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GS Paper: GS2

  • China manipulates the WHO, India needs to be cautious

    The article elaborates on the role played by China in manipulating WHO to its advantage and to the detriment of the rest of the world. India must take cognisance of the growing Chinese influence at various global platforms and act accordingly.

    China’s role in electing Director-General of WHO

    • Tedros was Ethiopia’s Minister of Health (2005—2012) and Minister of Foreign Affairs (2012 to 2016).
    • In 2017, China catapulted him to lead the WHO as its Director General (DG).
    • India, the world’s largest democracy, played second fiddle.
    • We will never know who gamed India inside and abroad, but tough questions must be asked.

    Pandemic as a wake-up call for India

    • Public health is a rights-driven developmental track for any country, especially for India.
    • The ministries of foreign, trade, information and broadcasting, home, finance, women and child development, law, infrastructure and industry, among others, should be part of the country’s health equation and decision-making on a daily basis.
    • Should the WHO be sitting in on high-level health ministry discussions given what we now know about its allegiance to all things Chinese?
    • China, an economic and military behemoth, now seeks the same power in public health.
    • India, with its double burden of disease and an uncritical alignment with the WHO, is fertile ground for data and dollars.

    Dependence on China for API

    • For now, India, like most countries, is at China’s mercy because of years of short-sightedness and corruption in the health sector.
    • While it is hailed as the pharmacy of the world and has sent drugs as humanitarian assistance, India relies heavily on raw materials from China.
    • Quick thinking and swift action can reverse this.

    The above points highlight the implications of Chinese dominance for India. Questions related to China is a recurrent theme in the UPSC papers. Next thing to note here is India’s dependence on China for APIs.

    The US’s stand on WHO funding

    • Some are blaming US President Donald Trump for contemplating cutting off funding for the WHO and not Tedros, for taking orders from China about the pandemic.
    • The war is not between an American President and Tedros.
    • It is between Tedros, a global public health head, and his subservience to China.
    • That ship of trust, the cornerstone of public health work that the WHO should have been leading, has long set sail.
    • Protecting Tedros is important as the WHO needs money to help poor countries with weak health systems.

    Last year, UPSC asked about UNESCO when the US and Israel withdrew from it. This year, WHO has been in focus for allegedly towing China’s line.

    Issue of funding and spending by the WHO

    • War chests are being mobilised to help the WHO help China disburse aid and assistance to dying people and gasping economies.
    • The recent announcement by the World Bank to fast track $1.9 billion for health systems to respond to Covid-19 also includes Ethiopia.
    • For the first time in its history, the WHO has opened its doors to private funding via a Solidarity fund and China is expected to keep an eye on this.
    • To keep track of how the money is spent is a problem.

    Conclusion

    India must decide if it wants to blindly follow the blind or lead by bringing the WHO back to its original promise. At stake is the country’s economic security of which public health is a key component. India can either be a part of history or pick up the pen even in these times of distress and rewrite it.

  • Partnership with the private sector in a fight against Covid-19

    The article delineates five areas in which partnership with the private sector is essential to deal effectively with the epidemic and ensure a whole-of-society response. Ensuring the participation of the private sector has been the recurring theme of many op-eds we have come across after the outbreak.

    Significance of private healthcare in India

    • According to the WHO, a critical lesson from the 2014-16 West African Ebola epidemic was that both the public and private sector need to work in tandem in responding to large-scale epidemics.
    • In the COVID-19 response in India, the private sector has to play an even more important role, as it is the dominant provider of health services in the country.
    • The private sector includes the for-profit and not-for-profit segments.
    • The dominance of the private sector in India: The NSSO 71st round data on social consumption of health show that private hospitals, clinics and nursing homes provide over 70 per cent of healthcare.
    • Data on the nearly 1 crore treatments received under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) corroborate this finding.
    • AB PM-JAY data shows that over half of all treatments are being availed of from private providers, accounting for over 60 per cent of total disbursements.

    UPSC asked about community-level healthcare intervention in 2018. So, pay attention to the significant role played by the private health sector in India.

    Following five are the areas in which cooperation with the private sector will be essential-

    1 Testing

    • Creating a large and accessible testing infrastructure is the first weapon in the armoury.
    • Countries like South Korea, Singapore, Germany and Japan have been successful at controlling the spread of COVDID-19 and reducing mortality through early detection and quick containment.
    • This has been possible only through widespread testing.
    • India has opened testing up to private labs.
    • Testing has been included under the AB PM-JAY as well.
    • We need to substantially expand testing capacity.
    • This cannot happen without the active participation of the private sector.

    2 Converting private hospitals into Covid-19-only hospitals

    • As the government deepens its containment efforts, the country will need to rapidly surge the numbers of quarantine units, isolation wards and ICU beds in COVID-19-only
    • It will also need to ensure increased and continued supply of essential medical products — from testing kits, masks and other PPEs to oxygen and ventilators.
    • According to a recent ICMR study, around five per cent of those infected will need intensive care and half of those in intensive care units will need mechanical ventilation.
    • These projections translate into large numbers that considerably exceed the capacity of the government health system.
    • Private hospitals with adequate infrastructure will need to convert in COVID-19-only hospitals.
    • There should be a clear policy framework of designated hospitals, reporting and referral systems and an appropriate payment system.
    • With many government facilities being converted into COVID-19-only hospitals, a large number of non-COVID-19 patients will need facilities and providers to take care of their other urgent, critical or continuing healthcare needs.
    • The AB PM-JAY has started a process to bring on board more hospitals to respond to such needs.

    3 Protecting healthcare workers

    • As more private providers join this fight, a major concern that will arise is keeping healthcare workers from becoming infected.
    • In addition to being at a high risk of contracting the virus, healthcare workers are also potential carriers.
    • Ensuring their protection is of paramount importance.
    • Increasing the production: Companies manufacturing essential medical products such as ventilators, masks will need to crank up their production.
    • Direct support from banks may be needed to keep production and supply chains going.

    4 The private sector has to support the ecosystem driving health system

    • The private sector will need to vigorously support the large ecosystem that drives the health system as the lockdown and ongoing epidemic restrict movement and normal economic activities.
    • Activities such as the production of essential drugs and medical products, logistics to maintain smooth supply need to not only continue but also accelerate.
    • Support for community activities such as night shelters and community kitchens will need to be strengthened.

    5 Collaborate to share knowledge on the epidemic

    • An adequate stage-wise response to the pandemic and its economic, social and political aftermath will require the rapid filling of the many knowledge gaps.
    • Government, private and not-for-profit research institutions need to collaborate to understand the nature of transmission of the virus.
    • They must understand the factors that slow its spread, the most at-risk communities, or the optimal quarantine period.

    In 2015, UPSC asked whether the private health sector could help bridge the gap in providing universal health coverage. A question can be asked based on the same theme but in reference to dealing with the pandemic.

    Conclusion

    The fight against COVID-19 is not a race to a hilltop. It involves the continuous management of an evolving public health crisis that threatens to spawn economic and social crises. These multiple dimensions will require a whole-of-society approach that goes beyond the government alone.

  • The WHO balance sheet

    The US has announced to halt the funding it gives to the WHO accusing it of mismanagement of the COVID-19 spread.

     

    WHO is facing the biggest pandemic in human history. For all the responsibility vested in the WHO, it has little power.  Whatever the causes of this disaster are, it is clear that the WHO has failed in its duty to raise the alarm in time. This shortfall of WHO is failure indicative of a deeper malaise: the global institutional framework is a pawn in the hands of the great powers, cash-strapped.

    About WHO

    • The WHO is a specialized agency of the United Nations responsible for international public health.
    • It is part of the U.N. Sustainable Development Group.
    • The WHO Constitution, which establishes the agency’s governing structure and principles, states its main objective as ensuring “the attainment by all peoples of the highest possible level of health.”
    • It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide.

    Where does WHO get its funding from?

    • It is funded by a large number of countries, philanthropic organisations, UN organisations etc.
    • Voluntary donations from member states (such as the US) contribute 35.41%, assessed contributions are 15.66%, philanthropic organisations account for 9.33%, UN organisations contribute about 8.1%; the rest comes from myriad sources.
    • India contributes 1% of member states’ donations.
    • Countries decide how much they pay and may also choose not to.

    Its expenditure

    • The WHO is involved in various programmes. For example, in 2018-19, 19.36% (about $1 bn) was spent on polio eradication, 8.77% on increasing access to essential health and nutrition services, 7% on vaccine preventable diseases and about 4.36% on prevention and control of outbreaks.
    • The Africa countries received $1.6 bn for WHO projects; and South East Asia (including India) received $375 mn.

    How does WHO prioritise its spending?

    • The annual programme of work is passed by the WHO’s decision-making body, the World Health Assembly.
    • It is attended by delegates from all member states and focuses on a specific health agenda prepared by the Executive Board.
    • The main functions of the Assembly, held annually in Geneva, are to determine WHO policies, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.
    • The decision on which country gets how much depends on the situation in the countries.

    WHO and India

    • India became a party to the WHO Constitution on January 12, 1948.
    • The first session of the WHO Regional Committee for South-East Asia was held on October 4-5, 1948 in the office of India’s Health Minister, and inaugurated by Prime Minister Jawaharlal Nehru.
    • The WHO India Country Cooperation Strategy (CCS) 2019-2023 has been developed jointly by the Health Ministry and the WHO India country office.
    • The CCS aims to address complex challenges such as the prevention of NCDs, the control of antimicrobial resistance (AMR), the reduction of air pollution, and the prevention and treatment of mental illnesses.
    • On the ground, the WHO has been a key partner in the immunisation programme, tackling TB and neglected diseases such as leprosy and kala azar, and nutrition programmes across states.

    Immediate reason for US withdrawal

    • The US contributes almost 15% of the WHO’s total funding and almost 31% of the member states’ donations, the largest chunk in both cases.
    • It receives $62.2 mn for WHO projects.
    • That is where most of the WHO funding comes from and the least of it goes.

    Impact

    • For the WHO, the loss of about 15% of its total funding is bound to have an impact on the world over.
    • However, unless other countries do the same as the US, the move may not severely hamstring WHO operations.

    Also read:

    [Burning Issue] World Health Organization (WHO) And Coronavirus Handling

  • TRAI wants set top boxes to be made interoperable

    The Telecom Regulatory Authority of India (TRAI) has recommended that all set-top boxes (STBs) in the country must be interoperable, meaning that consumers should be able to use the same STB across different DTH or cable TV providers.

    The TRAI and Telecom Disputes Settlement and Appellate Tribunal are quite often seen in the news.  Most recent was the dispute risen due to AGR dues.

    TRAI has a wide range of jurisdiction over Telecoms. Keep a track on all such news.

    Why such a recommendation?

    • TRAI noted that while the STBs deployed in the cable TV networks are non-interoperable, those by DTH players complied with licence conditions to support common interface module based interoperability.
    • However, in practice, even in the DTH segment the STBs are not readily interoperable.
    • The lack of interoperability of set-top boxes between different service providers deprives the customer of the freedom to change her/his service provider.
    • It also creates a hindrance to technological innovation, improvement in service quality, and the overall sector growth.

    About TRAI

    • The TRAI is a statutory body set up under section 3 of the Telecom Regulatory Authority of India Act, 1997.
    • It is the regulator of the telecommunications and its tariffs in India.
    • The TRAI Act was amended by an ordinance, effective from 24 January 2000, establishing a Telecom Disputes Settlement and Appellate Tribunal (TDSAT) to take over the adjudicatory and disputes functions from TRAI.
    • TRAI regularly issues orders and directions on various subjects such as tariffs, interconnections, quality of service, DTH services and mobile number portability.

  • Anti Defection Law

  • What is pooled testing, recommended by the ICMR?

    The Indian Council of Medical Research (ICMR) has issued an advisory for using pooled samples for testing of COVID-19 in order to increase the number of tests conducted by laboratories across the country.

    COVID-19 containment measures are pacing up across the country. However, it is argued that we are lagging in the number of tests to be carried out.  With certain limitations, pooled testing promises an edge over individual testings of suspected patients.

    What is pooled testing?

    • In a pooled testing algorithm, samples of multiple individuals are put together in a tube and screened through the PCR test.
    • In case the pooled test turns out to be positive, individual samples are tested, which is referred to as pool de-convolution.
    • If there’s no positive result, all individual samples in the pool are regarded as negative, resulting in substantial cost savings.

    What the ICMR has recommended?

    • ICMR has advised that while more than two samples can be pooled together, the number should not exceed five samples to avoid sample dilution, which can lead to false negatives.
    • This method can be used in areas where the prevalence of COVID-19 is low, which means a positivity rate of less than two per cent.
    • In areas with a positivity rate between two to five per cent, sample pooling of PCR screening may be considered in a community survey of surveillance among asymptomatic individuals.
    • Samples of individuals with known contact with confirmed cases or healthcare workers should not be included in the pooled samples.
    • Also, ICMR has said pooling of sample is not recommended in areas or population with positivity rates of over five per cent.

    Benefits of pooled testing

    • Using this method, substantial costs and testing kits are saved.
    • For instance, if a pooled sample consists of the samples of five individuals and it tests negative, the cost of four testing kits is saved and more number of people are covered with fewer resources.
    • Significantly, pooled screening can also help in tracking down the asymptomatic cases of the disease, thereby tracking community transmission.
    • But in case the sample tests positive, all individuals need to be tested separately.

  • [pib] Swayam Prabha TV Channels

    The HRD Ministry has taken several prompt, new and unique initiatives to ensure that the education of learners should not get affected by the challenging situation arising out of COVID 19. One of them is Swayamprabha TV channels.

    There are various web/portals/apps with peculiar names such as YUKTI, DISHA, SWAYAM etc. Their core purpose is similar with slight differences. Pen them down on a separate sheet under the title various digital HRD initiatives.

    SWAYAM Prabha

    • The SWAYAM Prabha is a group of 32 DTH channels devoted to telecasting of high-quality educational programmes on a 24X7 basis using the GSAT-15 satellite.
    • The channels are uplinked from BISAG, Gandhinagar. The contents are provided by NPTEL, IITs, UGC, CEC, IGNOU, NCERT and NIOS.
    • The INFLIBNET Centre maintains the web portal.
    • Every day, there will be new content for at least 4 hours which would be repeated 5 more times in a day, allowing the students to choose the time of their convenience.

    The DTH Channels shall cover the following:

    Higher Education: Curriculum-based course contents at post-graduate and under-graduate level covering diverse disciplines such as arts, science, commerce, performing arts, social sciences and humanities, engineering, technology, law, medicine, agriculture, etc.

    School education (9-12 levels): Modules for teacher’s training as well as teaching and learning aids for children of India to help them understand the subjects better and also help them in preparing for competitive examinations for admissions to professional degree programmes.

    Curriculum-based courses: These channels can meet the needs of life-long learners of Indian citizens in India and abroad.

    Back2Basics: SWAYAM Portal

    • SWAYAM is a Hindi acronym that stands for “Study Webs of Active-Learning for Young Aspiring Minds” is an Indian Massive open online course (MOOC) platform.
    • It is an initiative launched by the Ministry of HRD, under Digital India to give a coordinated stage and free entry to web courses, covering all advanced education, High School and skill sector courses.
    • It was launched on 9th July 2017 by Honorable President of India.
    • The platform offers free access to everyone and hosts courses from class 9 till post-graduation.
    • It enables professors and faculty of centrally funded institutes like IITs, IIMs, IISERs, etc. to teach students.

  • Removal of AP State Election Commissioner by ordinance route

    The removal of the SEC by the ordinance route raises the question over the legality of the move. And if it passes the judicial scrutiny it would harm the independence of the body.

    The legality of the removal and its implication for free and fair elections

    • The fact that it was the culmination of an open conflict between the Election Commissioner and Chief Minister makes it a glaring instance of misuse of power.
    • The State government got the Governor to issue an ordinance to cut the SEC’s tenure from five to three years.
    • The ordinance also amended the criterion for holding that office from being an officer of the rank of Principal Secretary and above to one who had served as a High Court judge.
    • This automatically rendered the SEC’s continuance invalid.
    • Last month, just days before the local body polls were to be held, the SEC postponed the elections, citing the COVID-19 outbreak.
    • The State government approached the Supreme Court, but the court declined to interfere.
    • Having exhausted its legal remedy, the government should have waited for the ongoing fight against the disease to be over.
    • The Chief Minister has no legal right to terminate the SEC’s tenure.
    • The Constitution makes the holder of that post removable only in the same manner as a High Court judge.
    • If courts uphold this means of dislodging the head of an independent election body, it would mark the end of free and fair elections.

    Past judgements on the issue

    • The State government seems to have gone by legal opinion that citedAparmita Prasad Singh vs. State of U.P. (2007).
    • Cessation of term vs. removal: In that judgement the Allahabad High Court ruled that cessation of tenure does not amount to removal, and upheld the State Election Commissioner’s term being cut short.
    • The Supreme Court, while dismissing an appeal against the order, kept open the legal questions arising from the case.

    UPSC can frame the question based on the judgement in case by the SC and its implication for the independence of the body in conducting the fair, free and impartial election.

    Issues arising out of the past judgements

    • The judgment seems erroneous, as it gives freedom to the State government to remove an inconvenient election authority by merely changing the tenure or retirement age.
    • This was surely not what was envisioned by Parliament, which wrote into the Constitution provisions to safeguard the independence of the State Election Commission.
    • It is a well-settled principle in law that what cannot be done directly cannot be done indirectly.
    • Therefore, the removal of an incumbent SEC through the subterfuge of changing the eligibility norms for an appointment may not survive judicial scrutiny.
    • Prohibition on the variation of condition of service: Further, the Constitution, under Article 243K, prohibits the variation of any condition of service to the detriment of any incumbent.
    • Even if the State government argues that a change of tenure does not amount to varying the conditions of service, the new norm can only apply to the successor SEC, and not the one holding the office now.

    Conclusion

    In order to ensure the independence of the SEC and free and fair elections, legality of the move should not pass the legal scrutiny. Even if it passes the legal scrutiny the government should amend this provision avoid such instances in the future.

     

  • Is the Centre’s lockdown different from a state’s lockdown?

    The central government has extended the 21-day nationwide lockdown by two more weeks. Before this, some states had already ordered to extend the lockdown till the end of this month.

    How do the two lockdowns differ?

    Newspapers are flooded up with news on lockdowns. The two lockdowns are fundamentally different from each other. Such difference sparks a thought in the mind of question framers.

    1) State lockdowns

    • As per the Constitution, subjects of law and order and public health lie with state governments.
    • Additionally, the Epidemic Diseases Act of 1897, which many states have invoked to order a lockdown, empowers them to prescribe temporary regulations to prevent the outbreak and spread of disease.

    2) Centre’s lockdown

    • The lockdown ordered by the centre is implemented under the Disaster Management Act, 2005.
    • The Union home ministry, in compliance with the NDMAs order can issue orders for the lockdown under Section 10(2)(l) of the DMA.

  • COVID-19 and the crumbling world order

    Theme of this article is the failure of the world order in mounting a collective fight against the epidemic that has become the global problem. Role of WHO has also come under the scanner. Functioning and reluctance of UNSC to discuss the pandemic have raised questions over its relevance. The issue of China’s growing influence and implications for the rest of the world are being discussed. In the past week, some newspaper articles have covered the same issue for instance-“The deep void in global leadership” in the Hindu.

    Failure of the world order and global institutions

    • The contemporary global order and institutions were a hegemonic exercise meant to deal with isolated political and military crises and not serve humanity at large.
    • COVID-19 has exposed this as well as the worst nativist tendencies of the global leadership in the face of a major crisis.
    • That the United Nations Security Council took so long to meet (that too inconclusively) to discuss the pandemic is a ringing testimony to the UN’s insignificance.

    The above para. indicates that global order we are living in was made for entirely different purpose i.e. to maintain the peace and they are not capable to deal with the Covid-19  like challenges. So, from UPSC mains point of view you must take note of this.

    Failure of regional groupings

    • Regional institutions haven’t fared any better.
    • Prime Minister Narendra Modi’s SAARC initiative, curiously resurrecting a practically dead institution, was short-lived.
    • The EU, the most progressive post-national regional arrangement, stood clueless when the virus spread like wildfire in Europe.
    • Its member states turned inward for solutions: self-help, not regional coordination, was their first instinct. Brussels is the loser.

    What these failures indicate?

    • These failures are indicative of a deeper malaise: the global institutional framework is unrepresentative, a pawn in the hands of the great powers, cash-strapped, and its agenda is focused on high-table security issues.
    • The global institutional architecture of the 1940s cannot help humanity face the challenges of the 2020s.
    • What can be the solutions? Nothing less than a new social contract between states and the international system can save our future.

    Here we come across  the reasons for the failure of the world order and institutions. UPSC has asked questions related to UNESCO in 2019, who knows next could be the WHO.

    Factors that will help China come out stronger from the pandemic

    • Reports indicate that China has now managed the outbreak of COVID-19, and its industrial production is recovering even as that of every other country is taking a hit.
    • The oil price slump will make its recovery even faster.
    • When the greatest military power found itself in denial mode and the members of the EU were looking after their own interests, China appeared to use its manufacturing power to its geopolitical advantage.
    • Beijing has offered medical aid and expertise to those in need; it has increased cooperation with its arch-rival Japan.
    • This will aid Beijing’s claims to global leadership, push Huawei 5G trials as a side bargain, and showcase how the Belt and Road Initiative is the future of global connectivity.
    • COVID-19 will further push the international system into a world with Chinese characteristics.

    As China comes to dominate the emerging world order, we must pay attention to things related to China. Here, we can note down the factors that could help China emerge out stronger from the corona crisis.

    Implications for globalisation: the rise of protectionism and hypernationalism

    • Neoliberal economic globalisation will have taken a major beating in the wake of the pandemic.
    • Economists are warning of a global recession.
    • How the world reacted? The first instinct of every major economy was to close borders, look inwards and
    • The pre-existing structural weakness of the global order and the COVID-19 shock will further feed states’ protectionist tendencies fueled by hypernationalism.
    • A more inclusive global political and economic order is unlikely any time soon, if ever.
    • Instead, as former National Security Adviser Shivshankar Menon warns, “we are headed for a poorer, meaner, and smaller world.”
    • How this epidemic impact big corporations? The ability of big corporations to dictate the production, stocks, supply chains and backup plans will be limited by increased state intervention to avoid unpredictable supply sources, avoid geopolitically sensitive zones, and national demands for emergency reserves.
    • The profits of big corporations will reduce, and the demand for stability will increase.
    • Will the world after Covid-19 be more balance? State intervention in economic matters and protectionism are the easy way out, and that’s precisely what states will do once the crisis is over.
    • It would be a return of the ‘Licence Raj’ through the backdoor, not a push for inclusive and responsible globalisation with its associated political benefits.

    It is clear now that post-Covid-19 world would be different from the world we know today. Globalisation would take a significant beating. And globalisation is important topic from mains point of view. So, pay close attention to the points mentioned here.

    Will post-Covid-19 world lead to some positive controls?

    • Rise of state-led models: With the severe beating that globalisation has taken, state-led models of globalisation and economic development would be preferred over (big) corporates-led globalisation.
    • Will this enable some positive controls over the inherent deficiencies of globalisation? We will have to wait and see.
    • The relation between capitalists and the states: But the more important question is whether the state has any incentive to take on big capital.
    • Given the symbiotic relationship between the state and big capital, states have become used to protecting the interests of their corporations, often at the cost of the general public.
    • States preferred capital over health: Consider, for instance, that the first response of many Western states was to protect their capital markets than be concerned about public health.

    Rise of racism in post-Covid-19 world

    • Yet another undesirable outcome of the pandemic would be a spike in various forms of discrimination.
    • Globally, societies could become more self-seeking and inward-looking leading to further pushback against liberal policies regarding migration and refugees.
    • Implications for world trade: New questions are likely to be asked about the source of goods. More stringent imposition of phytosanitary measures by advanced states on products emanating from the less developed countries might become the new normal.
    • Lockdowns and travel restrictions could potentially legitimise the rhetoric around border walls in more conservative countries.
    • Tragically, therefore, while one answer to global pandemics is political globalisation, COVID-19 might further limit it.

    Conclusion

    The world order needs to wake up to new reality take measures to avoid the above listed undesired fallouts that could emerge in the post-Covid-19 world, and before that there is an urgent need for the global coalition to deal with the pandemic.