February 2022
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Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Weighing in on a health data retention plan

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Ayushman Bharat Digital Mission

Mains level: Paper 2- Privacy centric health data retention policy

Context

The National Health Authority (NHA) — the body responsible for administering the Ayushman Bharat Digital Mission (ABDM) — has initiated a consultation process on the retention of health data by healthcare providers in India. The consultation paper asks for feedback on what data is to be retained, and for how long.

Issues with the policy for healthcare data retention

  • Risk of over-collection: A simple classification system, as suggested in the consultation paper, exposes individuals to harms arising from over-collection and retention of unnecessary data.
  • At the same time, this kind of one-size-fits-all system can also lead to the under-retention of data that is genuinely required for research or public policy needs.
  • Instead, we should seek to classify data based on its use. 

Do we need a policy for the mandatory retention of health data?

  • Currently, service providers can compete on how they handle the data of individuals or health records, in theory, each of us can choose a provider whose data policies we are comfortable with.
  • Whether the state should mandate a retention period at all is an open question.
  • Given the landscape of healthcare access in India, including through informal providers, many patients may not think about this factor in practice.
  • Nonetheless, the decision to take the choice out of the individual’s hands should not be taken lightly.

Balancing the policy for public health data retention with the right to privacy

  • Four-part test for privacy: The Supreme Court of India has clarified that privacy is a fundamental right, and any interference into the right must pass a four-part test: legality; legitimate aim; proportionality, and appropriate safeguards.
  • Health data and privacy: The mandatory retention of health data is one such form of interference with the right to privacy.
  • 1] Legality: In this context, the question of legality becomes a question about the legal standing and authority of the NHA.
  • Since the NHA is not a sector-wide regulator, it has no legal basis for formulating guidelines for healthcare providers in general.
  • 2]Legitimate aim: The aim of data retention is described in terms of benefits to the individual and the public at large.
  • Benefits to the individuals: Individuals benefit through greater convenience and choice, created through portability of health records.
  • The broader public benefits through research and innovation, driven by the availability of more and better data to analyse.
  • Risk involved: Globally, legal systems consider health data particularly sensitive, and recognise that improper disclosure of this data can expose a person to a range of significant harms. 
  • Benefits must be clearly defined: As per Indian law, if an individual’s rights are to be curtailed due to anticipated benefits, such benefits cannot be potential or speculatory: they must be clearly defined and identifiable.
  • 3] Proportionality: This is the difference between saying that data on patients with heart conditions will help us better understand cardiac health — a vague explanation — and being able to identify a specific study that will include data from that patient.
  • It would further mean demonstrating that the study requires personally identifiable information, rather than just an anonymous record — the latter flowing from the principle of proportionality, which requires choosing the least intrusive option available.
  • 4] Safeguard: Standards for anonymisation are still developing.
  • We are not yet able to rule out the possibility of anonymised data still being linked back to specific individuals.
  • In other words, even anonymisation may not be the least intrusive solution to safeguarding patients’ rights in all scenarios.

Way forward

  • Clear and specific case for retention: The test for retaining data should be that a clear and specific case has been identified for such retention, following a rigorous process run by suitable authorities.
  • Anonymise data: A second safeguard would be to anonymise data that is being retained for research purposes — again, unless a specific case is made for keeping personally identifiable information.
  • If neither of these is true, the data should be deleted.
  • Express and informed consent: An alternate basis for retaining data can be the express and informed consent of the individual in question.
  • User-based classification process: Health-care service providers — and everyone else — will have to comply with the data protection law, once it is adopted by Parliament.
  • The current Bill already requires purpose limitation for collecting, processing, sharing, or retaining data; a use-based classification process would thus bring the ABDM ecosystem actors in compliance with this law as well.

Consider the question “What are the advantages and concerns with the retention of public health data? Suggest the ways to ensure the privacy-centric public health data retention policy.”

Conclusion

A privacy-centric process is needed to determine what data to retain and for how long.

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Foreign Policy Watch: India-SCO

India- Central Asia Relations

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Not much

Mains level: Paper 2- India's engagement with Central Asia

Context

The inaugural India-Central Asia Summit, the India-Central Asia Dialogue, and the Regional Security Dialogue on Afghanistan in New Delhi — all held over the past four months — collectively indicate a renewed enthusiasm in New Delhi to engage the Central Asian region.

Significance of Central Asia for India

  • India has limited economic and other stakes in the region, primarily due to lack of physical access.
  • And yet, the region appears to have gained a great deal of significance in India’s strategic thinking over the years, particularly in the recent past.
  • New geopolitical realities: India’s mission Central Asia today reflects, and is responsive to, the new geopolitical, if not the geo-economic, realities in the region.

Factors driving India’s engagement

  • One of the factors driving this engagement and shaping it is the great power dynamics there.
  • Withdrawal of the US from Afghanistan: The decline of American presence and power in the broader region (due primarily to the U.S. withdrawal from Afghanistan) has led to a reassertion by China and Russia seeking to fill the power vacuum.
  • India-Russia relations: Moscow considers India to be a useful partner in the region: it helps it to not only win back New Delhi, which is moving towards the U.S., but also to subtly checkmate the rising Chinese influence in its backyard.
  • For the U.S., while growing India-Russia relations is not a welcome development, it recognises the utility of Moscow-New Delhi relations in Central Asia to offset Beijing’s ever-growing influence there.
  • India’s dilemma:  In the wake of the U.S. withdrawal from Afghanistan, New Delhi faces a major dilemma in the wider region, not just in the pre-existing theatres like the Line of Control and the Line of Actual Control.
  • India’s China challenge: India in the region might get further hemmed in due to the combined efforts by China, Pakistan and Taliban-led Afghanistan.
  • If so, it must ensure that there is no China-led strategic gang up with Pakistan and the Taliban against India in the region, which, if it becomes a reality, would severely damage Indian interests.
  • Consolidation of Afghan policy: India’s engagement of Central Asia would also help it to consolidate its post-American Afghan policy.
  • Now that the Taliban have returned to Kabul, New Delhi is forced to devise new ways of engaging Afghanistan.
  • That’s where the Central Asian Republics (CARs) and Russia could be helpful. 
  • The announcement of a Joint Working Group on Afghanistan during the summit between India and the CARs is surely indicative of such interest.

Russia’s prominence

  • In India’s current vision for a regional security architecture, Russia appears prominent
  • Countering China: By courting Russia — its traditional partner, also close to China and getting closer to Pakistan — to help it re-establish its presence in the Central Asian region, India is seeking to work with one of the region’s strongest powers and also potentially create a rift between China and Russia.
  • Joint defence production by India and Russia has been on the rise and the CARs could play a key role in it.
  • India’s non-critical stance on developments in Ukrain and Kazakhstan: This growing India-Russia partnership also explains India’s non-critical stance on the developments in Ukraine and Kazakhstan.

Challenges in India’s engagement with Central Asia

  • China’s dominance in the region:  China, which shares a land border with the region, is already a major investor there.
  • Iran’s role: An even bigger challenge for India may be Iran.
  • India’s best shot at reaching the CARs is by using a hybrid model – via sea to Chabahar and then by road/rail through Iran (and Afghanistan) to the CARs.
  •  So, for New Delhi, the ongoing re-negotiations on the Joint Comprehensive Plan of Action are of crucial importance.
  • While Iran getting close to the West is not preferred by Russia (but preferred by India), if and when it becomes a reality, India would be able to use it to its advantage and join Russia in engaging the CARs.
  • Delivering on the commitment: Most importantly, India will have to walk the talk on its commitments to Central Asia.
  • Does it have the political will, material capability and diplomatic wherewithal to stay the course in the region?

Conclusion

India’s renewed engagement of Central Asia is in the right direction for the simple reason that while the gains from an engagement of Central Asia may be minimal, the disadvantages of non-engagement could be costly in the longer run.

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WTO and India

What is TRIPS Agreement?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Geographical Indication, WTO, TRIPS

Mains level: India and WTO

India runs the risk of being excluded from a proposal it co-authored at the World Trade Organization (WTO) negotiations, in 2020, to “temporarily waive” intellectual property rights (IPR) held, by primarily Western countries, on vaccines, therapeutics, and diagnostics for COVID-19.

What is the case?

  • India and China are two major global suppliers of medicine.
  • A small group of WTO members was discussing suggestions to exclude drug manufacturers in India and China from prospective waivers to IPR obligations.
  • IPR obligations are a result of the Trade-Related Intellectual Property Rights (TRIPS) which WTO members are committed to upholding.

What is the Agreement on TRIPS?

  • The Agreement on TRIPS is an international legal agreement between all the member nations of the World Trade Organization (WTO).
  • It establishes minimum standards for the regulation by national governments of different forms of intellectual property (IP) as applied to nationals of other WTO member nations.
  • TRIPS was negotiated at the end of the Uruguay Round of the General Agreement on Tariffs and Trade (GATT) between 1989 and 1990 and is administered by the WTO.
  • It introduced intellectual property law into the multilateral trading system for the first time and remains the most comprehensive multilateral agreement on intellectual property to date.

Key provisions

  • TRIPS requires member states to provide strong protection for intellectual property rights.
  • It seeks to provide copyright rights, covering authors and other copyright holders, as well as holders of related rights, namely performers, sound recording producers, and broadcasting organizations.
  • It provides for geographical indications (GI); industrial designs; integrated circuit layout designs; patents; new plant varieties; trademarks; trade names and undisclosed or confidential information.
  • It also specifies enforcement procedures, remedies, and dispute resolution procedures.
  • TRIPS also has a most favored nation (MFN) clause.

Why TRIPS?

  • The obligations of the main international agreements of the World Intellectual Property Organization (WIPO) that already existed before the WTO was created:
  1. Paris Convention for the Protection of Industrial Property (patents, industrial designs, etc)
  2. Berne Convention for the Protection of Literary and Artistic Works (copyright).
  • Some areas are not covered by these agreements. In some cases, the standards of protection prescribed were thought inadequate.
  • So the TRIPS Agreement adds significantly to existing international standards.

What else is covered under TRIPS Agreement?

  • Copyright terms must extend at least 50 years unless based on the life of the author.
  • Computer programs must be regarded as “literary works” under copyright law and receive the same terms of protection.
  • Patents must be granted for “inventions” in all fields of technology and must be enforceable for at least 20 years.

 

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Medical Education Governance in India

Legislative Powers of Governor

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Legislative Powers of Governor

Mains level: Read the attached story

Tamil Nadu CM has charged that the Governor that he had failed to perform the duty vested in him by the Constitution when it came to deciding on the Bill adopted in the Legislative Assembly against the National Eligibility cum Entrance Test (NEET).

What is the issue?

  • The Governor had returned the Bill to the Assembly Speaker instead of forwarding it for Presidential assent.

Constitutional Powers of the Governor

  • Article 154: The executive power of the state shall be vested in the
    governor and shall be exercised by him either directly or through
    officers subordinate to him in accordance with this Constitution.
  • Article 163 (1): There shall be a council of ministers with the chief minister as the head to aid and advise the governor in the exercise of his functions, except in so far as he is required to exercise his functions in his discretion.
  • Article 163 (2): If any question arises whether a matter falls within the governor’s discretion or not, the decision of the governor is final and the validity of anything done by him cannot be called in question on the ground that he ought or ought not to have acted in his discretion.
  • The governor has constitutional discretion in the following cases:
    a) Reservation of a bill for the consideration of the President (Articles 200 and 201).
    b) Recommendation for the imposition of the President’s Rule in the state (Article 356).
    c) While exercising his functions as the administrator of an adjoining Union territory (in case of an additional charge).
    d) Special responsibility in 5th and 6th schedule areas.
    e) Seeking information from the chief minister with regard to the administrative and legislative matters of the state.
  • Also, the governor has situational discretion (i.e., the hidden discretion derived from the exigencies of a prevailing political situation) in the following cases:
    a) Appointment of the chief minister when no party has a clear-cut majority in the state legislative assembly or when the chief minister in office dies suddenly and there is no obvious successor.
    b) Dismissal of the council of ministers when it cannot prove the confidence of the state legislative
    assembly.
    c) Dissolution of the state legislative assembly if the council of ministers has lost its majority.

What are the Legislative Powers of Governor?

Governor summons the sessions of both houses of the state legislature and prorogues them.

  • The governor can even dissolve the State Legislative Assembly.
  • These powers are formal and the governor’s use of these powers must comply with the advice of the Council of Ministers headed by the Chief Minister.
  • He addresses the first session of the state legislature after the general elections in the state.

Appointments to the legislature

  • He appoints 1/6th members of the State Legislative Council in states wherever there is a bicameral legislature.
  • He nominates one member in the state legislative assembly from the Anglo-Indian Community if in view; the community is not well represented.
  • Governor is empowered under Article 192 to disqualify a member of the State legislature when the election commission recommends that the legislator is no longer complying with provisions of Article 191.

Passing of Bills

  • All the bills passed by the state legislatures are sent to the Governor for assent.
  • Once a bill is sent to Governor for assent, he can:
    a) Give assent to the bill
    b) Withhold the assent
    c) Return the bill to the legislature for reconsideration if it is not a money bill.
    d) If the bill is re-passed by the legislature with or without amendment, the governor has to give assent to the bill.
    e) Reserve the bill for consideration of the President.

When is the Bill sent to the President?

This is done under the circumstances when a bill:

  1. Violates the constitution or against directive principles of state policy (DPSP)
  2. Conflict with union powers
  3. Against the larger interest of the country and people
  4. May endanger the position of the high court in the state.

Ordinance making power

  • When the state legislature is not in session and the governor considers it necessary to have a law, then the governor can promulgate ordinances.
  • These ordinances are submitted to the state legislature at its next session.
  • They remain valid for no more than six weeks from the date the state legislature is reconvened unless approved by it earlier.

Others

  • As per Articles 165 and 177, Governor can ask the Advocate General to attend the proceedings of both houses of the state legislature and report to them any unlawful functioning if any.

Concerns with the role of governor

  • Misuse of discretionary powers: States allege that this provision has often been misused by the governor who acts on the behest of the union government which is opposed to the basic scheme of the Indian Constitution.
  • Appointment by centre: This often leads to the appointment of persons aligning with the party’s ideology to the post of Governor and he/she remains faithful to the Union government of the day rather than acting on the advice of the State Executive.
  • Arbitrary removal: Even after Supreme Court Judgement in B.P. Singhal v. Union of India calling for a fixed tenure for Governors to encourage neutrality and fairness in the discharge of their duties, it is not being implemented on the ground.

 

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Innovations in Sciences, IT, Computers, Robotics and Nanotechnology

What are Artificial Neural Networks (ANN)?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Artificial Neural Networks (ANN)

Mains level: Artificial Intelligence

This newscard is an excerpt from the original article published in TH.

What are ANN?

  • The concept behind an ANN is to define inputs and outputs, feed pieces of inputs to computer programs that function like neurons and make inferences or calculations.
  • It then forwards those results to another layer of computer programs and so on, until a result is obtained.
  • As part of this neural network, a difference between intended output and input is computed at each layer and this difference is used to tune the parameters to each program.
  • This method is called back-propagation and is an essential component to the Neural Network.

Setting up of ANNs

  • Instead of CPUs, Graphic Processing Units (GPU) which are good at performing massive parallel tasks can be used for setting up ANNs.
  • A few free ANN frameworks are TensorFlow, Keras, PyTorch and Theano.
  • These can be used for both normal Machine Learning tasks like classification or clustering and for Deep Learning/ANN tasks.

Why called Neural Network?

  • Neuron is the building block of the brain and it inspired computer scientists from the 1950s to make a computer perform tasks like a brain does.
  • It is not a simple problem and the clue to its complexity is in the brain structure.

Why ANN?

Ans. Making an artificial brain

  • We need billions of artificial neurons if we were to build an artificial brain.
  • With the increase in computing power, mimicking billions of neurons is now possible.

Popularity of ANNs

  • Data Science, used interchangeably with Machine Learning, is the computer technology that uses data to detect patterns.
  • Hand-written digit recognition is a good example of machine learning.
  • However, in order for the computer to do this task, large amounts of sample data need to be manually labelled as examples of images of digits.
  • The ANN mentioned above with its backpropagation does exactly this.
  • This is why ANNs have become hugely popular in the past decade. This approach of using neural networks of many layers to automatically detect patterns and parameters is called Deep Learning.

 

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Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

What is Havana Syndrome?

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Havana Syndrome

Mains level: NA

A recent US intelligence report says that ‘Havana Syndrome’ —a collection of symptoms and related brain injuries, reported by some US officials could be caused by pulsed electromagnetic energy or close-range ultrasound.

What is Havana Syndrome?

  • ‘Havana Syndrome’ is a colloquial name given to a set of symptoms such as dizziness, hearing loss, headaches, vertigo, nausea, memory loss and possible brain injuries.
  • It was first reported by 16 American Embassy staff and their family members in Havana, Cuba, in 2016-17.
  • There have been other instances of the phenomenon, which has mostly impacted US officials.

What did the latest investigation find?

  • Such cases have been caused by pulsed electromagnetic energy in the radio frequency.
  • The results of the investigation did not point to who may have been behind the phenomenon, nor commented on their motivations.
  • A partially redacted report summary finds that the symptoms of AHI are “genuine and compelling.”

What can be the other reasons?

  • Psychosocial factors alone do not explain the core characteristics, the report finds, although they may cause other incidents or contribute to long-term effects.
  • These other incidents could occur via hyper-vigilance or reactions to stress especially among individuals who are security-oriented.

 

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Wetland Conservation

Places in news: Basai Wetlands

Note4Students

From UPSC perspective, the following things are important :

Prelims level: Basai Wetlands

Mains level: Not Much

The Basai Wetlands in Gurugram has shrunk to a quarter of its original size over the years.

Basai Wetlands

  • Basai wetland, located in Basai village in Gurgaon Haryana is a flora and fauna rich water body.
  • It lies in one of the paleochannel of the Sahibi River, a tributary of Yamuna which originates from the Aravalli range in Rajasthan and flows through the region.

Its significance

  • It is recognized as one of India’s Important Bird and Biodiversity Areas and is of global conservation significance.
  • It supports populations of several endangered, vulnerable, and threatened bird species.
  • It is recognized globally as an Important Bird Area (IBA) by the BirdLife International housing 20,000 birds of over 280 species including migratory birds and endangered birds.
  • However, it has not yet been declared a protected wetland by the Government of Haryana.

Threats

  • Given the accelerated expansion of the city of the future, the wetland continues to disappear under newly laid roads, modern housing constructions and other infrastructure development.
  • An upcoming expressway, cutting through the terrain here, has majorly impacted the flyway of thousands of migratory birds from Europe and Central Asia.

 

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