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GS Paper: GS2

  • AMMA Canteen and its success

    The Amma Canteen, a delivery system to provide urban food security in Tamil Nadu, has become an effective mechanism in reaching the needy during the lockdown.

    AMMA Canteen

    • Amma Unavagam better known as Amma Canteen is a food subsidization programme run by the Government of Tamil Nadu.
    • Under the scheme, municipal corporations of the state-run canteens serving subsidised food at low prices.
    • The dishes are offered at low prices: ₹1 for an idli, ₹5 for a plate of sambar rice, ₹5 for a plate of “Karuvapellai Satham” (Curry leaves rice) and ₹3 for a plate of curd rice.

    Feeding the stranded

    • Migrants usually benefit from this canteen scheme.  It is not uncommon to see policemen, municipal workers and people from the media having their breakfast in these canteens.
    • The system, in short, has ensured urban food security and is a boon to migrants during lockdown. There are, thus, unexpected but pleasant benefits from this scheme.

    Reasons for success

    • It is a delivery system with minimum leakages and has reached to its target group very effectively compared to the PDS system.
    • People realized the benefits of the scheme in due course of time and thus it emerged popularly.

    A lesson for all

    • Welfare schemes are started with the intention to provide benefits to vulnerable sections of society.
    • The success of any welfare scheme depends on the seriousness of the people at the helm of affairs, the efficiency of the scheme’s functionaries and the involvement of the people.
    • During the process of implementation, some deserving people get excluded from the scheme, while some of those who were undeserving manage to enjoy its benefits.
    • Welfare schemes deliver unexpected but pleasant benefits sometimes.

    Way forward

    • For such a welfare scheme to be successful, it must be launched in letter and spirit.
    • The benefits of the schemes cannot be realized at pan India level in the absence of a good delivery system.
    • These states should explore the possibility of utilising available infrastructure in existing private canteens and hotels (closed during lockdown).
    • This measure would not only help migrant workers but also provide employment to workers who remained unemployed since the lockdown came into effect.

  • What is Drive-through Testing?

    To work around the challenges of home-based testing in the country, a New Delhi based firm has offered ‘drive-through test’ for COVID-19.

    Drive-through Testing

    • Those who feel sick drive up to a test centre where nurses wearing protective gear collect a nose or throat sample from the car itself.
    • Results are mailed or messaged in a day.
    • This method of mass testing has allowed reduced contact between patients and healthcare workers, thereby lessening the chances of transmission.
    • South Korea has led the world in the number of tests per million to check for coronavirus infection through this method.

    Germany: leading through examples

    • Germany is conducting around 3,50,000 coronavirus tests a week, far more than any other country.
    • It means that more people with few or no symptoms are reported thereby increasing the number of known cases and adequate quarantines.

    Limitations (for India)

    • We have seen so far is that many are uncomfortable with the home collection process.
    • Some people are worried that lab personnel visiting home in full protective gear would scare the neighbours.
    • There are also instances when spouses of some healthcare personnel have separated for a while.

  • The spectre of a post-COVID-19 world

    Context

    As COVID-19 spreads exponentially across the world, profound uncertainty and extreme volatility are wreaking havoc of a kind seldom encountered previously. It might, hence, be wise to start thinking of what next, if at least to try and handle a situation created by the most serious pandemic in recent centuries.

    China’s important role

    • No previous experience: The problem with the novel coronavirus is that with the exception of China, which battled another coronavirus epidemic in 2003 — SARS epidemic — there is little available for most nations on which to base their assessment of what next.
    • Further drop in China’s growth rate: What is known is that China’s growth rate has further plummeted, even as it was confronting an economic slowdown which had been in the works for some time.
    • Economic downturn internationally: The consequences for the global economy of China ceasing to be the world’s biggest exporter of manufactured goods are considerable.
    • And with no country in a position to replace it, this development will precipitate a further economic downturn internationally.

    Uncertainties before epidemic

    • The COVID-19 pandemic could not have come at a more difficult time.
    • Uncertain economic environment: The world was already having to contend with an uncertain economic environment, with industries in turn facing newer challenges such as having to adjust to a shift from cost efficiencies to innovation and breakthrough improvements.
    • Added to this were: a global slowdown, increasing political and policy uncertainties, alterations in social behaviour, new environmental norms, etc.
    • India’s position: Newly emerging economies, such as India, were even more affected by all this, than some of the older established ones.

    Impact on India and what lies ahead?

    • Estimate of cost by ADB: An early estimate by the Asian Development Bank, soon after the epidemic was declared, was that it would cost the Indian economy $29.9 billion.
    • A recent industry estimate pegs the cost of the lockdown at around $120 billion or 4% of India’s GDP.
    • May require six months to recover after epidemic: The Confederation of Indian Industry (CII) had at one point warned that the COVID-19 impact, and the existing stress in the financial sector, meant that India would require up to six months even after the entire course of the COVID-19 epidemic is over to restore normalcy and business continuity.
    • The COVID-19 Taskforce under the Finance Minister come up with measures to mitigate the economic hardship engendered by the pandemic, and finally a three-week-long lockdown.
    • Several precautionary measures based on guidelines in vogue elsewhere in the world for preventing pandemics of this kind, have also been introduced including ‘home isolation’, ‘home quarantine’, etc.
    • The prognosis as to what lies ahead is indeed bleak.
    • On the economic plane, according to most experts, a global recession seems inevitable.
    • The decline in demand: Uncertainty, panic and lockdown policies are expected to cause demand worldwide to decline in a precipitous way.
    • Start of downward cycle: Decline in demand will inevitably lead to a vicious downward cycle, where companies close down, resulting in more lay-offs and a further drop in consumption.
    • A precipitous decline in GDP would follow.
    • Massive funds would be needed: To compensate for this loss, massive inflows of government funds would be needed, but most governments, India included, might find it difficult to find adequate resources for this purpose.
    • Right time for fund: Equally important, if not more so, is that such massive inflows of funds (if they are to be effective) should be here and now, and not later, by which time the situation may well have spiralled out of control. Global coordination was a must in the extant situation.

    Disruption in the global order- Implications for the position of the US

    • COVID-19 is, in turn, expected to bring about major changes in the global order.
    • Changes would get accelerated: Some of these changes have, no doubt, been in the making for some time, but would get accelerated.
    • As of now, though the U.S. is no longer the global power that it once was, it is hardly in retreat.
    • Retreat from Afghanistan, not the end: The US is, without doubt, increasingly disinclined to act as the world’s gendarme, as instanced by its retreat from Afghanistan after a dubious accord with the Afghan Taliban,
    • But this was not the end of the road as far as U.S. power was concerned.
    • The US would step back further: Post COVID-19, however, and given that the U.S. is among the countries badly affected by this pandemic, together with existing uncertainties affecting its financial markets, the U.S. can be expected to step back even further — from one of assertion to neutrality in global affairs.
    • Already, U.S. command of the global commons has weakened. Meantime, China and Russia have strengthened their relationship and improved their asymmetric capabilities.
    • US not the largest economy by PPP: The challenge from China is becoming more obvious by the day — measured by purchasing power parity, the S. is not the largest economy in the world as of now.
    • Russian challenge: Even more daunting from a U.S. standpoint, and also representing a sea-change from the recent past, Russia has become far more economically and politically stable and an important power broker in West Asia.
    • Impact on liberal international order: These shifts cannot but, and are likely to, have a direct impact on the liberal international order. It could, in turn, give a boost to authoritarian regimes and authoritarian trends.

    Impact on social behaviour

    • Moving away from the political and economic consequences of COVID-19 are other concerns arising from an extended lockdown, social distancing and isolation.
    • The epidemic of despair: Psychologists are even talking of an ‘epidemic of despair’ arising from a fear of unknown causes, resulting in serious anxiety and mental problems.
    • Problems due to extended isolation: Extended isolation, according to psychologists, can trigger a different kind of pandemic even leading to possible suicidal tendencies, fits of anger, depression, alcoholism and eccentric behavioural patterns.

    Inequality and impact

    • The impact is not the same for all: Another fallout from the current epidemic might well be the extent to which inequality in incomes impact segments of the population, facing a common malaise.
    • Countries lacking a comprehensive nation-wide health system would find this an even more difficult situation to handle.
    • Meantime, as the economy weakens, accompanied by job losses, those without high levels of skills would fall further behind.
    • This is evident to some extent already given recent reports of mass migration across the Indian landmass.
    • Out of work migrant labour, unable to find new jobs since they lack the necessary skills, are attempting to return to their normal habitat, bringing in their wake untold suffering and, perhaps even the spread of the virus.
    • This has all the makings of a huge human tragedy. Existing curbs on their movement would further exacerbate the problem, and could even lead to a major law and order situation.

    Possibility of the rise of digital authoritarianism

    • One possible, and unexpected, aspect of the COVID-19 epidemic could be the thrust it could provide to ‘digital authoritarianism’.
    • China’s authoritarian methods seem to have helped it to contain the spread of the virus — at least for the time being.
    • Somewhat similar tactics are being employed by some other countries as well.
    • In turn, leaders across many nations may find China’s methods, and the embracing of technology to refashion authoritarianism for the modern age irresistible, and a standard to be adapted, even if they profess to be democratic.
    • The rise of digital autocracies could lead to digital repression, and in the age of AI-powered surveillance, create a capacity for predictive control, or what is often referred to as ‘social management’.

    Conclusion

    The pandemic even after it’s over could change the world in more than one ways and we must be cautious in our approach in accepting or rejecting these changes brought about by the epidemic.

  • Operation Sanjeevani

    An Indian Air Force (IAF) C-130J transport aircraft o delivered 6.2 tonne of essential medicines and hospital consumables to Maldives under Operation Sanjeevani.

    Operation Sanjeevani

    • At the request of the govt. of Maldives, the IAF aircraft activated Operation Sanjeevani and lifted these medicines from airports in New Delhi, Mumbai, Chennai and Madurai before flying to the Maldives.
    • Among other things, these medicines include influenza vaccines, anti-viral drugs such as lopinavir and ritonavir — which have been used to treat patients with COVID-19 in other countries.
    • The flights are being operated on commercial basis following demands from pharmaceutical companies and their intermediaries and will carry cargo on inbound as well as outbound flights.
    • The cargo operations will help the airline earn some revenue at a time there is a ban on passenger flights and the entire fleet is grounded.

  • Making the private sector care for public health

    Context

    As India enters the second week of a national lockdown imposed in response to COVID-19, it is still unclear how well prepared the healthcare system is in dealing with the pandemic.

    Need for roping in the private healthcare

    • No indication of an increase in expenditure on health: A preparedness plan has to address all levels of care in terms of infrastructure, equipment, testing facilities and human resources in both the public and private sectors.
    • However, so far, the Central and State governments have given little indication of bringing an increase in public expenditure on health.
    • So, an already overburdened public health system will be unable to meet the increase in moderate and severe cases of COVID-19 that would require hospitalisation.
    • Need for the comprehensive national policy: While some individual private sector companies have come forward with offers of creating capacity and making it available to COVID-19 patients, there is a need for a comprehensive national policy to ensure that private healthcare capacity is made available to the public.
    • Some states like Chhattisgarh, Rajasthan, Madhya Pradesh and Andhra Pradesh have already roped in the private sector to provide free treatment.

    What the government should do?       

    • Provide universal health service: The governments at the Centre and in States have to take responsibility for providing universal health services free of charge and accessible to all.
    • Tap into private sector capacity: This will require governments to not just expand the capacity within the public sector, but also to tap into the available capacity in the private sector.
    • Faced with a serious health emergency, the silence of the government on the expected role of the private sector is intriguing.
    • Include COVID-19 testing in PM-JAY: The National Health Authority has recommended that the testing and treatment of COVID-19 be included in the PM-Jan Arogya Yojana (PM-JAY) but this proposal is still awaiting clearance.
    • Form the central command: The governance of the health service system is clearly fragmented and has created anxiety among the public.
    • There is a lack of a visible central command, which should be created under the supervision of the Union Health Minister, aided by a team of experts.
    • They should be tasked to make policies as and when required and communicate them to State governments, taking into account an evolving situation.
    • Ensure that there is no cost to the patient: There have been some tentative measures taken by States to allow individuals seeking testing for COVID-19 to access private laboratories at subsidised rates.
    • At present, the government has put a cap on the cost at ₹4,500 per test, which is a burden for even a middle-class patient.
    • The poor will clearly have no access to this and the government itself does not have adequate facilities to meet the increasing demand. It is here that the government needs to ensure that there is no cost to the patient.
    • Create adequate testing facilities: At this point, and certainly, before the lockdown is lifted, it is absolutely essential that adequate testing and quarantine facilities are created.
    • The Central government has already taken over some private hotels to accommodate persons quarantined for COVID-19.
    • One way of expanding such facilities would be for the government to ‘take over’ private corporate laboratories and hospitals for a limited period.
    • Standard treatment protocol: The political directive for such a move needs to come from the Central government while ensuring that the Ministry of Health provides standard treatment protocols for health personnel.

    Learning lessons from Spanish and British experience

    • The Spanish government issued an order bringing hospitals in the large private corporate sector under public control for a limited period.
    • This tough decision was taken with the understanding that existing public healthcare facilities would not be able to cope with the sudden, if short-term, rise in COVID-19 cases.
    • British trade unions have demanded that the government make the 8,000 beds in 570 private hospitals in the country available.
    • They have argued that while beds in private hospitals are lying empty, there is a severe shortage of beds in public hospitals.
    • The unions have also been critical of the U.K. government decision to rent these beds at an exorbitant cost to the exchequer.

    Way forward

    • Rope in the private healthcare sector: In India, private corporate hospitals have, in the past, received government subsidies in various forms and it is now time to seek repayment from them.
    • They are also well poised to provide specialised care and have the expertise and infrastructure to do so.
    • Bring in the universal public healthcare: Universal public healthcare is essential not only to curb outbreaks but also to ensure crisis preparedness and the realisation of the promise of the right to health.

  • The SC order on migrants labours raises several issues

    Context

    On March 31, the Supreme Court of India (SC), entertaining a writ petition under Article 32, passed an order which raises more questions than it seeks to answer.

    What were the issues involved in the writ petition?

    • The writ petition was purportedly filed in the public interest, “for redressal of grievances of migrant workers in different parts of the country”.
    • Directions which are in favour of the Union government: The Court has proceeded to issue several directions which are clearly in favour of the respondent, the Union of India.
    • The following three directions were uncalled for:

    What were the directions issued by the Supreme Court?

    • One, that under section 54 of the Disaster Management Act, 2005, persons can be punished with imprisonment, which may extend to one year, or with a fine for making or circulating a false alarm or warning.
    • Disobedience of the order including an advisory by a public servant would result in punishment under section 188 of the IPC.
    • Two, all concerned, that is the state government, public authorities and citizens will faithfully comply with directives, advisory and orders issued by the Union of India in letter and spirit in the interest of public safety.
    • Three, the media should only refer to and publish the official version of the Government of India, publishing a daily bulletin.
    • The SC observations about migrant labourers: After giving substantial reliefs to the Union of India, the SC proceeded to make mere observations about migrant labourers by directing that they should be dealt with “in a humane manner”.
    • And that “trained counsellors, community leaders and volunteers must be engaged along with the police to supervise the welfare activities of migrants”.
    • The SC has virtually absolved the government for its handling of the situation.

    What was the basis for issuing orders and issues with it

    • The basis of the directions is a statement made by the Solicitor General of India and some status reports to the effect that “the exodus of migrant labourers was triggered due to panic created by some fake/misleading news and social media”.
    • What is an issue with basis? The SC has proceeded on assumptions and surmises which were untested and unchallenged.
    • What the court should have done? In a matter of such seriousness, the least it should have done was to have appointed an amicus curiae (a friend of the court) to assist it rather than simply accept the self-serving status reports and statements made before it.
    • The Court overlooked the fact that in India, hundreds of millions of people work during the day and are paid at the end of the day and then go and buy their foodstuffs.
    • They have no savings, nor do they have foodgrains stored.
    • It is surprising that the Court, the custodian of fundamental rights, should be oblivious to this reality.

    Issue of press freedom

    • Citizens have the right to freedom of speech and expression. Press freedom is a part of this. Citizens have the right to receive information as well.
    • Article 13 (2) of the Constitution says that the state cannot make any law which takes away or abridges the fundamental rights.
    • If Parliament cannot do so, the Supreme Court — the upholder of the constitutional rights — surely cannot do so.
    • The SC has itself held in M Nagraj (2006): “A right becomes a fundamental right because it has foundational value. The fundamental right is a limitation on the power of the State. A Constitution, and in particular that part of it which protects and which entrenches fundamental rights and freedoms to which all persons in the State are to be entitled, is to be given a generous and purposive construction.”
    • The SC should not have made all media subservient to the government by directing that the former “refer to and publish the official version about the developments”.
    • Such an order could be justified only during an emergency and that too by the executive, subject to challenge before the courts.

    Conclusion

    The SC has given a carte blanche to the authorities, and citizens appear to have no avenues of redress. Most of all, by condemning the media and social media, holding them responsible for fake news, the SC has done a great disservice to the institution which provides information to citizens and upholds democracy.

  • BCG vaccine

    According to a  US-based research, a combination of reduced morbidity and mortality could make the Bacillus Calmette-Guerin (BCG) vaccination a “game-changer” in the fight against novel coronavirus.

    What is BCG Vaccine?

    • Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB).
    • In countries where TB or leprosy is common, one dose is recommended in healthy babies as close to the time of birth as possible.
    • In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated.

    How can TB vaccine help fight COVID-19?

    • The BCG vaccine contains a live but weakened strain of tuberculosis bacteria that provokes the body to develop antibodies to attack TB bacteria.
    • This is called an adaptive immune response, because the body develops a defense against a specific disease-causing microorganism, or pathogen, after encountering it.
    • Most vaccines create an adaptive immune response to a single pathogen.
    • Unlike other vaccines, the BCG vaccine may also boost the innate immune system, first-line defenses that keep a variety of pathogens from entering the body or from establishing an infection.

  • Telemedicine/Telehealth as a tool to fight COVID-19

     

    The Medical Council of India and the NITI Aayog have developed new guidelines released on March 25, 2020 for registered medical practitioners to deliver consultations to patients via telemedicine.

    Telemedicine

    • Telemedicine involves the use of telecom and virtual technology to deliver health care outside of traditional health-care facilities.
    • It is the essential delivery of health care services where distance is a critical factor — comes in.
    • At least one doctor is needed for a population of 1,000, according to WHO guidelines.
    • Telemedicine, thus, holds significance for countries like India that have low doctor-to-patient ratios.

    About the guidelines

    • The guidelines aim to empower registered doctors to reach out to patients safely using technologies for the exchange of valid information.
    • This information can be used for diagnosis, treatment and prevention of disease and injuries, research and evaluation and for continuing the education of healthcare providers.
    • The guidelines have empowered medical practitioners. They have, however, also imposed many restrictions.
    • Registered medical practitioners, for instance, have to take the patient’s consent.
    • If the patient denies her consent, however, the practitioner cannot insist that the patient to go in for telemedicine.

    How telemedicine can help against COVID-19?

    • Telemedicine can help bridging the gap between people, physicians and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels.
    • It thus helps reducing the spread of the virus to mass populations and the medical staff on the frontlines.
    • It can help provide routine care for patients with chronic diseases who are at high risk if exposed to the virus.

    Limitations

    • The out-of-hospital management is has not been yet established in India. Perhaps a ‘crisis-based’ evolution of telemedicine can help find local testing centers and also manage the flow of patients seeking a test.
    • However, for a smaller subset of higher risk patients, the clinical course may not be consistent with conventional telemedicine.
    • These patients often present with a more serious condition require rapid hospitalization.
    • Telemedicine hasn’t traditionally been used in response to public health crises. Many health practitioners are not equipped to deliver care in this way.
    • Another issue is access to broadband – some hospitals struggle with running a quality connection within their facilities and now we are faced with taking this to potential new areas of care, such as an outside tent.

  • Price Monitoring and Resource Unit (PMRU)

    The National Pharmaceutical Pricing Authority (NPPA) has set up price monitoring and resource unit (PMRU) in the UT of Jammu and Kashmir. With this J&K has become the 12th State/UT where the PMRU has been set up.

    Price Monitoring and Research Unit (PMRU)

    • It is a registered society set up for drug price monitoring.
    • PMRUs have already been set up by the drug price regulator NPPA in 11 states such as Kerala, Odisha, Gujarat, Rajasthan, Punjab, Haryana, Nagaland, Tripura, Uttar Pradesh, Andhra Pradesh and Mizoram.

    Its composition

    • The State Health Secretary would be the Chairman of the society and the Drugs Controller would be its member secretary.
    • Its members include a State government representative, representatives of private pharmaceutical companies, and those from consumer rights protection fora.
    • The society would also have an executive committee headed by the Drugs Controller.

    Terms of reference

    PMRU offers technical help to the State Drug Controllers and the NPPA to:

    • Monitor notified prices of medicines
    • Detect violation of the provisions of the DPCO
    • Look at price compliance
    • Collect test samples of medicines, and
    • Collect and compile market-based data of scheduled as well as non-scheduled formulations.

    Why need PMRU?

    • Pharma companies have been accused of overcharging prices of drugs in the scheduled category fixed by the DPCO and those outside its ambit too.
    • The suggestion to set up PMRUs was made against the backdrop of the lack of a field-level link between the NPPA and the State Drugs Controllers and State Drug Inspectors to monitor drug prices.

    Expected outcomes

    • The NPPA had fixed the prices of around 1,000 drugs and the unit would track if buyers were being overcharged.
    • It would also check if pharma companies were hiking the prices of non-scheduled drugs by more than 10% a year.
    • It will check if there is any shortage of essential medicines.

  • [pib] ArogyaSetu App

     

    The Government of India has launched a mobile app ArogyaSetu developed in a public-private partnership to bring the people of India together in a resolute fight against COVID-19.

    AarogyaSetu App

    • The App enables people to assess themselves the risk of their catching the Corona Virus infection.
    • It will calculate this based on their interaction with others, using cutting edge Bluetooth technology, algorithms and artificial intelligence.
    • Once installed in a smartphone through an easy and user-friendly process, the app detects other devices with AarogyaSetu installed that come in the proximity of that phone.
    • The app can then calculate the risk of infection based on sophisticated parameters if any of these contacts has tested positive.
    • The personal data collected by the App is encrypted using state-of-the-art technology and stays secure on the phone till it is needed for facilitating medical intervention.