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Subject: Social Justice

  • Indian biotech investigated following deaths of Uzbek children

    The Central Drugs Standards Control Organisation (CDSCO) are investigating Noida-based firm after the deaths of 18 children in Uzbekistan by drinking health syrup contaminated with Diethylene Glycol (DEG).

    India’s response to these deaths

    • It is certainly the responsibility of the importing country to test medicines before releasing them in their market.
    • After being informed about the incident, India’s apex regulatory body, Central Drugs Standard Control Organisation (CDSCO) opened investigations and lifted control samples.

    Issue: India’s credibility at stake

    • India is one of the leading exporters of medicines.
    • PM Modi recently stressed that Indian drugs had earned the world’s trust and that India could be called the ‘pharmacy to the world’.
    • However, such negative reports on the quality and safety of our medicines will be a massive blow to the country’s image as a source of cheap generic drugs to the world.

    Issues highlighted by the incident

    • Smuggling of cheap drugs: Inquiry reveals that these were imported from an Indian manufacturer, not under public tender but privately.
    • Ignorance by authorities: The drug which is banned for domestic consumption has got exported and led to fatalities. This is a huge blissful mistake by Indian Authorities.
    • Lack of inspection: There are not enough drug inspectors in the country to conduct as many inspections as is ideally required in such as vast set-up.
    • Inadequacies in quality-check: Despite huge production units, there are not an adequate number of laboratories to test the samples in time if all the samples that should be lifted for testing are picked up.
    • Blot on credibility: The matter, if not properly handled, can damage the perception that Indian medicines are trustworthy for many countries and the global South.

    Possible factors behind this tragedy

    • There are rackets of counterfeit Indian medicines turning up in many countries.
    • Some of these were coming from unregistered producers in India, who would produce medicine depending on what cost was paid to them without concern for quality.
    • In some cases, competitors from other countries were known to make counterfeit medicines with Indian markings and dump them in markets where Indian pharmaceuticals were well regarded.

    Way forward

    • The pharmaceutical trade is vital and must be protected from predatory practices and violations of regulatory norms.
    • Regulatory mechanism on both sides should be strengthened.
    • Importers should be given lists of recognised Indian manufacturers.
    • Training should be provided to drug controllers to curtail the menace of counterfeit and poor-quality medicine entering from India.

    Back2Basics: Diethylene Glycol (DEG)

    • A/c to WHO, Diethylene Glycol (DEG) or ethylene glycol is toxic to humans when consumed and can prove fatal.
    • It can cause kidney and neurological toxicity and has been associated with several cases of mass poisoning when consumed via drugs.
    • The chemical tastes sweet and is water-insoluble.
    • The toxic effects of the chemical include abdominal pain, vomiting, diarrhea, inability to pass urine, headache, altered mental state, and acute kidney injury.

     

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  • Union Health Ministry rolls out India’s 1st Suicide Prevention Policy

    The Ministry of Health and Family Welfare announced a National Suicide Prevention Strategy, the first of its kind in the country.

    What is Suicide?

    • Suicide is the act of intentionally causing one’s own death.
    • Mental and physical disorders, substance abuse, anxiety and depression are risk factors.
    • Some suicides are impulsive acts due to stress (such as from financial or academic difficulties), relationship problems (such as breakups or divorces), or harassment and bullying.
    • Despite being entirely preventable, India has been increasingly losing individuals to suicide.

    Why need such strategy?

    Ans. Suicides in India

    • The burden of deaths by suicide has increased in India — by 7.2 per cent from 2020 — with a total of 1,64,033 people dying by suicide in 2021.
    • In India, more than one lakh lives are lost every year to suicide, and it is the top killer in the 15-29 years category.
    • In the past three years, the suicide rate has increased from 10.2 to 11.3 per 1,00,000 population, the document records.
    • The most common reasons for suicide include family problems and illnesses, which account for 34% and 18% of all suicide-related deaths.
    • The report follows a 2021 Lancet study that noted “India reports the highest number of suicide deaths in the world”.

    About the National Suicide Prevention Strategy

    The NSPS puts a time-bound action plan and multi-sectoral collaborations to achieve reduction in suicide mortality by 10% by 2030.  The strategy broadly seeks to establish-

    1. Effective surveillance mechanisms for suicide within the next three years,
    2. Establish psychiatric outpatient departments that will provide suicide prevention services through the District Mental Health Programme in all districts within the next five years, and
    3. Integrate a mental well-being curriculum in all educational institutions within the next eight years.

    The strategy also envisages:

    1. Developing guidelines for responsible media reporting of suicides and
    2. Restricting access to means of suicide

    Significance of the strategy

    • The most important thing is that the government has acknowledged that suicide is a problem.
    • We now have a well-conceived plan involving multi-sectoral collaborations, because the only way a strategy would work would be to involve various sectors.
    • The strategy should now be passed on to the States for them to develop locally relevant action plans; and then cascade to the district, primary health and community levels.

    Why suicide is such a big issue?

    • More youth committing: For the youth of the country (15-29 years), among whom 1/3rd of all suicides take place.
    • Performance pressure: Data suggests that one student dies by suicide every 55 minutes, and 1,129 suicides among children below 18 years of age in 2020 were due to failure in examinations.
    • Farm distress: This is followed by farmer’s suicide and the gendered variance observed these days.
    • Gendered variances: More women are committing suicides these days.

    Way forward

    suicide

    • Holistic approach: Promoting national and sectoral research into the reasons for suicide mortality and its rise, and making culturally and economically appropriate suggestions to help mitigate the problem is critical.
    • Counselling by mass-media: During times of distress, media must promote health-seeking behaviour, correct information and counter the possible myths related to suicide.
    • Evidence-based interventions: Keep in mind the needs of the most vulnerable and marginalized populations, like women and young individuals, providing the required support systems can reduce the number of lives lost and build a healthier response system.

     

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  • Is India a Diabetes capital of the world?

    Diabetes

    Context

    • India is often referred to as the ‘Diabetes Capital of the World as it accounts for 17%percent of the total number of diabetes patients in the world. There are currently close to 80 million people with diabetes in India and this number is expected to increase to 135 million by 2045. World Diabetes day is observed on 14 November.

    What is Diabetes?

    • Diabetes is a chronic (long-lasting) health condition that affects how our body turns food into energy.
    • Diabetes is a metabolic disorder in which the body has high sugar levels for prolonged periods of time.
    • The lack of insulin causes a form of diabetes.
    • Type-I Diabetes: It is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas. Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction stops your body from making insulin. Approximately 5-10% of the people who have diabetes have type 1
    • Type-2 diabetes: With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2.

    Diabetes

    Type-2 diabetes in brief 

    • Long term Condition: It is long-term (chronic) condition which results in too much sugar circulating in the bloodstreams and poor response of insulin. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems. Type 2 diabetes is an impairment in the way the body regulates and uses sugar (glucose) as a fuel. It is a defective response of Insulin
    • More common in adults: Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.
    • Slow signs and symptoms: Signs and symptoms of type 2 diabetes often develop slowly. Symptoms include, Increased thirst, Frequent urination, Increased hunger, Unintended weight loss, Fatigue, Blurred vision, Slow-healing sores, Frequent infections etc. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults).
    • Cure for Type-2: There’s no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease. If diet and exercise aren’t enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.

    What is insulin?

    • Insulin is a hormone produced by the pancreas.
    • Insulin regulates the movement of sugar into your cells.
    • Blood glucose levels tightly controlled by insulin.
    • When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level

    Diabetes

    The prevalence of diabetes in India

    • People living with Diabetes in India: There are an estimated 77 million people with diabetes in India. Which means one in every 10 adults in India has diabetes. Half of those who have high blood sugar levels are unaware. Even among those who have been diagnosed with diabetes, only half of them have their blood sugar level under control.
    • Rapid increase in younger population: According ICMR report, the prevalence of diabetes in India has increased by 64 percent over the quarter-century. prevalence among the younger population has also increased above 10%.
    • Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.
    • Projected Estimation: About 98 million Indians could have diabetes by 2030, these projections come from the International Diabetes Federation and the Global Burden of Disease project.
    • Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.

    Why Indians are more prone to diabetes?

    • Lifestyle changes: The current exponential rise of diabetes in India is mainly attributed to lifestyle changes. The rapid change in dietary patterns, physical inactivity, and increased body weight, especially the accumulation of abdominal fat, are some of the primary reasons for increased prevalence.
    • Ethnically more prone: Ethnically, Indians seem to be more prone to diabetes as compared to the Caucasians, although the precise mechanisms are not well known. we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
    • Greater genetic predisposition: The epidemic increase in diabetes in India along with various studies on migrant and native Indians clearly indicate that Indians have an increased predilection to diabetes which could well be due to a greater genetic predisposition to diabetes in Indians.
    • Decrease in traditional diets: At the same time, the increased ‘westernization’, especially in the metros and the larger cities, has led to a drastic change in our dietary pattens. Indian diets have always been carbohydrate-heavy and now the reliance on refined sugars, processed food in the form of quick bites and fuss-free cooking and trans fatty acids are creating havoc.
    • Mechanization of day-to-day work: With the increasing availability of machines to do our work, there’s also a substantial drop in day-to-day activities.
    • Consumption of high calorie food and lack of physical activities: Obesity, especially central obesity and increased visceral fat due to physical inactivity, and consumption of a high-calorie/high-fat and high sugar diets, thus become major contributing factors.
    • Rapid urbanization: Currently, India is undergoing a rapid epidemiological transition with increased urbanization. The current urbanization rate is 35% compared to 15% in the 1950’s and this could have major implications on the present and future disease patterns in India with particular reference to diabetes and coronary artery disease.
    • Rural-urban migration: The rural migration to urban areas and associated stress plays a significant role in lifestyle change.

    Diabetes

    Ways to manage Increasing Diabetes in India

    • Aggressive Screening procedures: Indians need an upstream approach or prioritizing protection of the population as a whole, beginning with women and children. This can be done with aggressive screening procedures. “Anybody above 18, with a clear-cut risk like family history, weight issues and young women with polycystic ovarian syndrome (PCOS) should be tested. All Indians above 30 should be screened.
    • Timely diagnosis and right management: Medical experts feel that timely detection and right management can go a long way in helping patients lead a normal life.
    • Diet discipline for children: For children, Doctors recommends a serious diet discipline. “Only healthy meals are the option that remains. Tutor the tastebuds of the young and stop their access to fast foods. There can be supportive policy measures making healthy fruits and vegetables accessible in a cost-effective manner to all instead of plain carbs. The mid-day meal or tiffin needs to be looked at thoughtfully and to make it healthy.
    • Promoting physical activities: “The overall decline in physical activity has had devastating impacts on our metabolism,” while agreeing with the 30-minute a day exercise and activity schedule, sounds a note of caution. The recent scientific evidence suggests even five minutes of walk after any meal provides some protection.
    • Adopting healthy Lifestyle: Though a chronic medical condition, Diabetes can be curbed at the initial level by introducing lifestyle changes. Experts suggests, reduce stress; sleep on time and for minimum of seven hours, maintaining ideal body weight, regular physical activity stop smoking, stopping/ minimum alcohol intake and get early treatment for any pre-existing or co-morbid health condition such as hypertension.
    • Regular check-ups: Regular visits to the doctor are important to assess sugar control and assessment/ prevention of complications related to the disease.

    Conclusion

    • With the country having the highest number of diabetic patients in the world, the sugar disease is posing an enormous health problem to our country today. According to a World Health Organization (WHO) fact sheet on diabetes, an estimated 3.4 million deaths are caused due to high blood sugar in the world.

    Mains Question

    Q. Diabetes is increasing alarmingly across all age groups in India. Discuss the reasons and suggest measures to manage epidemic of diabetes if it is not curable?

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  • Role of Private Sector in Ayushman Bharat Digital Mission

    Ayushman Bharat Digital Mission

    Context

    • On 27 September, 2021, Prime Minister Narendra Modi announced the rollout of the Ayushman Bharat Digital Mission with the aim of integrating the different and disparate digital health systems that exist into a National Digital Health Ecosystem.

    What is Ayushman Bharat Digital Mission (ABDM)?

    • The ABDM currently has five main components:
    • Ayushman Bharat Health Account (ABHA) number: A unique health identification number,
    • Healthcare Professionals Registry (HPR): A repository of healthcare professionals across both modern and traditional systems of medicine,
    • Health Facility Registry (HFR): A repository of both public and private health facilities, including hospitals, clinics, diagnostic laboratories, and pharmacies,
    • Unified Health Interface (UHI): An open protocol for digital health services linking patients with healthcare providers,
    • ABHA Mobile App: An app allowing an individual to carry electronic health records.

    Ayushman Bharat Digital Mission

    Analyzing the future of India’s health care system

    • Digitization push of Government: To achieve the Sustainable Development Goals and targets of universal health coverage, the Indian government has expended significant efforts to promote the digitization of the healthcare sector to make health accessible, affordable, and equitably distributed.
    • Citizens and doctors can access the health registry: The two registries would ostensibly create a database of India’s healthcare institutions and professionals that citizens would be able to access.
    • Digital health card: The ABHA number and the application allow citizens to securely identify themselves and carry their health records to any healthcare facility.
    • Targeted health care services: And lastly, the UHI would facilitate greater access to and delivery of healthcare services.
    • Huge data for research: All of this activity has and will generate a tremendous quantity of data, which will be crucial for research, innovation, and policymaking.

    Importance of private sector in health sector

    • Mixed health care system: India has a mixed healthcare system, which means that it has both public and private healthcare providers. Without significant participation from the private healthcare providers, the ABDM’s ability to achieve its objectives will be limited.
    • 81% doctors are private: This is because private healthcare infrastructure accounts for nearly 62 per cent of all of India’s health infrastructure and the private sector also provides 81 per cent of the doctors in India.
    • Preference to private healthcare: Both rural and urban population in India seem to prefer seeking treatment from the private sector. Only 33 per cent of the rural and 26 per cent of the urban population depend on the public sector for healthcare.

    Ayushman Bharat Digital Mission

    Why Private health care are opting out of ABDM?

    • Voluntary participation in ABDM: The voluntary nature of participation in the ABDM has led to a significant portion of private healthcare providers opting to not participate in the universal programme nor integrate into the UHI.
    • High cost for digital records: Small healthcare providers like charitable hospitals, clinics, diagnostic labs, pharmacies, or nursing homes are less inclined to participate because of the significant costs involved.
    • Requirement of manpower for digitization: The cost to these healthcare providers, who are most likely in various stages of digitisation, is the number of man hours required to digitise their health records and other data.
    • Financial cost of digitization: The actual financial cost of upgrading or altering their digital health systems to meet basic required standards to participate in the ABDM and the UHI.

    Impact of non-participation by private players

    • A lack of participation from the private sector will negatively impact the objectives of the ABDM in major way:
    • Limited success for UHI: Considering the concentration of private healthcare providers in urban areas, a lack of their participation and integration would limit the UHI’s ability to bring previously inaccessible services to the rural population who would otherwise have to travel to access them.
    • Incomplete data and ineffective policy: The data generated by the ABDM and use of the UHI would be incomplete, which in turn would significantly limit the effectiveness of policy planning and programme delivery.

    Ayushman Bharat Digital Mission

    Conclusion

    • It is unclear whether the government intends to achieve private sector participation through incentives or mandates. Without either approach, it seems that the ABDM will see little participation from smaller private healthcare providers, though how this will play out remains to be seen.

    Mains Question

    Q. What is the significance of Private Players in health care system of India? Explain the crucial role of Private health care in Ayushman Bharat digital Mission.

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  • Centre opposes petition in HC against provisions of Surrogacy Law

    surrogacy

    The Centre has opposed before the Delhi HC a petition challenging certain provisions of the surrogacy laws, including the Assisted Reproductive Technology (Regulation) Act, 2021, and the Surrogacy (Regulation) Act, 2021.

    What is the case?

    • The provisions challenged includes the exclusion of a single man and a married woman having a child from the benefit of surrogacy as a reproductive choice.
    • It challenged the ban on commercial surrogacy.
    • In their plea, the petitioners have stated that commercial surrogacy is the only option available to them.

    Invoking Article 21

    • The personal decision of a single person about the birth of a baby through surrogacy, that is, the right of reproductive autonomy is a facet of the right to privacy guaranteed under Article 21 of the Constitution.
    • Thus, the right affecting a decision to bear or beget a child through surrogacy cannot be taken away, the petition said.

    What rules say?

    • Under the Surrogacy (Regulation) Act, 2021, a married couple can opt for surrogacy only on medical grounds.
    • The law defines a couple as a married Indian “man and woman” and also prescribes an age-criteria with the woman being in the age of 23 years to 50 years and the man between 26 years to 55 years.
    • The couple should not have a child of their own.
    • Though the law allows single women to resort to surrogacy, she has to be a widow or a divorcee between the age of 35 and 45 years.
    • The law does not allow single men to go for surrogacy.

    Distinct features of the Surrogacy (Regulation) Act, 2021

    • Definition of surrogacy: It defines surrogacy as a practice where a woman gives birth to a child for an intending couple with the intention to hand over the child after the birth to the intending couple.
    • Regulation of surrogacy: It prohibits commercial surrogacy, but allows altruistic surrogacy which involves no monetary compensation to the surrogate mother other than the medical expenses and insurance.
    • Purposes for which surrogacy is permitted: Surrogacy is permitted when it is: (i) for intending couples who suffer from proven infertility; (ii) altruistic; (iii) not for commercial purposes; (iv) not for producing children for sale, prostitution or other forms of exploitation; and (v) for any condition or disease specified through regulations.
    • Eligibility criteria: The intending couple should have a ‘certificate of essentiality’ and a ‘certificate of eligibility’ issued by the appropriate authority ex. District Medical Board.

    Eligibility criteria for surrogate mother:

    • To obtain a certificate of eligibility from the appropriate authority, the surrogate mother has to be:
    1. A close relative of the intending couple;
    2. A married woman having a child of her own;
    3. 25 to 35 years old;
    4. A surrogate only once in her lifetime; and
    5. Possess a certificate of medical and psychological fitness for surrogacy.
    • Further, the surrogate mother cannot provide her own gametes for surrogacy.

     

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  • Recognizing “ASHA”: The real hope

    ASHA

    Context

    • One of the biggest issues facing rural health services is lack of information. ASHA workers are the first respondents even when there is lack of access to medical aid are threatened with violence and abused on the number of occasions while handlining the prospected patients in COVID19 pandemic.

    Evolution of “ASHA” you may want to know

    • The ASHA programme was based on Chhattisgarh’s successful Mitanin programme, in which a Community Worker looks after 50 households.
    • The ASHA was to be a local resident, looking after 200 households.
    • The programme had a very robust thrust on the stage-wise development of capacity in selected areas of public health.
    • Many states tried to incrementally develop the ASHA from a Community Worker to a Community Health Worker, and even to an Auxiliary Nurse Midwife (ANM)/ General Nurse and Midwife (GNM), or a Public Health Nurse.

    Who are ASHA workers?

    • ASHA workers are volunteers from within the community who are trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.
    • The role of these community health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.
    • They act as a bridge connecting marginalized communities with facilities such as primary health centers, sub-centers and district hospitals.

    Qualifications for ASHA Workers

    • ASHAs are primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community.
    • They must have good communication and leadership skills; should be literate with formal education up to Class 8, as per the programme guidelines.

    ASHA

    What role do the ASHA Workers play? 

    • Involved in Awareness programs: They go door-to-door in their designated areas creating awareness about basic nutrition, hygiene practices, and the health services available. They also counsel women about contraceptives and sexually transmitted infections.
    • Ensures Mother and child health: They focus primarily on ensuring that pregnant women undergo ante-natal check-up, maintain nutrition during pregnancy, deliver at a healthcare facility, and provide post-birth training on breast-feeding and complementary nutrition of children.
    • Actively involved in Immunization programs: ASHA workers are also tasked with ensuring and motivating children to get immunized.
    • Providing medicines and therapies: Other than mother and childcare, ASHA workers also provide medicines daily to TB patients under directly observed treatment of the national programme. They also provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anemia etc.
    • Tasked with Screening tests: They are also tasked with screening for infections like malaria during the season. They also get people tested and get their reports for non-communicable diseases. They were tasked to quarantine the covid 19 infected patients in the pandemic.
    • Informing the birth and death in respective areas:  The health volunteers are also tasked with informing their respective primary health center about any births or deaths in their designated areas.

    ASHA

    What are the challenges that ASHA workers face?

    • Lack of communication threating the job of ASHA Workers: One of the biggest issues facing rural health services is lack of information.
    • Lack of resources burdening the ASHA works job: Another area of concern is the lack of resources. Over the years, with the closest hospital being 9 km away and ambulances taking hours to respond, ASHA workers had to take multiple women in labour to the hospital in auto rickshaws.
    • Poor medical health facilities: Medical facilities are understaffed and lack adequate equipment for various basic procedures like deliveries. Simple tests, like for sickle cell anemia and HIV, cannot be conducted in no of respective areas of ASHA workers.
    • Low wages according to the job they do: The initial payment used to be paid was Rs 250 a month in 2009. Since ASHA’s unionized and agitated for a living wage. Thirteen years on, they earn around Rs 4,000 a month. It is simply not enough to sustain a family of four.
    • Covid 19 disruptions added to the existing problems: Low wages forcing ASHA’s to work two or more jobs. In the pandemic, no of women lost their husband or the means of earnings and had to revert to farming. Weather fluctuations disrupting the farm produce leaving no of ASHA’s the sole earner for the family. Those who don’t have land are living in miserable conditions.
    • Delayed payments reduce the morale: Payments are also delayed by months, Desperation for work leaves us unable to focus on the groundwork we do.

    ASHA

    What can be done to improve the work conditions of ASHA workers?

    • Improving the communication channels: Channels of communication between the government and the rural population need to be robust. A deadly pandemic makes the value of these channels obvious but in order to get people on board, information needs to be sent out much more effectively and in a hands-on manner. ASHA workers play a crucial role in aiding this effort. ASHA’s can’t do this alone. They need new systems to ensure the dissemination of life-saving information in remote areas.
    • ASHA’s should have fixed income: ASHA’s should have a fixed income, giving them the stability in a job where they spend between eight to twelve hours daily.
    • Role needs to be formalized ensuring the dignity: ASHA’s are recognized as “volunteers” currently. Their role needs to be formalized. Recognizing them as workers provides dignity and protection, and helps them to be taken seriously, by the state, the gram panchayat responsible for the disbursal of funds, and patients.
    • Recognizing and awarding their role will empower and motivate ASHA’s further: For people in villages, ASHA’s have become lifelines. They have led innumerable immunization drives and are everybody’s first call in a medical emergency. They have labored to build trust and serve as a bridge with the state. Examples shows recognition gives some leverage to circumvent the system and seek funds for people in my community.

    Conclusion

    • ASHA’s are lifelines of rural primary healthcare, they are playing critical role on no of fronts ensuring the basic health of India. A better, stronger India is possible if ASHA’s are enabled to serve people. Giving them due recognition would serve this end, along with making rural India’s needs medical or otherwise a priority.

    Mains Question

    Q. For the villagers, ASHA has been a lifeline in the last few years. Acknowledge the problems they face on a daily basis and suggest solutions to raise their morale for the primary health of the village community and the nation as a whole.

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  • Why the SC slammed the two-finger test on rape and sexual assault victims?

    finger

    The Supreme Court has declared that any person conducting the invasive ‘two-finger’ or ‘three-finger’ vaginal test on rape or sexual assault survivors will be found guilty of misconduct.

    What is the two-finger test?

    • The test is conducted to check whether the victim has had recent sexual intercourse.
    • It includes an inspection of the hymen.
    • The hymen is inspected as it can be torn only if the woman has had any sexual intercourse.
    • This test was performed on rape or sexual assault survivors.

    What did the Verma Committee say on the two-finger test?

    • The committee under former Chief Justice JS Verma, formed soon after the 2012 Nirbhaya Gangrape case had recommended tougher laws for such cases and ban of the two-finger test.
    • This test has no bearing on a case of sexual assault.
    • On the basis of this test observations/ conclusions such as ‘habituated to sexual intercourse’ should not be made and this is forbidden by law.
    • Yet, the test continues to be conducted in India and other countries despite rape test kits are being provided by the government to all medical institutions after the committee recommendations.

    Is the two-finger test scientifically accepted?

    • Of course NOT.
    • According to medical experts, science has proved that the hymen is not a reliable source of proving vaginal penetration.
    • The hymen, which is a thin membrane in the vagina, can rupture not just during sexual activity but also during day-to-day work or any physical activity, including playing sports.

    What has the Supreme Court said previously?

    • Violation of privacy: In May 2013, the Supreme Court banned the two-finger test on rape victims on the grounds that it violated their right to privacy.
    • Alternative procedures: The court asked the government to provide better medical procedures in order to confirm sexual assault.
    • Painful for women: The test is medically unnecessary, often times painful, humiliating and a traumatic practice that must end.

    Way ahead

    • Workshops should be held for health providers to prevent the test from being conducted on rape survivors.
    • The curriculum in medical schools should be revised.
    • The court ordered copies of the judgment to be handed over to the Health Ministry, which should be circulated to the health and home departments of the States.
    • The home departments should circulate the judgment to the Director Generals of Police in the States.

     

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  • Physical Inactivity, Neglected Burden on Economy

    physical

    Context

    • Global status report on physical activity is WHO’s first dedicated global assessment of global progress on country implementation of policy recommendations of the Global Action Plan on Physical Activity (GAPPA) 2018-2030.

    What are the findings of the report?

    • Poor physical activity standards: Over 80 per cent adolescents and 27 per cent adults do not meet the physical activity standards set by the World Health Organization (WHO), according to a new report.
    • developing non-communicable diseases: This will lead to 500 million additional people developing non-communicable diseases from 2020-2030 and cost the global economy $27 billion annually, it added.

    How physical Inactivity impacts health and Economy?

    • Changing lifestyles: Sedentary lifestyle of a large share of the global population has been linked to rising prevalence of heart diseases, obesity, diabetes or other noncommunicable diseases.
    • Increasing Hypertension and depression: Of the 500 million new cases projected, nearly half will be attributed to hypertension and 43 per cent to depression, the authors of the report said.
    • A strain on the health systems: The report quantified the economic burden of not being able to meet the GAPPA target. The sharp rise in non-communicable diseases will also put a strain on the health systems in every country.
    • Rising cost of treatment: If the current prevalence of physical inactivity doesn’t change, the world will incur treatment costs of just over $300 billion till 2030, the report mentioned.
    • 70 per cent of health-care expenditure: The largest economic cost is set to occur among high-income countries, according to the analysis. This will account for 70 per cent of health-care expenditure on treating illness resulting from physical inactivity, it showed. Around 75 per cent of the cases will occur in low- and middle-income countries, it added.

    What are the government efforts to address the physical inactivity menace?

    • National physical activity policy: Less than half the countries in the world have any national physical activity policy, showed the analysis of 194 countries by WHO published October 19, 2022.
    • National policies are in operation: Less than 40 per cent of the existing national policies are in operation, the United Nations health agency noted in the Global status report on physical activity 2022.
    • Monitor physical activity among adolescents: As many as 75 per cent of countries monitor physical activity among adolescents, and less than 30 per cent monitor physical activity in children under 5 years.
    • Addressing lack of public Infrastructure: The report highlighted that data regarding progress on certain policy actions is missing. These include provision of public open space, provision of walking and cycling infrastructure, provision of sport and physical education in schools.
    • National physical activity guidelines: only 30 per cent of countries have national physical activity guidelines for all age groups, according to the findings of the report.

    physical

    What are the Recommendations of WHO?

    • Exercise benefits mental and physical health: Light exercise and even walking has proven benefits for mental and physical health, studies have shown.
    • Infrastructural changes by governments: Citizens cannot make healthier lifestyle choices without infrastructural changes by governments such as safe walking and cycling lanes. “In policy areas that could encourage active and sustainable transport, only just over 40% of countries have road design standards that make walking and cycling safer,” the WHO analysts found.
    • Five ways to address the policy gaps: 
    1. Strengthen whole-of-government ownership and political leadership
    2. Integrate physical activity into relevant policies and support policy implementation with practical tools and guidance
    3. Strengthen partnerships, engage communities and build capacity in people
    4. Reinforce data systems, monitoring, and knowledge translation
    5. Secure sustainable funding and align with national policy commitments
    • Four areas of policy intervention:
    1. Active societies,
    2. active environments,
    3. active people and
    4. active systems.

    physical

    Government of India’s efforts to promote physical activity

    • FIT India Movement: FIT INDIA Movement was launched on 29th August 2019 by Honorable Prime Minister with a view to make fitness an integral part of our daily lives. The mission of the Movement is to bring about behavioral changes and move towards a more physically active lifestyle.
    • Objectives of Fit India: Fit India proposes to undertake various initiatives and conduct events to achieve the following objectives:
    1. To promote fitness as easy, fun and free.
    2. To spread awareness on fitness and various physical activities that promote fitness through focused campaigns.
    3. To encourage indigenous sports.
    4. To make fitness reach every school, college/university, panchayat/village, etc.
    5. To create a platform for citizens of India to share information, drive awareness and encourage sharing of personal fitness stories.

    physical

    Conclusion

    • Physical inactivity is silent poison, killing the future of the citizens. Work from home, remote working has increased the physical inactivity among the working populations. Indoor games, mobile addictions, e-learning have reduced the physical activity of children. It’s a collective responsibility of parents, society and government to promote and encourage the physical activity among citizens.

    Mains Question Q.

    What are the ill effects of physical inactivity on health and economy? What are the policies of government India to promote healthy life style?

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  • Food Security, Success Story and Challenges Ahead

    Food Security

    Context

    • The Hunger Hotspots Outlook (2022-23) a report by the Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme (WFP) forebodes escalating hunger, as over 205 million people across 45 countries will need emergency food assistance to survive. 16 October is celebrated as World Food Day.

    What is the current situation of Food security worldwide?

    • Adverse impact of COVID 19 pandemic: Globally, food and nutrition security continue to be undermined by the impacts of the COVID 19 pandemic, climate change, spiralling food inflation, conflict, and inequality.
    • Challenge of Severe hunger continues: Today, around 828 million people worldwide do not have enough to eat, and over 50 million people are facing severe hunger.

    Food Security

    What are the challenges for ensuring food security?

    • The challenge of Climate change: Recent climate shocks have raised concerns about India’s wheat and rice production over the next year. Therefore, it is important to place a greater focus on climate adaptation and resilience building.
    • Rising population will need more resource: By 2030, India’s population is expected to rise to 1.5 billion. Agro food systems will need to provide for and sustainably support an increasing population.
    • The challenge of Soil degradation: Nutrition and agricultural production are not only impacted by climate change but also linked to environmental sustainability. Soil degradation by the excessive use of chemicals, non-judicious water use, and declining nutritional value of food products need urgent attention.

    How India managed its food security?

    • Constant efforts towards Self-sufficiency: India has had an inspiring journey towards better production and achieving self-sufficiency and is now one of the largest agricultural product exporters. During 2021-22,it recorded $49.6billion in total agriculture exports a 20%increase from 2020-21.
    • Efficient targeted public distribution system: One of India’s greatest contributions to equity in food is its National Food Security Act (NFSA)2013 which anchors the Targeted Public Distribution System (TPDS), the PM POSHAN scheme (earlier known as the Midday Meals scheme), and the Integrated Child Development Services (ICDS).
    • Extensive food safety net: Today, India’s food safety nets collectively reach over a billion people. The WFP works with State and national governments to strengthen these systems to reach the people who need them most.
    • Large scale digitization of programmes: The Government continues to take various measures to improve these programmes with digitisation and measures such as rice fortification, better health, and sanitation.
    • Better buffer stock policy: Food safety nets and inclusion are linked with public procurement and buffer stock policy visible during the global food crisis (2008-12)and the COVID19 pandemic fallout, whereby vulnerable and marginalised families in India continued to be buffered by the TPDS which became a lifeline.
    • Successful implementation of PMGKAY: An International Monetary Fund paper titled ‘Pandemic, Poverty, and Inequality: Evidence from India’ asserted that‘ extreme poverty was maintained below 1% in 2020 due to the Pradhan Mantri Garib KalyanAnna Yojana (PMGKAY

    Food Security

    How India and World can manage food security?

    • Avoiding conventional input intensive agriculture: There is increased recognition to move away from conventional input intensive agriculture towards more inclusive, effective and sustainable agro food systems that would facilitate better production.
    • Promoting sustainable practices: Since 1948, the FAO has continued to play a catalytic role in India’s progress in the areas of crops, livestock, fisheries, food security, and management of natural resources through the promotion of sustainable practices.
    • Focus on millets: Millets have received renewed attention as crops that are good for nutrition, health, and the planet. As climate-smart crops, they are hardier than other cereals. Since they need fewer inputs, they are less extractive for the soil and can revive soil health.
    • India’s Efforts as an example: India has led the global conversation on reviving millet production for better lives, nutrition, and the environment, including at the UN General Assembly, where it appealed to declare 2023 as the International Year of Millets. It is the world’s leading producer of millets, producing around 41% of total production in2020. The national government is also implementing a Sub-Mission on Nutrition-Cereals (Millets) as part of the National Food Security Mission.
    • G20 presidency an opportunity for India: India’s upcoming G20 presidency is an opportunity to bring food and nutrition security to the very centre of a resilient and equitable future.

    Food Security

    Conclusion

    • India can lead the global discourse on food and nutrition security by showcasing home grown solutions and best practices, and championing the principle of leaving no one behind working continuously to make its food system more equitable, empowering, and inclusive.

    Mains Question

    Q.Food security has become increasingly challenging due to unpredictable weather conditions. Illustrate. How India can contribute to the global food security issue.

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  • Mental health in India

    10th October, yesterday was observed as World Mental Health Day.

    What is the news?

    • The Lancet released a new report calling for radical action to end stigma and discrimination in mental health.
    • It stated that 90% of people living with mental health conditions feel negatively impacted by stigma and discrimination.

    Mental Illness in India

    • Mental disorders are now among the top leading causes of health burden worldwide, with no evidence of global reduction since 1990.
    • In 2017, an estimation of the burden of mental health conditions for the states across India revealed that as many as 197.3 million people required care for mental health conditions.
    • This included around 45.7 million people with depressive disorders and 44.9 million people with anxiety disorders.
    • The situation has been exacerbated due to the Covid-19 pandemic, making it a serious concern the world over.

    Reasons for Persistence of Mental Illness

    • Stigma to seek help: The staggering figures are void of millions of others directly, or indirectly impacted by the challenge and those who face deep-rooted stigma, many times rendering them unable to seek help.
    • Lack of awareness: This growing challenge in dealing with mental health issues is further compounded by a lack of information and awareness, self-diagnosis, and stigma.
    • Psycho-social factors: Institutions like gender, race, and ethnicity, are also responsible for mental health conditions.
    • Post-Treatment gap: There is a need for proper rehabilitation of mentally ill persons post/her treatment which is currently not present.
    • Rise in Severity: Mental health problems tend to increase during economic downturns, therefore special attention is needed during times of economic distress.

    Need for immediate intervention

    • Neglected Area: Mental health which forms the core of our personhood is often neglected which impeded the development of an individual to full potential.
    • Disproportionate impact: It is the poor, dispossessed and marginalised who bear the greatest burden of mental health problems, but historically their sufferings are dismissed as a natural extension of their social and economic conditions.
    • Vulnerability of the ills: Mentally ill patients are vulnerable to and usually suffer from drug abuse, wrongful confinement, even at homes and mental healthcare facilities which is a cause of concern and a gross human right violation.
    • Suicidal tendencies: Suicidal behavior was found to have relation with female gender, working condition, independent decision making, premarital sex, physical abuse and sexual abuse.
    • Gendered nature: Females are more predisposed to mental disorders due to rapid social change, gender discrimination, social exclusion, gender disadvantage like marrying at young age, concern about the husband’s substance misuse habits, and domestic violence.

    Policy initiatives

    • National Mental Health Program (NMHP): To address the huge burden of mental disorders and shortage of qualified professionals in the field of mental health, the government has been implementing the NMHP since 1982.
    • Mental HealthCare Act 2017: It guarantees every affected person access to mental healthcare and treatment from services run or funded by the government.
    • Rights of Persons with Disabilities Act, 2017: The Act acknowledges mental illness as a disability and seeks to enhance the Rights and Entitlements of the Disabled and provide an effective mechanism for ensuring their empowerment and inclusion in the society
    • Manodarpan Initiative: An initiative under Atmanirbhar Bharat Abhiyan aims to provide psycho-social support to students for their mental health and well-being.

    Way Forward

    • Policy boost: Mental health situation in India demands active policy interventions and resource allocation by the government.
    • Public sensitization: To reduce the stigma around mental health, we need measures to train and sensitize the community/society.
    • Awareness: People should be made aware of the significance of mental health, as much as that of physical health.
    • Destigmatising: Sharing one’s story about mental health (through media campaigns) is the most effective strategy to reduce stigma attached with mental illness
    • Community Approach: There is need to deploy community health workers who, with appropriate training and supervision, effectively deliver psychosocial interventions for the needy
    • Broadening the scope: Mental health care must embrace the diversity of experiences and strategies which work, well beyond the narrow confines of traditional biomedicine with its emphasis on “doctors, diagnoses, and drugs”.

     

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