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Subject: Governance

Important aspects of Society

  • Duty exemption for drugs for Rare Diseases

    rare

    Central idea: The Centre has exempted all drugs and food for special medical purposes, imported for personal use, for the treatment of rare diseases listed under the National Policy for Rare Diseases 2021 from basic customs duty.

    What are Rare Diseases?

    • Rare diseases are those medical conditions that affect a small percentage of the population.
    • In India, a disease is considered rare if it affects less than 1 in 2,000 people.
    • These diseases are often genetic and are chronic, degenerative, and life-threatening.
    • There are over 7,000 known rare diseases, and it is estimated that about 70 million people in India are affected by them.
    • Many of these diseases do not have a cure, and the treatment can be expensive and difficult to access.

    Need for duty exemption

    • This decision has been taken to help reduce the burden of the cost of treatment for patients and families.
    • The drugs and food required for the treatment of these rare diseases are often expensive and need to be imported.
    • This exemption will result in substantial cost savings and provide much-needed relief to patients with rare diseases.

    Key medicines under this exemption

    • The central government has fully exempted Pembrolizumab (Keytruda), a drug used in the treatment of various types of cancer, from basic customs duty.
    • Previously, the GST rate for Keytruda was cut to 5 per cent from 12 per cent in a meeting held in September 2021 by the GST Council.
    • Life-saving drugs Zolgensma and Viltepso used in the treatment of spinal muscular atrophy were exempted from GST when imported for personal use.

    How the new duty exemption works?

    • The exemption has been granted by the Central Board of Indirect Taxes and Customs (CBIC) by substituting “Drugs, Medicines or Food for Special Medical Purposes (FSMP)” instead of “drugs or medicines”.
    • To avail of this exemption, the individual importer has to produce a certificate from the central or state director health services or district medical officer/civil surgeon of the district.

    How are life-saving medicines taxed?

    • Drugs/medicines generally attract basic customs duty of 10 per cent, while some categories of lifesaving drugs/vaccines attract a concessional rate of 5 per cent or nil.
    • In its meeting in September 2021, the GST Council had reduced tax rates for several life-saving drugs.

     

  • Public Policy Education: Essential For Developing Effective Policies

    Central Idea

    • Government policies play a crucial role in determining the future of a country. They not only impact economic growth and public welfare but also improve the ease of living for citizens. Unfortunately, there is a lack of interest in public policy education in India, with only a small percentage of policymakers having formal education in public policy and administration.

    Public policy education

    • Public policy education refers to the study and teaching of the principles, theories, and methods involved in the development, implementation, and evaluation of policies that address societal issues.
    • This field of education aims to equip students with the knowledge and skills necessary to analyze, create, and manage public policies effectively.

    How the government policies, economic growth, and public welfare are closely interconnected?

    • Government policies: Governments create and implement policies to guide economic activities, maintain social order, and promote the welfare of their citizens. These policies cover a wide range of areas, such as fiscal and monetary policy, trade policy, education, healthcare, social security, and infrastructure development. The effectiveness of these policies can have a direct impact on economic growth and public welfare.
    • Economic growth: Economic growth is the increase in a country’s output of goods and services over time, usually measured by the growth rate of gross domestic product (GDP). A growing economy typically leads to higher employment, increased income, and improved living standards for citizens. Government policies play a crucial role in stimulating or hindering economic growth by influencing factors such as investment, consumption, trade, and innovation.
    • Public welfare: Public welfare refers to the overall well-being of a society, encompassing aspects such as income distribution, access to essential services, health, education, and environmental quality. Government policies can significantly impact public welfare by determining the allocation of resources, setting priorities, and providing social safety nets.

    Paucity of Programs

    • As per the All-India Council for Technical Education, there are 3,182 institutions with an approved intake of 4.22 lakh in business management programs, but only about 130 universities that offer public administration programs and only 29 institutes that offer public policy programs.
    • The batch size of public policy courses is 20-60, and there are few jobs available for people pursuing such courses, which disincentivizes educational institutions and students from choosing public management courses.

    Lack of Exposure to Public Management

    • Most civil servants undergo departmental induction training programs that focus on the role they play in their department and not much on how to make good public policies.
    • Consequently, very few civil servants have exposure to public management before joining service, which is critical for developing effective policies.

    Suggestions to boost public policy education in India

    1. Public Management as a Compulsory Subject in UPSC:
    • Public management should be a compulsory subject for the UPSC civil service examination, either as a substitute for one optional subject or an additional paper. This will incentivize universities and private institutions to offer public policy education, research, and case studies at the graduate or post-graduate level, leading to a major boost in public policy education.
    • Additionally, civil servants who join government would have formal education in public management before they enter service, and even those who do not make it to government jobs would develop better understanding and sensitivity towards complexities involved in public management, making them better citizens and effective private sector managers.
    1. Larger Component of Public Policy in Induction Training: Existing training institutions of the government should have a larger component of public policy as part of their induction training. Moreover, a case study bank for training should also be established.
    2. Specialized Positions of Public Policy Analysts: The government can create certain specialized positions of public policy analysts to be picked up from the market directly, thereby creating new job avenues for the graduates of public policy programs.

    Conclusion

    • The lack of formal education in public management has led to governance lagging behind private sector management in terms of efficiency and effectiveness. Public policy education is essential for developing effective policies that spur economic growth, public welfare, and improve ease of living for citizens.

    Mains Question

    Q. What is public policy education, and why is it important for policymakers in India to have formal education in public policy and administration? Suggest measures to boost public policy education in India.

  • Healthcare: Remarkable Progress But The Gaps Needs to be Addressed

    Central Idea

    • The Indian healthcare system has overcome many challenges and has made significant progress, but there are still many tough health challenges that need to be addressed. There is need to bridge the gap between the services available in metropolitan and Tier-II and Tier-III cities, provide healthcare insurance to the unorganised middle class, and use Artificial Intelligence and digital technology to improve healthcare services.

    Overcoming past challenges

    • The Indian healthcare system has overcome seemingly insurmountable problems, including high maternal and infant mortality rates, and low hospital delivery rates.
    • The National Family Health Survey (NFHS-5) results show that even in the so-called BIMARU states, hospital deliveries have soared to 89 per cent.

    Current Health Challenges

    • Five interrelated challenges: The current macro picture shows at least five interrelated challenges that are pervading the population, including non-communicable diseases (NCDs), obesity, and chronic respiratory diseases.
    • NCDs: The proportion of deaths due to NCDs has increased from around 38 per cent in 1990 to 62 per cent in 2016.
    • Obesity: Obesity has increased from 19 per cent to 23 per cent between NFHS-4 and NFHS-5. Awareness about leading healthy lives will save millions from illness and decelerate premature death.

    Current state of healthcare in India

    1. Infrastructure:
    • The state of infrastructure matters. Since 2018, governments at the Centre as well as the state have been trying to bolster primary healthcare by establishing health and wellness centres.
    • But there are still huge variations between states, and some states have better arrangements than others. States must step up efforts to improve infrastructure in the healthcare sector.
    1. Bridging the gap in hospital services:
    • In urban areas, the challenge is to bridge the gap in hospital services between large urban agglomerations and Tier-II and Tier-III cities.
    • Large hospital chains provide only 4-5 per cent of the beds in the private sector.
    • Standalone hospitals and nursing homes provide 95 per cent of private hospital beds but are unable to provide multi-specialty, leave alone tertiary and quaternary care.
    • The gaps between services available in the metros and big cities and in districts must be bridged.
    1. Health Insurance Coverage:
    • Low health insurance penetration and the very high personal outgo on healthcare remain a challenge.
    • But over the past three years, more than four crore Indians have bought health insurance.
    • From 2018, the Ayushman Bharat insurance scheme for 10 crore poor families has been undertaken to provide insurance against hospitalisation for up to Rs 5 lakh per year per family.
    • Nearly 74 per cent of Indians are either covered or eligible for health insurance coverage.
    1. Use of Artificial Intelligence and digital technology:
    • An emerging concern is the use of Artificial Intelligence (AI) and digital technology to improve healthcare services.
    • Surgery assisted by robots, the use of genetic codes, clinical decision support systems, and telemedicine can help in making healthcare more accessible and efficient.

    Conclusion

    • India has shown how the impossible can be achieved, but the healthcare system needs to overcome various challenges to fully redeem its advantage of having the youngest population. The government needs to step up efforts in improving infrastructure, bridging the gap in hospital services, and providing health insurance coverage for the unorganized middle class. It is also essential to regulate the use of AI and digital technology in the healthcare sector to ensure accountability and prevent malpractice.
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  • DPDP Bill 2022: Need for Sector-Specific Safeguards

    Central Idea

    • India’s digital economy is growing rapidly and generating massive amounts of personal data. As citizens embrace convenience, understanding how this data is handled and protected has become critical. The Digital Personal Data Protection (DPDP) Bill 2022 aims to safeguard citizens’ information from misuse and unauthorised access but lacks specificity in certain clauses such as the interaction with sectoral data protection regulations.

    The Digital Personal Data Protection (DPDP) Bill 2022

    • The Digital Personal Data Protection (DPDP) Bill 2022 is a proposed legislation aimed at safeguarding the personal data of Indian citizens from misuse and unauthorized access.
    • The bill aims to regulate the handling of personal data in the rapidly growing digital economy of India.

    Seven principles of DPDP Bill, 2022

    According to an explanatory note for the bill, it is based on seven principles-

    1. Lawful use: The first is that usage of personal data by organisations must be done in a manner that is lawful, fair to the individuals concerned and transparent to individuals.
    2. Purposeful dissemination: The second principle states that personal data must only be used for the purposes for which it was collected.
    3. Data minimisation: Bare minimum and only necessary data should be collected to fulfill a purpose.
    4. Data accuracy: At the point of collection. There should not be any duplication.
    5. Duration of storage: The fifth principle talks of how personal data that is collected cannot be stored perpetually by default, and storage should be limited to a fixed duration.
    6. Authorized collection and processing: There should be reasonable safeguards to ensure there is no unauthorised collection or processing of personal data.
    7. Accountability of users: The person who decides the purpose and means of the processing of personal data should be accountable for such processing

    Challenges regarding conflicting sectoral regulations in India

    • The DPDP Bill 2022 lacks specificity in certain clauses regarding the interaction with sectoral data protection regulations.
    • While the Bill allows for filling regulatory gaps, conflicting sectoral regulations may create confusion.
    • India already has sectoral regulations regarding data protection, such as the Reserve Bank of India’s directive on storage of payment data and the National Health Authority’s Health Data Management Policy. Any deviation from existing regulations will further require the industry to readjust their operations again at considerable cost.

    Approach to regulate privacy and protect data

    • The two major approaches to regulating privacy and protecting data is comprehensive legislation and sector-specific regulations
    • The European Union’s General Data Protection Regulation (GDPR) as an example of comprehensive legislation with sector-specific provisions
    • The American sectoral approach as a patchwork of regulations tailored to specific industries, with flaws in inconsistent protection, enforcement, and lack of federal regulation

    Way ahead: Finding the right balance for India

    • There is a need for greater clarity and specificity in the interaction between the DPDP Bill and sectoral regulations in India
    • It is important to build on existing sectoral regulations to avoid undermining their efforts and require further costly adjustments
    • The role of sectoral experts in ensuring a safer, more secure, and dynamic digital landscape for Indian citizens in the future is important.

    Conclusion

    • The DPDP Bill must serve as the minimum layer of protection, with sectoral regulators having the ability to build on these protections for a safer and more secure digital landscape.
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  • Type 1 and Type 2 Diabetes among Children

    diabetes

    The National Commission for Protection of Child Rights (NCPCR) has written to Education Boards of all States/UTs, stating schools must ensure proper care/facilities for children with Type 1 diabetes (T1D).

    What is Diabetes?

    • Diabetes is a chronic medical condition that occurs when the body cannot regulate blood sugar levels properly.
    • Blood sugar, also known as blood glucose, is the main source of energy for the body’s cells.
    • Insulin, a hormone produced by the pancreas, helps the body use and store glucose from food.
    • In diabetes, the body either does not produce enough insulin or cannot use the insulin it produces effectively, resulting in high blood sugar levels.
    • Over time, high blood sugar levels can cause serious health problems, such as damage to the heart, blood vessels, eyes, kidneys, and nerves.

    Types of Diabetes

    There are two main types of diabetes: Type 1 and Type 2.

    • Type 1 diabetes: It is an autoimmune disease in which the immune system attacks and destroys insulin-producing cells in the pancreas, resulting in a lack of insulin. This type of diabetes is typically diagnosed in children and young adults, although it can occur at any age. It requires insulin injections or pump therapy for survival.
    • Type 2 diabetes: It is a metabolic disorder in which the body becomes resistant to the effects of insulin or doesn’t produce enough insulin to maintain normal glucose levels. This type of diabetes is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet. It is typically diagnosed in adults, but it is becoming increasingly common in children and adolescents as well. Treatment for Type 2 diabetes may include lifestyle changes, oral medications, or insulin therapy.

    Menace of diabetes in India

    • According to data from the International Diabetes Federation Atlas 2021, India has the world’s highest number of children and adolescents living with Type I Diabetes Mellitus (TIDM).
    • There are over 2.4 lakh TID patients in the Southeast Asia region.

    Measures to mitigate TID impact on students

    • CBSE circular in 2017 allowed students with T1D in Classes X and XII to carry certain eatables to board exam hall to avoid low sugar episodes.
    • They are permitted to carry medicines, snacks, water, a glucometer, and testing strips.
    • NCPCR suggests states allow students to use smartphones to monitor sugar levels.
    • Tamil Nadu has been providing free insulin to children with T1D since 1988.

    Back2Basics: National Commission for Protection of Child Rights (NCPCR)

    • NCPCR is a statutory body established in India under the Commissions for Protection of Child Rights Act, 2005.
    • Its objective is to protect, promote and defend the rights of children in India.
    • It functions as a watchdog to prevent child rights violations, as well as to take action against those responsible for such violations.
    • The NCPCR also advocates for the implementation of laws, policies and programs aimed at promoting child welfare and development.

     

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  • Healthcare: Public Health and The Insurance Funding

    Central Idea

    • The Tamil Nadu public health model has achieved success in improving healthcare outcomes and maintaining equity in healthcare delivery. However, the shift in healthcare funding to insurance companies has brought both benefits and drawbacks to the public healthcare system.

    The key features of the Tamil Nadu public health model

    • Primary Healthcare: The Tamil Nadu public health model is based on a strong emphasis on primary healthcare, which is the first point of contact for patients seeking medical attention. Primary healthcare centres provide basic healthcare services and preventive care, which are critical to reducing the burden of disease.
    • Public Health Infrastructure: The state has a well-established public health infrastructure, including a network of primary healthcare centres, secondary and tertiary care hospitals, and medical colleges. The state government has also invested in health infrastructure, including sanitation facilities, water supply, and waste management.
    • Health Insurance: The Tamil Nadu government has implemented a comprehensive health insurance scheme, the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), which provides free healthcare services to families living below the poverty line and low-income groups.
    • Human Resource Development: The state government has also focused on developing human resources in healthcare. It has set up a large number of nursing and paramedical institutions to train healthcare professionals.
    • Health Awareness: The Tamil Nadu government has launched various health awareness campaigns to educate people about health issues, including communicable and non-communicable diseases. The government has also launched campaigns to promote healthy lifestyle choices, such as a balanced diet and regular exercise.
    • Partnership with NGOs: The government has partnered with non-governmental organizations (NGOs) to implement various health programs. These partnerships have helped in the effective delivery of healthcare services in remote and rural areas of the state.
    • Innovations: Tamil Nadu has implemented several innovative approaches in healthcare, such as telemedicine, which enables patients to receive medical consultation and treatment remotely using technology. The state has also established mobile clinics to provide healthcare services to people living in remote areas.

    Benefits of Decentralization

    • Improved access to healthcare: Decentralization can help to improve access to healthcare services, particularly in rural or remote areas. By empowering local communities and healthcare providers to make decisions about healthcare delivery, services can be tailored to meet the specific needs of the population.
    • Better quality of care: Decentralization can lead to better quality of care by enabling healthcare providers to respond more quickly and effectively to the needs of their patients. It can also promote innovation and experimentation in healthcare delivery, leading to new and improved approaches to patient care.
    • Increased accountability: Decentralization can increase accountability in healthcare delivery by empowering local communities and healthcare providers to monitor and evaluate the quality of care. This can help to identify and address problems in healthcare delivery, leading to improved outcomes for patients.
    • Cost savings: Decentralization can lead to cost savings in healthcare delivery by reducing the administrative costs associated with centralized decision-making and management. It can also promote greater efficiency in healthcare delivery, leading to reduced waste and duplication of services.

    Insurance Funding in healthcare

    • Insurance funding in healthcare refers to the use of insurance mechanisms to finance healthcare services. This involves pooling financial resources from individuals or groups through insurance schemes, which are then used to pay for healthcare services.
    • Insurance funding can help to mitigate the financial risks associated with healthcare, and ensure that individuals have access to the care they need without incurring excessive costs.

    Drawbacks of Insurance Funding

    • Shifted focus: The focus on indemnity and negotiations with insurance companies has shifted the focus of hospitals from patient care to claiming money.
    • Compromised quality of service: The appointment of contractual employees with meager pay has created a divide between permanent high-paid staff and temporary low-salaried staff, leading to a compromise in the quality of service.

    Facts for prelims

    Type of Insurance Funding Description
    Private health insurance Purchased by individuals or employers to cover healthcare costs. Coverage, cost, and benefits vary widely and may be offered by commercial insurers, nonprofit organizations, or government programs
    Public health insurance Provided by government-run programs, typically funded through taxes or other government revenues. Coverage is provided to eligible individuals based on criteria such as age, income, or medical need. Pradhan Mantri Jan Arogya Yojana (PMJAY) is a government-funded health insurance program that provides free health coverage to economically disadvantaged families across India.
    Social health insurance A hybrid model that combines elements of private and public insurance. Individuals and employers contribute to a national insurance fund that is used to pay for healthcare services, typically managed by a government agency but delivered by private providers
    Employer-sponsored insurance Private insurance provided by employers to their employees, often mandatory in many countries. Employers are required to provide a certain level of coverage to their employees.

    Conclusion

    • While insurance funding has brought benefits, it has also created challenges, including the erosion of compassion among health professionals and a diversion of funds from public to private hospitals. It is necessary to strike a balance between decentralization, insurance funding, and preserving the fundamental principles of equity, compassion, and excellence in care to maintain the success of Tamil Nadu’s public healthcare system.

    Mains Question

    Q. Highlight the benefits of decentralization in healthcare delivery. Analyse the benefits and drawbacks of insurance funding in India?

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  • Tuberculosis (TB): India’s Renewed Commitment

    TB

    “The theme of World TB Day 2023 — “Yes, we can end TB!”

    Central Idea

    • India’s National TB Elimination Programme has set a goal to eliminate TB by 2025. However, with India contributing 28% of the global TB burden and spending only 2.1% of its total budget on healthcare, the pace of program implementation has slowed down, especially during COVID-19. Increased investments and multi-sector collaboration are required to meet the target. 24 th March is marked as World TB day.

    Back to basics: TB

    • Tuberculosis is an infectious disease caused by bacteria called Mycobacterium tuberculosis.
    • It mainly affects the lungs, but can also affect other parts of the body such as the kidneys, spine, and brain.
    • TB spreads through the air when a person with active TB disease in the lungs or throat coughs, sneezes, or speaks.
    • Symptoms of TB include coughing that lasts for three or more weeks, chest pain, coughing up blood, fatigue, fever, and weight loss.
    • TB can be treated with antibiotics, but drug-resistant forms of TB are a growing concern.

    India’s Battle Against TB

    • International Union Against TB: India’s fight against TB began in 1929, when it joined the International Union Against Tuberculosis.
    • TB division: After independence, the Union government established a TB division under the Directorate General of Health Services with the Ministry of Health to oversee the plan.
    • National TB Control Programme: The National TB Institute was established in Bengaluru in 1959, and the National Tuberculosis Control Programme (NTP) was formulated in 1962. The Revised National TB Control Programme was developed in 1963.
    • National TB Elimination Programme: India’s National TB Elimination Programme now leads the effort to eliminate TB by 2025, five years ahead of the Sustainable Development Goals.
    • TB Harega Desh Jeetega: TB Harega Desh Jeetega (TB will lose, the nation will win) campaign to raise awareness about the disease and encourage people to get tested and treated.

    Challenges in Implementation

    • Lower budgetary allocation: India contributes 28% of the global TB burden, and as of 2022-23, it spends only 2.1% of its total budget on healthcare, the lowest among BRICS countries, and comparable to Bangladesh (2.5%) and Pakistan (3.4%).
    • Slow release of funds: The Joint Monitoring Mission Report 2019 by the Ministry of Health mentions that the slow release of funds has had a significant impact on the program’s effectiveness.
    • Low fund utilization: The low fund utilization has resulted in a lack of resources for critical TB control interventions such as early detection, diagnosis, and treatment.
    • COVID-19 slowed down implementation: Implementation of the TB program has slowed down with COVID-19 and requires further policy development, planning, and additional financing.

    Way Ahead: Opportunities for Collaboration

    • Different actors need to join hands to support the government’s inter-sectoral, multi-centric program approach for TB elimination and empower community response at the grass roots level.
    • Investing in strategic areas like diagnostics and access that have been barriers in the past is critical for reshaping the national TB strategy.
    • The theme of World TB Day 2023, “Yes, we can end TB!” conveys a message of hope that getting back on track to turn the tide against the TB epidemic is possible.

    Facts for Prelims: CB-NAAT

    • CB-NAAT stands for Cartridge-Based Nucleic Acid Amplification Test, which is a diagnostic test used to detect the presence of genetic material of certain types of bacteria, including Mycobacterium tuberculosis.
    • CB-NAAT is a highly sensitive and specific test that can detect MTB and drug-resistant strains of MTB in a short amount of time.
    • The test uses a small cartridge that contains all the necessary reagents and probes to detect MTB nucleic acid. The sample (usually sputum or other respiratory specimen) is mixed with the reagents and the cartridge is placed into a machine that performs the amplification and detection of the nucleic acid.
    • CB-NAAT has been endorsed by the World Health Organization (WHO) as a preferred test for the diagnosis of TB and drug-resistant TB.
    • The Government of India has launched a national program called Revised National TB Control Programme (RNTCP) to provide free diagnosis and treatment of TB, and CB-NAAT is a key component of this program.
    • However, the cost of the test remains a challenge, and efforts are underway to make the test more affordable and accessible to all.

    TB

    Conclusion

    • To successfully eliminate TB by 2025, India must prioritize sustainability through strategic investments, focusing on areas with the greatest need and adequately resourcing TB initiatives. With collaborative efforts and commitment, India can overcome its TB burden and achieve its ambitious target. Together, we can make it happen.

    Mains Question

    Q. Highlight the major initiatives taken by India to combat Tuberculosis and enumerate the challenges and way ahead towards achieving the goal of TB elimination by 2025.

     

     

  • ICMR releases Ethical Guidelines for AI usage in Healthcare

    health

    The Indian Council of Medical Research (ICMR) has recently released the first-ever set of ethical guidelines for the application of artificial intelligence (AI) in biomedical research and healthcare.

    Ethical Guidelines for AI usage in Healthcare

    • The guidelines aim to create “an ethics framework which can assist in the development, deployment, and adoption of AI-based solutions” in specific fields.
    • Through this initiative, the ICMR aims to make “AI-assisted platforms available for the benefit of the largest section of common people with safety and highest precision possible”.
    • It seeks to address emerging ethical challenges when it comes to AI in biomedical research and healthcare delivery.

    Key features

    • Effective and safe development, deployment, and adoption of AI-based technologies: The guidelines provide an ethical framework that can assist in the development, deployment, and adoption of AI-based solutions in healthcare and biomedical research.
    • Accountability in case of errors: As AI technologies are further developed and applied in clinical decision making, the guidelines call for processes that discuss accountability in case of errors for safeguarding and protection.
    • Patient-centric ethical principles: The guidelines outline 10 key patient-centric ethical principles for AI application in the health sector, including accountability and liability, autonomy, data privacy, collaboration, risk minimisation and safety, accessibility and equity, optimisation of data quality, non-discrimination and fairness, validity and trustworthiness.
    • Human oversight: The autonomy principle ensures human oversight of the functioning and performance of the AI system.
    • Consent and informed decision making: The guidelines call for the attainment of consent of the patient who must also be informed of the physical, psychological and social risks involved before initiating any process.
    • Safety and risk minimisation: The safety and risk minimisation principle is aimed at preventing “unintended or deliberate misuse”, anonymised data delinked from global technology to avoid cyber attacks, and a favourable benefit-risk assessment by an ethical committee among a host of other areas.
    • Accessibility, equity and inclusiveness: The guidelines acknowledge that the deployment of AI technology assumes widespread availability of appropriate infrastructure and thus aims to bridge the digital divide.
    • Relevant stakeholder involvement: The guidelines outline a brief for relevant stakeholders including researchers, clinicians/hospitals/public health system, patients, ethics committee, government regulators, and the industry.
    • Standard practices: The guidelines call for each step of the development process to follow standard practices to make the AI-based solutions technically sound, ethically justified, and applicable to a large number of individuals with equity and fairness.
    • Ethical review process: The ethical review process for AI in health comes under the domain of the ethics committee which assesses several factors including data source, quality, safety, anonymization, and/or data piracy, data selection biases, participant protection, payment of compensation, possibility of stigmatisation among others.

    Policy moves for streamlining AI in Healthcare

    • India already offers streamlining of AI technologies in various sectors, including healthcare, through the National Health Policy (2017), National Digital Health Blueprint (NDHB 2019), and Digital Information Security in Healthcare Act (2018) proposed by the Health Ministry.
    • These initiatives pave the way for the establishment of the National Data Health Authority and other health information exchanges.

    Potential applications of AI in healthcare

    Artificial Intelligence (AI) has revolutionized the healthcare industry by enabling various applications. These applications include:

    • Diagnosis and screening: AI can be used to identify diseases from medical images like X-rays, CT scans, and MRIs.
    • Therapeutics: AI can assist in the development of personalised medicines by analyzing a patient’s genetic makeup.
    • Preventive treatments: AI can predict the risk of developing a disease, helping healthcare professionals to take preventive measures.
    • Clinical decision-making: AI can analyze large amounts of data to assist healthcare professionals in making treatment decisions.
    • Public health surveillance: AI can be used to monitor disease outbreaks and inform public health policies.
    • Complex data analysis: AI can analyze large amounts of data from multiple sources to identify patterns and inform healthcare decision-making.
    • Predicting disease outcomes: AI can predict disease outcomes based on patient data, enabling early
    • Behavioural and mental healthcare: AI can help diagnose and treat mental health conditions.
    • Health management systems: AI can assist in managing patient records, appointment scheduling and reminders, and medication management.

    Various challenges for imbibing

    • Data privacy and security: With the use of AI in healthcare, there is a significant amount of personal and sensitive data is collected. This data needs to be kept secure and protected from potential cyber-attacks.
    • Regulatory and ethical issues: AI technology is still in its early stages of development and there are no clear guidelines or regulations in place for its use in healthcare. There are also ethical considerations, such as accountability, transparency, and bias that need to be addressed.
    • High cost involved: The implementation of AI in healthcare requires significant investment in terms of infrastructure, software, and training. This cost can be a major challenge for healthcare organizations, especially in developing countries.
    • Integration with existing systems: AI systems need to be integrated with existing healthcare systems and processes. This can be challenging, especially in cases where the existing systems are outdated or incompatible with AI technology.
    • Lack of trust and acceptance: AI technology is still relatively new in healthcare and there is a lack of trust and acceptance among healthcare professionals and patients. This can be a major hurdle in the widespread adoption of AI in healthcare.

    Threats posed by AI to healthcare

    • Data privacy and security: The use of AI in healthcare requires the collection and analysis of vast amounts of personal health data, which could be at risk of being stolen or misused.
    • Bias and discrimination: There is a risk that AI algorithms could perpetuate existing biases and inequalities in healthcare, such as racial or gender bias.
    • Lack of transparency: Some AI models are complex and difficult to understand, which can make it difficult to explain the reasoning behind a particular decision.
    • Medical errors: AI systems can make errors if they are trained on biased or incomplete data, or if they are used inappropriately.
    • Ethical concerns: There are several ethical concerns associated with the use of AI in healthcare, including the potential for AI to replace human doctors, the impact on patient autonomy, and the implications for informed consent.

    Way forward

    • Develop a national AI strategy for healthcare: This strategy should include policies for data sharing, privacy, and security, as well as guidelines for the ethical and responsible use of AI.
    • Invest in AI research and development: The government should invest in research and development of AI technologies that can help address the challenges in healthcare.
    • Promote collaboration between stakeholders: Collaboration between stakeholders such as healthcare providers, researchers, government agencies, and industry can help accelerate the development and adoption of AI technologies in healthcare.
    • Train healthcare professionals in AI: The government can work with academic institutions and the industry to create training programs and certifications for healthcare professionals.
    • Address regulatory challenges: The government should work to address regulatory challenges related to the use of AI in healthcare.
    • Focus on affordability and accessibility: This can be achieved by promoting innovation, encouraging competition, and ensuring that AI technologies are integrated into existing healthcare infrastructure.

     

  • Family Courts: Need for Expansion and Reforms

    Central Idea

    • Mumbai’s only family court, inundated with divorce applications and family disputes, showcases a range of emotions and highlights the need for additional family courts to better address these complex and sensitive issues.

    The Nature of Family Court Cases

    • Mostly divorce cases: Common grounds for divorce include domestic violence, adultery, and dowry, but absurd reasons can also be found among the cases.
    • Other issues and counselling: Family courts handle not only divorce cases but also maintenance, child custody, and alimony cases, with judges first suggesting counseling for couples seeking to end their marriages.
    • Emotional scenes: Family courts witness heightened emotions, such as anger, blame, heartbreak, relief, and joy, as people struggle with the consequences of broken relationships.
    • Inequal treatment: Instances of inequality in the judicial system are evident, with influential individuals sometimes receiving preferential treatment.
    • Role of technology and empathy: During the COVID-19 pandemic, non-custodial parents sought to maintain contact with their children through video calls.
    • For instance: A lactation room was recently inaugurated at the Bandra family court to provide a refuge for women with infants amidst child custody and divorce proceedings.

    Why Family courts were established?

    • Family courts were established to provide a forum for speedy settlement of family-related disputes, emphasizing non-adversarial conflict resolution and promoting conciliation.

    What are the challenges faced by Family courts in India?

    • Backlog of cases: One of the most significant challenges faced by family courts in India is the backlog of cases. Family disputes are often complex and require a significant amount of time to resolve, which results in long waiting periods for litigants.
    • Lack of infrastructure: Many family courts in India lack adequate infrastructure, such as courtrooms, staff, and equipment, which makes it difficult to manage cases efficiently.
    • Shortage of judges: There is a shortage of judges in family courts, leading to delays in the disposal of cases.
    • Low awareness: Many people in India are not aware of the role and functions of family courts, which often leads to confusion and delays in the resolution of disputes.
    • Socio-cultural factors: In many cases, socio-cultural factors such as patriarchy, gender discrimination, and dowry-related issues pose significant challenges to family courts in India.
    • Limited jurisdiction: Family courts in India have limited jurisdiction and can only hear certain types of cases related to family disputes. This can result in some cases being heard by multiple courts, leading to delays and confusion.

    The Need for Expansion and Reform in Family Courts: A Case of Mumbai’s family court

    • With over 5,000 divorce cases pending in Mumbai’s family court, frivolous applications and counter-applications add to the pendency of cases and negatively impact children.
    • The current seven judges at Mumbai’s family court are insufficient to handle the caseload, and the promise of 14 additional family courts in Mumbai, along with one each in Thane and Navi Mumbai, is a much-needed and welcome move.

    Conclusion

    • Mumbai’s family court reveals the complexity and emotional intensity of family disputes, and the urgent need for additional family courts to better address these sensitive issues. Expanding the number of family courts will help ensure that more families receive the support and resolution they need during these challenging times.

    Mains Question

    Q. Establish the purpose of Family courts. Discuss the challenges faced by family court in India.

     

     

  • Strengthening the Fight Against Tuberculosis (TB)

    Tuberculosis

    Central Idea

    • The fight against tuberculosis (TB) has been going on for over 30 years since it was declared a global health emergency, yet the goal of ending TB by 2030 is still uncertain. The fight against TB needs a renewed focus on three key areas i.e., vaccine development, newer therapeutic agents, and improved diagnostics to meet the goal of ending TB by 2030.

    Background

    • In 1993, the World Health Organization declared TB a global health emergency and the 1993 World Development Report stated that TB treatment for adults was the best buy among all developmental interventions.
    • Since then, the global response to TB has been slow and lacks urgency.

    Global Fund

    • The Global Fund to Fight AIDS, TB, and Malaria was created in response to the call for action against TB at the G7 summit in Okinawa, Japan, in 2001.
    • The Global Fund has become the single largest channel of additional funding for global TB control.
    • However, it faces constraints due to zero-sum games from donor constituents and competition between the three diseases it finances.

    Tuberculosis

    StopTB Partnership

    • The StopTB Partnership was constituted to mobilize and marshal a disparate set of actors towards the goal of ending TB.
    • It has been adapting to changes, such as using molecular diagnostic tools developed to respond to bioterrorism to diagnose TB and using social safety programs to address the poverty drivers of the TB epidemic.

    Facts for prelims: Basics of TB

    • Tuberculosis is an infectious disease caused by bacteria called Mycobacterium tuberculosis.
    • It mainly affects the lungs, but can also affect other parts of the body such as the kidneys, spine, and brain.
    • TB spreads through the air when a person with active TB disease in the lungs or throat coughs, sneezes, or speaks.
    • Symptoms of TB include coughing that lasts for three or more weeks, chest pain, coughing up blood, fatigue, fever, and weight loss.
    • TB can be treated with antibiotics, but drug-resistant forms of TB are a growing concern.

    Tuberculosis

    Three key areas that need attention

    1. Vaccine development:
    • The development of an adult TB vaccine is the first area that needs urgent attention.
    • The current vaccine is 100 years old, and the development and wide use of an adult TB vaccine are essential to ending TB.
    • COVID-19 vaccine development process provides insights into accelerating the process.
    • India’s capabilities can play a significant role in vaccine development and equitable distribution.
    1. Newer therapeutic agents for TB:
    • A few new anti-TB drugs are available but face cost and production constraints.
    • Shorter, injection-free regimens are needed to improve compliance and reduce patient fatigue.
    • A continuous pipeline of new drugs is essential to combat drug resistance.
    1. Improved diagnostics:
    • AI-assisted handheld radiology and passive surveillance of cough sounds can revolutionize TB diagnostics.
    • Incentivize biotech startups to disrupt the complexity and price barriers of molecular testing.

    Tuberculosis

    Conclusion

    • India’s leadership role in the G20 and the upcoming StopTB Partnership board meeting in Varanasi provide the perfect opportunity for India to lead the way in ending TB. With the collective will and action of leaders, it is possible to end TB sooner rather than later.
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