[op-ed snap] A manifesto for health

Mains Paper 2 : Health & Education |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing Much

Mains level : Steps to be taken to improve health care in India.


CONTEXT

Health is making an impact on the political scene, when on the one hand, Prime Minister launches the Ayushman Bharat scheme a year before the elections and on the other hand, the Congress’s manifesto carries the party’s pledge to enact a Right to Healthcare Act.

Current health scenario in the country

  • Stagnated spending – In the past five years, the Union health budget has stagnated in real terms, allocations to the National Health Mission do not cover inflation and there have been avoidable deaths of scores of children in public hospitals in Gorakhpur and other places that can be ascribed to the lack of material and human resources.
  • Failure in regulation – Governments have failed to regulate private hospitals effectively, leading to numerous instances of mismanagement and massive over-charging of patients, such as the tragic case of Adya Singh in Fortis hospital, Gurgaon.
  • Underfunding of the schemes – There are convincing facts which show that the “solution” being offered in the form of the Pradhan Mantri Jan Aarogya Yojna is not only seriously underfunded (current funds being less than one-fourth of required) but it will only scratch the tip of the iceberg of healthcare requirements in India.

Proposals to improve Health Sector

  • Right to Healthcare  – Adopting a Right to Healthcare legislation at the Centre and state levels. This would ensure that all residents of the country are entitled to healthcare facilities. Development of asystem for Universal Healthcare (UHC) would be a key constituent of this initiative, which would require expansion and strengthening of public health services at all levels. Private providers would also be involved, as per need, to supplement the public health system.
  •  Increasing the public health expenditure -Increasing the public health expenditure exponentially through taxation. This expenditure should be increased from the current grossly inadequate 1.2 per cent of the GDP to reach 3.5 per cent of the GDP in the next five years, and eventually touch 5 per cent of the GDP in the medium term.
  • Strengthening of public health services – Three, ensuring major reform and strengthening of public health services with increased staff and infrastructure. A key component of this reform would be guaranteed provision of free essential medicines and diagnostics to all patients in public health facilities, by adopting systems for procurement and distribution which are similar to the current models in Tamil Nadu, Kerala and Rajasthan.
  •  Health sector human resource policy – there should be a comprehensive health sector human resource policy, which provides upgraded skill training, fair wages, social security and decent working conditions for all public health services staff. The services of all contractual health workers, including ASHAs and anganwadi workers, should be regularised.
  • Community-based monitoring and planning – Community-based monitoring and planning of health services that are being practised in a few states should be upscaled and user-friendly grievance redressal systems put in place to ensure social accountability and participation.
  • Replacing Schemes – the PMJAY component of Ayushman Bharat, which is based on a discredited insurance model, should be jettisoned. Such schemes need to be replaced by the universal healthcare system.
  • Regulations – Private hospitals must be brought under the ambit of regulations by modifying and adopting the Clinical Establishments Act in all states. This legislation must ensure that the Charter of Patient’s Rights is observed, it must provide a grievance redressal mechanism to patients, the rates for services must be regulated and standard treatment guidelines should be adopted in healthcare institutions.
  • Price Regulations – essential medicines and medical devices must be subject to price regulation, based on their manufacturing cost. A Uniform Code for Pharmaceutical Marketing Practices should be put in place to curb unethical marketing practices. Manufacturers should be asked, in a stepwise manner, to sell medicines only under their generic name, and doctors should be directed to write generic names of medicines in prescriptions.
  • Focus on vulnerable Sections – These initiatives must be accompanied by measures to ensure that people with special needs — women, children, differently-abled persons, people living with HIV — enjoy appropriate health services.
  • Environment – Traditional social determinants of health such as nutrition, water supply, sanitation and healthy environment must be ensured. There should be plans in place to tackle new determinants like air and water pollution and addictions.

Way Forward

  • Such a paradigm shift towards a rights-based system for universal healthcare, based on massive increase in health budgets and strengthened health systems, is not an unrealistic dream
  • EXAMPLES  -. Several low- and middle-income countries such as Thailand, Brazil and Sri Lanka have such systems in place. 
  • The core ingredient required for UHC is political will. As we prepare to exercise our choice in the elections, we need to boost such political will by supporting parties which have pledged the right to health care to all.

 

 

 

Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

[op-ed snap] Hard landing: Jet Airways’ temporary halt

Mains Paper 3 : Infrastructure: Energy, Ports, Roads, Airports, Railways Etc. |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing Much

Mains level : Need for policy intervention in air transport.


CONTEXT

Jet Airways announced a temporary halt of its operations from Wednesday night as funds to keep the airline going dried up.

Background

  • To the long line of private airline carcasses dotting the bleak landscape of Indian aviation, one more may soon be added.
  • Jet Airways announced a temporary halt of its operations from Wednesday night as funds to keep the airline going dried up.
  • Despite intense lobbying by the bankrupt airline, banks stood firm on their decision to not release emergency funds to sustain operations until a white knight is found.
  • With operations halted and the half a dozen or so planes that were flying till Wednesday grounded, the airline is staring down the barrel, especially because most of its prized departure slots at major airports across the country have either already been or will soon be allocated to other airlines.

Future prospects

  • Jet will be able to regain these slots only if it bounces back before the end of the summer schedule in October.
  • Whether that will happen is now in the hands of prospective buyers, who are said to have evinced interest in buying the airline during the Expression of Interest (EOI) process called by banks last week.
  • The fact that the banks refused to extend emergency support is probably an indicator of the quantity and quality of the EOIs received by them.
  • It is hard to believe that they would not have temporarily supported Jet if the EOIs had been serious.
  • In sum, it does appear at this point that a miracle will be needed for Jet to take wing again.

Reasons for such instances

  • The collapse of Jet has caused turbulence in the market and also raised some serious questions over why the domestic airline industry is proving to be so perilous for enterprises.
  • There have been more than half-a-dozen private airline companies that have fallen by the wayside in the last decade and more, and it is well-known how Air India is propped up with government support.
  • Reckless competition – While it is true that fuel costs, which account for about half of the expenses of running an airline, have been difficult to manage, the fact is that reckless competition is responsible for the sorry plight of the industry.
  • Low Margins – Margins in the airline industry are wafer-thin in the best of times and the combined effect of rising fuel prices and the inability to pass them on to consumers due to competition has proved to be a deadly cocktail.
  • Similar instances – In the race to the bottom, it was Kingfisher seven years ago, Air Deccan and Air Sahara before that, it is Jet now, and who knows which airline could be next. It is notable that airfares have largely stayed stable over several years, benefiting passengers but biting airlines.

Way Forward

  • Stopping undercutting – It is time that airlines took stock of their collective plight and stopped undercutting each other on fares.
  • Centre’s support – The Centre can help too by reviewing fuel taxes and surcharges apart from airport levies, which the airlines complain are too high.
  • After all, a healthy airline industry can only be good for government revenues over the long term.

 

 

Civil Aviation Sector – CA Policy 2016, UDAN, Open Skies, etc.

CSIR plans genome sequencing to map population diversity

Mains Paper 3 : S&T - Applications In Everyday Life |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Genome Sequencing

Mains level : Applications of Genome Sequencing


News

  • In an indigenous genetic mapping effort, nearly 1,000 rural youth from the length and breadth of India will have their genomes sequenced by the Council of Scientific and Industrial Research (CSIR).

Genome Sequencing

  • A genome is all of a living thing’s genetic material. It is the entire set of hereditary instructions for building, running, and maintaining an organism, and passing life on to the next generation.
  • Genome sequencing is figuring out the order of DNA nucleotides, or bases, in a genome—the order of As, Cs, Gs, and Ts that make up an organism’s DNA.
  • The human genome is made up of over 3 billion of these genetic letters.
  • Ever since the human genome was first sequenced in 2003, it opened a fresh perspective on the link between disease and the unique genetic make-up of each individual.
  • Nearly 10,000 diseases — including cystic fibrosis, thalassemia — are known to be the result of a single gene malfunctioning.
  • While genes may render some insensitive to certain drugs, genome sequencing has shown that cancer too can be understood from the viewpoint of genetics, rather than being seen as a disease of certain organs.

About the Project

  • The CSIR project aims at educating a generation of students on the “usefulness” of genomics.
  • It would involve the Hyderabad-based Centre for Cellular and Molecular Biology (CCMB).
  • This is the first time that such a large sample of at least 10,000 Indian genomes will be recruited for a detailed study.
  • The project is an adjunct to a much larger government-led programme, still in the works, to sequence at least 10,000 Indian genomes.
  • Typically, those recruited as part of genome-sample collections are representative of the country’s population diversity.
  • The bulk of them will be college students, both men and women, and pursuing degrees in the life sciences or biology.

Methodology

  • Genomes will be sequenced based on a blood sample and the scientists plan to hold at least 30 camps covering most States.
  • Every person whose genomes are sequenced will be given a report.
  • The participants would be told if they carry gene variants that make them less responsive to certain classes of medicines.

Utility of the Project

  • Globally, many countries have undertaken genome sequencing of a sample of their citizens to determine unique genetic traits, susceptibility (and resilience) to disease.
  • The project would prove India’s capabilities at executing whole-genome sequencing.
  • The human genome has about 3.2 billion base pairs and just 10 years ago cost about 10,000 dollars. Now prices have fallen to a tenth.

Ethical issues involved

  • For instance, having a certain gene makes some people less responsive to clopidogrel, a key drug that prevents strokes and heart attack.
  • CSIR won’t share such information in the report. A person can request such information through their clinician because many disorders have single-gene causes but no cure or even a line of treatment.
  • Ethics require such information to be shared only after appropriate counselling.
Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Universe’s first molecule detected in space

Mains Paper 3 : Awareness In The Fields Of It, Space, Computers, Robotics, Nano-Technology, Bio-Technology |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Helium hydride ion

Mains level : Formation of Elements


News

  • Scientists have detected the most ancient type of molecule in our universe in space for the first time ever.

Helium hydride ion

  • Helium hydride ion (HeH+) was the first molecule that formed when, almost 14 billion years ago, falling temperatures in the young universe allowed recombination of the light elements produced in the Big Bang.
  • At that time, ionized hydrogen and neutral helium atoms reacted to form HeH+.
  • Despite its importance in the history of the early Universe, HeH+ has so far escaped detection in astrophysical nebulae — cloud of gas and dust in outer space.
  • Operating the GREAT spectrometer aboard SOFIA the team now reports the unequivocal detection of HeH+ towards the envelope of the planetary nebula NGC 7027.

Formation

  • During the dawn of chemistry when the temperature in the young universe had fallen below 4000 Kelvin, the ions of the light elements (hydrogen, helium, deuterium and traces of lithium) produced in Big Bang nucleosynthesis recombined in reverse order of their ionization potential.
  • Helium combined first with free electrons to form the first ever neutral atom.
  • At that time hydrogen was still ionized or present in form of bare protons.
  • Helium atoms combined with these protons into the helium hydride ion HeH+, the universe’s first molecular bond.
  • As recombination progressed, HeH+ reacted with then neutral hydrogen and created a first path to the formation of molecular hydrogen — marking the beginning of the modern universe.

Importance of the discovery

  • The chemistry of the universe began with HeH+.
  • The lack of definitive evidence of its very existence in interstellar space has been a dilemma for astronomy for a long time.
  • In the late 1970s, astro-chemical models suggested the possibility that HeH+ might exist at detectable abundances in local astrophysical nebulae.
  • The discovery of HeH+ is a dramatic and beautiful demonstration of nature’s tendency to form molecules.

Studying Nebulae

  • It would be most easily observed in so-called planetary nebula, ejected by Sun-like stars in the last stage of their lifetime.
  • The hard radiation field produced by the central white dwarf star with a temperature of more than 100,000 degrees drives ionization fronts into the ejected envelope, where HeH+ is predicted to form.
  • The molecule will emit its strongest spectral line at a characteristic wavelength of 0.149 mm.

Renewable Energy Certificates

Mains Paper 3 : Mobilization Of Resources |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : REC

Mains level : REC and its functioning


News

  • Renewable Energy (RE) companies have moved the Delhi High Court, seeking an exemption for Renewable Energy Certificates (RECs) under the GST.

RECs in India

  • In a bid to promote renewable energy market in India, the Indian government has framed policies under the Electricity Act, 2003 and the National Action Plan on Climate Change (NAPCC) to increase the total renewable power generation capacity in the country.
  • Renewable Energy Certificates (REC) is a policy instrument to catalyze the development of renewable energy.
  • It is a market based mechanism which will help the states meet their regulatory requirements (such as Renewable Purchase Obligations (RPOs)) by overcoming the geographical constraints on existing renewable potential in different states.
  • RECs unbundle the electricity component (commodity) from the green/environmental attributes of the power generated from renewable sources.
  • Both the components can then be traded separately.
  • Thus RECs help in incentivizing the production of renewable energy over and above the RPO state limit as tradable certificates are not constrained by the geographical limitations of commodity electricity.

Working with RECs

  • The tradable RECs are awarded for every 1 mega-watt hour (MWh) of electricity generated.
  • Together with Renewable Purchase Obligations (RPO), RECs act as market-pull incentives that create demand for renewable energy installations.
  • RPO, instituted in 2011, is a mandate that requires large power procurers to source a pre-determined fraction of their electricity from renewable sources.

Problems of states

  • The concentration of RE potential in a few states means that the same level of RPO compliance cannot be expected from all states.
  • Low potential states will have to resort to expensive cross-border procurement, accompanied with many regulatory hurdles and additional charges.

Why REC?

  • The REC market was introduced to facilitate RPO compliance by incentivizing RE procurement.
  • First, the REC mechanism presents an alternative for state discoms, with insufficient renewable capacity, to meet their RPO obligations.
  • Second, stand-alone projects built independent of the well-established auction regime have little incentive and a high risk perception, lacking purchase guarantees and payment default protections.
  • The income generated from trading RECs will bolster such independent projects.

Why GST on RECs?

  • RECs are being charged GST, while bundled power (RECs plus electricity, irrespective of source) or even just electricity are devoid of the same.
  • Cost of electricity generation from renewable energy sources is classified as cost of electricity generation (equivalent to conventional energy sources) and the cost of environmental attributes.
  • RECs is the environmental attribute of the electricity derived from RE.
  • As per regulations, RPO compliance through REC is at par with sourcing electricity directly from RE.
  • Therefore, GST applicable on the sale of RECs negatively affects its parity with similar electricity sale alternatives, be it conventional or renewable.
Renewable Energy – Wind, Tidal, Geothermal, etc.