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Subject: Governance

Important aspects of Society

  • In India, reproductive autonomy remains a pipedream

    Central idea

    • A recent Supreme Court case in India has spotlighted reproductive autonomy. It centers on a 27-year-old mother of two, grappling with an unwanted pregnancy due to lactational amenorrhea, igniting a debate on India’s abortion rights, known for their relative liberalism.

    Background

    • India’s population policy promotes a two-child norm, making it seemingly unremarkable for a woman to seek an abortion to avoid becoming a mother for the third time.
    • However, this case is far from straightforward due to the pregnancy being at 26 weeks, exceeding the gestational limit prescribed in the 2021 Medical Termination of Pregnancy (MTP) Act.
    • In such cases, medical practitioners’ opinions hold paramount importance.

    Reproductive Autonomy vs. Ethical Concerns

    • Interchangeable Terminology: The heart of the matter lies in the interchangeable use of terms like foetus, child, and baby, particularly given the advanced stage of pregnancy. This linguistic flexibility can significantly impact the ethical considerations of the case.
    • Concerns of Foeticide: As the pregnancy had reached 26 weeks, concerns emerged regarding the termination possibly constituting “foeticide.” The advanced stage of pregnancy blurs the line between a developing foetus and a potentially viable child, leading to ethical dilemmas.
    • Justice Nagarathna’s Emphasis: Justice Nagarathna emphasized the paramount importance of prioritizing the petitioner’s decision and upholding her reproductive autonomy. Her stance echoes Justice D Y Chandrachud’s earlier observation regarding the intrinsic right of pregnant women to choose abortion without the need for consent or authorization from a third party.
    • Balancing Reproductive Autonomy and Ethics: The case highlights the intricate balance required between recognizing and safeguarding the fundamental rights of pregnant women to make choices about their bodies and reproductive health, while simultaneously addressing the ethical dimensions of such decisions within the framework of societal values and laws.

    The legal framework and amendments pertaining to abortion in India

    • MTP Act of 1971: The Medical Termination of Pregnancy (MTP) Act of 1971 was the foundational legislation that regulated abortion in India. It permitted abortions up to 20 weeks of gestation under specific conditions, such as the risk to the life or physical or mental health of the pregnant woman.
    • Amendment in 2021: In 2021, the MTP Act underwent significant amendments to modernize and liberalize India’s abortion laws. The key changes included:
      • Extending the permissible gestational limit from 20 to 24 weeks.
      • Expanding access to abortion services by allowing a broader range of healthcare providers to perform abortions, including mid-level providers.
    • Constitution of Medical Boards: The 2021 amendment introduced provisions for the constitution of Medical Boards. These boards consist of medical experts responsible for assessing cases where pregnancy termination is sought beyond 24 weeks.
    • Reducing Dependency on Courts: By allowing Medical Boards to make determinations, the amendment sought to reduce the burden on the judicial system and expedite the decision-making process for cases involving late-term pregnancies.

    Way forward

    • Citizen with Agency: The petitioner approached the court as an empowered citizen, asserting her right to make choices about her own body.
    • Socially Accepted Context: Her pregnancy occurred within societal norms, emphasizing that reproductive autonomy applies broadly.
    • Sound Mental Health: Her rational decision challenges stereotypes about individuals seeking abortions.
    • Absence of Foetal Anomalies: Her request is driven by personal choice, not medical necessity.
    • Reproductive Choice: She firmly expressed her desire not to have another child, highlighting the importance of individual reproductive decisions.
    • Seeking State Support: By seeking state support for safe abortion services, she aligns with international commitments on access to reproductive healthcare as a human right.

    Conclusion

    • This case underscores the battle between reproductive autonomy and ethical considerations surrounding abortion in India. As women navigate the complex journey to assert their reproductive rights, questions arise about whether they can truly claim ownership of their bodies on their own terms.

  • Money Laundering Probe against a Political Party

    Central Idea

    • The Enforcement Directorate (ED) is contemplating adding a political party as an accused in a money laundering probe linked to the now-defunct Excise Policy of the Delhi government.

    Booking a Political Party for Money Laundering

    • Applicable Law: Section 70 of the Prevention of Money Laundering Act (PMLA) addresses offences by companies, and it can be invoked in this case.
    • Definition of “Company”: While a political party isn’t a ‘company’ under the Companies Act, the PMLA includes an explanation that broadens the scope to include ‘associations of individuals,’ potentially encompassing political parties.

    Precedent for such Cases

    • If pursued, this action could set a significant precedent in India’s legal landscape.
    • Previously, political parties have been investigated under the Income Tax Act.
    • Trusts and NGOs are already within the purview of the PMLA, as per a notification by the Finance Ministry.

    Connection between Charges and Political Party

    • The central allegation by the ED is that the political party received the proceeds of crime in the excise scam.
    • An additional explanation in Section 70 of the PMLA specifies that a “company may be prosecuted, notwithstanding whether the prosecution or conviction of any legal juridical person shall be contingent on the prosecution or conviction of any individual.”
    • This implies that even if cases involving party members fail, the party can still be prosecuted for money laundering separately.

  • Confronting the long-term risks of Artificial Intelligence

    AI

    What’s the news?

    • The film ‘Ex Machina’ highlights the unpredictability of AI risks as technology evolves.

    Central idea

    • In the digital age, sharing personal information has become riskier due to cyberattacks and data breaches. Once fictional, AI now impacts various sectors, bringing evolving risks that require global governance.

    Short-term risks associated with AI

    • Malfunction of AI Systems: Ensuring that AI systems do not malfunction in their day-to-day tasks, especially in critical infrastructure like water and electricity supply, to prevent disruptions and harm to society
    • Immediate Dangers of Runaway AI: Although improbable, the potential for AI systems to go rogue and manipulate crucial systems, leading to catastrophic consequences even in the near future,

    Long-term risks associated with AI

    • AI and Biotechnology: The combination of AI and biotechnology could alter human emotions, thoughts, and desires, posing profound ethical and societal challenges.
    • Human-Level AI: Advanced AI systems capable of human-level or superhuman performance may emerge, potentially acting on misaligned or malicious goals.
    • Dire Consequences: Superintelligent AI with harmful intentions could have catastrophic consequences for society and human well-being.
    • Ethical and Safety Concerns: Developing AI with such capabilities raises significant ethical and safety concerns.

    AI

    Challenges in Aligning AI with Human Values

    • Transparency and Explainability: Many AI systems, particularly deep learning models, are often seen as black boxes where it’s challenging to understand how they make decisions.
    • Human Control: Ensuring that humans maintain control over AI systems and that AI does not act autonomously in ways that could harm individuals or society is a key challenge.
    • Ethical Decision-Making: Developing AI that can make ethical decisions in complex situations, such as autonomous vehicles deciding how to respond to potential accidents, is an ongoing challenge.
    • Cultural and Societal Values: Different cultures and societies have varying values and norms. Aligning AI with human values involves navigating these differences and ensuring that AI systems respect cultural diversity.
    • Long-Term Considerations: As AI evolves and becomes more powerful, addressing long-term ethical considerations, such as the potential for superintelligent AI, is a critical challenge.

    The Threat of Militarized AI

    • The merging of AI with warfare intensifies long-term risks.
    • Treaties like the Non-Proliferation of Nuclear Weapons show global norms can be established.
    • Nations need clear rules for AI’s role in warfare.

    The Uncharted Territory of AI Governance

    • There’s no unified global approach to AI regulation.
    • Only 37 laws included the term artificial intelligence among 127 countries, as per Stanford’s AI Index.
    • The EU’s AI Act, with its risk-based approach, may be oversimplified.

    The importance of global cooperation

    • Uniform Regulation: AI risks are not confined by borders, and inconsistent regulations across countries can lead to confusion and inefficiencies. Global cooperation allows for the development of uniform standards and regulations.
    • Mitigating Global Risks: Many AI-related risks, especially those with global implications such as AI’s convergence with biotechnology or the potential for superintelligent AI, demand a collaborative approach.
    • Ethical Frameworks: Collaborative efforts can lead to the establishment of universally accepted ethical frameworks for AI development and deployment. These frameworks can guide the responsible and ethical use of AI, regardless of where it is developed or employed.
    • Preventing a Race to the Bottom: In the absence of global cooperation, countries may prioritize rapid AI development over safety and ethics to gain a competitive edge. This race to the bottom can undermine global AI safety efforts, making coordination crucial.
    • Technological Divides: Global cooperation helps prevent technological divides where some nations advance rapidly in AI capabilities while others lag behind. Such divides can exacerbate global inequalities and have far-reaching geopolitical consequences.

    Conclusion

    • The evolving nature of AI risks necessitates a unified global approach to governance. Immediate action in creating comprehensive regulations and international norms is crucial. The choices we make today will determine the world we inhabit in the future.

  • India seeks inclusion of Traditional Medicine on WHO’s ICD List

    Central Idea

    • The Centre seeks to include traditional Indian medicines in the 11th revision of the World Health Organisation’s International Classification of Diseases (ICD).
    • The traditional Indian medicine system is categorized into Ayurveda, Siddha, Unani and Yoga, Naturopathy, and Homoeopathy

    About International Classification of Diseases (ICD)

    Purpose Standardized system for classifying and coding diseases, health conditions, and related information.
    Established 1893, by International Statistical Institute (WHO’s predecessor)
    Authority Developed and maintained by the World Health Organization (WHO).
    Scope Covers a wide range of diseases, health conditions, injuries, and health-related factors.
    Coding System Assigns unique alphanumeric codes to each health condition for consistent recording and reporting.
    Global Applicability Internationally recognized and used for health data collection, analysis, and reporting.
    Updates Periodically updated to reflect advances in medical knowledge and changing health trends.
    Latest Version ICD-11 became effective in January 2022.
    Uses Clinical diagnosis, health record documentation, research, health policy, and resource allocation.

    India’s quest to update ICD-11

    • Universal Language: The ICD provides a universal language that enables healthcare professionals worldwide to share standardized information.
    • Traditional Medicine Module: The 11th revision includes a module dedicated to traditional medicine conditions, offering a standardized way to collect and report data on these conditions internationally.
    • Formal Recognition: Ayurveda and related Indian traditional healthcare systems are formally recognized and widely practised in India, making a strong case for their inclusion.
    • Chinese Medicine Inclusion: After a decade of consultations, ICD-11 included Module-1, covering traditional medicine conditions originating in ancient China.

  • Shortage of Doctors in India

    What’s the news?

    • The demand for doctors exceeds the supply in large parts of India.

    Central idea

    • The demand for doctors in India consistently surpasses the available supply, while the pursuit of medical education often outstrips the number of seats available. Reducing this demand-supply gap in medical education has proven to be a challenging endeavor, with potential implications for the availability of healthcare professionals.

    Expanding Medical Education

    • Over the last decade, India has made significant strides in expanding medical colleges and seats at both undergraduate (UG) and postgraduate (PG) levels.
    • UG seats have nearly tripled, PG seats have almost quadrupled, and the number of medical colleges has doubled since 2010-11.
    • Despite this expansion, in 2021, India had only 4.1 medical graduates per lakh population, falling behind countries like China, Israel, the US, and the UK.

    Challenges in scaling

    • Regulatory and Financial Constraints: On average, Indian medical colleges offer 153 UG seats per college, significantly fewer than Eastern Europe (220) and China (930). This discrepancy is a result of regulatory and financial constraints.
    • Infrastructure Limitations: Expanding UG seats in a public medical college from 150 to 200 required additional resources, such as a larger library, increased daily outpatient department (OPD) footfalls, and more nursing staff, as per the draft guidelines for establishing new medical colleges in 2015.
    • Quality Maintenance: Concerns that disproportionate scaling can impact the quality of pedagogy and, subsequently, the quality of doctors produced
    • Faculty Shortages: Both public and private colleges face teaching faculty shortages, despite better remuneration structures in public colleges. Scaling up can further strain the already limited pool of qualified teaching staff.
    • Economic Viability for Private Colleges: Investing in scaling can be risky for private colleges if seats remain vacant and costs aren’t recovered. This can lead to high capitation fees and price distortions.
    • Curriculum Limitations: The nature of the competency-based curriculum dictates constraints on scalability. For example, there can’t be more than 15 students surrounding a bed or in any other practical class.
    • Equity Concerns: The goal of producing doctors evenly across regions might not result in efficient production. Migration of doctors from states with higher production can be an issue.

    Value addition box

    Innovations from the US

    • India’s competency-based curriculum is akin to that of the US, which has successfully scaled up the production of doctors by optimizing resource utilization.
    • Innovations, such as involving practicing MD doctors as mentors for medical students and integrating interprofessional education (IPE) into the curriculum, have enhanced the quality of education and reduced the faculty requirements.

    Quality vs. Scale vs. Equity: A triad of challenges

    • Quality:
    • Ensuring the highest standards of medical education, which translates into competent, skilled, and ethical practitioners.
    • The competency-based curriculum in India requires small-group teaching to ensure a thorough understanding and hands-on experience for students.
    • There’s a concern that rapid scaling could lead to a decline in the quality of education and subsequently the quality of doctors produced.
    • Quality assurance becomes even more critical given the life-and-death implications of medical practice.
    • Scale:
    • Increasing the number of medical graduates to meet the country’s healthcare needs.
    • Despite the expansion of UG and PG seats in medical colleges, the demand-supply gap persists.
    • Regulatory, infrastructural, and financial constraints pose significant challenges in scaling up.
    • Equity:
    • The National Medical Commission prioritizes an even distribution of medical colleges and seats. They aim for localized doctor production to ensure different regions have adequate healthcare.
    • Policies such as the cap on UG seats and the location restrictions of new colleges highlight this focus.
    • However, this might not lead to efficient doctor production due to phenomena like interstate migration of doctors.

    Way forward

    • Regulatory Reforms: Streamline regulations to facilitate the establishment and expansion of medical colleges while ensuring quality standards.
    • Faculty Development: Prioritize investment in faculty development programs to address shortages and retain experienced educators.
    • Technology Integration: Embrace technology to enhance scalability and access to medical education, including e-learning and telemedicine tools.
    • Competency-Based Curriculum: Continue to implement competency-based curricula to produce doctors with practical skills and real-world readiness.
    • Incentives for Rural Service: Develop and implement policies that incentivize medical graduates to serve in underserved rural areas, addressing healthcare disparities.
    • Public-Private Collaboration: Foster collaboration between public and private sectors to expand the availability of medical education seats and improve educational infrastructure.

    Conclusion

    • Bridging the gap between the demand for doctors and the supply of medical education is a multifaceted challenge in India. To meet the growing healthcare needs of the population, policymakers must carefully consider the trade-offs between quality, scale, and equity in medical education.

  • Abortion Rights in India: Legal Complexities and Ethical Dilemmas

    abortion

    Central Idea

    • CJI DY Chandrachud said that India’s abortion law was liberal, pro-choice and far ahead of other countries.
    • SC is hearing the case of a married woman who wants to medically terminate her 26-week pregnancy.
    • This raises critical questions about a woman’s autonomy in deciding to abort and the existing legislative framework.

    Woman’s Perspective

    • Unplanned Pregnancy: A 27-year-old married woman, already a mother of two, contends that her pregnancy was unplanned.
    • Financial Strain: She argues that her family’s income is inadequate to support another child, and she is undergoing treatment for postpartum depression after her second child’s birth.

    Court Decisions and AIIMS Report

    • Initial Approval: A two-judge Bench initially allowed the termination, reasoning that an unplanned pregnancy due to contraceptive failure is akin to a forced pregnancy, permitting abortion up to 24 weeks.
    • AIIMS Concern: AIIMS, Delhi, raised questions about whether foeticide (stopping the foetal heart) could be performed before termination since the foetus is currently viable.
    • Three-Judge Bench: The case was transferred to a three-judge Bench, led by Chief Justice of India (CJI) D Y Chandrachud, which called for a fresh medical report to assess the foetus’s health and the woman’s medical condition.

    Understanding the Abortion Law

    • Medical Termination of Pregnancy Act (MTP Act): The MTP Act allows termination of pregnancy in three stages.
      1. Termination up to 20 weeks with the advice of one doctor.
      2. Pregnancy at 20-24 weeks requires the opinion of two registered medical practitioners, under specific conditions.
      3. After 24 weeks, a medical board in approved facilities assesses the termination based on substantial foetal abnormalities.

    Court’s History of Allowing Late-Term Abortion

    • Several Precedents: The court has previously permitted terminations beyond 26 weeks in various cases, often in cases of rape or consensual relationships.
    • Marital Status Factor: The current case distinguishes itself by the woman’s marital status, implying that the conception is consensual and not a forced pregnancy.

    Balancing Rights: Woman vs. Unborn Child

    • Ongoing Debate: The CJI-led Bench oscillates between prioritizing a woman’s rights over abortion and the need to balance the rights of the unborn child.
    • Liberal Approach: India’s law on abortion is considered liberal and pro-choice, with courts often favouring the woman’s autonomy.

    Comparisons with International Standards

    • Foetal Viability: The concept of “foetal viability” as a benchmark for abortion approval is relatively new in India. It aligns with international standards.
    • US Roe v Wade: The landmark 1973 US Supreme Court case, Roe v Wade, allowed abortion until foetal viability. In 1973, viability was at 28 weeks, now lower due to scientific advancements.
    • Criticism of Indian Law: Some critics argue that India’s law lacks clarity as the decision to terminate after 20 weeks falls on doctors rather than the women, leading to frequent court interventions.

    Autonomy vs. Unborn Child’s Rights

    • Legislative Gap: While the Indian legal framework supports a woman’s autonomy in reproductive decisions, gaps persist, especially concerning last-minute interventions.
    • Ethical Debate: The Indian law leans toward women’s autonomy, but ethical dilemmas arise regarding the rights of the unborn child.
    • Legal Precedents: Cases like Nand Kishore Sharma versus Union of India have debated the constitutionality of the MTP Act concerning the right to life of an unborn child.

    Conclusion

    • The ongoing Supreme Court case highlights the intricate legal and ethical considerations surrounding abortion in India.
    • While the law supports a woman’s right to choose, the challenge lies in finding a delicate balance between individual autonomy and the rights of the unborn child.
    • As the court grapples with this complex case, it underscores the need for continued legal discourse and potential legislative amendments to address evolving reproductive rights issues.

  • India ranks 111/125 in Global Hunger Index, 2023

    Central Idea

    • India has been ranked 111th out of 125 countries in the Global Hunger Index-2023, a stark decline from its 107th position in 2022.
    • The index highlights a concerning statistic – India reports the world’s highest child wasting rate at a staggering 18.7 percent.
    • Interestingly, India’s neighboring countries, including Pakistan (102nd), Bangladesh (81st), Nepal (69th), and Sri Lanka (60th), have performed comparatively better in the index.

    Global Hunger Index (GHI)
    Publication Jointly published annually by Concern Worldwide and Welthungerhilfe.
    Scale Measures hunger on a 100-point scale, with 0 as the best (no hunger) and 100 as the worst score.
    Purpose Comprehensively measures and tracks hunger globally, regionally, and at the country level. Aims to trigger action to reduce hunger worldwide.
    Indicators 4 key indicators for each country:

    1. Undernourishment (reflects inadequate food availability): Share of the population that is undernourished.

    2. Child Wasting (reflects acute undernutrition): Share of children under five with low weight for their height.

    3. Child Stunting (reflects chronic undernutrition): Share of children under five with low height for their age.

    4. Child Mortality (reflects inadequate nutrition and unhealthy environment): Mortality rate of children under five.

     

    Hunger in India: Fact Check

    • Serious Hunger Levels: India’s score of 28.7 in the Global Hunger Index-2023 places it in the “serious” category, according to the report.
    • Child Wasting: India’s child wasting rate, the proportion of undernourished children measured by weight relative to their height, stands at an alarming 18.7 percent, signaling acute undernutrition.
    • Undernourishment Rate: The rate of undernourishment in India is reported at 16.6 percent, further highlighting the gravity of the issue.
    • Child Mortality: Under-five mortality in India is recorded at 3.1 percent.
    • Anemia Among Women: The report underscores a significant concern, with 58.1 percent of women aged 15 to 24 in India being affected by anemia.

    A report to bully India

    • Disputed Ranking: The Indian government has rejected the GHI 2023 ranking, citing serious methodological concerns and suggesting a malicious intent behind the report (considering elections).
    • Methodological Issues: The WCD Ministry asserts that the GHI 2023 report suffers from significant methodological issues. It contends that 3 out of 4 indicators used for calculation pertain to child health, which does not represent the entire population.
    • Sample size issue: It is questionable that only small sample size of 3,000 is used for the “Proportion of Undernourished Population” indicator for crores population in India.
    • Child Wasting Discrepancy: The ministry highlights a significant disparity between the child wasting rate as per the Poshan Tracker (consistently below 7.2 percent) and the 18.7 percent reported in GHI 2023.
    • Undue link with Child mortality: It also challenges the notion that child mortality is solely an outcome of hunger.

    Conclusion

    • India’s ranking underscores the persistent challenges in addressing hunger and undernutrition.
    • The report serves as a stark reminder of the critical need to comprehensively tackle these issues, especially child wasting and undernourishment, to ensure the well-being of the nation’s population.

  • Supreme Court’s divided on Abortion: A Complex Legal Dilemma

    Central Idea

    • A Division Bench of two judges of the Supreme Court grappled with divergent views regarding the abortion of a 26-week pregnancy and the government’s stance to protect the “unborn child.”
    • The judges, unable to reach a consensus, opted to refer the case to the CJI to convene a three-judge Bench for further deliberation.

    Woman’s Plight for Abortion

    • A mother of two with her youngest child just a one-year-old infant, she asserted her desire for a medically induced abortion due to her mental health condition and her inability to care for a third child.
    • Her lawyer stressed the court should prioritize the mother’s well-being.
    • He emphasized the threat to her privacy and dignity and her conscious decision to not proceed with the pregnancy.

    Government’s Stance

    • Legal Argument: The Additional Solicitor General contended that the woman did not possess an “absolute right of autonomy” to exercise her reproductive rights in a manner that would compromise the rights of the unborn child.
    • MTP Act of 2021: Reference was made to the Medical Termination of Pregnancy (Amendment) Act of 2021, which extended the abortion deadline to 24 weeks in “exceptional circumstances,” primarily to save the mother’s life or in the case of fatal foetal deformity.

    Legal Debate

    • Bodily Autonomy vs. Foetal Rights: The core of the debate centred on whether, once a viable baby exists, the woman’s right to bodily autonomy or integrity should yield to the Act, curbing her fundamental right to choose.
    • Court’s Earlier Decision: On October 9, the Bench had initially permitted the medical termination in line with the woman’s wishes, following a report from an All India Institute of Medical Sciences (AIIMS) medical board.

    Government’s Reversal

    • Government’s Appeal: Subsequently, the Union government filed an application, citing an expert doctor’s opinion received on October 10, which advocated for giving the child a chance to survive.
    • State’s Responsibility: The argument was that a categorical medical opinion had emerged, offering hope for the child’s survival, and placing a responsibility on the state.

    Judicial Opinions

    • Justice Kohli’s Stance: One judge aligned with the government’s position that the woman should not be allowed to terminate the pregnancy.
    • Justice Nagarathna’s Dissent: In contrast, the other judge dissented, asserting that the woman’s decision should be respected, considering her socio-economic circumstances, mental health, and the young age of her second child.

    Conclusion

    • The Supreme Court’s divided opinion on this intricate abortion case underscores the challenging balance between a woman’s right to make decisions about her body and the state’s interest in protecting the unborn.
    • As the case proceeds to a three-judge Bench, it raises broader questions about the legal and ethical complexities surrounding reproductive rights and foetal interests in India’s legal landscape.

  • Threat posed by cardiovascular diseases (CVD)

    What’s the news?

    • World Heart Day, observed globally on September 29, serves as a crucial reminder of the escalating threat posed by cardiovascular diseases (CVD) and the need to promote heart-healthy lifestyles.

    Central idea

    • World Heart Day, an annual event, initiated by the World Heart Federation in collaboration with the World Health Organization (WHO) in 2000, seeks to heighten awareness, engage communities, and advocate for universal access to CVD prevention, detection, and treatment. Tackling the silent epidemic of cardiovascular diseases in India demands a multi-pronged approach.

    Public Awareness Efforts on CVD

    • On World Heart Day, several English-language national dailies published full-page advertorials, which are advertisements designed to resemble written articles. These advertorials aimed to raise awareness about cardiovascular diseases (CVD) and promote heart-healthy lifestyles.
    • The content of these advertorials seemed to provide information about CVD rather than directly promoting a product.
    • Notably, there was limited involvement or a meaningful campaign by public health agencies like the Union Ministry of Health in raising awareness about CVD on this occasion.
    • These advertorials were sponsored by the diagnostics, devices, and pharmaceutical industries, indicating a partnership between these industries and media outlets for public awareness efforts.
    • Additionally, clinicians from high-end corporate tertiary care hospitals contributed by providing lifestyle modification advisories as part of the public awareness campaign

    Alarming Data on Hypertension

    • Data from the National Family Health Survey-5 (2019–2021) and the 2017-18 National NCD Monitoring Survey (NNMS) in India reveals concerning statistics about hypertension.
    • The NFHS-5 data shows that 18.3 percent of the country’s population has hypertension, while the NNMS reports a higher rate of 28.5 percent among individuals aged 18-69.
    • These percentages translate to significant numbers, given India’s large population.
    • Both surveys highlight low levels of awareness, treatment, and control of hypertension.

    Treatment Gaps and Disparities

    • The NNMS data indicates that only 28 percent of those with hypertension were aware of it.
    • Among those aware, 52 percent were receiving treatment, and a smaller percentage had their blood pressure under control.
    • Disparities exist based on factors such as education, income, and geographic location, with better access to healthcare services in south India.
    • Vulnerable groups, including males, illiterates, those with lower income, rural residents, smokers, and alcohol users, were less likely to be part of the treatment cascades.

    Efforts in India

    • India launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in 2010, expanding its implementation.
    • The program primarily focuses on screening and treatment.
    • India is committed to the principles of primary healthcare and Universal Health Coverage (UHC), as outlined in the 2018 Astana Declaration.

    Challenges

    • Challenges include inadequate awareness, limited healthcare access in various regions, and disparities in healthcare access and outcomes. More resources are needed for primary healthcare.
    • Contemporary approaches to managing CVD heavily emphasize risk factors, particularly lifestyle-related ones like diet, physical activity, smoking, and obesity.
    • Epigenetic modifications may emerge as a consequence of a lifetime of disadvantage, structural inequalities, and discrimination, thereby influencing future generations.
    • There is a challenge in retaining rural health workers.

    The Need for a Holistic Approach

    • Contemporary approaches to managing cardiovascular diseases (CVD) emphasize lifestyle risk factors.
    • The WHO’s Commission on Social Determinants of Health highlights that these risk factors often result from systemic compromises rather than individual choices.
    • The Commission emphasizes addressing socioeconomic factors that affect health across an individual’s lifespan and calls for equity and social justice in healthcare.

    Conclusion

    • As the WHO rightly asserts, Reducing health inequities is… an ethical imperative. Social injustice is killing people on a grand scale. World Heart Day serves as a stark reminder that the battle against CVD must continue with renewed vigor and a holistic perspective.

  • Baiga Tribal group gets habitat rights in Chhattisgarh

    baiga

    Central Idea

    • The Baiga Particularly Vulnerable Tribal Group (PVTG) recently became the second community in the state to receive habitat rights, following the Kamar PVTG in Chhattisgarh.
    • Habitat rights recognition marks a crucial step towards preserving the culture, livelihoods, and heritage of these indigenous groups.

    Baiga PVTG

    • The Baiga are an ethnic group found in central India primarily in the state of Madhya Pradesh, and in smaller numbers in the surrounding states of Uttar Pradesh, Chhattisgarh and Jharkhand.
    • The largest number of Baiga is found in Baiga-chuk in Mandla district and Balaghat district of Madhya Pradesh.

    Understanding Habitat Rights

    • Significance: Habitat rights recognition bestows upon the concerned community various rights over their customary territory, encompassing habitation, socio-cultural practices, livelihood means, ecological knowledge, and protection of natural and cultural heritage.
    • Empowering Communities: These rights empower PVTG communities by safeguarding their traditional livelihoods and ecological knowledge, thereby promoting their development.
    • Coordination: Habitat rights facilitate the convergence of government schemes and initiatives across departments, fostering the holistic development of PVTG communities.

    Legal Framework

    • Forest Rights Act: Habitat rights for PVTGs are granted under Section 3(1)(e) of The Scheduled Tribes and Other Traditional Forest Dwellers (Recognition of Forest Rights) Act, 2006, commonly known as the Forest Rights Act (FRA).
    • Definition of Habitat: As per Section 2(h) of FRA, habitat encompasses customary habitats and other habitats within reserved forests and protected forests, catering to the needs of primitive tribal groups and pre-agricultural communities.
    • Protection from Developmental Activities: While habitat rights do not convey ownership, they require consent and consultation with the gram sabha (village council) for any developmental activity. These rights also offer legal protection under various laws.

    Habitat Rights as a Protective Measure

    • Legal Safeguards: Habitat rights serve as an additional layer of legal protection against activities that may harm the habitat or livelihood of PVTGs.
    • Administrative Resolution: If developmental activities threaten habitat rights, the tribal community can raise the issue with the administration under the Forest Rights Act, potentially seeking legal recourse.

    Determining Habitats

    • Procedure: Habitat determination is based on comprehensive guidelines issued by the Ministry of Tribal Affairs (MoTA) in 2014. Coordination among four state-level departments—Forest, Revenue, Tribal, and Panchayati Raj—is crucial.
    • Consultation: Traditional tribal leaders are consulted to assess cultural practices, traditions, and livelihoods. The government corroborates this information before officially declaring a habitat.

    Back2Basics: Particularly Vulnerable Tribal Group (PVTG)

    Definition Tribal communities with declining population, low literacy, pre-agricultural tech, and economic backwardness.
    Habitat Inhabit remote areas with poor infrastructure and limited administrative support.
    Vulnerability Highly vulnerable due to small numbers and lack of socio-economic development.
    Number 75 such groups identified and categorized as Particularly Vulnerable Tribal Groups (PVTGs).
    Origin of the Concept
    Dhebar Commission (1960-1961) Identified inequality in development among Scheduled Tribes.
    Fourth Five Year Plan Created a sub-category within Scheduled Tribes to identify lower development groups.
    Sub-Category Name Change Renamed “Primitive tribal group” to “Particularly vulnerable tribal group” in 2006.
    Features of PVTGs
    Characteristics Pre-agricultural lifestyle, hunting and gathering, zero/negative population growth, low literacy.
    Criteria Any one criterion makes a group a PTG, later renamed PVTG by the Indian government.