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Subject: Governance

Important aspects of Society

  • Strengthening healthcare through ABHIM

    Context

    The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (ABHIM), announced recently, seeks to realise greater investment in the health system as proposed in the Budget, implement the Fifteenth Finance Commission recommendations such as strengthening of urban and rural primary care, stronger surveillance systems and laboratory capacity.

    Measures of ABHIM

    • It will support infrastructure development of 17,788 rural health and wellness centres (HWCs) in seven high-focus States and three north-eastern States.
    • In addition, 11,044 urban HWCs will be established in close collaboration with Urban Local Bodies.
    • The various measures of this scheme will extend primary healthcare services across India.
    • Areas like hypertension, diabetes and mental health will be covered, in addition to existing services.
    • Support for 3,382 block public health units (BPHUs) in 11 high-focus States and establishment of integrated district public health laboratories in all 730 districts will strengthen capacity for information technology-enabled disease surveillance.
    • To enhance the capabilities for microbial surveillance, a National Platform for One Health will be established.
    • Four Regional National Institutes of Virology will be established.
    • Laboratory capacity under the National Centre for Disease Control, the Indian Council of Medical Research and national research institutions will be strengthened.
    • Fifteen bio-safety level III labs will augment the capacity for infectious disease control and bio-security.

    Way forward

    • There is a need to train and deploy a larger and better skilled health workforce.
    • We must scale up institutional capacity for training public health professionals.
    • Private sector participation in service delivery may be invited by States, as per need and availability.
    • ABHIM, if financed and implemented efficiently, can strengthen India’s health system by augmenting capacity in several areas and creating a framework for coordinated functioning at district, state and national levels.
    • Many independently functioning programmes will have to work with a common purpose by leaping across boundaries of separate budget lines and reporting structures.
    • That calls for a change of bureaucratic mindsets and a cultural shift in Centre-State relations.

    Conclusion

    The ABHIM can fix the weaknesses in India’s healthcare system.

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  • Preparing for outbreaks

    Context

    Prime Minister Narendra Modi launched the Ayushman Bharat Health Infrastructure Mission, one of the largest pan-India schemes for strengthening healthcare infrastructure, in his parliamentary constituency Varanasi in Uttar Pradesh.

    Aims of Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (ABHIM) and how it seeks to achieve it

    • This was launched with an outlay of â‚č64,180 crore over a period of five years.
    •  In addition to the National Health Mission, this scheme will work towards strengthening public health institutions and governance capacities for wide-ranging diagnostics and treatment, including critical care services.
    • The latter goal would be met with the establishment of critical care hospital blocks in 12 central institutions such as the All India Institute of Medical Sciences, and in government medical colleges and district hospitals in 602 districts.
    • Laboratories and their preparedness: The government will be establishing integrated district public health labs in 730 districts to provide comprehensive laboratory services.
    • Research: ABHIM will focus on supporting research on COVID-19 and other infectious diseases, including biomedical research to generate evidence to inform short-term and medium-term responses to such pandemics.
    • One health approach: The government also aims to develop a core capacity to deliver the ‘one health’ approach to prevent, detect, and respond to infectious disease outbreaks in humans and animals.
    • Surveillance labs: A network of surveillance labs will be developed at the block, district, regional and national levels for detecting, investigating, preventing, and combating health emergencies and outbreaks.
    • Local capacities in urban areas: A major highlight of the current pandemic has been the requirement of local capacities in urban areas.
    • The services from the existing urban primary health centres will be expanded to smaller units – Ayushman Bharat Urban Health and Wellness Centres and polyclinics or specialist clinics.

    Conclusion

    The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (ABHIM) is another addition to the arsenal we have to prepare for such oubreaks in the future.

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  • Ayushman Bharat Health Infrastructure Mission

    PM has launched the Ayushman Bharat Health Infrastructure Mission (AB-HIM), one of the largest pan-India schemes for strengthening healthcare infrastructure.

    AB- Health Infrastructure Mission

    • AB-HIM is being rolled out as India’s largest scheme to scale up health infrastructure.
    • It is aimed at ensuring a robust public health infrastructure in both urban and rural areas, capable of responding to public health emergencies or disease outbreaks.

    Key features

    • Health and Wellness Centres: In a bid to increase accessibility it will provide support to 17,788 rural HWC in 10 ‘high focus’ states and establish 11,024 urban HWC across the country.
    • Exclusive Critical Care Hospital Blocks: It will ensure access to critical care services in all districts of the country with over five lakh population through ‘Exclusive Critical Care Hospital Blocks’.
    • Integrated public health labs: will also be set up in all districts, giving people access to “a full range of diagnostic services” through a network of laboratories across the country.
    • Disease surveillance system: The mission also aims to establish an IT-enabled disease surveillance system through a network of surveillance laboratories at block, district, regional and national levels.
    • Integrated Health Information Portal: All the public health labs will be connected through this Portal, which will be expanded to all states and UTs, the PMO said.

    Why is the scheme significant?

    • India has long been in need of a ubiquitous healthcare system.
    • A 2019 study has highlighted how access to public health care remained elusive to those living on the margins.
    • The study found that 70 per cent of the locations have public healthcare services.
    • However, availability was less in rural areas (65 per cent) compared to urban areas (87 per cent).
    • In 45 per cent of the surveyed locations, people could access healthcare services by walking, whereas in 43 per cent of the locations they needed to use transport.

     

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  • Mullaperiyar Dam Issue

    The Supreme Court has directed the Supervisory Committee to take an immediate and firm decision on the maximum water level that can be maintained at Mullaperiyar dam amidst torrential rains in Kerala.

    What is the news?

    • A report by United Nations has stated that the Mullaperiyar dam, situated in a seismically active area, faces the risk of failure.
    • Earlier this year, the Supreme Court warned the TN Chief Secretary against the failure to give information on the rule curve for dam which decides the discharge of excess water.

    Mullaperiyar Dam

    • It is a masonry gravity dam on the Periyar River in Kerala.
    • It is located on the Cardamom Hills of the Western Ghats in Thekkady, Idukki District.
    • It was constructed between 1887 and 1895 by John Pennycuick and also reached in an agreement to divert water eastwards to the Madras Presidency area.
    • It has a height of 53.6 m (176 ft) from the foundation, and a length of 365.7 m (1,200 ft).

    Operational issue

    • The dam is located in Kerala but is operated and maintained by Tamil Nadu.
    • The catchment area of the Mullaperiyar Dam itself lies entirely in Kerala and thus not an inter-State river.
    • In November 2014, the water level hit 142 feet for first time in 35 years.
    • The reservoir again hit the maximum limit of 142 feet in August 2018, following incessant rains in the state of Kerala.
    • Indeed, the tendency to store water to almost the full level of reservoirs is becoming a norm among water managers across States.

    The dispute: Control and safety of the dam

    • Supreme court judgment came in February 2006, has allowed Tamil Nadu to raise the level of the dam to 152 ft (46 m) after strengthening it.
    • Responding to it, the Mullaperiyar dam was declared an ‘endangered’ scheduled dam by the Kerala Government under the disputed Kerala Irrigation and Water Conservation (Amendment) Act, 2006.
    • For Tamil Nadu, the Mullaperiyar dam and the diverted Periyar waters act as a lifeline for Theni, Madurai, Sivaganga, Dindigul and Ramnad districts.
    • Tamil Nadu has insisted on exercising the unfettered colonial rights to control the dam and its waters, based on the 1886 lease agreement.

    Rule of Curve issue

    • A rule curve or rule level specifies the storage or empty space to be maintained in a reservoir during different times of the year.
    • It decides the fluctuating storage levels in a reservoir.
    • The gate opening schedule of a dam is based on the rule curve. It is part of the “core safety” mechanism in a dam.
    • The TN government often blames Kerala for delaying the finalization of the rule curve.

     

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  • What the low rank on the Global Hunger Index means for India

    Context

    This year’s Global Hunger Index (GHI) ranks India 101 out of 116 countries for which reliable and comparable data exist.

    Government’s stand

    • Is India’s performance on hunger as dismal as denoted by the index or is it partly a statistical artefact?
    • This question assumes immediacy, especially since the government has questioned the methodology and claimed that the ranking does not represent the ground reality.
    • This calls for careful scrutiny of the methodology, especially of the GHI’s components.

    Understanding the GHI methodology

    • The GHI has four components.
    • The first — insufficient calorie intake — is applicable for all age groups.
    • The data on deficiency in calorie intake, accorded 33% weight, is sourced from the Food and Agriculture Organization’s Suite of Food Security Indicators (2021).
    • The remaining three — wasting (low weight for height), stunting (low height for age) and mortality — are confined to children under five years.
    • The data on child wasting and stunting (2016-2020), each accounting for 16.6% of weight, are from the World Health Organization, UNICEF and World Bank, complemented with the latest data from the Demographic and Health Surveys.
    • Under-five mortality data are for 2019 from the UN Inter-Agency Group for Child Mortality Estimation.

    Issues with GHI

    • The GHI is largely children-oriented with a higher emphasis on undernutrition than on hunger and its hidden forms, including micronutrient deficiencies.
    • The first component — calorie insufficiency — is problematic for many reasons.
    • The lower calorie intake, which does not necessarily mean deficiency, may also stem from reduced physical activity, better social infrastructure (road, transport and healthcare) and access to energy-saving appliances at home, among others.
    • For a vast and diverse country like India, using a uniform calorie norm to arrive at deficiency prevalence means failing to recognise the huge regional imbalances in factors that may lead to differentiated calorie requirements at the State level.

    Understanding the connection between stunting and wasting and ways to tackling them

    • India’s wasting prevalence (17.3%) is one among the highest in the world.
    •  Its performance in stunting, when compared to wasting, is not that dismal, though.
    • Child stunting in India declined from 54.2% in 1998–2002 to 34.7% in 2016-2020, whereas child wasting remains around 17% throughout the two decades of the 21st century.
    • Stunting is a chronic, long-term measure of undernutrition, while wasting is an acute, short-term measure.
    • Quite possibly, several episodes of wasting without much time to recoup can translate into stunting.
    • Effectively countering episodes of wasting resulting from such sporadic adversities is key to making sustained and quick progress in child nutrition.
    • Way forward: If India can tackle wasting by effectively monitoring regions that are more vulnerable to socioeconomic and environmental crises, it can possibly improve wasting and stunting simultaneously.

    Low child mortality

    • India’s relatively better performance in the other component of GHI — child mortality — merits a mention.
    • Studies suggest that child undernutrition and mortality are usually closely related, as child undernutrition plays an important facilitating role in child mortality.
    • However, India appears to be an exception in this regard.
    • This implies that though India was not able to ensure better nutritional security for all children under five years, it was able to save many lives due to the availability of and access to better health facilities.

    Conclusion

    The low ranking does not mean that India fares uniformly poor in every aspect. This ranking should prompt us to look at our policy focus and interventions and ensure that they can effectively address the concerns raised by the GHI, especially against pandemic-induced nutrition insecurity.

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  • NEET hasn’t created the equality of opportunity

    Context

    The Tamil Nadu government has passed an Act seeking an exemption from treating NEET as the sole and mandatory requirement for medical admission in the state. The Act, which is yet to get approval from the President.

    NEET issue in Tamil Nadu

    • The Justice A K Rajan committee was appointed by the state government of Tamil Nadu to examine whether NEET is an equitable method of selection.
    • Its report lends credence to the belief that NEET tends to give an advantage to students from privileged backgrounds.
    • It also observed that NEET, in terms of orientation, is biased towards the Central Board of Secondary Education (CBSE).
    • In the section titled ‘Size of coaching market’, the report brings out two poignant facts.
    • One, by inadvertently creating a “market for coaching”, NEET has helped to create an “extractive industry of coaching” as an essential condition for clearing it.
    • Two, the coaching fees are not only high, but are beyond the reach of many, especially the poor and marginalised.
    • Acting upon the committee’s recommendation, the Tamil Nadu government has passed an Act seeking an exemption from treating NEET.
    • The Act, which is yet to get approval from the President.
    •  An educational intervention which was introduced as a solution to foster equality of opportunity has turned out to be the primary cause of deepening inequality of participation and opportunity.

    Important questions

    • There are at least two important questions.
    • Equality of opportunity: First, does NEET help foster equality of opportunity for everyone without unduly advantaging or disadvantaging anyone?
    • Second, is NEET’s bias towards CBSE justifiable in an immensely diverse country like ours, where varied school curricula coexist with a highly unequal access to financial and educational resources and opportunities?
    • The question here is: How can NEET promote parity of participation when aspiring first-generation students from marginalised and poor households participate from a highly unequal position in the first place?
    • NEET disregards the fact that the terms and conditions of participation are highly unequal and biased.

    Way forward

    • The National Education Policy (NEP 2020) envisions a curriculum and pedagogy which will promote holistic learning, social responsibility and multilingualism, among other things.
    • It is important, therefore, to significantly restructure the focus of NEET keeping in mind the spirit of NEP and varied school curricula in regional languages.

    Conclusion

    A restructured NEET, which does not require intensive and repeated coaching as a prerequisite and is not biased towards any board, can go a long way in promoting the parity of participation and nourishing the capacity to aspire, especially of the poor and marginalised.

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  • Why India’s bureaucracy needs urgent reform

    Context

    The bureaucracy that took India through the last 75 years can’t be the one to take it through the next 75 — we need a proactive, imaginative, technology-savvy, enabling bureaucracy.

    Role of bureaucracy and challenges it faces

    • The civil services, and the Indian Administrative Service (IAS) in particular played important role in holding India together post-Independence.
    • Much of the impressive nation-building across sectors happened because of their dedication and commitment.
    • It is also forgotten that the bureaucracy, unlike the private sector, is a creature of the Constitution and is bound by multiple rules, laws, and procedures.
    • Understaffed: As per estimates compiled by the Institute of Conflict Management, the government of India (GOI) has about 364 government servants for every 1,00,000 residents, with 45 per cent in the railways alone.
    • About 60 per cent and 30 per cent are in Groups C and D, respectively, leaving a skeletal skilled staff of just about 7 per cent to man critical positions.
    • We are grossly understaffed.
    • Inaction: Further, faced with extensive judicial overreach reporting to an often rapacious, short-sighted political executive, and a media ever ready to play the role of judge, jury and executioner, the bureaucracy has in large part found comfort in inaction and ensuring audit-proof file work.

    Suggestions

    • Get out of business: That we need not be in many sectors is well-recognised — leave them to the markets — and politicians must get bureaucrats out of business, in more ways than one.
    • Prevent punitive actions: To increase the officers’ willingness to take decisions, one possible solution is to legally prevent enforcement agencies from taking punitive action, like arrest for purely economic decisions without any direct evidence of kickbacks.
    • Lateral entry: The toughest challenge is to change an inactive bureaucracy to one that feels safe in taking genuine risks.
    • Lateral entry needs to expand to up to 15 per cent of Joint/Additional and Secretary-level positions in GOI.
    • Recruitment process: Changes in recruitment procedures, like the interview group spending considerable time with the candidates, along with psychometric tests, will improve the incoming pool of civil servants.
    • Evaluation: Most importantly, after 15 years of service, all officers must undergo a thorough evaluation to enable them to move further, and those who do not make it should be put out to pasture.
    • Adoption of technology: Every modern bureaucracy in the world works on technology-enabled productivity and collaboration tools.
    •  India procures about $600 billion worth of goods and services annually — can’t all payments be done electronically?

    Consider this question ” The civil services held India together after Independence, but if the country’s potential is to be realised, existing problems of inefficiency and inaction must be fixed. In light of this, examine the factors reasponsible for inefficiency and suggest the reforms.”

    Conclusion

    India cannot hope to get to a $5-trillion economy without a modern, progressive, results-oriented bureaucracy, one which says “why not?” instead of “why?” when confronted with problems.

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  • India ranked 101 in Global Hunger Index (GHI)

    The Global Hunger Index 2021 has ranked India at 101 positions out of a total 116 countries.

    Note the parameters over which the GHI is based and their weightage composition.

    Global Hunger Index (GHI)

    • The Global Hunger Index is a peer-reviewed annual report, jointly published by Concern Worldwide and Welthungerhilfe.
    • It determines hunger on a 100-point scale, where 0 is the best possible score (no hunger) and 100 is the worst.
    • It is designed to comprehensively measure and track hunger at the global, regional, and country levels.
    • The aim of the GHI is to trigger action to reduce hunger around the world.

    For each country in the list, the GHI looks at four indicators:

    1. Undernourishment (which reflects inadequate food availability): calculated by the share of the population that is undernourished (that is, whose caloric intake is insufficient)
    2. Child Wasting (which reflects acute undernutrition): calculated by the share of children under the age of five who are wasted (that is, those who have low weight for their height)
    3. Child Stunting (which reflects chronic undernutrition): calculated by the share of children under the age of five who are stunted (that is, those who have low height for their age)
    4. Child Mortality (which reflects both inadequate nutrition and unhealthy environment): calculated by the mortality rate of children under the age of five

    India’s (poor) performance

    • India is among the 31 countries where hunger has been identified as serious.
    • Only 15 countries fare worse than India.
    • Some of these include Afghanistan (103), Nigeria (103), Congo (105), Mozambique (106), Sierra Leone (106), Timor-Leste (108), Haiti (109), Liberia (110), Madagascar (111) and Somalia (116).
    • India was also behind most of the neighbouring countries.
    • Pakistan was placed at 92 rank, Nepal at 76 and Bangladesh also at 76.

    Reasons for such poor performance

    • Poor maternal health: Mothers are too young, too short, too thin and too undernourished themselves, before they get pregnant, during pregnancy, and then after giving birth, during breast-feeding.
    • Poor sanitation: Poor sanitation, leading to diarrhoea, is another major cause of child wasting and stunting.
    • Food insecurity: Low dietary diversity in India is also a key factor in child malnutrition.
    • Poverty: Almost 50 million households in India are dependent on these small and marginal holdings.
    • Livelihood loss: The rural livelihoods loss after COVID and lack of income opportunities other than the farm sector have contributed heavily to the growing joblessness in rural areas.

    Issues over credibility of GHI

    • India has ranked among many African countries while it is among the top 10 food-producing countries in the world.

     

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  • On Digital Health ID, proceed with caution

    Much recently, the Prime Minister had launched the Digital Health ID project (DHID), generating debate on issues related to the use of technology in a broken health system.

    Explained: Digital Health ID

    Good intents of the DHID

    • The key objective of DHID is to improve the quality, access and affordability of health services by making the service delivery “quicker, less expensive and more robust”.
    • The ambition is undoubtedly high. Given that health systems are highly complex, the DHID would hardly be able to address some of the issues plaguing it.

    Why need DHID?

    (a) Record maintenance

    • The use of technology for record maintenance is not just inevitable but necessary. Its time has certainly come.
    • A decade ago, the process to shift towards electronic medical records was initiated in the private sector.
    • It met with limited success, despite the strong positives.
    • With DHID, the burden of storing and carrying health records for every visit to the doctor is minimised.

    (b) Better tracking of medical history

    • The doctor has instant access to the patient’s case history –the treatment undertaken, where and with what outcomes — enabling more accurate diagnosis and treatment.
    • As the DHID enables portability across geography and healthcare providers, it also helps reduce re-testing or repeating problems every time a patient consults a new doctor.
    • That’s a huge gain, impacting the quality of care and enhancing patient satisfaction and confidence.

    (c) Better Diagnosis

    • DHID can have a transformative impact in promoting ecosystems that function as paperless facilities.
    • Paperless hospitals can promote early diagnosis before the patient reaches the doctor after spending long hours in queue.
    • The doctor can already go through the patient’s record and the pharmacist can make the drugs available by the time the patient reached its counter.

    (d) Promoting medical research

    • Digitisation of medical records is another important positive, given the problems related to space and retrieving huge databases.
    • Well organised repositories that enable easy access to records can stimulate much-needed research on medical devices and drugs.
    • This storehouse of patient data can be valuable for clinical and operational research.

    Given our population, would this be an idealistic expectation?

    • We need to conduct pilot studies to assess the use of technology for streamlining patient flows and medical records and thereby increase efficiencies across different typologies of hospitals and facilities.
    • While technology helps smoothen processes and enhance patient experience, there is a cost attached.
    • Investments have to be made upfront and results should not be expected overnight.

    Issues with DHID

    (a) A costly affair

    • In the immediate short run, DHID will increase administrative costs by about 20 per cent, due to the capital investment in data infrastructure.
    • Over the long run, the additional cost to healthcare is expected to be about 2 per cent.
    • Any scaling up of this reform would require extensive fiscal subsidies and more importantly providing techno-logistical support to both government and private hospitals.

    (b) Privacy concerns

    • Most important is the issue of privacy, the high possibility of hacking and breach of confidentiality.
    • The possibility of privacy being violated increases with the centralisation of all information.
    • Though it is said that the patient is the owner of the information, how many of us deny access, as a matter of routine, when we download apps or programmes that seek access to all our records?
    • How far is this “consent” practical for an illiterate, vulnerable patient desperate to get well?
    • So, taking refuge behind a technical statement that access is contingent on patient consent is unconvincing.

    Ground situation in India

    • Inherently unaffordable healthcare: The costs in the Indian context can be high and that should lead to a careful assessment of the project.
    • Digital divide: Such a scenario is not inconceivable and in the case of health, may cause immense hardship to the most marginalised sections of our population.
    • Infrastructure gap: A large majority of facilities do not have the required physical infrastructure — electricity, accommodation, trained personnel.
    • Usual nature of technical glitches: Cards getting corrupted, servers being down, computers crashing or hanging, and power outages are common in India.
    • Conformity over data synchronization: The inability to synchronise biometric data with ID cards has resulted in large-scale exclusions of the poor from welfare projects.
    • Accuracy of records: Besides, the efficacy of the DHID hinges on the assumption that every visit and every drug consumed by the patient is faithfully and accurately recorded.
    • Increased workload on Medical Professionals: Moreover, while electronic mapping of providers may enable patients to spot a less busy doctor near their location, it is simplistic to assume that the patient will go there.

    Plugging the existing gaps

    • Patient preference for a doctor is dependent upon perception and trust. Likewise, teleconsultations need a huge backend infrastructure and organisation.
    • Teleconsulting has certainly helped patients access medical advice for managing minor ailments, getting prescriptions on the phone and even getting drugs delivered home.
    • But in handling chronic diseases that necessitate continuity of care, teleconsultations have been problematic and cannot be substituted for actual physical examination.
    • Continuity of care is central to good outcomes in inpatient management of chronic diseases.
    • The one serious shortcoming of using teleconsultation for such management is the high attrition rate of doctors within the context of an overall shortage of doctors.
    • Technology can be of little use in the absence of doctors and basic infrastructure.

    Way forward

    • What is needed is building very robust firewalls and trust.
    • Seeing the frequency with which Aadhaar cards have been breached, it is not unreasonable to be concerned with this issue and the implications it has at the family and societal levels.
    • For this reason, instead of a big bang approach, it is better to go slow and steady.
    • That’s the only way to ensure that a good policy does not die along the way due to poor implementation.

     

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  • Reimagining food systems with lessons from India

    Context

    The first and historic United Nations Food Systems Summit (UNFSS) 2021 was held in September this year.

    Significance of food system transformation

    • Global food systems are the networks that are needed to produce and transform food, and ensure it reaches consumers, or the paths that food travels from production to plate.
    • Global food systems are in a state of crisis in many countries affecting the poor and the vulnerable.
    • In terms of larger goals, the food system transformation is considered essential in achieving the sustainable development agenda 2030.
    • This makes strong sense as 11 Sustainable Development Goals (SDGs) out of 17 are directly related to the food system.

    Achievements of the Food Systems Summit

    • The summit created a mechanism for serious debates involving UN member states, civil society, non-governmental organisations, academics, researchers, individuals, and the private sector.
    • The debate and response focused on five identified action tracks namely: Ensure access to safe and nutritious food for all; Shift to sustainable consumption patterns; Boost nature-positive production; Advance equitable livelihoods, and Build resilience to vulnerabilities, shocks, and stress.
    • The Statement of Action emerging from the summit offers a concise set of ambitious, high-level principles and areas for action to support the global call to “Build back better” after the COVID-19 pandemic.

    Lessons from India’s experience with food systems

    • India’s long journey from food shortage to surplus food producer offers several lessons for other developing countries.
    • The learnings encompassed elements of nutritional health, food safety and standards, sustainability, deployment of space technology, and the like.
    • Safety nets: One of India’s greatest contributions to equity in food is its National Food Security Act 2013 that anchors the Targeted Public Distribution System (TPDS), the Mid-Day meals (MDM), and the Integrated Child Development Services (ICDS).
    • Today, India’s food safety nets collectively reach over a billion people.
    • Food safety nets and inclusion are linked with public procurement and buffer stock policy.
    • Challenge of climate change: Climate change and unsustainable use of land and water resources are the most formidable challenges food systems face today.
    • The latest Intergovernmental Panel on Climate Change (IPCC) report has set the alarm bells ringing, highlighting the urgency to act now.
    • Nutrition and food diversity: Dietary diversity, nutrition, and related health outcomes are another area of concern as a focus on rice and wheat has created nutritional challenges of its own.
    • India has taken a bold decision to fortify rice supplied through the Public Distribution System with iron.
    • Low nutrition: Despite being a net exporter and food surplus country at the aggregate level, India has a 50% higher prevalence of undernutrition compared to the world average.
    • But the proportion of the undernourished population declined from 21.6% during 2004-06 to 15.4% during 2018-20.
    • Food wastage: Reducing food wastage or loss of food is a mammoth challenge and is linked to the efficiency of the food supply chain. Food wastage in India exceeds â‚č1-lakh crore.

    Need to eliminate hunger

    • ‘The State of Food Security and Nutrition in the World’ report, estimates that around a tenth of the global population was undernourished last year.
    • Hunger and food insecurity are key drivers of conflict and instability across the world.
    • The Nobel Peace Prize 2020 conferred on the United Nations WFP highlighted the importance of addressing hunger to prevent conflicts and create stability.

    Way forward

    • Collaboration: We must collaborate to invest, innovate, and create lasting solutions in sustainable agriculture contribution to equitable livelihood, food security, and nutrition.
    • Lessons from India: India has so much to offer from its successes, and learning also, to prepare itself for the next 20 to 30 years.
    • There is a need to reimagining the food system towards the goal of balancing growth and sustainability, mitigating climate change, ensuring healthy, safe, quality, and affordable food, maintaining biodiversity, improving resilience, and offering an attractive income and work environment to smallholders and youth.

    Conclusion

    We are on the cusp of a transformation to make the world free of hunger by 2030 and deliver promises for SDGs, with strong cooperation and partnership between governments, citizens, civil society organisations, and the private sector.