing Index, which maps 152 coastal countries, ranked China as the worst offender.
    • China is considered responsible for 80% to 95% illegal fishing in the region after having overfished its own waters.
    • It, in fact, is known to incentivise illegal fishing with generous subsidies to meet its growing domestic demand.

    China and distant-water fishing (DWF)

    • China’s DWF fleet has almost 17,000 vessels and is the largest in the world.
    • Vessel ownership is highly fragmented among many small companies and the fleet includes vessels registered in other jurisdictions.

    Issues with Chinese IUU Fishing

    • Chinese are often accused of pillaging ocean wealth with great sophistication and with little regard for maritime boundaries.
    • China also uses them to project strategic influence and to bully fishing vessels from weaker nations.
    • China uses destructive practises such as bottom trawling and forced, bonded and slave labour and trafficked crew, alongside the widespread abuse of migrant crewmembers.

     

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • As Indian economy grows, Centre and states must work together

    Context

    The ongoing discords between the Centre and states over issues ranging from the allocation of financial resources to fixing of GST rates has once again brought to the fore issues pertaining to our federal structure, the resolution of which is essential for the country’s growth.

    Combination of cooperative and competitive spirit

    • Positive competition: It is undeniable that cooperation is key to the smooth functioning of federal design.
    • However, if it is coupled with positive competition among the states, then the overall result would be large-scale economic development across the country.
    • The competitive aspect of federalism can positively be harnessed by encouraging states to adopt each other’s best practices.
    • Exclusivity and mutualism: Indian federalism today enables the Centre and states to function with both exclusivity and mutualism.
    • Vertical and horizontal level: Cooperation between the Centre and states is required at both vertical (between Centre and states) and horizontal (among states) levels and on various fronts.
    • What does it mean? This includes fine-tuning of developmental measures for desired outcomes, development-related policy decisions, welfare measures, administrative reforms, strategic decisions, etc.

    Steps in the direction of cooperation

    • Recent efforts in this direction, such as according greater leeway to states in the functioning of the NITI Aayog, frequent meetings of the prime minister with chief ministers as well as with chief secretaries and district magistrates, periodic meetings of the President of India with governors, and the functioning of “PRAGATI” to review the progress of developmental efforts have generated the requisite synergy between the Centre and states.
    • Positive efforts of states towards attracting investment can create a conducive environment for economic activities in urban and backward regions alike.
    • Healthy competition coupled with a transparent ranking system would ensure the full materialisation of the vast but least utilised potential of the federal framework.
    • Sector specific indices: In this direction, NITI Aayog’s initiatives such as launching sector-specific indices like the School Education Quality Index, Sustainable Development Goals Index, State Health Index, India Innovation Index, Composite Water Management Index, Export Competitiveness Index, etc. could prove to be a great contribution.
    • Central efforts toward synchronisation of cooperation and competition can be observed in the implementation of the 14th and 15th Finance Commission reports, which have greatly contributed to resource devolution.
    • Recent reform measures in the form of the New Labour Code and other amendments/enactments by the legislature also exhibit this trend.

    Conclusion

    The rising stature of the Indian economy on the world stage can only be strengthened by a tailored approach to cooperation and competition. The mandate to marry the two would inevitably be the collective responsibility of the Centre and the states. Any ideological differences between them will have to be inevitably put on the backburner for the great Indian federal structure to succeed and prosper.

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • Structural interventions by state governments that can create higher-wage jobs

    Context

    The recent decision to deduct off-budget borrowings from state borrowing limits reminds chief ministers to be good policy ancestors.

    Financing welfare state

    • In A Brief History of Equality, economist Thomas Piketty suggests that “the world of the early 2020s, no matter how unjust it may seem, is more egalitarian than that of 1950 or 1900, which were… more egalitarian than those of 1850 or 1780”.
    • But how the welfare state is financed matters.
    • Changes in state borrowing limits: Adjusting state borrowing limits for their off-budget borrowings leads to transparency because they are routinely breached through vehicles for schemes whose bill comes due far in the future.
    • The confiscation of future spending — interest payments crowd out expenditure and revenue expenditure crowd out capex — matters because our prosperity problem is productivity, wages, not jobs.

    5 Structural interventions that can create high wage jobs

    1] Reduce regulatory hurdles

    • States control 80 per cent of India’s employers’ compliance ecosystem of 67,000+ compliances, 6,500+ filings and 26,000+ criminal provisions.
    • State governments that rationalise, decriminalise, and digitise their compliance ecosystem will reap lower corruption and higher formality.

    2] Fix government schools

    • The most powerful tool for social mobility and employability is free and quality school education.
    • State governments that undertake a significant overhaul of school performance management (the fear of falling and hope of rising for teachers) and governance (the allocation of decision rights around resources and hiring) will create an unfair advantage in human capital.

    3] Converge education and employability

    • States should set up skill universities that create qualification modularity (between certificates, diplomas, advanced diplomas, and degrees), delivery flexibility (equate online, apprenticeships, on-site and on-campus classrooms), and pray to the one god of employers.
    • Degree apprentices innovate at the intersection of employment, employability and education.
    • State governments that remove barriers in their path will see their population of employed learners exceed full-time learners.

    4] Devolution of money and power

    • Cities drive productive job creation — New York City’s GDP is higher than Russia’s.
    •  It took 70 years after 1947 for the budget of 28 states to cross the central government’s budget.
    • The combined budget of state governments now exceeds Rs 45 lakh crore, but 2.5 lakh municipalities and panchayats have a budget of only Rs 3.7 lakh crore.
    • Governments that devolve money and power from state capitals to their towns will avoid the curse of megacities and create the competition that drove China’s growth (they have 375 cities with more than a million people versus our 52).

    5] Civil service reforms

    • State governments must sell their 1,500+ loss-making public sector units, cut civil service compensation to less than 40 per cent of budget spending, and replace expenditure with capex.
    • Moving from outlays to outcomes needs a new human capital regime for civil servants via seven interventions; structure, staffing, training, performance management, compensation, culture, and HR capabilities.

    Shifting resources to protective and productive  version of states

    • Nobel Laureate James Buchanan said any state had three versions — the protective state (police, rule of law, defence, courts), the productive state (common goods like roads, power, health, education, etc.), and the redistributive state.
    • Too many state governments accept the status quo in the first two and “innovate” in the third version.
    • It’s time to shift resources to the first two.

    Conclusion

    Chief Ministers ought to create high wage jobs, and not borrow money future generations will have to repay.

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • The constitutional battle between governor and government

    Context

    The Supreme Court’s action in ordering the release of A G Perarivalan, a convict in the Rajiv Gandhi assassination case, has resulted in mixed reactions.

    Background

    • After the assassination of Rajiv Gandhi, the assailants were tried under the notorious Terrorist and Disruptive Activities (Prevention) Act, 1987 (TADA).
    • All 26 accused were given the death sentence by the Special Court for various offences, including under TADA (1998).
    • Fortunately, the SC held that the offences under TADA were not made out since there was no case to proceed for acts of terrorism.
    • It also modified the death penalty for 22 persons and confirmed the same only for Nalini, Perarivalan, Murugan and Santhan (1999).
    • Petition for mercy under Article 161: They petitioned the governor of Tamil Nadu for mercy under Article 161.
    • The then governor of Tamil Nadu dismissed their petition without any advice from the cabinet.
    • The Madras High Court ruled that the governor cannot exercise the power of pardon without the advice of the council of ministers.
    • The cabinet advised the governor to give reprieve only to Nalini Sriharan and rejected the case of the other three, including Perarivalan.
    • Perarivalan and the two other convicts appealed to the president with a mercy plea under Article 72. 
    •  Two successive presidents of India – K R Narayanan and APJ Abdul Kalam — did not pass any mercy orders.
    • But all of a sudden, their mercy pleas were rejected after a delay of 11 years by President Pratibha Patil.
    • When they were about to be executed, the convicts moved the Madras HC challenging the execution of the death warrant issued against them.
    • The cases were transferred to the SC, which decided that the president’s action in not considering the mercy plea within a reasonable time was improper and since the three prisoners had been on death row for 11 years, it was a fit case for commuting their sentence to life imprisonment.
    • Meanwhile, on February 19, 2014, the TN cabinet advised the governor to grant reprieve to all seven accused.
    • Once again, all of them applied for remission from the governor.
    • The state cabinet also advised the governor to grant pardon.
    • WhenPerarivalan’s mother, filed a case for parole, the court noting the inordinate delay observed: “the Governor of T N, a constitutional authority, cannot sit on the state’s recommendation on the release of all seven life convicts in the Rajiv Gandhi assassination case for so long” (July 2020).
    • The court was informed that the governor was awaiting the final report of the CBI’s Multi-Disciplinary Monitoring Agency (MDMA).

    Role of MDMA

    • The role of MDMA itself came up for criticism by the SC in January 2018 and it observed that the agency did not appear to have made “much headway”.
    • The court observed that the question of reopening the case against them will not arise as they had been already convicted for murder and conspiracy.
    • Article 20(2) of the Constitution guarantees that no person can be prosecuted and punished for the same offence more than once.

    Use of powers under Article 142 by the Supreme Court

    • Once again, the process of granting mercy to the seven accused began with a resolution passed by the T N Assembly on September 9, 2018.
    • On the same day, the state cabinet advised the governor to give reprieve to all seven prisoners.
    • On being compelled by the court, the governor stated that the matter was to be dealt with by the President.
    • It was at this stage the matter went back to the SC.
    • It was finally decided that the authority to grant pardon is with the governor and he is bound by the advice of the state government.
    • The court also ruled that the action of the governor in delaying the matter for more than 2.5 years was unacceptable.
    • Exercising its power under Article 142 as well as considering all the relevant circumstances, the SC ordered Perarivalan’s release.

    Limitations on governor’s power

    • Giving reprieve to persons sentenced to the death penalty, even in the exercise of the plenary powers by a governor, has limitations.
    • In 1978, Parliament amended the Criminal Procedure Code and introduced Sec 433A by which in such cases, prisoners cannot be released from prison unless they had served a minimum of 14 years in prison. 

    Reformatory penal system of India

    • India’s penal system is undoubtedly reformatory and not retributive.
    • The SC ruled on this issue by stating “a barbaric crime does not have to be visited with a barbaric penalty.”
    • It is also surprising that the successive governments at the Centre appeared to be guided in this case by geopolitical considerations rather than this country’s laws.

    Conclusion

    The question now is whether the six other prisoners will receive the same relief or will there be a confrontation between the state government and governor once again. Let us hope that wisdom prevails and the governor’s office is not manipulated for narrow political considerations.

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

  • Bridging the health policy to execution chasm

    Context

    In April this year, the Union government released a guidance document on the setting up of a ‘public health and management cadre’ (PHMC) as well as revised editions of the Indian Public Health Standards (IPHS) — for ensuring quality health care in government facilities.

    Background

    • The need for a public health cadre and services in India rarely got any policy attention.
    • Limited understanding: The reason was that even among policymakers, there was limited understanding on the roles and the functions of public health specialists and the relevance of such cadres, especially at the district and sub-district levels.
    • However, the last decade and a half was eventful.
    • The initial threat of avian flu in 2005-06, the Swine flu pandemic of 2009-10; five more public health emergencies of international concern between years 2009-19; the increasing risks and regular emergence and re-emergence of of new viruses and diseases (Zika, Ebola, Crimean-Congo Hemorrhagic fever, Nipah viruses, etc.) in animals and humans, resulted in increased attention on public health.
    • National Public health Act: In 2017, India’s National Health Policy 2017 proposed the formation of a public health cadre and enacting a National Public Health Act.
    • The COVID-19 pandemic changed the status quo.
    • In the absence of trained public health professionals at the policy and decision making levels, India’s pandemic response ended up becoming bureaucrat steered and clinician led.

    Different cadres and its implications

    • Lack of career progression opportunities: At present, most Indian States (with exceptions such as Tamil Nadu and Odisha) have a teaching cadre (of medical college faculty members) and a specialist cadre of doctors involved in clinical services.
    • This structure does not provide similar career progression opportunities for professionals trained in public health.
    • Limited interest: It is one of the reasons for limited interest by health-care professionals to opt for public health as a career choice.
    • The outcome has been costly for society: a perennial shortage of trained public health workforce.

    Public health cadre

    • The proposed public health cadre and the health management cadre have the potential to address some of these challenges.
    • With the release of guidance documents, the States have been advised to formulate an action plan, identify the cadre strengths, and fill up the vacant posts in the next six months to a year.
    • A public health workforce has a role even beyond epidemics and pandemics.
    • A trained public health workforce ensures that people receive holistic health care, of preventive and promotive services (largely in the domain of public health) as well as curative and diagnostic services (as part of medical care).

    Revised version of IPHS and significance

    • This is the second revision in the IPHS, which were first released in 2007 and then revised in 2012.
    • The regular need for a revision in the IPHS is a recognition of the fact that to be meaningful, quality improvement has to be an ongoing process.
    • The development of the IPHS itself was a major step.
    • The revised IPHS is an important development but not an end itself.
    • In the 15 years since the first release of the IPHS, only a small proportion — around 15% to 20% — of government health-care facilities meets these standards. .
    • If the pace of achieving IPHS is any criteria, there is a need for more accelerated interventions.
    • Opportunities such as a revision of the IPHS should also be used for an independent assessment on how the IPHS has improved the quality of health services.

    Implementation challenges

    • The effective part of implementation is interplay: policy formulation, financial allocation, and the availability of a trained workforce.
    • In this case, policy has been formulated.
    • Financial allocations: Then, though the Government’s spending on health in India is low and has increased only marginally in the last two decades; however, in the last two years, there have been a few additional — small but assured — sources of funding for public health services have become available.
    • The Fifteenth Finance Commission grant for the five-year period of 2021- 26 and the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) allocations are available for strengthening public health services and could be used  as States embark upon implementing the PHMC and a revised IPHS.
    • Availability of trained workforce: The third aspect of effective implementation, the availability of trained workforce, is the most critical.
    • As States develop plans for setting up the PHMC, all potential challenges in securing a trained workforce should be identified and actions initiated.

    Conclusion

    The public health and management cadres and the revised IPHS can help India to make progress towards the NHP goal. To ensure that, State governments need to act urgently and immediately.

    UPSC 2023 countdown has begun! Get your personal guidance plan now! (Click here)

    Back2Basics: Indian Public Health Standards (IPHS)

    • IPHS are a set of uniform standards envisaged to improve the quality of health care delivery in the country.
    • The IPHS documents have been revised keeping in view the changing protocols of the existing programmes and introduction of new programmes especially for Non-Communicable Diseases.
    • Flexibility is allowed to suit the diverse needs of the States and regions.
    • These IPHS guidelines will act as the main driver for continuous improvement in quality and serve as the bench mark for assessing the functional status of health facilities.