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

How the Budget can push India’s health system transformation

Note4Students

From UPSC perspective, the following things are important :

Prelims level: National Health Authority

Mains level: Paper 2- Health system transformation

Context

After decades of low government expenditure on health, the Covid pandemic created a societal consensus on the need to strengthen our health system.

Steps to strengthen our health system

  • The Fifteenth Finance Commission recommended greater investment in rural and urban primary care, a nationwide disease surveillance system extending from the block-level to national institutes, a larger health workforce and the augmentation of critical care capacity of hospitals.
  • The Union budget of 2021 reflected these priorities in a proposed Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana (PMASBY) to be made operational over six years, with a budget of Rs 64,180 crore.
  • Broader vision of health: The Finance Minister also projected a broader vision of health beyond healthcare by merging allocations to water, sanitation, nutrition and air pollution control with the health budget.
  • Under the Ayushman Bharat umbrella the Digital Health Mission was launched in September 2021.
  • The Health Infrastructure Mission, launched in October 2021, was a renamed and augmented version of the PMASBY.
  • These missions join the two other components of Ayushman Bharat launched in 2018.
  • The Comprehensive Primary Health Care (CPHC) component is nested in the National Health Mission (NHM) while the Pradhan Mantri Jan Arogya Yojana (PMJAY) is steered by the National Health Authority (NHA).

Way forward

  • While much of the following needs to be done by the states, the Centre should incentivise and support such efforts by the states.
  • Link synergically: Primary healthcare services under the CPHC and linkage with water, sanitation, nutrition and pollution control programmes will strengthen the capacity of the health system for health promotion and disease prevention.
  • The budget of 2022 must not only fund these missions adequately but indicate how they will link synergically while functioning under different administrative agencies.
  • Allocate more funds: The NHM received only a 9.6 per cent increase in the 2021 budget.
  • PMJAY did not see an increase in allocation last year, because its utilisation for non-Covid care declined sharply in the previous year.
  •  More importantly, limiting cost coverage to hospitalised care reduces the PMJAY’s capacity to significantly lower out-of-pocket expenditure (OOPE) on health, which is driven mostly by outpatient care and expenditure on medicines.
  • Focus on Digital Heath Mission: The Digital Health Mission can enhance efficiency of the health systems in a variety of ways.
  • These include better data collection and analysis, improved medical and health records, efficient supply chain management, tele-health services, support for health workforce training, implementation of health insurance programmes, real time monitoring and sharper evaluation of health programme performance along with effective multi-sectoral coordination.
  • Improve the skill and number of healthcare workers:  We need to increase the numbers and improve the skills of all categories of healthcare providers.
  • While training specialist doctors could take time, the training of frontline workers like Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) can be done in a shorter time.
  • Upgrade district hospitals: District hospitals need to be upgraded, with greater investment in infrastructure, equipment and staffing.
  • In underserved regions, such district hospitals should be upgraded to become training centres for students of medical, nursing and allied health professional courses.

Conclusion

The expanded ambit of health, as defined in last year’s budget, must continue for aligning other sectors to public health objectives. The Union budget of 2022 can add further momentum to our health system transformation.

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Foreign Policy Watch: India-Middle East

30 years of India-Israel Diplomatic Relations

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Not much

Mains level: India-Israel-Gulf Trilateral

A recent speech by the PM Modi has marked three decades since New Delhi established formal diplomatic ties with Tel Aviv on January 29, 1992, when P.V. Narasimha Rao was the Prime Minister.

India-Israel Relation: A Backgrounder

(I) Recognition of Israel

  • Both nations became independent almost at the same time, in the late 1940s, following a long struggle against British Colonialism.
  • Though India had recognized Israel on September 17, 1950, full-fledged diplomatic relations between the countries were established on January 29, 1992.
  • Their diplomatic relationship was previously based on popular consensus and only much later became official.

(II) India’s reluctance for extending ties

  • The popular perception of Israel was negative as it was a state formed on religion and analogous to Pakistan.
  • This was because during that time India was a young state that needed to take into account Arab states’ numerical impact at the United Nations.
  • Furthermore, it could not afford to antagonize its Muslim population by establishing ties with a Jewish state.
  • Sympathizing the Palestinian cause is a by-product of these motives.

(III) India’s shift towards Israel

  • Though India voted against a UN resolution for the creation of Israel, once Israel is created, India officially recognized Israel (in 1950).
  • But full diplomatic ties were established only in 1992.

Reasons for India prioritizing Israel

  • India’s exclusion from OIC: The formation of an Organisation of Islamic Cooperation (OIC) in 1969 which neglected the sentiments of Indian Muslims by blocking India’s membership to this group by Pakistan is one of the primary triggers for the change instance.
  • Backing of Kashmir: India has received no backing from the Arab countries on the Kashmir Issue. There have been no serious attempts by the Arab world to put pressure on Pakistan to reign in the cross-border insurgency in Kashmir.
  • Support in crucial wars: Israel supported India during the Indo-Pak wars even before full diplomatic ties were established.
  • India’s US allegiance: With the collapse of the Soviet Union and the rise of the US as a superpower, India started aligning itself with the US, and this further added to our improved relations with Israel.
  • Deviation from NAM: After decades of Non-Alignment and Pro-Arab policy, in 1992 India changed its stance and established full diplomatic ties with Israel.
  • Support at global forums: Israel has always been a vocal supporter of India’s permanent seat in the UNSC.
  • Technology: India’s world-class institutes of higher education could benefit from the strong culture of research and high-end innovation that thrives in Israel.

Israeli interests in India

  • India presents a massive market for Israel’s manufactured goods and technology.
  • India has for long enjoyed great goodwill among Israel’s citizens as the only country in the world where Jews have not faced anti-Semitism.
  • There are many instances of Jews under Hitler’s persecution finding shelter in India including some that were said to have been facilitated by Nehru.
  • The minuscule Jew community was able to rise to eminence in various fields.
  • Israel cherishes its admirers in India for its ability to thrive in spite of very adverse situations in its short history as an independent nation.

Collaborations between India and Israel

[A] Military collaboration

  • Against terrorism: India and Israel have increased collaboration in military ventures since both nations face the threats of rising radical terrorism and separatism.
  • Arms trade: India is the largest buyer of Israeli military equipment and Israel is the second-largest defense supplier to India after Russia.
  • Security: Working groups in areas of border management, internal security and public safety, police modernization, and capacity building for combating crime, crime prevention, and cybercrime were established.
  • Defence R&D: IAI is developing the Barak 8 missile for the Indian Navy and Indian Air Force which is capable of protecting sea vessels and ground facilities from aircraft and cruise missiles.

[B] Political collaboration

  • Since the up-gradation of relations in 1992, defense and agriculture have become the two main pillars of the bilateral engagement.
  • The political ties have become especially cordial under the Modi Government.
  • In 2017, Prime Minister Modi became the first-ever Indian Prime Minister to visit Israel.

[C] Agriculture collaboration

  • India has chosen Israel as a strategic partner (G2G) in the field of agriculture.
  • This partnership evolved into the Indo-Israel Agricultural Project (IIAP), under the Indo-Israel Action Plan, based on an MOU signed by Indian and Israeli ministers of Agriculture in 2006.
  • The partnership aims to introduce crop diversity, increase productivity & increase water use efficiency.
  • India has a lot to learn from the dryland agriculture of Israel. The Economic Survey 2016-17 batted for Indo-Israel cooperation in drip-irrigation technologies.

[D] Economic collaboration

  • India is Israel’s third-largest trading partner in Asia after China and Hong Kong.
  • In recent years, bilateral trade has diversified to include several sectors like pharmaceuticals, agriculture, IT and telecom, and homeland security.
  • Major exports from India to Israel include precious stones and metals, chemical products, textiles, etc.
  • Major imports from Israel include chemicals and mineral products, base metals and machinery, and transport equipment. Potash is a major item of Israel’s exports to India.

Various deterrents in ties

  • Bilateral Trade and investment still below potential: From just $200 million in 1992, bilateral trade (excluding defense) peaked at about $5 billion in 2012 but since then it has dropped to about $4 billion. Also, bilateral trade has not diversified much—diamonds and chemicals still make up for the large chunk of the pie.
  • Connectivity between the two countries is still poor with just one direct flight from Mumbai 3 times a week and no direct flights from Delhi.
  • Historical retrenchment: India’s consistent support for a sovereign, independent, viable, and united Palestinian state with East Jerusalem as its capital, living within secure and recognized borders, side by side, and at peace with Israel and Pro-Arab stance has been a sticky point.
  • Limited People to People ties and cultural differences: Israelis and Indian approach business differently and often find it difficult to get on the same page.
  • India’s support for Palestinian Cause: Though formal ties were established in 1992, the ideological divide resurfaces time and again due to India’s affinity for Palestine.

Way forward

  • Indian policy appears to be guided primarily by strategic considerations.
  • There is a strong need to use soft power diplomacy to build people-to-people bridges and to add to economic benefits through robust inter-country tourism.
  • The Indian and Israeli markets do not compete with one another but complete one another.
  • A potential quadrilateral with US and UAE can help this relationship soar to new heights.

 

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Also read:

Indo-Abrahamic Accord: A new QUAD

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Indian Ocean Power Competition

India-Oman Relations

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Mapping of the Persian Gulf region

Mains level: Significance India-Oman Ties from Chinese threat perspective

India is laying out the red carpet for Oman’s top defence official Mohammed Nasser Al Zaabi, who will be in India for a four-day official visit.

India-Oman Relations: A Backgrounder

  • The Sultanate of Oman is a strategic partner of India in the Gulf.
  • Both nations are linked by geography, history and culture and enjoy warm and cordial relations.
  • An Indian consulate was opened in Muscat in February 1955 which was upgraded to a consulate general in 1960 and later into a full-fledged embassy in 1971.
  • The first ambassador of India arrived in Muscat in 1973.

History of the ties

  • Oman, for many years, was ruled by Sultan Qaboos bin Said al Said, who was a friend of India.
  • Sultan Qaboos, the longest-reigning leader of the modern Arab world, died in January ‘2020 at the age of 79.
  • He was a man who was, as a student, taught by Shankar Dayal Sharma who went on to become the President of India.
  • Sultan Qaboos’s father, an alumnus of Ajmer’s Mayo College, sent his son to study in Pune for some time, where he was former President Shankar Dayal Sharma’s student.

Economic ties

  • Expatriate community: Oman has over five hundred thousand Indian nationals living there making them the largest expatriate community in Oman. They annually remit $780 million to India.
  • Bilateral trade: In 2010, bilateral trade between India and Oman stood at $4.5 billion. India was Oman’s second-largest destination for its non-oil exports and its fourth-largest source for Indian imports.
  • Energy: India has been considering the construction of a 1,100-km-long underwater natural gas pipeline from Oman called the South Asia Gas Enterprise (SAGE).

Defense cooperation

Oman is the first Gulf nation to have formalized defense relations with India.

  • Naval cooperation: The Indian Navy has berthing rights in Oman, and has been utilizing Oman’s ports as bases for conducting anti-piracy operations in the Gulf of Aden.
  • Tri-services base: In February 2018, India announced that it had secured access to the facilities at Duqm for the Indian Air Force and the Indian Navy. Duqm had previously served as a port for the INS Mumbai.
  • Arms trade: The standard issue rifle of the Royal Army of Oman is India’s INSAS rifle.
  • Bilateral exercises: Naseem al-Bahr (Arabic for Sea Breeze) is a bilateral maritime exercise between India and Oman. The exercise was first held in 1993.

Significance of Oman for India

  • Oman is India’s closest defense partner in the Gulf region and an important anchor for India’s defense and strategic interests.
  • It is the only country in the Gulf region with which all three services of the Indian armed forces conduct regular bilateral exercises and staff talks, enabling close cooperation and trust at the professional level.
  • It also provides critical operational support to Indian naval deployments in the Arabian sea for anti-piracy missions.

Duqm port and its strategic imperative

  • In a strategic move to expand its footprint in the Indian Ocean region, India has secured access to the key Port of Duqm in Oman for military use and logistical support.
  • This is part of India’s maritime strategy to counter Chinese influence and activities in the region.
  • The Port of Duqm is strategically located, in close proximity to the Chabahar port in Iran.
  • With the Assumption Island being developed in Seychelles and Agalega in Mauritius, Duqm fits into India’s proactive maritime security roadmap.
  • In recent years, India had deployed an attack submarine to this port in the western Arabian Sea.

Deterrent in ties: Chinese influence in Oman

  • China started cultivating ties with the Arab countries following the former Soviet Union’s invasion of Afghanistan.
  • Beijing has cultivated close ties with Oman and the latter was, in fact, the first country to deliver oil to China.
  • As of today, 92.99 per cent of Oman’s oil exports go to China, making China Oman’s largest oil importer.
  • Oman and China signed an agreement to establish an Oman-China Industrial Park at Duqm in 2016.
  • China has identified Oman as a key country in the region and has been enhancing defence ties with it steadily.

Way forward

  • India does not have enough energy resources to serve its current or future energy requirements. The rapidly growing energy demand has contributed to the need for long term energy partnerships with countries like Oman.
  • Oman’s Duqm Port is situated in the middle of international shipping lanes connecting East with West Asia.
  • India needs to engage with Oman and take initiatives to utilise opportunities arising out of the Duqm Port industrial city.

 

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Cyber Security – CERTs, Policy, etc

What is Pegasus Spyware Controversy?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Pegasus

Mains level: State survellience and Right to Privacy

A New York Times report has claimed that the Indian government had bought the Pegasus Spyware in 2017.

What is Pegasus?

  • Pegasus is a spyware developed by NSO Group, an Israeli surveillance firm that helps spies hack into phones.
  • In 2019, when WhatsApp sued the firm in a U.S. court, the matter came to light.
  • In July 2021, Amnesty International, along with 13 media outlets across the globe released a report on how the spyware was used to snoop hundreds of individuals, including Indians.
  • While the NSO claims its spyware is sold only to governments, none of the nations have come forward to accept the claims.

Why is Pegasus so lethal?

  • What makes Pegasus really dangerous is that it spares no aspect of a person’s identity.
  • It makes older techniques of spying seem relatively harmless.
  • It can intercept every call and SMS, read every email and monitor each messaging app.
  • Pegasus can also control the phone’s camera and microphone and has access to the device’s location data.
  • The app advertises that it can carry out “file retrieval”, which means it could access any document that a target might have stored on their phone.

Dysfunctions created by Pegasus

  • Privacy breach: The very existence of a surveillance system, whether under a provision of law or without it, impacts the right to privacy under Article 21 and the exercise of free speech under Article 19.
  • Curbing Dissent: It reflects a disturbing trend with regard to the use of hacking software against dissidents and adversaries. In 2019 also, Pegasus software was used to hack into HR & Dalit activists.
  • Individual safety: In the absence of privacy, the safety of journalists, especially those whose work criticizes the government, and the personal safety of their sources is jeopardised.
  • Self-Censorship: Consistent fear over espionage may grapple individuals. This may impact their ability to express, receive and discuss such ideas.
  • State-sponsored mass surveillance: The spyware coupled with AI can manipulate digital content in users’ smartphones. This in turn can polarize their opinion by the distant controllers.
  • National security: The potential misuse or proliferation has the same, if not more, ramifications as advanced nuclear technology falling into the wrong hands.

Snooping in India:  A Legality check

For Pegasus-like spyware to be used lawfully, the government would have to invoke both the IT Act and the Telegraph Act. Communication surveillance in India takes place primarily under two laws:

  1. Telegraph Act, 1885: It deals with interception of calls.
  2. Information Technology Act, 2000: It was enacted to deal with surveillance of all electronic communication, following the Supreme Court’s intervention in 1996.

Cyber security safeguards in India

  • National Cyber Security Policy: The policy was developed in 2013 to build secure and resilient cyberspace for India’s citizens and businesses.
  • Indian Computer Emergency Response Team (CERT-In): The CERT-In is responsible for incident responses including analysis, forecasts, and alerts on cybersecurity issues and breaches.
  • Indian Cyber Crime Coordination Centre (I4C): The Central Government has rolled out a scheme for the establishment of the I4C to handle issues related to cybercrime in the country in a comprehensive and coordinated manner.
  • Budapest Convention: There also exists Budapest Convention on Cybercrime. However, India is not a signatory to this convention.

Issues over government involvement

  • It is worth asking why the government would need to hack phones and install spyware when existing laws already offer impunity for surveillance.
  • In the absence of parliamentary or judicial oversight, electronic surveillance gives the executive the power to influence both the subject of surveillance and all classes of individuals, resulting in a chilling effect on free speech.

Way forward

  • The security of a device becomes one of the fundamental bedrock of maintaining user trust as society becomes more and more digitized.
  • Constituting an independent high-level inquiry with credible members and experts that can restore confidence and conduct its proceedings transparently.
  • The need for judicial oversight over surveillance systems in general, and judicial investigation into the Pegasus hacking, in particular, is very essential.

Conclusion

  • We must recognize that national security starts with securing the smartphones of every single Indian by embracing technologies such as encryption rather than deploying spyware.
  • This is a core part of our fundamental right to privacy.
  • This intrusion by spyware is not merely an infringement of the rights of the citizens of the country but also a worrying development for India’s national security apparatus.

 

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Monetary Policy Committee Notifications

What is Reverse Repo Normalization?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Repo , Reverse Repo, Normalization

Mains level: Normalization of Monetary Policy

In a recent report, the State Bank of India, which is the largest public sector bank in the country, has stated that the stage is set for a reverse repo normalization.

What is Monetary Policy Normalisation?

The RBI keeps tweaking the total amount of money in the economy to ensure smooth functioning by two types of policies:

(I) Loose Monetary Policy

When the RBI wants to boost economic activity it adopts a so-called “loose monetary policy”.

There are two parts to such a policy:

  1. RBI injects more money (liquidity) into the economy: It does so by buying government bonds from the market. As the RBI buys these bonds, it pays back money to the bondholders, thus injecting more money into the economy.
  2. RBI also lowers the interest rate: it charges banks when it lends money to them; this rate is called the repo rate. Lower interest rates and more liquidity, together, are expected to boost both consumption and production in the economy.

(II) Tight Monetary Policy

  • It involves the RBI raising interest rates and sucking liquidity out of the economy by selling bonds (and taking money out of the system).
  • When any central bank finds that a loose monetary policy has started becoming counterproductive in reducing inflation, the central bank “normalizes the policy” by tightening the monetary policy stance.

What is Reverse Repo?

  • An interest rate that the RBI pays to the commercial banks when they park their excess “liquidity” (money) with the RBI.
  • The reverse repo, thus, is the exact opposite of the repo rate.
  • Under normal a circumstance, that is when the economy is growing at a healthy pace, the repo rate becomes the benchmark interest rate in the economy.
  • That’s because it is the lowest rate of interest at which funds can be borrowed.
  • As such, the repo rate forms the floor interest rate for all other interest rates in the economy — be it the rate you pay for a car loan or a home loan or the interest you earn on your fixed deposit, etc.

How does Reverse Repo fit into policy normalization?

  • Imagine a scenario where the RBI pumps more and more liquidity into the market but there are no takers of fresh loans.
  • This is because the banks are unwilling to lend or because there is no genuine demand for new loans in the economy.
  • In such a scenario, the action shifts from repo rate to reverse repo rate because banks are no longer interested in borrowing money from the RBI.
  • Rather they are more interested in parking their excess liquidity with the RBI. And that is how the reverse repo becomes the actual benchmark interest rate in the economy.

What does reverse repo normalization mean?

  • Simply put, it means the reverse repo rates will go up.
  • Over the past few months, in the face of rising inflation, several central banks across the world have either increased interest rates or signaled that they would do so soon.
  • In India, too, it is expected that the RBI will raise the repo rate.
  • But before that, it is expected that the RBI will raise the reverse repo rate and reduce the gap between the two rates.
  • In the immediate aftermath of Covid, RBI had increased this gap.

Implications of such policy

  • Incentivize commercial banks to park excess funds with RBI, thus sucking some liquidity out of the system.
  • The next step would be raising the repo rate.
  • This process of normalization, which is aimed at curbing inflation, will not only reduce excess liquidity but also result in higher interest rates across the board in the Indian economy.
  • This will help reduce the demand for money among consumers (since it would make more sense to just keep the money in the bank) and make it costlier for businesses to borrow fresh loans.

Try this PYQ from CSP 2020:

Q.If the RBI decides to adopt an expansionist monetary policy, which of the following it would NOT do?

  1. Cut and optimize the statutory liquidity ratio
  2. Increase the Marginal Standing Facility Rate
  3. Cut the Bank Rate and Repo Rate

Select the correct answer using the code given below:

(a) 1 and 2 only

(b) 2 only

(c) 1 and 3 only

(d) 1, 2 and 3

 

Post your answers here:

 

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New Species of Plants and Animals Discovered

Species in news: Septemeranthus

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Septemeranthus

Mains level: NA

A new genus of a parasitic flowering plant has recently been discovered from the Nicobar group of islands.

Septemeranthus

  • The genus Septemeranthus grows on the plant species Horsfieldia glabra (Blume) Warb.
  • The parasitic flowering plants have a modified root structure spread on the stem of the tree and are anchored inside the bark of the host tree.
  • It has a distinct vegetative morphology, inflorescence architecture and floral characters.
  • The leaves of the plant are heart-shaped with a very long tip and the ovary,fruit and seeds are ‘urceolate’ (earthen pot-shaped).
  • Birds consume viscous seeds of this new genus and seeds have potential of pseudo viviparous germination that deposit on the leaves and branches of their same plant which is already attached to host plants.

Key features

  • They need a host tree or shrub in order to thrive and exhibit a worldwide distribution in tropical as well as temperate habitats.
  • They are important in forest ecology, pathology and medicine.
  • They play an important role as they provide food for frugivorous birds.

Try this PYQ from CSP 2019:

Q.Recently, there was a growing awareness in our country about the importance of Himalayan nettle (Girardinia diversifolia) because it is found to be a sustainable source of

(a) anti-malarial drug

(b) bio-diesel

(c) pulp for paper industry

(d) textile fibre

 

 

Post your answers here.

 

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