May 2021
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Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Digital Technologies and Inequalities

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Not much

Mains level: Paper 2- Growing inequality in access to health and education

Impact of pandemic

  • The novel coronavirus pandemic has accelerated the use of digital technologies in India, even for essential services such as health and education, where access to them might be poor.
  • Economic inequality has increased: people whose jobs and salaries are protected, face no economic fallout.
  • Well-recognised channels of economic and social mobility — education and health — are getting rejigged in ways that make access more inequitable in an already unequal society.

Growing inequality in access to education

  • According to National Sample Survey data from 2017, only 6% rural households and 25% urban households have a computer.
  • Access to Internet facilities is not universal either: 17% in rural areas and 42% in urban areas.
  • Surveys by the National Council of Educational Research and Training (NCERT), the Azim Premji Foundation, ASER and Oxfam suggest that between 27% and 60% could not access online classes for a range of reasons: lack of devices, shared devices, inability to buy “data packs”, etc.
  • Further, lack of stable connectivity jeopardises their evaluations.
  • Besides this, many lack a learning environment at home.
  • Peer learning has also suffered.

Inequality in access to health care

  •  India’s public spending on health is barely 1% of GDP.
  • Partly as a result, the share of ‘out of pocket’ (OOP) health expenditure (of total health spending) in India was over 60% in 2018.
  • Even in a highly privatised health system such as the United States, OOP was merely 10%.
  • Moreover, the private health sector in India is poorly regulated in practice.
  • Both put the poor at a disadvantage in accessing good health care.
  • Right now, the focus is on the shortage of essentials: drugs, hospital beds, oxygen, vaccines.
  • In several instances, developing an app is being seen as a solution for allocation of various health services. 
  • Digital “solutions” create additional bureaucracy for all sick persons in search of these services without disciplining the culprits.
  • Platform- and app-based solutions can exclude the poor entirely, or squeeze their access to scarce health services further.
  • In other spheres (e.g., vaccination) too, digital technologies are creating extra hurdles.
  • The use of CoWIN to book a slot makes it that much harder for those without phones, computers and the Internet. 

Issues with the creation of centralised database

  • The digital health ID project is being pushed during the pandemic when its merits cannot be adequately debated.
  • Electronic and interoperable health records are the purported benefits.
  • For patients, interoperability i.e., you do not have to lug your x-rays, past medication and investigations can be achieved by decentralising digital storage say, on smart cards as France and Taiwan have done.
  • Given that we lack a data privacy law in India, it is very likely that our health records will end up with private entities without our consent, even weaponised against us.
  • For example, a private insurance companies may use health record to deny poor people an insurance policy or charge a higher premium.
  • There are worries that the government is using the vaccination drive to populate the digital health ID database.

Way forward

  • Unless health expenditure on basic health services (ward staff, nurses, doctors, laboratory technicians, medicines, beds, oxygen, ventilators) is increased, apps such as Aarogya Setu, Aadhaar and digital health IDs can improve little.
  • Unless laws against medical malpractices are enforced strictly, digital solutions will obfuscate and distract us from the real problem.
  • We need political, not technocratic, solutions.

Conclusion

Today, there is greater understanding that the harms from Aadhaar and its cousins fall disproportionately on the vulnerable. Hopefully, the pandemic will teach us to be more discerning about which digital technologies we embrace.

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Foreign Policy Watch: India-United States

What does US departure from Afghanistan mean for South Asia?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Not much

Mains level: Paper 2- US withdrawal from Afghanistan and its implications for the region

The article highlights the important role played by the US in the geopolitics of the region and the impact of the US retreat on the region foreign policy landscape.

How the US shaped the regional politics of South Asia

  • Since it replaced Britain as the major external power in Greater Middle East half a century ago, America has been the pivot around which the regional politics has played out.
  • Many regional actors sought alliances with America to secure themselves against ambitious or troublesome neighbours.
  • Others sought to balance against America.
  • Israel’s security, ensuring oil supplies, competing with other powers, making regional peace, promoting democracy, and stamping out terrorism are no longer compelling factors demanding massive American military, political and diplomatic investments in the region.

Region now has to learn to live with neighbours

  • As America steps back from the Middle East, most regional actors either need alternate patrons or reduced tensions with their neighbours.
  • Although China and Russia have regional ambitions, neither of them bring the kind of strategic heft America brought to bear on the Middle East all these decades.
  • Turkey has figured that its troubled economy can’t sustain the ambitious regional policies.
  •  After years of challenging Saudi leadership of the Islamic world, Erdogan is offering an olive branch to Riyadh.
  • After years of intense mutual hostility, Saudi Arabia and Iran are now exploring means to reduce bilateral tensions and moderate their proxy wars in the region.
  • Saudi Arabia is also trying to heal the rift within the Gulf by ending the earlier effort to isolate Qatar. 
  •  These changes come in the wake of the big moves last year by some Arab states — the UAE, Bahrain, Morocco and Sudan — to normalise ties with Israel.

How India’s approach helped maintain ties in the region

  • India’s emphasis on good relations with all the regional actors without a reference to their conflicts has been vindicated by the turn of events.
  • Barring Turkey, which turned hostile to India under Erdogan, India has managed to expand its ties with most regional actors.
  • Hopefully, the new regional churn will encourage Turkey to take a fresh look at its relations with India.

Effect on India-Pak relations

  • The regional reset in the Middle East has coincided with efforts by Delhi and Rawalpindi to cool their tensions.
  • The ceasefire on the Line of Control in Kashmir announced at the end of February appears to be holding.
  • The US withdrawal from Afghanistan poses major challenges to the Subcontinent.
  • India and Pakistan, for very different reasons, would have liked to see the US forces stay forever in Afghanistan.
  • For India, American military presence would have kept a check on extremist forces and created conducive conditions for an Indian role in Afghanistan.
  • For Pakistan, American military presence in Afghanistan keeps the US utterly dependent on Pakistan for geographic access and operational support.

Challenge of terrorism

  • The prospect of trans-border links between the Taliban and other extremist forces in the region is a challenge that South Asian states will have to confront sooner than later.
  • Soaring levels of violence in Afghanistan and attack on the former president of Maldives, underlines South Asia’s enduring challenges with terrorism.
  • Unless the South Asian states collaborate on countering extremism and terrorism, every one of them will be weakened.

Consider the question “How US troop withdrawal from Afghanistan will influence the regional geopolitics of the region?”

Conclusion

The region needs to focus on the peace and harmony in the region while resolving the bilateral issues through dialogue.

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ISRO Missions and Discoveries

NASA’s OSIRIS-REx begins journey back from asteroid

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Asteroid Bennu

Mains level: Paper 3- OSIRIS-REx starts journey back to the earth

On May 11, NASA’s Origins, Spectral Interpretation, Resource Identification, Security, Regolith Explorer (OSIRIS-REx) spacecraft will depart asteroid Bennu, and start its two-year-long journey back to Earth.

About OSIRIS-REx

  • OSIRIS-REx is NASA’s first mission to visit a near-Earth asteroid, survey its surface and collect a sample from it.
  • The mission was launched in 2016, it reached its target in 2018 and since then, the spacecraft has been trying to match the velocity of the asteroid using small rocket thrusters.
  • It also utilised this time to survey the surface and identify potential sites to take samples.
  • In October 2020, the spacecraft briefly touched asteroid Bennu, from where it collected samples of dust and pebbles. 
  • Once the surface was disturbed, the spacecraft’s robotic arm captured some samples.
  • The spacecraft’s engineers have also confirmed that shortly after the spacecraft made contact with the surface, it fired its thrusters and “safely backed away from Bennu”.

About Bennu

  • Bennu is considered to be an ancient asteroid that has not gone through a lot of composition-altering change through billions of years, which means that below its surface lie chemicals and rocks from the birth of the solar system.
  • Around 20-40 percent of Bennu’s interior is empty space and scientists believe that it was formed in the first 10 million years of the solar system’s creation, implying that it is roughly 4.5 billion years old.
  • Bennu is a B-type asteroid, implying that it contains significant amounts of carbon and various other minerals.
  • Because of its high carbon content, the asteroid reflects about four percent of the light that hits it, which is very low when compared with a planet.
  • Bennu is named after an Egyptian deity.
  • The asteroid was discovered by a team from the NASA-funded Lincoln Near-Earth Asteroid Research team in 1999.

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Israel-Palestine Clash

Note4Students

From UPSC perspective, the following things are important :

Prelims level: al-Aqsa mosque

Mains level: Paper 2- Israel-Palestine conflict

Context

On Monday, Israeli police stormed the Al-Aqsa mosque compound in East Jerusalem, leaving a reported 300 people injured. The stand-off came at the end of a week of tensions over the eviction of Palestinian residents from two neighbourhoods of East Jerusalem, Sheikh Jarrah and Silwan, to make way for Jewish settlers.

Cause of the clashes

  • The Al-Aqsa is located on a plaza at Temple Mount, which is known in Islam as Haram-e-Sharif.
  • The Mount is also Judaism’s holiest site.
  • The most imposing structure on the compound is the Dome of the Rock, with its golden dome.
  • The Western Wall, also known as the Wailing Wall sacred to Jews, is one side of the retaining wall of the Al-Aqsa compound.
  • Soon after the 1967 Six-Day War ended, Israel gave back to Jordan the administration and management of the Al-Aqsa compound.
  • While non-Muslims have not been allowed to worship at Al-Aqsa, Jewish individuals and groups have made repeated attempts to gain entry to the Mount Temple plaza.
  • Since the late 1990s, around the time of the first intifada, such attempts began occurring with a regularity as Jewish settlers began claiming land in East Jerusalem and surrounding areas.
  • It has led to repeated clashes and tensions at Al-Aqsa.

Rival claims over Jerusalem

  • Both Israel and Palestine have declared Jerusale their capital.
  • In July 1980, the Israeli Parliament passed the Jerusalem Law declaring it the country’s capital.
  • Palestinians declared Jerusalem the capital of the putative state of Palestine by a law passed by the Palestinian Authority in 2000.
  • The 1988 Palestinian Declaration of Independence also declared Jerusalem as the capital.
  • For the present, the Palestinian Authority has its headquarters in Ramallah.

How the world is reacting

  • The Security Council held a meeting on the situation in Jerusalem, but did not make any statement immediately.
  • Last Friday, the US said it was “extremely concerned” .
  • The UAE, which recently recognised as Israel as a state and sealed a historic peace agreement to normalise relations with it, has “strongly condemned” the clashes and the planned evictions in Jerusalem over the past week.
  • Saudi Arabia said it “rejects Israel’s plans and measures to evict dozens of Palestinians from their homes in Jerusalem”.
  • Pakistan Prime Minister also condemned Israel for violation of international law.

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Pharma Sector – Drug Pricing, NPPA, FDC, Generics, etc.

What is 2-deoxy-D-glucose (2-DG) and is it effective against Covid?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: 2-DG

Mains level: Paper 3- Drug developed by DRDO approved for Covid treatment

About the drug

  • DRDO’s new anti-Covid oral drug, 2-deoxy-D-glucose (2-DG), was recently granted emergency use approval by the Drug Controller General of India (DCGI).
  •  2-DG halts the spread of COVID-19 inside the body cells.
  • Clinical trial results have shown that this molecule helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence.
  • In efficacy trends, the patients treated with 2-DG showed faster symptomatic cure than Standard of Care (SoC) on various endpoints.
  • A significantly favourable trend (2.5 days difference) was seen in terms of the median time to achieving normalisation of specific vital signs parameters when compared to SoC.

How 2-DG reduces dependence on oxygen

  • The 2 DG drug, like glucose, spreads through the body, reaches the virus-infected cells and prevents virus growth by stopping viral synthesis and destroys the protein’s energy production.
  • The drug also works on virus infection spread into lungs which help us to decrease patients dependability on oxygen.

 

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