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Subject: Health

  • The antibiotic pipeline is running dangerously dry

    Why in the News?

    Antimicrobial resistance (AMR) has become a serious global public health threat as the development of new antibiotics has not kept pace with the rapid rise in drug resistance. Unlike earlier decades, when ineffective antibiotics were regularly replaced by new ones, no truly new antibiotic classes have emerged in recent years. India is among the worst affected, with very high antibiotic use and an estimated 2.74 lakh deaths linked to AMR in 2019.

    Why is antimicrobial resistance a growing public health crisis?

    1. Rising mortality burden: AMR-attributable deaths in India were estimated at 2.74 lakh in 2019, reflecting a large and growing health burden.
    2. Treatment failure: Common infections are increasingly difficult to treat, increasing complications, hospital stays, and mortality.
    3. Systemic impact: AMR undermines surgery, chemotherapy, organ transplants, and neonatal care by increasing infection risk.
    4. Global spread: Resistant pathogens spread rapidly through travel, trade, food chains, and the environment.

    Why is India disproportionately affected by AMR?

    1. High infectious disease load: India continues to face a high burden of communicable diseases requiring antibiotic use.
    2. Extensive antibiotic consumption: India is among the world’s largest consumers of antibiotics, both in human and animal health.
    3. Healthcare pressures: Overcrowded hospitals and limited diagnostic capacity encourage empirical and broad-spectrum antibiotic use.
    4. Survival advantage of pathogens: Drug-resistant bacteria survive treatment and transmit resistance genes to other bacteria.

    How does antibiotic misuse accelerate resistance?

    1. Inappropriate prescribing: Antibiotics are frequently used for viral infections such as colds, coughs, and diarrhoea.
    2. Empirical treatment: Lack of timely diagnostics leads to blind antibiotic use without pathogen identification.
    3. Prophylactic use: Antibiotics are prescribed preventively, even where clinical benefit is uncertain.
    4. Seasonal misuse: Antibiotics are used for seasonal viral illnesses due to patient demand and prescribing habits.

    What is happening to the global antibiotic pipeline?

    1. Limited innovation: Very few new antibiotic classes have been developed in the past three decades.
    2. R&D stagnation: Most recent approvals involve modifications of existing drugs rather than new mechanisms of action.
    3. Commercial disincentives: Antibiotics offer low returns compared to chronic disease drugs, discouraging private investment.
    4. Effectiveness erosion: Even newly introduced antibiotics lose effectiveness rapidly due to resistance.

    Why is antibiotic stewardship more effective than blanket bans?

    1. Behavioural regulation: Stewardship programs guide rational prescribing rather than eliminating access.
    2. Evidence from India: The Indian Council of Medical Research (ICMR) launched a national antibiotic stewardship programme in 2015.
    3. Measured impact: Prescription awareness improved, but full behavioural internalisation remains limited.
    4. Sustainability challenge: Stewardship requires continuous monitoring, training, and institutional commitment.

    How do livestock and agriculture worsen the AMR problem?

    1. Non-therapeutic use: Antibiotics are used in animals for growth promotion and disease prevention.
    2. Shared drug classes: Many antibiotics critical for humans are also used in animals.
    3. Environmental spread: Antibiotic residues enter soil and water through animal waste and food chains.
    4. Resistance transfer: Resistance genes move between human, animal, and environmental bacteria.

    Why is data collection on AMR inadequate?

    1. Limited surveillance: ICMR’s AMR surveillance network covers only 25 tertiary hospitals.
    2. Urban bias: Most data originates from large hospitals, missing community-level resistance patterns.
    3. Underestimation risk: Resistance prevalence is likely higher than reported due to incomplete coverage.
    4. Policy constraint: Inadequate data limits targeted interventions and resource allocation.

    Why can’t new antibiotics alone solve AMR?

    1. Rapid resistance development: Resistance emerges even against newly introduced drugs.
    2. Finite effectiveness window: Antibiotics lose usefulness within a few years of widespread use.
    3. Overreliance risk: Dependence on drug discovery ignores behavioural and systemic drivers.
    4. Adjunct necessity: Stewardship, infection prevention, and diagnostics remain central.

    Conclusion

    The antibiotic pipeline crisis reflects a structural mismatch between rising resistance and declining innovation. India’s experience demonstrates that stewardship, surveillance, and behavioural regulation are as critical as drug discovery. Without systemic correction, modern medicine risks returning to a pre-antibiotic era.

    PYQ Relevance

    [UPSC 2024] Can overuse and free availability of antibiotics without Doctor’s prescription, be contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

    Linkage: This question directly maps to GS Paper III (Science & Technology-Public Health), aligning with UPSC’s repeated focus on antimicrobial resistance as a governance and regulatory challenge. It links with PYQs on antibiotic overuse, emerging health challenges, and technology-policy gaps, reflecting UPSC’s trend of testing systemic failures rather than medical details.

  • Nimesulide Ban 

    Why in the News?

    The Government of India has banned manufacture, sale and distribution of oral formulations of Nimesulide above 100 mg with immediate effect under Section 26A of the Drugs and Cosmetics Act, 1940.

    About Nimesulide

    Nimesulide is a Non Steroidal Anti Inflammatory Drug (NSAID) used for acute pain relief and fever reduction.

    Key Features of the Drug

    • Pharmacological class: NSAID
       • Mechanism of action: Inhibits prostaglandin synthesis by blocking inflammatory chemical mediators
       • Therapeutic use: Short term treatment of pain and fever
       • Common side effects: Nausea, vomiting, diarrhoea, raised liver enzymes
       • Known risk: Hepatotoxicity, especially at higher doses or prolonged use

    Reason for the Ban

    • Oral doses above 100 mg pose serious risk to liver health
       • Increased incidence of drug induced liver injury
       • Safer alternative analgesics available
       • Action taken under Section 26A, which allows banning drugs harmful to public health
    [2019] Which of the following are the reasons for the occurrence of multi-drug resistance in microbial pathogens in India? 

    1. Genetic predisposition of some people 

    2. Taking incorrect doses of antibiotics to cure diseases 

    3. Using antibiotics in livestock farming 

    4. Multiple chronic diseases in some people 

    Select the correct answer using the code given below. 

    (a) 1 and 2 (b) 2 and 3 only (c) 1, 3 and 4 (d) 2, 3 and 4

  • FSSAI Egg Safety Drive 

    Why in the News?

    • FSSAI launched a nationwide egg safety drive. Triggered by allegations of nitrofurans residues in eggs

    Regulatory Authority

    • Food Safety and Standards Authority of India
     • Regulates manufacture, storage, distribution, sale, and import of food

    Trigger for Action

    • Viral social media video alleging nitrofurans in Eggoz eggs
     • Raised public health concerns

    Action by FSSAI

    • Directed Food Safety Officers to collect samples
     • Sampling of branded and unbranded eggs
     • Testing in 10 FSSAI laboratories across India

    About Nitrofurans

    • Synthetic antibiotics
     • Banned in food producing animals
     • Residues may occur due to illegal veterinary use
     • Linked to carcinogenic risk

    International Context

    • European Union has banned nitrofurans in food producing animals

    Company Response

    • Eggoz assured consumer safety
     • Committed to publishing lab reports publicly
     • Reaffirmed compliance with food safety norms

    Public Health Significance

    • Strengthens food safety surveillance
     • Protects consumer health
     • Addresses risks of antibiotic residues and AMR

    Prelims Pointers

    • FSSAI functions under Food Safety and Standards Act, 2006
     • Eggs are animal origin food products
     • Antibiotic residue monitoring is part of food safety regulation

    In India, the use of carbofuran, methyl parathion, phorate and triazophos is viewed with apprehension. These chemicals are used as (2019)

    (a) pesticides in agriculture 

    (b) preservatives in processed foods 

    (c) fruit-ripening agents 

    (d) moisturising agents in cosmetics

  • [10th December 2025] The Hindu OpED: Charting an agenda on the right to health

    PYQ Relevance

    [UPSC 2021]“Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. 

    Linkage: This question is relevant to GS II (Social Justice – Health) as it focuses on the state’s welfare responsibility through primary healthcare. It links to the right to health and sustainable development, highlighting the need for strong public health systems over market-led models.

    Mentor’s Comment

    This article analyses the National Convention on Health Rights and its significance in reframing health care as a rights-based public good. It highlights systemic failures in public health financing, privatisation-driven inequities, medicine access barriers, and workforce distress, while foregrounding the demand for a legally enforceable right to health in India.

    Why in the News

    The National Convention on Health Rights (December 11-12) is being held in New Delhi, coinciding with Human Rights Day and Universal Health Coverage Day, bringing together 400+ health professionals, community leaders, and activists from over 20 states. It is significant as it attempts a post-COVID national reset of India’s health policy discourse, challenging the long-standing trend of commercialisation and privatisation of health care. The convention highlights a stark contradiction: while health crises have intensified, public health spending remains at just 2% of the Union Budget, with per capita public spending at only ₹25 per day, forcing households into high out-of-pocket expenditure. The event is notable for explicitly framing health as a justiciable right, not merely a welfare objective.

    Introduction

    India’s health system stands at a crossroads where rising private sector dominance, weak public provisioning, and inequitable access coexist with constitutional commitments to dignity and equality. The National Convention on Health Rights seeks to reclaim health care as a public responsibility by addressing structural distortions exposed during the COVID-19 pandemic and by proposing an alternative rights-based framework.

    Privatisation and the Erosion of Public Health Systems

    1. Privatisation of Services: Expansion of public-private partnerships has transferred medical colleges and health facilities to private entities, weakening public capacity and oversight.
    2. Cost Escalation: Commercial health care has made treatment unaffordable for large sections dependent on public provisioning.
    3. Regional Resistance: Movements in Andhra Pradesh, Karnataka, Maharashtra, Madhya Pradesh, and Gujarat highlight citizen-led opposition to health sector privatisation.
    4. Regulatory Gaps: The Clinical Establishments Act, 2010 remains weakly implemented, allowing opaque pricing and unnecessary medical procedures, including excessive caesarean sections.

    Inadequate Public Financing and Insurance-Centric Models

    1. Budgetary Allocation: Public health receives only 2% of the Union Budget, insufficient for universal access.
    2. Out-of-Pocket Expenditure: Low public spending results in high household health costs, deepening poverty.
    3. Insurance Dependence: Government-sponsored insurance schemes prioritise hospitalisation rather than preventive and primary care.
    4. Structural Limitation: Insurance-based models fail to strengthen health systems or reduce systemic inequities.

    Health Workforce Crisis and Structural Injustice

    1. Pandemic Exposure: COVID-19 highlighted the indispensable role of doctors, nurses, paramedics, and support staff.
    2. Workplace Insecurity: Health workers face inadequate social security, unsafe working conditions, and poor remuneration.
    3. Justice Deficit: The convention stresses the absence of legal and institutional mechanisms to protect health workers’ rights.
    4. Systemic Link: Workforce distress directly undermines service quality and system resilience.

    Access to Medicines and Regulatory Barriers

    1. Household Burden: Medicines constitute nearly 50% of household medical spending, making them the most significant cost driver.
    2. Market Distortions: Irrational fixed-dose combinations, unethical marketing, and high retail mark-ups inflate prices.
    3. Policy Barriers: Patent regimes, regulatory gaps, and GST on medicines limit affordability.
    4. Public Manufacturing: Strengthening public sector drug production is identified as critical for universal access.

    Social Discrimination and Health Inequities

    1. Structural Exclusion: Caste, gender, disability, and sexuality shape access to health care.
    2. Marginalised Groups: Dalits, Adivasis, Muslims, LGBTQ+ persons, persons with disabilities, and those living with HIV face systemic discrimination.
    3. Intersectional Determinants: Food security, environmental pollution, and climate change exacerbate health vulnerabilities.
    4. Rights Framework: Non-discrimination is positioned as central to the right to health.

    Reimagining Health Care as a Fundamental Right

    1. Public Provisioning: Emphasis on strong, decentralised, community-led public health systems.
    2. Participatory Governance: Inclusive planning and local accountability mechanisms strengthen service delivery.
    3. Legal Anchoring: Health care framed as an enforceable fundamental right rather than a discretionary policy choice.
    4. Political Engagement: Parliamentary dialogue sought to translate convention outcomes into policy reform.

    Conclusion

    The National Convention on Health Rights articulates a coherent alternative to market-driven health care by grounding access, affordability, and equity within a rights-based public framework. It reinforces the principle that health systems must serve people rather than profits.

  • Care as disability justice, dignity in mental health

    Introduction

    Mental health systems globally and in India continue to prioritise biomedical treatment and functional integration. They often overlook lived experiences of distress, social exclusion, and structural vulnerability. There is a need for a fundamental shift: from care as a technical service to care as disability justice, grounded in dignity, equity, and relational accountability.

    Reframing Mental Health Care Beyond Treatment

    1. Dignity-Centred Care: Positions dignity, rather than cure or productivity, as the primary objective of mental health systems.
    2. Disability Justice Lens: Recognises mental illness as shaped by intersecting social, economic, and political structures.
    3. Relational Accountability: Frames care as embedded in relationships, not limited to institutional or clinical settings.

    Limits of Dominant Psychosocial Disability Models

    1. Productivity Bias: Prioritises economic functionality and independence as markers of recovery.
    2. Reductionist Integration: Treats community inclusion as an end-state without addressing exclusionary social norms.
    3. Invisible Chronic Distress: Marginalises individuals whose suffering does not conform to biomedical recovery trajectories.

    Structural Determinants of Mental Distress

    1. Material Deprivation: Highlights housing insecurity, income precarity, and food scarcity as persistent stressors.
    2. Social Abandonment: Identifies shame, rejection, and relational breakdown as under-recognised drivers of distress.
    3. Political and Cultural Loss: Notes erosion of cultural meaning, safety nets, and social identity as contributory factors.

    Multiplicity of Explanations for Mental Illness

    1. Biological Factors: Includes neurotransmitter alterations and inflammatory markers.
    2. Psychological Factors: Covers trauma, grief, and interpersonal loss.
    3. Socio-Structural Factors: Integrates caste, gender, class, and institutional neglect into causation analysis.
    4. Intersectionality: Emphasises overlapping vulnerabilities rather than single-cause explanations.

    Care as Relational and Material Practice

    1. Everyday Care Practices: Includes shelter, nutrition, social connection, and safety as therapeutic.
    2. Non-Linear Recovery: Rejects uniform timelines and outcome metrics.
    3. Shared Responsibility: Frames care as a collective moral obligation rather than individual compliance.

    Justice-Oriented Mental Health Engagement

    1. Recognition of Harm: Acknowledges that distress often arises from unjust social arrangements.
    2. Ethical Accountability: Asks what society owes to those it has marginalised.
    3. Transformative Focus: Shifts emphasis from symptom management to social repair.

    Implications for Education, Research, and Practice

    1. Curricular Reorientation: Calls for training that values lived experience and contextual care.
    2. Practice Diversity: Recognises non-specialist and community-based care providers.
    3. Interdisciplinary Learning: Supports integration of social theory, ethics, and practice.
    4. Systemic Support: Emphasises that professional competence requires institutional backing, not credentials alone.

    Conclusion

    Mental health care must be reimagined as an ethical, relational, and justice-oriented practice rather than a narrowly clinical intervention. By centering dignity and disability justice, the article calls for a paradigm shift that recognises suffering as socially produced and care as a shared societal responsibility.

    Mental Health in India

    1. About 10.6% of Indian adults, roughly 11 out of every 100 adults, were living with a diagnosable mental health disorder, according to a 2015-16 National Mental Health Survey (NMHS) conducted by the National Institute of Mental Health and Neurosciences (NIMHANS).
    2. The survey also revealed:
      1. 15% of India’s adult population experiences mental health issues requiring intervention
      2. The lifetime prevalence of mental disorders was 13.7%, indicating that around 14 out of every 100 people in India have experienced a mental disorder at some point in their lives
      3. Mental health disorders are more prevalent in urban areas (13.5%), compared to rural areas (6.9%).

    PYQ Relevance

    [UPSC 2024] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest measures through which the State can enhance the reach of public healthcare at the grassroots level.

    Linkage: The article directly links to GS-II (Social Justice, Health) by highlighting the limitations of market-centric and outcome-driven public healthcare in addressing mental health and disability. It also enriches GS-IV by framing mental health care as an ethical obligation grounded in dignity, compassion, and justice rather than mere service delivery.

  • Measles  

    Why in the News?

    • According to recent global health reports, measles caused approximately 95,000 deaths in 2024, despite the presence of a highly effective vaccine.
    • Most deaths occurred among unvaccinated children under five, highlighting concerns about declining immunization coverage, vaccine hesitancy, and disruptions in routine immunization services in several regions.
    • The spike has raised alarms globally, making measles a significant public health priority in 2025.

    About Measles

    • Type: Highly contagious airborne viral disease.
    • Causative Agent: Measles virus (family Paramyxoviridae, genus Morbillivirus).
    • Severity: Can lead to pneumonia, encephalitis, blindness, and death.

    Who Is at Risk?

    • Any non-immune person.
    • Higher risk:
      • Unvaccinated young children
      • Pregnant persons
    • Common in parts of Africa, the Middle East, and Asia.

    Treatment

    • No specific antiviral treatment.
    • Management is supportive (hydration, fever control, nutrition, monitoring complications).

    Prevention

    • Measles-Rubella (MR) vaccine offers long-term protection.
    • India:
      • Measles vaccine included in Universal Immunization Programme (UIP) in 1985.
      • Ongoing campaigns aim to eliminate measles and rubella.

    UPSC Prelims Pointers

    • Measles virus → Paramyxoviridae.
    • Virus survives 2 hours in air/surfaces → high transmission.
    • No antiviral; vaccine is key preventive tool.
    • Koplik spots → diagnostic hallmark.
    • India introduced measles vaccine in Universal Immunization Programme (UIP) → 1985.
    • Recent spike in global deaths makes measles a current affairs hotspot.
    HINI virus is sometimes mentioned in the news with reference to which one of the following diseases? (2015)

    (a) AIDS 

    (b) Bird flu 

    (c) Dengue 

    (d) Swine flu

  • Shingles Disease 

    Why in the news?

    A recent large study shows that shingles vaccination can reduce the risk of death from dementia and may help slow disease progression.

    What is Shingles

    • A viral infection characterized by a painful rash
    • Causative agent: Varicella zoster virus (VZV)
      • Same virus responsible for chickenpox
      • Remains latent in nerve cells after recovery from chickenpox
      • Can reactivate later in life

    Transmission

    • Shingles itself is not contagious
    • But the virus can spread to people without prior immunity, causing chickenpox (not shingles)

    Symptoms

    • Cluster of blisters appearing in a band-like pattern on one side of the body (typically torso, neck, or face)
    • Pain, burning, tingling sensation
    • Fever, fatigue, headache
    • Can lead to post-herpetic neuralgia (long-term nerve pain)
    HINI virus is sometimes mentioned in the news with reference to which one of the following diseases? (2015)

    (a) AIDS 

    (b) Bird flu 

    (c) Dengue 

    (d) Swine flu

  • The Second Issue: On Surrogacy for a Second Child

    Introduction

    The Surrogacy (Regulation) Act, 2021 stipulates that an “intending couple” is eligible for surrogacy only if they do not have any surviving child, biological, adopted or via surrogacy, except where the child is physically or mentally challenged or has a life-threatening disorder.A petition has been filed before the Supreme Court by a couple facing secondary infertility who seek to use surrogacy to have a second child. Their argument: the law’s restriction interferes with the reproductive choices of citizens and treats primary and secondary infertility differently.

    What is the law’s objective and rationale

    1. Objective of the Act: The primary stated purpose is to prohibit commercial surrogacy, regulate fertility and surrogacy clinics, and protect surrogate mothers and children born through surrogacy.
    2. Eligibility restriction: Section 4(iii)(C)(II) mandates the ‘no surviving child’ condition for an intending couple.
    3. Rationale for restriction: The government’s position is that the use of another woman’s body for surrogacy demands strict regulation; therefore, limiting eligibility helps prevent exploitation and commercialization.
    4. Court’s interim view: The Supreme Court has indicated the restriction appears “reasonable” but is examining whether the ban on surrogacy for couples with a surviving child amounts to a violation of reproductive choice.

    How does the law differentiate primary and secondary infertility

    1. Secondary infertility defined: In this context, it refers to couples unable to conceive or carry a pregnancy to term despite having borne a child naturally earlier.
    2. Law’s silence on distinction: The Act does not expressly differentiate between primary and secondary infertility in defining “infertility” for eligibility. The petitioners argue the statute uses “infertility” generically and should be read to include secondary infertility.
    3. Effect of the distinction: As a result of the clause, a couple with one surviving (healthy) child is barred from surrogacy for a second child, even if they face medical infertility. The petition argues this amounts to unreasonable discrimination.

    Why is this matter significant now?

    1. Reproductive autonomy at stake: The case raises the question whether reproductive choice including whether and how many children to have falls under the fundamental right to privacy and reproductive autonomy (Article 21).
    2. Scale of the issue: Secondary infertility affects a substantial number of couples; the law’s bar effectively restricts access to surrogacy for many intending parents. The article emphasises that restricting access solely because a couple already has a child may not align with the law’s stated objective.
    3. Precedents of regulation being diluted: The Court recently relaxed age restrictions for couples who had frozen embryos prior to the law’s enactment, signalling willingness to interpret surrogacy law expansively.
    4. Contradiction with other family-related rights: There is no law in India capping the number of children a person may have naturally; yet, the surrogacy law imposes a “one-child existing” rule. This invites scrutiny of rational basis for differentiation.

    What are the potential implications of a broader interpretation”

    1. Facilitating access: A more expansive reading allowing surrogacy for intending parents would align the law with reproductive autonomy and reduce arbitrary differentiation.
    2. Safeguard against exploitation: The law can maintain its core safeguards against commercialisation and exploitation while enabling access for medically infertile couples seeking a second child.
    3. Policy coherence: It would harmonise the surrogacy statute’s eligibility norms with the lack of statutory restriction on the number of natural children and prevent unjust exclusion of couples.
    4. Legal precedent: A favourable interpretation could open up examination of other eligibility criteria under the Act (such as age or marital status) in light of constitutional rights.

    What are the counter-arguments and concerns?

    1. Risk of commercial surrogacy revival: Critics argue liberalising eligibility may inadvertently open doors to exploitation of surrogate mothers and a resurgence of commercial surrogacy in disguised form.
    2. Resource and monitoring constraints: Greater eligibility implies more oversight burden on regulatory infrastructure (ART clinics, surrogacy boards, monitoring of insurance/compensation).
    3. State interest in regulation: The restriction can be defended as within the State’s margin of appreciation to regulate surrogacy in public interest, preserving dignity of women and children.
    4. Potential slippery slope: Expanding eligibility might raise questions about single individuals, LGBTQ+ couples or live-in partners accessing surrogacy, aspects the law currently restricts.

    Conclusion

    The surrogacy debate in India reflects the evolving tension between state regulation and personal autonomy. While the law rightly seeks to prevent exploitation and commercialisation, it must not overlook the constitutional promise of reproductive freedom and equality. A more inclusive, rights-based interpretation, sensitive to medical realities like secondary infertility, would uphold both ethical safeguards and individual dignity, aligning the law with India’s vision of gender justice and compassionate governance.

    Value Addition: Surrogacy Law in India

    Legal Framework:

    Surrogacy (Regulation) Act, 2021

    • Objective: Regulate surrogacy procedures, prohibit commercial surrogacy, and ensure ethical practices in assisted reproduction.
    • Type allowed: Only altruistic surrogacy (no monetary compensation except medical expenses and insurance).
      • Assisted Reproductive Technology (Regulation) Act, 2021
    • Objective: Regulate ART clinics and banks; maintain records, screening, and ethical standards for gamete donation and IVF processes.
    • Together, these Acts create a twin legal framework governing all forms of medically assisted reproduction in India.

    Key Provisions of the Surrogacy (Regulation) Act, 2021

    1. Eligibility of intending couple:
      • Must be Indian citizens, legally married, and aged:
        • Husband: 26–55 years
        • Wife: 23–50 years
      • Must possess a certificate of infertility from a District Medical Board.
      • Must not have any surviving child (biological, adopted, or through surrogacy), except if the child is mentally/physically challenged or suffers a life-threatening disorder.
    2. Eligibility of surrogate mother:
      • Must be a married woman with a child of her own.
      • Age limit: 25–35 years.
      • Can act as a surrogate only once in her lifetime.
      • Must be a close relative of the intending couple.
      • Must obtain a certificate of medical and psychological fitness.
    3. National and State Surrogacy Boards: Oversee implementation, formulate policies, and ensure ethical compliance.
    4. Penal provisions:
      • Commercial surrogacy, sale/purchase of human embryos, and exploitation of surrogate mothers attract imprisonment up to 10 years and fine up to ₹10 lakh.

    Objectives and Rationale

    1. Prevent commercial exploitation: Protects poor women from being coerced into surrogacy for financial gain.
    2. Ensure child welfare: Guarantees the child’s legal status and parentage from birth.
    3. Promote ethical medical practices: Prevents unregulated fertility clinics and misuse of technology.
    4. Align with constitutional morality: Balances individual reproductive rights with social ethics and public health considerations.

    Judicial and Policy Developments

    1. SC observations (2023–2025):
      • Examining secondary infertility cases to test whether barring surrogacy for a second child violates reproductive autonomy under Article 21.
      • Previously allowed age relaxation for couples with frozen embryos prior to enactment of the Act.
    2. Delhi High Court (2023): Directed the government to reconsider rules preventing single women or widows from accessing surrogacy, citing discrimination concerns.
    3. Policy evolution: Shift from the 2015 ban on foreign commercial surrogacy to a 2021 framework permitting only altruistic domestic surrogacy.

    PYQ Relevance

    [UPSC 2023] Explain the constitutional perspectives of Gender Justice with the help of relevant constitutional provisions and case laws.

    Linkage: This question is key as it tests understanding of Articles 14, 15 and 21 on women’s equality and autonomy. This is central to debates like the Surrogacy Act 2021, which restricts reproductive choice and raises issues of bodily rights and gender justice.

  • [pib] Swasth Nari, Sashakt Parivar Abhiyaan (SNSPA)

    Why in the News?

    The Union Health Ministry has achieved three GUINNESS WORLD RECORDS titles under the “Swasth Nari, Sashakt Parivar Abhiyaan (SNSPA)”, highlighting India’s leadership in women’s health and preventive care.

    Guinness World Records Achieved

    • Most people registered on a health care platform in one month: 3.21 crore (3,21,49,711).
    • Most people signed up for breast cancer screening in one week: 9.94 lakh (9,94,349).
    • Most people signed up for vital signs screening online in one week (State level): 1.25 lakh (1,25,406).

    These records reflect unprecedented participation across India’s digital health platforms under the Ayushman Bharat initiative.

    About Swasth Nari, Sashakt Parivar Abhiyaan (SNSPA):

    • Objective: Strengthen women’s, children’s, and family health services, focusing on rural, tribal, and underserved regions.
    • Launch: Introduced on 17 September 2025 by the PM, jointly led by Ministry of Health and Family Welfare and the Ministry of Women and Child Development.
    • Scale: Over 10 lakh health camps at Ayushman Arogya Mandirs, Community Health Centres (CHCs), and District Hospitals.
    • Screenings: Anaemia, hypertension, diabetes, TB, breast and cervical cancers, sickle cell disease, reproductive health conditions.
    • Services offered: Maternal, child, adolescent health including antenatal care, immunisation, nutrition counselling, menstrual hygiene, mental health, lifestyle awareness.
    • Digital Monitoring: SASHAKT portal ensures real-time data tracking and transparency.
    • Jan Bhagidaari: Collaboration with private hospitals, SHGs, Anganwadis, Panchayati Raj institutions, volunteers.
    • Tribal Focus: Specialised medical services and tailored counselling for remote and tribal areas.

    What is Rashtriya Poshan Maah?

    • Overview: Part of POSHAN Abhiyaan (National Nutrition Mission); celebrated annually since 2018.
    • 2025 Edition: 8th Poshan Maah, aligned with SNSPA for synergised impact.
    • Aim: Mobilise communities to improve nutrition of children, pregnant women, lactating mothers, and adolescent girls.
    • Activities: Poshan Panchayats, health and nutrition camps, recipe demos, rallies, school-Anganwadi outreach, Jan Andolan approach.
    • Focus Areas (2025):
      • Anaemia Mukt Bharat and micronutrient awareness.
      • Complementary feeding practices for infants and toddlers.
      • Poshan-Vatika (nutri-gardens) for food security.
      • Promotion of traditional and regional diets for sustainable nutrition.
    [UPSC 2024] With reference to the ‘Pradhan Mantri Surakshit Matritva Abhiyan’, consider the following statements:

    1. This scheme guarantees a minimum package of antenatal care services to women in their second and third trimesters of pregnancy and six months post-delivery health care service in any government health facility.

    2. Under this scheme, private sector health care providers of certain specialities can volunteer to provide services at nearby government health facilities.

    Which of the statements given above is/are correct?

    Options: (a) 1 only (b) 2 only* (c) Both 1 and 2 (d) Neither 1 nor 2

     

  • [25th October 2025] The Hindu Op-ed: Respect the health rights of India’s children

    PYQ Relevance

    [UPSC 2020] In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss.

    Linkage: Just as maternal and geriatric health require targeted policies, this article highlights the urgent need for child specific pharmaceutical regulation, reinforcing that inclusive social development demands age-segmented health care frameworks addressing the unique vulnerabilities of each group.

    Mentor’s Comment

    The tragic deaths of 25 children in Madhya Pradesh due to contaminated cough syrup have reignited a critical debate on India’s regulatory failure in child health and pharmaceutical safety. The incident exposes deep gaps in monitoring, quality control, and the larger question of how India safeguards its youngest citizens’ right to health. For UPSC aspirants, this issue links to public health governance (GS-2), ethical administration (GS-4), and inclusive growth (GS-3), all central to understanding India’s social contract with its people.

    Why in the News?

    Twenty five children lost their lives after consuming contaminated cough syrup, a tragedy that shocked the nation. The pediatrician involved reportedly received a ₹2.54 lakh commission for prescribing the syrup, raising questions about medical ethics, accountability, and the systemic failure of regulation. This is not an isolated case, since 2022, contaminated syrups from India have caused deaths in Gambia, Uzbekistan, Indonesia, and Cameroon, denting India’s image as the “pharmacy of the Global South.” The issue marks a repeated failure of quality control and enforcement, despite India having one of the largest pharmaceutical industries in the world.

    Where the Focus Needs to Be

    1. Regulatory framework: The emphasis must shift from blame to building robust regulatory architecture for the distribution of pediatric medicines.
    2. Child health protection: India must uphold its constitutional commitment under Article 39(f), ensuring children’s right to health and development.
    3. Legal ecosystem: Existing laws, such as the Pre-Conception and Pre-Natal Diagnostic Techniques Act and National Policy for Children 2013, must evolve to cover medicine safety for children.

    How Inadequate Oversight Endangers Children

    1. Weak pharmacovigilance: Insufficient clinical data and lack of dedicated pediatric testing result in drugs for adults being extrapolated for children.
    2. Dosage disparity: Absence of age-specific dosage guidelines often leads to overmedication and severe side effects.
    3. Special needs ignored: Pediatric pharmacology demands unique formulations, but most drugs are designed with adults as the reference.
    4. Ethical breach: The commission based medical practice further erodes trust, especially when children’s lives are at stake.

    What the Global Framework Teaches India

    1. Regulatory precedents: The European Union’s Paediatric Use Marketing Authorisation and the U.S. Best Pharmaceuticals for Children Act (BPCA) mandate pediatric testing for all drugs.
    2. Holistic approach: These frameworks ensure drug safety through clinical data collection, financial incentives for manufacturers, and legal enforcement.
    3. Indian gap: India lacks such comprehensive laws; existing rules focus only on general health safety, not pediatric-specific provisions.

    Why Pediatric Medicines Need Special Policy Attention

    1. Essential medicine concept: The WHO defines essential medicines as those meeting priority health needs. Pediatric formulations should be an integral part of this.
    2. Affordability: Without public support, many families cannot afford safe alternatives, forcing them to buy untested drugs.
    3. Domestic R&D: India’s dependency on adult-tested formulations highlights the absence of child focused pharmaceutical innovation.
    4. Education and regulation: Pharmacists and caregivers need training to ensure proper dosage and drug choice.

    How India Can Reform Pediatric Drug Policy

    1. Zero tolerance on contamination: Strong penalties and criminal accountability for substandard and spurious drugs.
    2. Independent regulator: A separate Pediatric Drug Safety Division within CDSCO (Central Drugs Standard Control Organisation).
    3. Integrated surveillance: Real time data monitoring for adverse pediatric drug reactions through digital reporting.
    4. International benchmarking: Alignment of India’s pediatric drug policy with WHO and OECD standards.
    5. Public awareness: Dissemination of safety information to parents, caregivers, and schools.

    Need for India Data

    1. Evidence based policy: India must base its pediatric drug policy on domestic child health data rather than extrapolations from adult studies or foreign datasets.
    2. Malnutrition link: Toxicity of contaminated syrups is worsened by underlying malnutrition, emphasizing a multi sectoral child health approach.

    Conclusion

    India’s children represent 39% of its population, yet policy neglect leaves them vulnerable to unsafe drugs and unethical practices. The current crisis is not just about regulatory lapses but about violating the fundamental right to health and life under Article 21. India must institutionalize a child-specific pharmaceutical policy, backed by strict monitoring, ethical medical practices, and international standard oversight. Ensuring safe, affordable, and regulated pediatric medicines is not merely a policy choice, it is a moral obligation and constitutional duty.