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

[1st July 2025] The Hindu Op-ed: How do unsafe cancer drugs reach patients?

PYQ Relevance:

[UPSC 2014] While doctor’s prescription is a must to get drugs, many people buy them over the counter without prescription. Discuss the contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

Linkage: The wider discussion about checking drug quality and the difficulties in doing so is very important to stop unsafe drugs, like cancer medicines, from reaching patients. This question is relevant because it looks into how drugs are monitored and the problems faced in keeping them safe.

 

Mentor’s Comment:  A major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, has revealed that poor-quality and unsafe cancer drugs, many of them from India, have been sent to over 100 countries. These faulty medicines have caused serious health problems, including the deaths of children in Yemen, Colombia, and Saudi Arabia. The report highlights serious regulatory weaknesses in low- and middle-income countries, and shows that the WHO’s warning system only acts after harm is done. This is especially worrying because it affects cancer patients, one of the most vulnerable groups.

Today’s editorial talks about the poor-quality and unsafe cancer drugs. This topic is important for GS Paper II (Health & Governance) in the UPSC mains exam.

_

Let’s learn!

Why in the News?

Recently, a major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, found that low-quality and unsafe cancer drugs.

The Bureau of Investigative Journalism (TBIJ) is an independent, non-profit news organization based in the United Kingdom. It was founded in 2010 with the aim of producing in-depth, public interest journalism that holds power to account.

What are the major quality risks in cancer drug manufacturing and distribution?

  • Contamination during manufacturing: Risk of bacterial contamination from improper disinfection, untrained staff, or poor cleanroom discipline. Even small errors like air movement or touching non-sterile items can spread bacteria.
  • Poor quality control: Failure to test raw ingredients, clean equipment, or filter water properly can make life-saving drugs toxic or lethal.
  • Distribution chain vulnerabilities: Changes in temperature, humidity, or poor handling during transport can degrade drug quality. The complex journey from raw materials to patient requires strict monitoring at each stage.

Why are poorer countries more exposed to unsafe cancer drugs?

  • Weak Regulatory Frameworks: Many low-income countries lack strong drug regulatory authorities and legal frameworks to ensure medicine quality. Eg: In Nepal, there is no effective testing or monitoring of imported drugs due to limited institutional capacity.
  • Lack of Testing Infrastructure and Experts: These countries often do not have certified laboratories or trained personnel to check for contamination, dosage accuracy, or manufacturing faults. Eg: Nepal and similar nations lack verified experts or facilities to evaluate drug safety before market entry.
  • Inability to Track Drugs Through Supply Chains: Poor digital and logistical infrastructure leads to ineffective drug tracking, making it easier for substandard or counterfeit drugs to infiltrate the system. Eg: In countries with porous borders and no tracking systems, drugs can be repackaged or sold without oversight.
  • Corruption and Weak Enforcement: Corruption in customs, licensing, and procurement processes allows unverified drugs to enter public hospitals and pharmacies unchecked. Eg: In some regions, low-cost cancer drugs without proper quality assurance enter due to bribery and lack of regulatory follow-up.
  • Dependence on Low-Cost Imports Without Verification: Due to budget constraints, poorer nations rely heavily on cheap generic imports without adequate checks for Good Manufacturing Practices (GMP) or source validation. Eg: In Yemen (2022), at least 10 children died after receiving contaminated methotrexate, highlighting the consequences of poor import verification.

How does WHO ensure drug safety?

  • Rapid Alert System for Dangerous Drugs: WHO operates a global Rapid Alert System to identify and inform member countries about harmful or substandard medicines. Eg: If contaminated cancer drugs are reported in one country, WHO sends out a global alert so others can take preventive action.
  • Global Benchmarking and Certification Tools: WHO uses tools like the Global Benchmarking Tool to assess national regulatory systems and ranks them from Level 1 (weakest) to Level 4 (strongest). Eg: In 2023, 70% of member countries were rated at Level 1 or 2, showing limited capacity to regulate drug safety.
  • Prequalification, GMP, and CoPP Systems: WHO runs prequalification programs to approve safe drugs, ingredients, and labs; enforces Good Manufacturing Practices (GMP); and issues the Certificate of Pharmaceutical Product (CoPP) to confirm quality of exported drugs. Eg: A CoPP acts like a passport for medicines, verifying they are approved and safely made in the exporting country.

What are the steps taken by the Indian Government?

  • Strengthening Drug Regulatory Framework: The government has empowered the Central Drugs Standard Control Organization (CDSCO) to regulate drug approval, quality checks, and enforcement across India. CDSCO conducts inspections and sampling under the Drugs and Cosmetics Act, 1940 to detect substandard medicines.
  • Track and Trace Mechanism: India has introduced a barcode-based Track and Trace system for export of pharmaceutical products to improve transparency and traceability. Eg: The system helps monitor supply chain integrity and detect counterfeit drugs, especially in exports.
  • The Production Linked Incentive (PLI) Scheme for pharmaceuticals promotes domestic manufacturing of quality drugs and APIs while reducing import dependence. Eg: Incentives are given to firms that meet Good Manufacturing Practices (GMP) and global export standards.

Way forward: 

  • Establish a National Drug Quality Monitoring Authority: Create a centralised, independent regulatory body to oversee real-time quality audits, enforce uniform GMP standards, and ensure accountability across manufacturing units.
  • Invest in Testing Infrastructure and Skilled Workforce: Strengthen drug testing laboratories, equip them with modern technology, and train qualified professionals to carry out rigorous inspections and batch verifications at every stage.

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Goods and Services Tax (GST)

GST reform and unfinished business in tobacco control

Why in the News?

As India completes eight years of implementing the Goods and Services Tax (GST), the focus has moved from its economic benefits to its problems, especially in public health, like the poor taxation of tobacco.

What are GST’s major achievements and gaps after eight years?

Achievements: 

  • Unified Tax System: Replaced multiple indirect taxes with one national tax, promoting the “One Nation, One Tax” concept.
  • Increased Revenue Collection: GST collections reached ₹22.08 lakh crore in 2024–25, showing consistent growth.
  • Improved Ease of Doing Business: Simplified compliance through harmonised tax rates and digital processes.
  • Boosted Logistics Efficiency: Removal of inter-State checkpoints reduced transport time and costs.
  • Reduced Tax Cascading: The Input Tax Credit mechanism lowered production costs for businesses and prices for consumers.

Gaps:

  • Ineffective Public Health Taxation: Tobacco taxation remains weak under GST, despite high health and economic burdens.
  • Decline in Specific Excise Duties: Over-reliance on ad valorem GST weakened price control on harmful products like bidis and cigarettes.
  • Inadequate Tax on Bidis: Bidis, widely consumed by low-income groups, are under-taxed and not covered under the GST compensation cess.
  • Loss of Revenue Post-Cess Expiry: The GST compensation cess (a major source of tobacco tax) will expire in 2026, risking affordability and public health.
  • Weak Deterrent Against Tobacco Use: Unlike pre-GST years, tax stagnation has failed to reduce tobacco consumption, ignoring WHO’s 75% tax recommendation.

Why is GST ineffective in curbing tobacco use?

  • Lack of Significant Tax Hikes Post-GST: Since the introduction of GST in 2017, there have been no major tax increases on tobacco products. In contrast, during the pre-GST era (2009–17), regular hikes in excise and VAT contributed to a 17% decline in tobacco use.
  • Low Overall Tax Burden: The total tax on tobacco remains below the WHO-recommended 75% of retail price — only 22% for bidis, 54% for cigarettes, and 65% for smokeless tobacco. This allows tobacco products to remain affordable, especially for youth and low-income groups.
  • Under-Taxation of Harmful Products like Bidis: Bidis, the most consumed smoked tobacco product, are exempt from the GST compensation cess. Despite causing harm similar to cigarettes, they generate very low tax revenue and are widely used by low-income populations, reducing the deterrent effect of taxation.
  • Reduced Price Deterrence:  After GST, the share of excise duty fell sharply (e.g., from 54% to 8% for cigarettes), weakening the price-based disincentive for tobacco use.
  • Industry Manipulation of Ad Valorem Taxes: GST relies heavily on ad valorem taxes (based on product price), which are easier for the tobacco industry to manipulate through pricing strategies. Without specific excise duties, companies can keep prices low, making harmful products like bidis and cheap cigarettes affordable to the masses.

What reforms can align tobacco taxes with health goals? (Way forward)

  • Introduce or Increase Specific Excise Duties: Add a fixed per-unit tax (specific excise) on tobacco products along with GST. Eg: Countries like the Philippines combine ad valorem and specific taxes, leading to higher prices and lower consumption.
  • Raise GST and Cess to Statutory Limits: Increase GST on tobacco to the legal ceiling of 40% and expand the GST Compensation Cess to include under-taxed products like bidis. Eg: Bidis, used by the poor and causing major health harm, are not covered under the cess, reducing their tax burdenand health deterrence.
  • Link Tax Policy with Inflation and Income Growth: Regularly update tobacco taxes to offset rising incomes and inflation, preventing increased affordability over time. Eg: WHO recommends adjusting taxes annually so that tobacco doesn’t become more affordable even if incomes rise.

Mains PYQ:

[UPSC 2019] Enumerate the indirect taxes which have been subsumed in the goods and services tax (GST) in India. Also, comment on the revenue implications of the GST introduced in India since July 2017.

Linkage: The article talks about the GST replaced many older taxes like VAT and excise duty, helping create a single national market. Although GST collections have steadily grown—reaching ₹22.08 lakh crore in 2024–25—the revenue from tobacco (about ₹551 billion a year) is much less than the huge cost of tobacco-related health problems, which is ₹2,340 billion every year.

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The Crisis In The Middle East

In a perilous world, India must read the tea leaves well 

Why in the News?

Recently, the world’s growing preference for military force over peaceful talks have made India’s old policy of staying neutral and keeping strategic independence no longer enough.

Why is India’s neutrality no longer viable in the current global conflicts?

  • Erosion of Strategic Leverage in Multilateral Crises: Neutrality has diminished India’s influence during major global conflicts where clear moral or strategic stands are expected. Eg: During the Israel-Iran conflict, India’s equidistant stance failed to garner goodwill from Iran, while Israel saw no added strategic value either.
  • Increased Global Polarisation and Military Alignments:  The world is now split into rival power groups, and staying neutral is often seen as being unsure or unwilling to take a stand. Eg: The U.S. bombing of Iran’s nuclear sites with bunker buster bombs, along with the growing China-Russia-Iran partnership, shows that being neutral in such a situation can actually be a liability and hurt a country’s interests.
  • Loss of Support from Traditional Partners: India’s neutral approach during its own security crises has failed to rally international support. Eg: During the recent India-Pakistan conflict, most West Asian countries and even the U.S. remained non-committal, despite India’s outreach in the Global South.
  • Reduced Credibility of Non-Alignment in a Hard Power World: Global forums are increasingly emphasising military strength over moral positioning. Neutrality is no longer seen as leadership. Eg: At the Shangri-La Dialogue, the U.S. stressed hard power and Indo-Pacific dominance, sidelining softer, non-aligned narratives like India’s.

What are the threats posed by the China-Pakistan military alliance?

  • Two-Front War Scenario: India faces the real risk of a coordinated military confrontation on both eastern and western borders. Eg: During the India-Pakistan conflict in May, intelligence revealed Pakistan’s preparedness using Chinese-supplied J-10C and JF-17 fighter jets, suggesting synchronised planning with China.
  • Enhanced Pakistani Military Capabilities: China’s transfer of advanced weaponry has significantly boosted Pakistan’s defence systems, improving its precision strike and surveillance capacity. Eg: Chinese radar, missile systems, and drone technology are now integrated into Pakistan’s command and control network, enhancing its offensive potential against India.
  • Asymmetric Nuclear Threat: The alliance magnifies the nuclear imbalance in the region, putting India at a strategic disadvantage. Eg: China and Pakistan together possess nearly a 5:1 advantage in nuclear warheads over India, escalating the deterrence challenge and increasing the risk of nuclear brinkmanship.

How has India’s Israel-Iran policy impacted its West Asia standing?

  • Loss of Credibility as a Neutral Mediator: India’s attempt to balance ties between Israel and Iran has diluted its influence in the region, as it failed to take a principled stand when it was needed most. Eg: During the Israel-Iran conflict, India’s mere call for “restraint on all sides” disappointed Iran, which expected vocal support against targeted attacks by Israel and the U.S.
  • Strained Relations with Key Regional Powers: India’s visible tilt towards Israel in recent years has alienated several West Asian countries, undermining its strategic and energy interests. Eg: India’s growing defence and technology cooperation with Israel has made its Iran policy less credible, especially after Iran was diplomatically isolated in the recent conflict.

What are the reforms needed to prepare India for a two-front war? (Way forward)

  • Strengthen Long-Duration War Capabilities: India must boost its ammunition reserves, logistics systems, and supply chain resilience to sustain prolonged conflicts on both fronts. Eg: The UK’s defence audit revealed critical gaps in its own war readiness—India too must conduct similar assessments to plug vulnerabilities.
  • Develop Advanced Technologies and AI Warfare: Investing in Artificial Intelligence (AI), drone warfare, loitering munitions, and electromagnetic systems is crucial to match modern battlefield requirements. Eg: Lessons from the Russia-Ukraine war show the growing role of AI-guided drones and precision weapons in shaping war outcomes.

Mains PYQ:

[UPSC 2022] How will I2U2 (India, Israel, UAE and USA) grouping transform India’s position in global politics?

Linkage: India’s role in emerging strategic alliances, emphasizing the need to understand how new groupings can re-shape India’s influence and standing in global politics. The article underscores that India’s foreign policy is currently facing an “existential crisis” due to events like the India-Pakistan conflict, the China-Pakistan nexus, and the Israel-Iran conflict, where “neutrality is no longer an option.

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New Species of Plants and Animals Discovered

ZSI records 683 faunal discoveries in its 110th year

Why in the News?

The Zoological Survey of India (ZSI) released Version 2.0 of the Checklist of Fauna of India, documenting 105,244 species and subspecies.

Back2Basics: Zoological Survey of India

  • The ZSI was set up by British zoologist Thomas Nelson Annandale in 1916.
  • It is the premier taxonomic research organisation in India, based in Kolkata.
  • It was established to promote surveys, exploration and research leading to the advancement of our knowledge of various aspects of the exceptionally rich animal life of India.
  • The ZSI had its genesis as the Zoological Section of the Indian Museum at Calcutta in 1875.
  • Since its inception, the ZSI has been documenting the diversity and distribution of the fauna of India towards carrying out its mandate of conducting exploration-cum-taxonomic-research programmes.
  • The ZSI has published an extremely large amount of information on all animal taxa, from Protozoa to Mammalia.

Key Findings About ZSI’s Work and Discoveries (2024–25):

  • Significant Animal Discoveries:
    • New Genus: Dravidoseps gouensis – a new genus of skink (lizard) from Western Ghats
    • New Species of Snakes: Anguiculus dicaprioi – named after actor Leonardo DiCaprio, belongs to the Colubridae family
    • Other Reptiles: 2 new genera and 37 new species of reptiles discovered
    • Amphibians: 5 new amphibian species, including frogs from northeastern and southern India
    • Other Invertebrates: Multiple new insect species, particularly among beetles, moths, flies, and bees
  • Highest representation among newly discovered species were insects, especially:
    • Coleoptera (beetles)
    • Lepidoptera (moths and butterflies)
    • Diptera (flies)
    • Hymenoptera (ants, bees, wasps)
[2020] With reference to India’s Biodiversity, Ceylon frogmouth, Coppersmith barbet, Gray-chinned minivet and White-throated redstart are:

(a) Birds

(b) Primates

(c) Reptiles

(d) Amphibians

 

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New Species of Plants and Animals Discovered

New flowering plant named after Nyishi Tribe

Why in the News?

A new species of flowering plant, Begonia nyishiorum, has been discovered in the East Kameng district of Arunachal Pradesh.

New flowering plant named after Nyishi Tribe

About Begonia nyishiorum:

  • Overview: Begonia nyishiorum is a recently identified flowering plant found in East Kameng, Arunachal Pradesh, and is endemic to this region.
  • Scientific Recognition: It was officially described in June 2025 in Novon, a peer-reviewed journal published by the Missouri Botanical Garden.
  • Feature: The species is notable for its crimson, fringed scales (indumentum) on light green petioles, a distinct trait among Asian begonias.
  • Habitat and Range: It thrives on moist, shaded mountain slopes between 1,500 and 3,000 metres in altitude.
  • Ecological Sensitivity: Known from only two forest locations, the plant is potentially vulnerable and warrants conservation attention.
  • Name Origin: The species name nyishiorum honours the Nyishi tribe, known for their traditional ecological stewardship of local forests.

About the Nyishi Tribe:

  • Overview: The Nyishi are the largest ethnic group in Arunachal Pradesh, with a population of about 300,000.
  • Name Meaning: The word “Nyishi” combines “Nyi” (man) and “Shi” (being), signifying a civilised human in their language.
  • Linguistic Identity: Their language belongs to the Sino-Tibetan family, although its origins remain debated among scholars.
  • Geographic Spread: They live in eight districts of Arunachal Pradesh (like East Kameng, Papum Pare, and Kurung Kumey) and parts of Assam.
  • Livelihood Practices: Their economy includes slash-and-burn farming, hunting, fishing, and handicrafts such as bamboo work and weaving.
  • Key Festivals: They celebrate Boori-Boot (Feb) for unity, Nyokum (Feb) for prosperity, and Longte (Apr) for protection from evil.
  • Social Structure: Nyishi society is patrilineal and clan-based, with no caste system or rigid social hierarchy.
  • Role of Women: Women are seen as symbols of peace and prosperity, and marriages involve reciprocal family exchanges that build community ties.
[UPSC 2016] Recently, our scientists have discovered a new and distinct species of banana plant which attains a height of about 11 metres and has orange-coloured fruit pulp.

In which part of India has it been discovered?

Options: (a) Andaman Islands* (b) Anaimalai Forests (c) Maikala Hills (d) Tropical rain forests of northeast

 

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Land Reforms

[pib] NAKSHA Programme 

Why in the News?

The Department of Land Resources (DoLR) under the Ministry of Rural Development is set to launch the second phase of capacity building for the NAKSHA programme (NAtional geospatial Knowledge-based land Survey of urban HAbitations).

About NAKSHA Program:

  • Overview: It was launched on 18th February 2025. It is a geospatial land survey initiative launched by the Department of Land Resources (DoLR), Ministry of Rural Development, under the Digital India Land Records Modernisation Programme (DILRMP).
  • Objective: The programme aims to modernise urban land records, make property ownership more transparent, and streamline urban governance.
  • Funding: It is 100% centrally funded, with an estimated cost of ₹194 crore.
  • Significance: The programme was launched in response to India’s rapidly growing urban population, which is expected to exceed 600 million by 2031.

Key Features:

  • Pilot Coverage: Implemented in 157 ULBs covering an area of 4,142.63 sq km, focusing on towns with an area of <35 sq km and a population of <2 lakh.
  • Drone-Based Survey: Uses drones equipped with LiDAR sensors and 5 cm resolution cameras to conduct aerial surveys.
  • Three-Stage Survey Process:
    • Drone Survey & Data Collection
    • Field Verification & Draft Mapping
    • Public Review & Finalisation
  • Integration with Legal Records: Field surveys validate and update property tax, ownership, and registration data.
[UPSC 2024] With reference to the Digital India Land Records Modernisation Programme, consider the following statements:

1. To implement the scheme, the Central Government provides 100% funding.

2. Under the Scheme, Cadastral Maps are digitised.

3. An initiative has been undertaken to transliterate the Records of Rights from local language to any of the languages recognized by the Constitution of India.

Which of the statements given above are correct?

(a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2 and 3*

 

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GI(Geographical Indicator) Tags

Prada-Kolhapuri Cultural Misappropriation Debate

Why in the News?

The Prada incident, involving footwear resembling India’s GI-tagged Kolhapuri chappals, has reignited debates on cultural respect, equitable benefit sharing, and the need for stronger global enforcement of GI rights.

prada

About the Kolhapuri Chappal Controversy:

  • Cultural Origin: They originated in Kolhapur and nearby districts in Maharashtra and Karnataka, dating back to the 12th–13th century, once worn by royals.
  • Craftsmanship and Features: These chappals are handmade from vegetable-tanned leather, use no nails or synthetic parts, and feature a T-strap design in natural tones.
  • GI Tag Recognition: They received a GI tag in 2019, covering eight districts across the two states.
  • Allegations Against Prada: Italian luxury brand Prada was accused of unauthorised cultural appropriation for selling similar sandals without acknowledging the traditional origin.
  • Global Enforcement Gap: The controversy highlights the limited international protection for GI-tagged goods and the need for stronger legal safeguards abroad.

Earlier Cultural Misappropriation Cases:

  • Basmati Rice (1997): The US Patent and Trademark Office granted a patent to Ricetec Inc., claiming new “lines and grains” of basmati rice. After diplomatic and legal pressure, Ricetec was barred from using the term “Basmati.”
  • Turmeric (1995): A U.S. patent was granted for turmeric’s wound-healing properties, a use long documented in Ayurveda. CSIR successfully challenged and had the patent revoked.
  • Neem (2000): The European Patent Office revoked a patent granted to the USDA and W.R. Grace for neem-based antifungal formulations, citing that such usage existed in Indian traditional knowledge.

Back2Basics: Geographical Indication (GI) Tags

  • Purpose: A GI tag is a form of intellectual property that certifies a product’s origin from a specific place where its quality or reputation is uniquely linked to that location.
  • Significance: GI tags help preserve cultural heritage, promote rural livelihoods, and enable market access for indigenous communities.
  • Legal Framework in India: In India, GI registration is governed by the Geographical Indications of Goods (Registration and Protection) Act, 1999, in force since 2003, and managed by the DPIIT, Ministry of Commerce.
  • Ownership and Validity: A GI tag is collectively owned by local producers, valid for 10 years, and renewable indefinitely, unlike private trademarks.
  • Examples of GI Goods: India has 658 GI goods, including Darjeeling tea, Madhubani paintings, Pashmina shawls, Chanderi sarees, and Kancheepuram silk.
  • Jurisdiction of Protection: GI protection is territorial, meaning legal misuse can only be challenged within the registered country, unless separately protected abroad.
  • Global Legal Backing: GI rights are supported by international treaties like the Paris Convention (1883) and the TRIPS Agreement (1995).

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