- CURRENT AFFAIRS – 17/10/2023
- How India can minimize climate risk in agriculture?
- How Jews first migrated to Palestine, and how Israel was born?
- Supreme Court refers electoral bonds case to 5-judge Constitution Bench
- The Indian Himalayan Region needs its own EIA
- Bengaluru’s waste management plan
- Palliative care, a way to reduce financial distress
CURRENT AFFAIRS – 17/10/2023
How India can minimize climate risk in agriculture?
(General Studies- Paper I and III)
Source : The Indian Express
World Food Day commemorates the founding of the FAO in 1945, with a mission to ensure global food and nutrition security.
- Despite sufficient food production globally, access to food remains uneven across nations.
- This year’s World Food Day theme is “Water is Life. Water is Food,” prompting a review of India’s progress in food security and water resource management.
- Food Security Progress in India:
- India has made significant strides in food security.
- Between 2020-21 and 2022-23, India exported 85 million tonnes of cereals, including rice, wheat, and corn.
- Despite providing free food to over 800 million people through the PM GaribKalyanYojana, India achieved this feat.
- India has witnessed substantial growth in milk production, becoming the largest producer of milk in the world.
- Poultry and fishery production have also grown since 2000-01, contributing to a “pink” (poultry) and “blue” (fishery) revolution.
- Challenges in Food Security:
- Access to sufficient, nutritious food remains a challenge.
- The latest National Family Health Survey (2020-22) indicates that 16.6% of India’s population is malnourished.
- Approximately 35% of children under the age of five are stunted, and 32% are underweight.
- India’s progress towards achieving its Sustainable Development Goal of zero hunger and malnutrition by 2030 has been slow.
- Water Resource Management in Agriculture:
- India faces a unique challenge with its water resources.
- Home to nearly 18% of the world’s population, India possesses only 4% of global freshwater resources.
- A significant portion of India’s limited freshwater is utilized in agriculture.
- Estimates vary, with FAO suggesting 90% and the Indian Central Water Commission indicating 78% of water use in agriculture.
- As India’s population and incomes rise, the demand for more food and the necessity to conserve water for drinking, manufacturing, and urbanization also increases.
- India needs a comprehensive approach to water management in agriculture due to challenges posed by climate change.
- A two-pronged strategy is required, addressing both supply-side and demand-side aspects of water management in agriculture.
- Supply-Side Strategies:
- Buffer Stocking of Water:
- India must focus on augmenting buffer stocking of water during the monsoon season in reservoirs.
- Recharging groundwater through measures like check dams and watersheds is essential to ensure a sustained water supply.
- Efficient Water Allocation:
- Rational allocation of water across different crops is critical to maximize water use efficiency.
- Institutional reforms in the Indian irrigation sector are required to improve water distribution and allocation practices.
- Pricing of Water and Power:
- A shift in water and power pricing for irrigation is needed to promote efficient use.
- Subsidized or free water and power have led to inefficiencies, and addressing this issue is essential for better water management.
- Buffer Stocking of Water:
- Demand-Side Strategies:
- Investments in Infrastructure:
- To achieve a target of irrigating at least 75% of India’s gross cropped area, massive investments in reservoirs and canal networks are necessary.
- However, attracting private sector investments has been challenging due to the historically low cost of water.
- Shifting Focus to Water Productivity:
- The focus of agricultural productivity should shift from land productivity to water productivity.
- Evaluating crop productivity in terms of kg of grain per cubic meter of irrigation water can help identify water inefficiencies.
- Rewarding Water-Efficient Farming Practices:
- Promoting water-efficient practices like direct seeded rice (DSR), alternate wet and dry (AWD) irrigation, and zero till farming can save water.
- Encouraging the use of drip irrigation, particularly in water-intensive crops like sugarcane, can significantly reduce water consumption.
- Incentivizing Crop Diversification:
- Incentives for farmers to switch from water-intensive crops like paddy and sugarcane to less water-intensive crops like millets, pulses, and oilseeds can be beneficial.
- Rewarding such shifts can create a level playing field for crops, benefit the environment, and improve nutrition.
- By ensuring sustainable and efficient use of water resources, India can work towards food security while mitigating the risks associated with water scarcity and climate change.
- Investments in Infrastructure:
How Jews first migrated to Palestine, and how Israel was born?
(General Studies- Paper II)
Source : The Indian Express
The Israel-Palestine conflict revolves around differing claims about the establishment of Israel on Palestinian land.
This article explores the origins of Jewish migration to ‘Israel’ and the setting of the stage before Israel’s official declaration in May 1948, highlighting the role played by the British and other Arab powers.
- Anti-Semitism and Zionism:
- The Hebrew Bible traces the name ‘Israel’ back to Jacob, the grandson of Abraham, considered a patriarch in Judaism, Christianity, and Islam.
- Descendants of Abraham settled in Canaan, the approximate modern territory of Israel.
- 19th Century and Ottoman Rule:
- In the late 19th century, Canaan was part of the Ottoman Sultanate, having passed through various empires over millennia.
- Jewish communities lived in several countries, often as prosperous minorities but vulnerable to persecution, particularly in Europe.
- In Imperial Russia, pogroms against Jews occurred in the 1880s, while the Dreyfus affair in France (1894) exposed widespread anti-Semitic prejudices.
- The Emergence of Zionism:
- A growing sentiment within the Jewish community emerged that they needed their own homeland to escape persecution.
- The movement to establish a Jewish homeland became known as Zionism.
- In 1896, Theodor Herzl, an Austro-Hungarian, published ‘Der Judenstaat,’ envisioning a Jewish nation.
- Herzl is regarded as the father of political Zionism.
- Initially, locations like Uganda and Argentina were considered for this homeland, but the focus shifted to Palestine due to its historical significance and presence of Jewish holy sites.
- The First Aliyah:
- The First Aliyah, spanning from 1881 to 1903, marked the initial wave of Jewish migration to Palestine.
- New arrivals began purchasing large tracts of land and engaging in farming, which eventually led to losses for the native Palestinian population.
- Ottoman Rule in Palestine:
- Palestine was a province within the Ottoman Empire, and residents identified more as Ottoman subjects, Arabs, Muslims, or along clan and family lines.
- Absentee landlordism was common, allowing land sales to Jews by those who did not reside in the area.
- The local, rural, and often poor Arab tenants had little say in these land transactions.
- Divergence and Dispossession:
- The new Jewish settlers did not assimilate into the local culture; they spoke little Arabic and interacted primarily among themselves.
- Mechanized agriculture and modern amenities set the Jewish settlements apart from Arab neighbourhoods.
- Land purchases often led to the dispossession of Arab tenants, causing resentment among the locals.
- Impact of Balfour Declaration:
- The Balfour Declaration of 1917 was a pivotal moment, where a British official pledged support for a national home for the Jewish people in Palestine.
- The British government sought Jewish support for its World War I efforts and, in return, endorsed the Zionist cause.
- The declaration promised to safeguard the civil and religious rights of non-Jewish communities but had limited impact on the ground.
- Growing Palestinian Nationalism and Conflict:
- Palestinian nationalism was on the rise, with various groups opposing the growing Jewish influence.
- These groups lacked cohesion and single-minded focus compared to Jewish organizations.
- Enduring hostility and mistrust between the two communities led to sporadic instances of violence.
- After World War I, the former Ottoman territories were divided among the Allies with the aim of promoting self-governance.
- Palestine fell under British mandate during the early 20th century, leading to a complex series of events that ultimately escalated the Israel-Palestine conflict.
- The British Mandate and Arab Frustration:
- The Mandate period spanning three decades involved commissions, white papers, resolutions, and violent conflicts.
- Arab frustration grew due to attacks on Jewish settlements, railways, and civilians.
- Arabs also resisted British presence, believing it was integral to addressing the Zionist issue.
- Jewish communities developed efficient intelligence wings and disciplined militias, diminishing the influence of moderate Jews advocating for Arab rights.
- Emergence of Rival Arab Factions:
- Two primary rival factions arose within the Arab community, led by the Grand Mufti of Jerusalem Mohammed Amin al-Husseini and the influential Nashashibi family.
- Armed resistance groups operated separately from political factions.
- Early attempts at negotiations between Jews and Arabs, such as the 1919 pact, yielded little progress.
- World War II and International Sympathy:
- World War II and the Holocaust garnered significant international sympathy for the Jewish cause.
- Training with British soldiers enhanced the discipline and capabilities of Jewish armed groups.
- The 1936-1938 Period of Violence:
- The years 1936 to 1938 witnessed widespread violence, with Palestinians attacking Jews and the British, the British implementing collective punishments on Palestinian villages, and Jews committing retaliatory killings.
- Palestinians referred to this period as the ‘al-thawra al-kubra,’ or the great rebellion.
- The Peel Commission and the Proposal of Partition:
- The Peel Commission, established by the British, suggested partition as the sole solution to the conflict.
- The Jewish side negotiated for improved terms, while the Palestinian side boycotted the proposal.
- The 1939 White Paper and British Withdrawal:
- In May 1939, a White Paper issued by the British was more favorable to the Palestinian side.
- The divided Palestinian leadership missed the opportunity presented by the White Paper.
- Ultimately, the British, following a similar pattern as they did with the partition in India, allowed tensions to reach a breaking point and announced their withdrawal from Palestine in 1947.
- UN Resolution of 1947
- On November 29, 1947, the UN General Assembly passed a resolution to divide Palestine into Jewish and Arab states, with Jerusalem under UN control.
- The proposed Jewish state was to encompass 55% of the land, including the sparsely populated Negev desert, with a population of 500,000 Jews and 400,000 Arabs.
- The Arab state was to have 44% of the land and a minority of 10,000 Jews. The Arab areas included the West Bank and Gaza.
- The Palestinian side vehemently rejected the UN resolution, while Israel declared its independence on May 14, 1948.
- This period was marked by civil war, and Israeli military groups managed to displace a significant number of Palestinians.
- The creation of Israel is termed the “Naqba” or catastrophe by Palestinians, symbolizing the day they lost their homeland.
- Invasion and Early Wars
- Shortly after Israel’s declaration of independence, it was invaded by Egypt, Jordan, Iraq, Syria, and Lebanon.
- However, Israel, supported by arms and funds from the US, managed to repel these invasions.
- Subsequent to these initial conflicts, the region experienced more Arab-Israeli wars, leading to Israel capturing significant territories.
- International Recognition
- Today, among the 193 member states of the United Nations, 139 recognize Palestine, while 165 recognize Israel.
- Gaza and the West Bank remain under Israeli military control.
Supreme Court refers electoral bonds case to 5-judge Constitution Bench
(General Studies- Paper II)
Source : TH
In a swift development, Chief Justice of India D.Y. Chandrachud has referred the challenge to the validity of the electoral bonds scheme, which allows anonymous donations to political parties, to a Constitution Bench consisting of five judges.
- During the oral mentioning hour, the Chief Justice revealed that the court had received a request to refer the case from the current three-judge Bench to a larger Bench of at least five judges.
- The decision was made due to the “importance of the issue.”
- The case will proceed before the five-judge Bench on October 31, as initially planned during an earlier hearing on October 10.
- The court’s refusal to delay the hearing sends a clear message to the government that further delays will not be tolerated.
- The case has been pending in the Supreme Court for over eight years.
- The court has acceded to the petitioners’ request to primarily address two core issues related to the electoral bonds scheme.
- These issues involve the legality of anonymous donations to political parties and the violation of citizens’ right to information about political party funding, which potentially promotes corruption.
- These concerns relate to the violation of Articles 19, 14, and 21 of the Constitution.
- Potential Avoidance of the Money Bill Question
- The five-judge Bench may decide not to delve into the legal question regarding the passage of the electoral bonds scheme as a Money Bill.
- Instead, it might await a seven-judge Bench’s authoritative decision on “when a Bill could be designated a Money Bill.”
- Concerns Raised by Petitioners
- Advocates representing the petitioners have raised critical concerns about the electoral bonds scheme.
- They argue that the scheme has effectively anonymized and sanitized political donations, withholding crucial information from the public.
- Amendments to the Companies Act have allowed companies to make anonymous contributions to political parties through the purchase of electoral bonds.
- The petitioners contend that amendments introduced through the Finance Acts of 2016 and 2017, both passed as Money Bills, have “opened the floodgates to unlimited political donations.”
- These amendments have removed donation caps by companies and have legalized anonymous contributions.
- Additionally, the Finance Act of 2017 introduced electoral bonds, which are exempt from disclosure under the Representation of the People Act, 1951, potentially enabling unchecked and undisclosed funding to political parties.
- International Influence on Indian Politics
- The Finance Act of 2016 also amended the Foreign Contribution Regulation Act, 2010, allowing foreign companies with subsidiaries in India to fund Indian political parties.
- This amendment has raised concerns about exposing Indian politics and democracy to international lobbyists.
About the electoral bonds scheme
- The electoral bonds scheme is a financial instrument introduced in India for the purpose of making donations to political parties.
- It was initiated by the Indian government in 2018 as a way to promote transparency and clean political funding.
- The primary objective of the electoral bonds scheme is to promote transparency in political funding and reduce the use of unaccounted or “black” money in politics.
- Only individuals and entities with a verified KYC (Know Your Customer) document can purchase electoral bonds.
- Electoral bonds are available in several denominations, ranging from as low as ₹1,000 to as high as ₹1 crore.
- Any person, including corporates, can purchase these bonds and donate them to a political party.
- The identity of the donor remains anonymous, as the bonds do not carry the donor’s name.
- Recipient Parties:
- Political parties registered under Section 29A of the Representation of the People Act, 1951, are eligible to receive electoral bonds.
- These bonds can only be encashed by a bank account of a political party.
- Anonymous Donations:
- One of the main features of electoral bonds is that they allow for anonymous donations.
- The donor’s identity is not disclosed to the recipient party or the public.
- Electoral bonds are issued by specified branches of authorized banks.
- These banks facilitate the sale and encashment of these bonds.
- Electoral bonds have a specific validity period, typically 15 days, during which they can be used.
- If not used within this period, the bond becomes void.
- While the donor’s identity remains confidential, the government introduced some transparency measures.
- Information about the total value of electoral bonds purchased and donated by a party is made available to the Election Commission of India.
- Money Bill Controversy:
- The designation of the electoral bonds bill as a “Money Bill” has also been controversial.
- Money Bills are not subject to the approval of the Rajya Sabha (upper house of Parliament), and this classification has been challenged in court.
What is a ‘Money Bill’?
A “Money Bill” is a specific type of legislation in the parliamentary system of India that exclusively deals with matters related to taxation, government revenue, or public expenditure.
- Article 110 of the Indian Constitution defines what constitutes a Money Bill.
- It includes bills that solely pertain to taxation, borrowing, expenditure of public funds, the custody of the Consolidated Fund of India, or the Contingency Fund of India.
- Passage in Lok Sabha:
- Money Bills can only be introduced in and passed by the Lok Sabha, the lower house of India’s Parliament.
- The Rajya Sabha (upper house) does not have the power to reject or amend a Money Bill.
- Once a Money Bill is passed by the Lok Sabha, it is sent to the President of India for their assent.
- The President’s role is largely ceremonial in this context.
- He/she can either give their assent or return the bill for reconsideration, but they cannot withhold their assent.
- Article 109(2) outlines the limited role of the Rajya Sabha in relation to Money Bills.
- The Rajya Sabha can review and offer recommendations on a Money Bill within 14 days of receiving it.
- However, it does not have the power to amend or reject the bill.
- If the Rajya Sabha does not return the bill within the specified time, it is deemed to have passed.
- Certification by the Speaker:
- Article 110(3) mandates that the decision of whether a bill is a Money Bill is made by the Speaker of the Lok Sabha.
- The Speaker’s decision is final and cannot be challenged.
The Indian Himalayan Region needs its own EIA
(General Studies- Paper III)
Source : TH
The recent Teesta dam breach in Sikkim and flooding in Himachal Pradesh highlight the adverse impact of development in mountainous regions on the environment and ecology.
- This calls for a closer assessment of the environmental repercussions of significant human endeavours in such areas.
- Understanding Environment Impact Assessment (EIA)
- The United Nations Environment Programme (UNEP) defines EIA as a process to identify the environmental, social, and economic impacts of a project before its implementation.
- EIA evaluates different project alternatives, predicts environmental consequences in various scenarios, and aids in choosing appropriate mitigation strategies.
- EIA relies on comprehensive and reliable data to predict future impacts.
- Accurate baseline data is crucial for making informed decisions regarding a project’s environmental impact.
- Evolution of EIA in India
- The precursor to EIA in India started in 1976-77 when the Planning Commission directed the assessment of river valley projects from an environmental perspective.
- Over the years, environmental clearance became a requirement for various projects, and the regulatory framework evolved.
- In 1994, the Ministry of Environment, Forests, and Climate Change issued the first EIA notification, making Environmental Clearance (EC) mandatory for specific projects.
- The EIA 2006 notification marked decentralization, allowing state governments to issue EC in some cases.
- A draft EIA in 2020 sparked controversy for being perceived as pro-industry and compromising ecological concerns.
- EIA as a Regulatory Tool for Sustainable Development
- EIA, if diligently applied, can be a potent regulatory tool for promoting sustainable development in India.
- It serves as a mechanism to balance economic growth with environmental preservation.
- EIA 2006 Notification
- The EIA 2006 notification outlines the procedure and institutional setup for granting environmental clearance.
- Only projects listed in the notification’s schedule require prior EC.
- Projects are categorized into areas like mining, resource extraction, power generation, and infrastructure development.
- Uniform Thresholds and the Indian Himalayan Region (IHR)
- One issue with EIA regulations is the uniform threshold limits for projects across the country.
- The specific needs and vulnerabilities of the Indian Himalayan Region (IHR) have not been considered separately, despite the region’s unique characteristics.
- Even the draft 2020 notification did not address the IHR’s special developmental requirements.
- The regulations do not distinguish the IHR from the rest of the country, which does not align with the region’s distinct environmental challenges and developmental priorities.
- The Graded Approach Flaws
- India’s regulatory system employs a graded approach for managing the risks associated with development projects, adjusting environmental conditions based on the project’s location, such as protected forests, reserved forests, national parks, or critical tiger habitats.
- However, this approach lacks sensitivity to the unique needs of the Indian Himalayan Region (IHR).
- The IHR, despite its ecological significance and special requirements, is treated no differently from other parts of the country in the graded approach.
- This region plays a crucial role as a water source and ecosystem services provider for the entire nation.
- The Himalayas are inherently vulnerable to extreme weather conditions, including heavy rains, flash floods, landslides, and seismic activity.
- Climate change further exacerbates this vulnerability.
- Nevertheless, there are no distinct environmental standards for projects in the IHR.
- The increasing frequency of natural disasters in the Himalayan States underscores the region’s vulnerability and the price it pays for the absence of special environmental standards in the EIA process.
- Integrating IHR Needs in EIA
- Addressing the needs of the Himalayan Mountains can be incorporated at all stages of the EIA process: screening, scoping, public consultation, and appraisal.
- Projects in mountainous regions should have standards aligned with the ecological requirements of the IHR.
- Introducing a clause in the general conditions at the end of the notification could establish specific requirements for projects in high-altitude regions or those with particular characteristics that heighten their environmental impact.
- Lack of National-Level Regulator
- There is no national-level regulator for independent, objective, and transparent appraisal and approval of projects for Environmental Clearances (ECs), as previously suggested by the Supreme Court of India.
- The EIA process is more reactive than anticipatory and may exhibit a bias toward the project due to its financial backing by the proponent.
- Limited Consideration of Cumulative Impacts
- The EIA process tends to focus on individual project impacts rather than cumulative impacts resulting from multiple projects in a given area.
- However, it does partially consider subcomponents or ancillary developments of a project.
- In many cases, the EIA process is executed as a mere formality or a “box-ticking” exercise for the purpose of obtaining EC before initiating a project.
- Policymakers should explore alternative tools, such as strategic environmental assessments, which consider cumulative development impacts in a region to better address the unique requirements of the IHR as a fundamental policy.
What is Environment Impact Assessment?
- Environment Impact Assessment (EIA) is a systematic and comprehensive process used to evaluate the potential environmental impacts and consequences of proposed development projects, policies, or activities.
- The primary objective of EIA is to ensure sustainable and responsible development by identifying, mitigating, and managing adverse environmental effects.
- It provides a framework for decision-makers to make informed choices and to balance development with environmental protection.
Environment Impact Assessment (EIA) process
In India, the EIA Notification, issued under the Environment (Protection) Act 1986, outlines the process and requirements for conducting an EIA for various categories of projects.
- EIA Notification and Categories:
- The EIA Notification is a crucial document that categorizes development projects into two primary categories: Category A and Category B.
- This categorization is based on the potential environmental impacts of the projects.
- Category A projects are considered to have significant environmental consequences and require mandatory environmental approval from the Central Government.
- They bypass the screening procedure.
- Category B projects, on the other hand, undergo a screening procedure to assess their environmental impact.
- Depending on the screening, some Category B projects may require environmental approval from the State Government, while others may not require such approval.
- Central and State Oversight:
- The Ministry of Environment, Forest, and Climate Change (MoEFCC) at the central level plays a central role in the implementation and oversight of the EIA process for Category A projects.
- State Environmental Impact Assessment Authorities (SEIAAs) are responsible for implementing the EIA process for Category B projects within their respective states.
- They assess the projects at the state level, which allows for a more localized evaluation of potential environmental impacts.
- Screening Procedure:
- Category B projects undergo a screening procedure to determine their potential environmental impact.
- This step involves the assessment of project details, location, and scale.
- The screening helps decide whether a project requires an Environmental Clearance (EC) or if it can proceed with minimal environmental evaluation.
- Environmental Clearance:
- For Category A projects, the MoEFCC grants Environmental Clearance (EC) following a comprehensive evaluation of the potential environmental impacts and proposed mitigation measures.
- For Category B projects requiring state-level approval, the respective SEIAAs evaluate the projects and issue ECs when deemed necessary.
- Public Participation:
- The EIA process also incorporates public participation through public hearings and consultations.
- Local communities and stakeholders have the opportunity to express their concerns and opinions regarding the proposed projects.
- Once projects receive EC, monitoring and compliance with the conditions laid down in the approval are critical.
- Regular monitoring helps ensure that projects adhere to environmental protection measures.
- The EIA Notification is a crucial document that categorizes development projects into two primary categories: Category A and Category B.
Bengaluru’s waste management plan
(General Studies- Paper III)
Source : TH
The Government of Karnataka is considering relocating waste processing facilities in Bengaluru to the outskirts, requiring identification of land parcels of 100 acres each in Bengaluru Rural and Ramanagara districts.
- Bengaluru currently generates around 5,000 tonnes per day (TPD) of waste, with an expected increase to approximately 6,000 TPD in the next few years.
- Existing waste processing capacity is around 2,000 TPD, including decentralized ward-level facilities, leaving roughly 3,000 TPD of waste unprocessed in landfills.
- Expected Opposition:
- The initiative to establish four additional waste-processing facilities outside the city is expected to face significant opposition, primarily from the surrounding villages.
- Historical issues with inefficient operations at existing waste-processing plants, including leachate and odor problems, have contributed to opposition.
- Operational Protocols for New Plants:
- To address these issues, it is crucial to expand the city’s waste processing capacity to handle 6,000 TPD through a combination of central and decentralized systems.
- Ensuring that no facility receives more waste than its designed capacity is essential to mitigate leachate and odor problems effectively.
- New waste-processing facilities should have the capacity to process 1,000 TPD, covering the entire waste generated in the city.
- Composting of fresh waste is the preferred technology, aligning with Bengaluru’s waste composition, which includes biodegradable wet waste (60%), dry waste (25%), and inert materials (15%).
- Each facility should include a 600-TPD composting unit, a 250-TPD material recovery facility, and a 150-TPD scientific landfill to handle inert materials.
- Addressing Local Concerns:
- Addressing odour and leachate concerns is vital; new waste-processing plants should have tertiary-level leachate treatment.
- High moisture content leads to odour in waste-processing facilities, which can be mitigated by equipping plants with high-capacity lane turners or windrow-turning equipment.
- Land acquisition and land-use changes may affect local terrain and rainwater management; thorough geotechnical investigations are necessary.
- In rural areas, engaging farmers and offering free organic compost can reduce chemical fertiliser reliance and save farmers money.
- Repurposing Existing Facilities:
- Existing wet-waste-processing facilities, sources of concern, could be converted into dry-waste management facilities.
- Converted facilities can handle dry waste, reducing transportation costs for the BBMP and operating at a more feasible utilization rate.
- Dry-waste segregation facilities are less likely to pose problems to residents, create job opportunities, and address waste management.
- The Need for Increased Waste-Processing Capacity:
- Expanding waste-processing capacity is essential to comply with waste management rules and environmental obligations.
- Success depends on strategies addressing technology, environmental and social impact, past experiences, and community involvement.
- Focusing on these factors can prevent waste-processing sites from becoming landfills and benefit urban and rural populations.
Palliative care, a way to reduce financial distress
(General Studies- Paper II)
Source : TH
Many Indians face financial hardship due to the high costs of healthcare.
- Approximately 5.5 crore people fall below the poverty line annually due to out-of-pocket healthcare expenses.
- Non-communicable diseases like cancer, cardiac disease, renal failure, and stroke are pushing people into poverty as they require lifelong treatment and periodic check-ups.
- Financial Implications and ‘Financial Toxicity’:
- Continuous treatment of non-communicable diseases often leads to ‘financial toxicity,’ with risks of bankruptcy, decreased treatment satisfaction, delays in seeking further medical care, and a poor quality of life.
- Government health spending in India is only 1.35% of the GDP, leaving patients to bear most of the healthcare expenses.
- Even in government hospitals where treatment is supposed to be free, patients incur costs for travel, purchasing medicines, and loss of wages due to work absences.
- A recent study reports significant expenses for patients, such as ₹8,035 per outpatient visit for cancer patients and ₹39,085 per hospitalization in tertiary care hospitals.
- Towards the end of life, attempts to prolong life through treatment lead to additional financial burdens, often forcing caregivers to sell assets and disrupt the education of children in the family.
- More than 65% of patients with late-stage cancer face impoverishment due to healthcare expenses.
- The Importance of Palliative Care:
- Palliative care focuses on improving the quality of life for individuals with life-limiting illnesses, such as cancer, kidney disease, brain disorders, and heart disease.
- It differs from other medical specialties by addressing uncontrolled symptoms of incurable illnesses and avoiding non-beneficial investigations and treatments.
- Palliative care considers not only the physical aspect of health but also the social and economic realities of the patient and their family.
- Early initiation of palliative care has been shown to reduce health expenditure by up to 25%.
- Lack of Investment in Palliative Care:
- Awareness about palliative care is low in India, among both healthcare workers and the general public.
- Palliative care is not covered by most insurance schemes in India, resulting in poor demand and limited access to such care.
- Inadequate funding and lack of services in public health centers have led to the dominance of private nonprofit organizations in meeting the country’s palliative care needs.
- Incorporating Palliative Care into the Healthcare System:
- The National Program for Palliative Care needs consistent funding to enable long-term planning, as opposed to its current occasional annual budgeting.
- Providing palliative care in public health centers can save money for both patients and healthcare providers, while also protecting people from avoidable health expenditures.
- Investment in palliative care not only improves patient well-being but also generates goodwill for corporate hospitals, leading to increased utilization of hospital beds and financial benefits for the healthcare sector.
- Prioritizing palliative care is a moral obligation of the health system and promises high returns in terms of patient quality of life and healthcare efficiency.
About Palliative care
- Palliative care is a specialized branch of healthcare focused on providing comprehensive and holistic support to individuals facing serious, life-limiting illnesses.
- The primary goal of palliative care is to improve the patient’s quality of life by addressing their physical, emotional, social, and spiritual needs, particularly when a cure may not be possible.