CURRENT AFFAIRS – 22/02/2024

CURRENT AFFAIRS - 22/02/2024

CURRENT AFFAIRS – 22/02/2024

CURRENT AFFAIRS – 22/02/2024

WHO Launches Global Initiative on Digital Health (GIDH)

(General Studies- Paper II)

Source : The Indian Express

The World Health Organization (WHO) has officially introduced the Global Initiative on Digital Health (GIDH) announced during India’s G20 presidency in 2023.

  • The GIDH aims to create a collaborative platform for knowledge sharing and digital product exchange among countries worldwide.

Key Highlights

  • The initiative will function as a network of networks, comprising four main components:
    • Country Needs Tracker: A tool to identify and address the specific digital health requirements of individual countries.
    • Country Resource Portal: A map of available resources in each country, facilitating efficient utilization and collaboration.
    • Transformation Toolbox: A platform to share quality-assured digital tools for healthcare, promoting technological advancement in the sector.
    • Knowledge Exchange: A space for global collaboration and the sharing of expertise in digital health technologies.
  • India’s Digital Response to the Pandemic:
    • In India, the pandemic served as a catalyst for digital transformation, leading to India’s success in digitally tracking cases and managing the largest vaccination drive through its CoWIN platform.
    • CoWIN enabled the issuance of digital, verifiable vaccination certificates, showcasing the country’s digital capabilities in healthcare management.
    • India’s initiatives such as the Ayushman Bharat Digital Mission, aimed at creating secure health accounts for all citizens have also been significant.
    • Similarly, the teleconsultation platform E Sanjeevni, which has provided 140 million consultations to date, emphasizes the significant impact of digital health in enhancing healthcare accessibility.
  • ITU’s Insight on Digital Health Potential:
    • Tomas Lamanauskas, Deputy Secretary-General of the International Telecommunication Union (ITU), highlighted the potential for digital health globally.
    • He pointed out that while nearly half of the world’s population may lack access to essential health services, almost 90% have access to a 3G connection.
    • This underscores the significant potential for leveraging digital health technologies to bridge gaps in healthcare accessibility worldwide.

About the Ayushman Bharat Digital Mission

  • Ayushman Bharat Digital Mission (ABDM) is an initiative launched by the Government of India under the Ayushman Bharat Scheme.
  • The Ayushman Bharat Digital Mission aims to establish a National Digital Health Ecosystem that connects digital health solutions across hospitals in India.
  • The primary goals include simplifying hospital processes, enhancing the ease of living for citizens, and ensuring the secure and efficient management of medical records through digital platforms.
  • Comprehensive Digital Integration:
    • The mission will facilitate the seamless integration of digital health solutions in hospitals nationwide.
    • This integration is expected to simplify hospital procedures, ensuring a more streamlined and accessible healthcare system.
    • The comprehensive digital ecosystem will not only provide ease of access to medical practitioners but also introduce features like digital consultations and patient consent for accessing medical records.
  • The various components of the Ayushman Bharat Digital Mission include:
    • Unique Health ID: A unique health ID for every citizen that contains their health records, lab reports, and prescriptions.
    • Electronic Medical Records (EMR): Store all medical records in digitized format and access the information from anywhere in the country.
    • Teleconsultation: Facilitates remote consultations with doctors using telemedicine technology.
    • Online Pharmacy: Promotes online pharmacies, making medicines available to people remotely.
    • Health Information Exchange: All healthcare providers can exchange medical reports, ensuring seamless access to healthcare services, irrespective of the location.
    • Healthcare Professionals Registry: Provides unique identifiers for all healthcare professionals and creates a Healthcare Professionals Registry.
    • Health Facility Registry: A real-time updated database of all health facilities, which will bring further ease of doing business for all health system stakeholders.

Why are we falling ill so frequently?

(General Studies- Paper III)

Source : The Indian Express

India is witnessing a concerning escalation of respiratory diseases, particularly Influenza A (H1N1), according to recent data from the National Centre for Disease Control (NCDC).

  • States such as Kerala, Maharashtra, Punjab, Tamil Nadu, Telangana, Chattisgarh, Sikkim, Uttarakhand, and West Bengal are reporting a resurgence of Influenza A (H1N1) cases, with some states recording deaths related to the influenza virus.
  • The NCDC’s report highlights the presence of A(H1N1) pdm09, A(H3N2), and Type B Victoria lineage strains in India.

Key Highlights

  • The flu viruses identified in India closely resemble those found worldwide, aligning with the types recommended for vaccination by the World Health Organization (WHO) for the Southern Hemisphere in 2024.
    • Clinicians are advising individuals with cough and cold symptoms to undergo testing for both influenza and Covid-19 due to an increase in chest infections and hospital admissions.
  • NCDC’s Response and Vaccine Recommendation:
    • In response to the rise in influenza infections, the NCDC is recommending the prudent use of the Southern Hemisphere’s 2024 quadrivalent influenza vaccine.
    • This proactive measure aims to mitigate the impact of the influenza outbreak and protect the population from severe illness or complications associated with the virus.
  • Characteristics of Seasonal Influenza:
    • Seasonal influenza is described as an acute respiratory infection caused by influenza viruses.
    • It is highly contagious and affects the respiratory system, leading to symptoms such as sudden onset of fever, dry cough, headache, muscle and joint pain, sore throat, and runny nose.
    • While most people recover within a week without medical attention, influenza can cause severe illness or fatalities, particularly in high-risk individuals.
  • Global Impact and Productivity Loss:
    • The effects of seasonal influenza epidemics extend beyond individual health, causing high levels of worker/school absenteeism and productivity losses.
    • In developing countries, research estimates indicate that a significant percentage of deaths in children under five years of age with influenza-related lower respiratory tract infections occur during epidemics.
    • In India, influenza viruses, notably subtypes A (H1N1), (H3N2), and influenza B, constantly evolve, leading to yearly outbreaks, particularly during the winter season.
    • The country’s high population density, suboptimal hygiene practices, conducive weather for virus survival, and low vaccination rates contribute to the increased risk of influenza transmission.
  • Climate Change and Epidemiological Impacts:
    • Extensive epidemiological studies have explored the relationship between respiratory virus epidemics, including influenza, and meteorological factors.
    • Climate change is identified as a factor influencing the occurrence and transmission of viral respiratory infections.
    • Rising temperatures and abnormal rainfall patterns may spatially and temporally shift seasonal influenza epidemics.
    • Additionally, extreme weather events can heighten the risks of influenza and transmission of other respiratory viruses.

Note: Epidemiological studies are scientific investigations conducted to understand the distribution and determinants of health-related events or conditions in a defined population. The field of epidemiology aims to identify patterns, causes, and risk factors for diseases and health-related outcomes. These studies provide crucial information for public health decision-making, intervention planning, and disease prevention.

  • Clinical Challenges and Influenza-like Illness (ILI):
    • Diagnosing influenza primarily relies on clinical assessment, especially during periods of low influenza activity or outside epidemic situations.
    • However, distinguishing influenza from other respiratory viruses (e.g., SARS-CoV-2, rhinovirus, respiratory syncytial virus) presenting as influenza-like illness (ILI) can be challenging.
    • This difficulty in clinical differentiation often leads to indiscriminate antimicrobial use.
    • Antimicrobial Challenges and Rising Antibiotic Resistance:
      • Indiscriminate antimicrobial use is a significant concern, particularly in the absence of definitive diagnoses, contributing to the leading cause of outpatient antibiotic prescriptions.
      • Over 80% of cases in Low- or Middle-Income Countries (LMIC), including India, receive antibiotics unnecessarily for acute respiratory infections, including influenza.
      • This misuse of antibiotics fuels the growing threat of antimicrobial resistance (AMR), a pressing issue in India highlighted by data published by the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) annually.
    • Antimicrobial Resistance Challenges:
      • The latest report by the National Centre for Disease Control (NCDC) highlights the excessive prescription of antimicrobials, particularly from the “Watch” category of the World Health Organization’s AWaRe classification.
      • This underscores the urgent need for interventions to reduce opportunities for antimicrobial prescriptions and combat the growing threat of antimicrobial resistance.
    • Global Success with Influenza Control Measures:
      • In more than 100 countries, including several Low- and Middle-Income Countries (LMICs) like Mexico, Tajikistan, Vietnam, Malaysia, Thailand, Oman, Philippines, and Sri Lanka, flu vaccine shots for the elderly have proven effective as part of influenza control measures.
      • This approach has led to a decreased risk of hospitalization and deaths in the elderly population, along with a reduction in antimicrobial usage.
    • Influenza Vaccination Landscape in India:
      • India has approved around a dozen flu vaccines, and the Ministry of Health and Family Welfare (MoHFW) recommends annual influenza vaccination for high-risk groups, including healthcare workers, pregnant women, and individuals with chronic health conditions.
      • However, the seasonal influenza vaccine is categorized as “desirable” or lower priority for children below five years and adults over 65 years.
      • Although recommended, MoHFW does not routinely purchase or provide these vaccines for these age groups.
    • Challenges in Influenza Prevention and Control Strategies:
      • The discussion on introducing the influenza vaccine into the government’s Universal ImmunisationProgramme faces challenges due to the lack of data on morbidity and mortality caused by influenza in India.
      • Additionally, health societies like the Indian Medical Association and Indian Academy of Pediatrics have not prioritized strategies for influenza prevention and control.
    • Opportunity for Preventive Approaches:
      • As India moves towards universal health coverage and in light of recent influenza outbreaks, there is an opportune time for the government to adopt a more preventive approach.
      • Leveraging the success of the COVID-19 vaccine program, the expansion of the immunization program to include influenza vaccines is proposed.
      • This approach is not only beneficial for the vaccinated individuals but can also contribute to reducing community transmission, unnecessary antimicrobial prescriptions, and superimposed bacterial infections, aligning with ongoing efforts to contain antimicrobial resistance.

About the National Centre for Disease Control (NCDC)

  • The NCDC is an apex institution under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India.
  • It was established in 1963 with the primary objective of providing technical expertise in the field of disease surveillance and epidemiology.
  • Functions and Responsibilities:
    • Disease Surveillance and Outbreak Response: NCDC is involved in monitoring and analyzing disease trends, detecting outbreaks, and responding to public health emergencies.
    • Epidemiological Research: Conducting research studies to understand the epidemiology of diseases and risk factors.
    • Capacity Building: Providing training and capacity-building programs for healthcare professionals and workers in the field of epidemiology and public health.
    • Laboratory Services: The NCDC operates laboratories for the diagnosis and confirmation of various diseases, including those with epidemic potential.
    • Collaboration and Networking: Collaborating with national and international organizations to strengthen disease control efforts.
  • International Collaboration:
    • The NCDC collaborates with international organizations, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), to strengthen global and regional efforts in disease control.

What is World Health Organization’s AWaRe classification?

  • The World Health Organization’s (WHO) AWaRe classification is a tool developed by WHO to categorize antibiotics into three groups based on their importance in human medicine and their recommended use.
  • The classification is designed to promote the responsible use of antibiotics and to combat the rising global threat of antibiotic resistance.
  • The AWaRe classification includes the following three groups:
    • Access group (green):
      • This group includes antibiotics that are considered essential for treating a wide range of common infections.
      • These antibiotics should be available at all times in the healthcare system.
      • They are generally first-line treatments for common bacterial infections, and their use is encouraged.
    • Watch group (yellow):
      • The antibiotics in this group are considered to have a higher potential for resistance development, and their use should be monitored and regulated.
      • These antibiotics are not first-choice treatments for many infections, and their use should be restricted to specific situations where other options are not effective.
    • Reserve group (red):
      • This group consists of antibiotics that are considered last-resort options and are used to treat severe infections caused by highly resistant bacteria.
      • These antibiotics are crucial for situations where no other alternatives are effective.
      • Their use should be strictly regulated to minimize the risk of resistance development.
    • The AWaRe classification aims to guide healthcare professionals, policymakers, and stakeholders in making informed decisions about antibiotic use.
    • It encourages the promotion of access to essential antibiotics while discouraging the unnecessary use of broad-spectrum antibiotics that may contribute to the development of antibiotic resistance.

CE20 cryogenic engine isnow human-rated for Gaganyaan missions

(General Studies- Paper III)

Source : The Hindu

The Indian Space Research Organisation (ISRO) has achieved a significant milestone in the human rating of its CE20 cryogenic engine, which powers the cryogenic stage of the human-rated LVM3 launch vehicle for Gaganyaan missions.

  • The completion of the final round of ground qualification tests marks the engine’s readiness to safely transport humans.

Key Highlights

  • Ground Qualification Tests Details:
    • The ground qualification tests for human rating involved rigorous life demonstration tests, endurance tests, and performance assessments under both nominal and off-nominal operating conditions.
    • These conditions include thrust variations, mixture ratio changes, and propellant tank pressure variations.
    • The tests were conducted at the High Altitude Test Facility at ISRO Propulsion Complex, Mahendragiri, simulating flight conditions.
    • To meet human rating standards, four CE20 engines underwent 39 hot firing tests, accumulating a total duration of 8,810 seconds.
    • This exceeds the minimum qualification standard requirement of 6,350 seconds.
    • The final vacuum ignition test, the seventh in the series, took place on February 13.
  • Gaganyaan Mission Objectives:
    • The Gaganyaan project aims to demonstrate human spaceflight capability by launching a crew of three members into a 400 km orbit for a 3-day mission, followed by a safe return to Earth, landing in Indian sea waters.
    • ISRO’s advancements in human-rating technology and successful engine testing contribute to the realization of this ambitious space mission.

About the Gaganyaan Mission

  • The Gaganyaan mission is a human spaceflight initiative led by the Indian Space Research Organization (ISRO) aiming to launch Indians into space and establish India as a major player in the field of human space exploration.
  • Objectives:
    • Demonstrate India’s ability to launch humans to Low Earth Orbit (LEO) and safely return them to Earth.
    • Establish foundations for a sustainable Indian human space exploration program.
    • Develop indigenous technologies required for human spaceflight.
  • Timeline:
    • Uncrewed test flights started in 2023, with plans for two more before the first crewed flight.
    • The first crewed flight is expected in 2025.
  • Components
    • Orbital Module: Consists of a Crew Module (CM) and a Service Module (SM).
    • Crew Module (CM): Designed to accommodate up to three astronauts and provides a habitable space with an Earthlike environment.
    • Service Module (SM): Contains propulsion and power systems.
  • Launch Vehicle: Human-Rated Launch Vehicle (HLVM3), derived from the existing Launch Vehicle Mark III (LVM3).
  • Crew Escape System: Enables rapid separation of the Crew Module from the rest of the stack if needed during launch or ascent phases.
  • Preparatory Measures
    • Several precursor missions have been conducted to verify technology preparedness levels prior to the human spaceflight mission.
    • These missions include Integrated Air Drop Tests (IADT), Pad Abort Tests (PAT), and Test Vehicle (TV) flights.
  • Training Program
    • Astronaut candidates receive comprehensive training covering classroom instruction, physical fitness, microgravity familiarization via parabolic flights, aerospace medicine, recovery and survival techniques, and flight procedures.
  • International Collaboration
    • ISRO has partnered with Russian organizations for initial astronaut selection and training.
    • Long-term goals include establishing the BharatiyaAntariksha Station (Indian Space Station) by 2035 and sending astronauts to the Moon by 2040.

In Image: LVM3 rocket.

Govt. approves 100%FDI in space sector

(General Studies- Paper III)

Source : The Hindu

The Union Cabinet, led by Prime Minister Narendra Modi, announced amendments to the Foreign Direct Investment (FDI) policy in the space sector.

  • The amendments aim to encourage investment in Indian space companies, fostering growth and self-reliance.

Key Highlights

  • Amendments to FDI Policy:
    • Under the amended FDI policy, 100% FDI is permitted in the space sector.
    • The liberalized entry routes are designed to attract potential investors to invest in Indian companies operating in space-related activities.
    • The policy changes include allowing up to 74% FDI under the automatic route for satellite manufacturing, operation, satellite data products, and ground/user segment.
      • Beyond 74%, these activities will require government approval.
    • For launch vehicles and associated systems or subsystems, as well as the creation of spaceports for launching and receiving spacecraft, up to 49% FDI under the automatic route is permitted.
      • Beyond this threshold, government approval is necessary.
    • Additionally, up to 100% FDI under the automatic route is allowed for manufacturing components and systems/sub-systems for satellites, ground segment, and user segment.
  • Expected Benefits and Integration into Global Value Chains:
    • The increased private sector participation is anticipated to generate employment, facilitate technology absorption, and enhance the self-reliance of the space sector.
    • The move is expected to integrate Indian companies into global value chains, enabling them to set up manufacturing facilities within the country.

Note: The earlier Foreign Direct Investment (FDI) policy in the space sector in India allowed FDI in the establishment and operation of satellites through the government approval route only.

  • Flood Management Program Continuation:
    • The Union Cabinet has also approved the continuation of the Flood Management and Border Areas Programme scheme with a substantial ₹4,100-crore outlay for the next five years, covering the period from 2021-22 to 2025-26.
    • The flood management component of the scheme, with an allocation of ₹2,940 crore, will provide Central assistance to states for effective flood control measures.
    • Funding Pattern for Flood Management:
      • For special category states, including eight northeastern states and hilly states such as Himachal Pradesh, Uttarakhand, and the union territory of Jammu and Kashmir, the funding pattern will be 90% (Centre) and 10% (State).
      • In the case of general/non-special category states, the ratio will be 60% (Centre) and 40% (State).
    • River Management and Border Areas Component:
      • The Flood Management and Border Areas Programme also include a River Management and Border Areas component with an allocated fund of ₹1,160 crore.
      • This component underscores the importance of effective river management and addressing challenges in border areas.
    • Continuation of “Safety of Women” Scheme:
      • The Union Cabinet has given approval for the continuation of the “Safety of Women” umbrella scheme proposed by the Ministry of Home Affairs.
      • The scheme has a budget of ₹1,179.72 crore for the period from 2021-22 to 2025-26.
      • Key initiatives under the scheme include scaling up the 112 helpline, establishing six cyber forensic science labs in various locations, and setting up a National Forensic Data Centre.
      • The scheme also focuses on training around 5,000 personnel annually to prevent crimes against women and children.
      • Women’s Safety Scheme Highlights:
        • 112 Helpline Expansion: The scheme aims to enhance the reach and effectiveness of the 112 helpline for women’s safety.
        • Cyber Forensic Science Labs: Six cyber forensic science labs will be set up in Pune, Kamrup (Assam), Bhopal, Chandigarh, Kolkata, and Delhi to address cybercrimes related to women’s safety.
        • National Forensic Data Centre: The establishment of a National Forensic Data Centre is part of the scheme, emphasizing the importance of forensic data in crime prevention and investigation.
        • Training Initiatives: A significant aspect involves training 5,000 personnel annually to proactively prevent crimes against women and children.

What is Foreign Direct Investment (FDI)?

  • Foreign Direct Investment (FDI) refers to the investment made by an individual, organization, or government of one country into business interests located in another country.
  • This investment involves a significant degree of influence or control by the foreign investor over the management and operations of the business in which the investment is made.
  • FDI is a key component of international economic integration and globalization, as it allows for the flow of capital, technology, and expertise across borders.
  • Key characteristics of Foreign Direct Investment include:
    • Direct Ownership and Control:
      • FDI involves a long-term investment in which a foreign entity acquires a substantial ownership stake in a business entity located in another country.
      • This implies a significant level of control and influence over the operations and decision-making of the invested business.
    • Capital Investment:
      • FDI involves the transfer of financial resources, such as capital, technology, and expertise, from the foreign investor to the host country.
      • This capital investment is aimed at contributing to the growth and development of the host country’s economy.
    • Long-Term Perspective:
      • FDI is distinguished from other forms of investment, such as portfolio investment, by its long-term perspective.
      • Foreign investors in FDI typically seek to establish a lasting presence in the host country and are often involved in the day-to-day management of the invested enterprise.
    • Technology Transfer:
      • FDI often involves the transfer of technology and know-how from the foreign investor to the host country.
      • This can contribute to the development of local industries and enhance the host country’s capabilities.
    • Job Creation and Economic Development:
      • FDI has the potential to create employment opportunities and stimulate economic growth in the host country.
      • The infusion of capital, skills, and technology can lead to the expansion of industries and increased productivity.

About the Flood Management and Border Areas Programme scheme

  • The Flood Management and Border Areas Programme (FMBAP) is a scheme launched by the Government of India to provide technical guidance and financial assistance to state governments for flood management, erosion control, and anti-sea erosion measures.
  • The scheme has two components:
    • Flood Management Component (FMP):
      • Under this component, central assistance is provided to state governments for taking up works related to flood control, anti-erosion, drainage development, anti-sea erosion, restoration of damaged flood management works, etc.
      • Expenditure on these schemes is shared between the Union Government and State Government on a certain funding pattern approved by the Cabinet.
    • River Management and Border Areas (RMBA):
      • Under this component, hydrological observations and flood forecasting on common border rivers with neighboring countries, investigation of water resources projects in neighboring countries, pre-construction activities for water resources projects on common border rivers, and activities of Ganga Flood Control Commission (GFCC) are taken up with 100% central assistance.
    • The FMBAP scheme was initially launched during the XI Plan and has continued thereafter.
    • As per the data for the period 1953-2021 maintained by the Central Water Commission (CWC), the average annual area affected in the country due to floods is 7.4 million hectares (mha), average annual human lives lost are 1,671, and the average annual damage due to floods including crops, houses, and public utilities is worth about Rs. 17,564 crore.
    • The scheme has funded 522 projects under the FMP component, out of which 427 projects have been completed, providing an area benefitted of 4.99 mha and protection to 53.57 million populations in the country.
    • On February 21, 2024, the Union Cabinet approved the Flood Management and Border Areas Programme (FMBAP) for the period 2021-26.

Electoral season and restructuring the health system

(General Studies- Paper II)

Source : The Hindu)

With the electoral season underway, political parties are set to release their manifestos, providing insights into their priorities and thinking.

  • Manifestos from both the Bharatiya Janata Party (BJP) and the Indian National Congress in 2014 and 2019 shared common goals such as revamping the primary health system, ensuring universal healthcare, expanding human resources, and leveraging technology.

Key Highlights

  • Policy Progression under UPA and NDA:
    • Under the United Progressive Alliance (UPA) and National Democratic Alliance (NDA), there has been incremental progress in healthcare policies.
    • The UPA’s National Rural Health Mission significantly increased funding and focused on strengthening healthcare delivery in rural India.
    • The NDA continued this trajectory by scrapping the Medical Council of India (MCI), establishing the National Medical Commission (NMC), enhancing rural health infrastructure, and expanding social health insurance.
    • Notably, the NDA set up additional medical colleges and increased medical seats.
    • Despite increases in budgetary allocations, public spending on healthcare under both the UPA and NDA has averaged around 1.2% of GDP.
    • This indicates the need for a deeper examination of the proportionality of spending relative to the overall economic context.
  • Incremental Measures and Systemic Challenges:
    • Over the past two decades, India has implemented incremental measures in healthcare, but these efforts have not addressed the fundamental issues plaguing the health system’s architecture.
    • The system has become distorted and dysfunctional over the years, requiring comprehensive reforms.
    • While the measures have been impressive, they fall short of achieving transformative changes that could address systemic challenges.
  • Global Comparisons and Achievements:
    • Comparisons with countries of similar economic strength reveal that India’s progress has been slower.
    • Thailand, for instance, achieved Universal Health Coverage in 2000, significantly reducing financial burdens on the population and achieving notable improvements in disease incidence, maternal and infant mortality.
    • Thailand consolidated the dominance of its public delivery system, particularly in primary and secondary care.
    • Similarly, Turkey’s Health Transformation Program in 2003 banned dual practice, strengthened public health infrastructure, and restricted private sector presence.

  • Persisting Challenges in India:
    • India faces persisting challenges, with maternal mortality three times higher than the global average.
    • The primary and secondary health infrastructure is weak, marked by severe shortages of human resources.
    • States like Bihar have a doctor-to-population ratio of one doctor per 20,000 people.
    • Despite these challenges, there appears to be a policy shift towards emphasizing medical care in tertiary centers, even though a substantial portion of ailments and disease reduction can be effectively addressed at the primary and secondary levels.
  • Critical Areas for Improvement:
    • Maternal Mortality: India needs significant improvements to bring its maternal mortality rates in line with global standards.
    • Primary and Secondary Health Infrastructure: Strengthening primary and secondary health infrastructure is essential, especially addressing human resource shortages.
    • Policy Focus: While there is a shift towards tertiary care, a more balanced approach is crucial, given that the majority of ailments and disease reduction can be handled at the primary and secondary levels.
  • Critical Importance of Strengthening Primary Healthcare:
    • The foundation of a robust healthcare system lies in strengthening primary healthcare.
    • This involves integrating community surveillance, demographic data, and disease profiles to plan for the appropriate skill mix required to address current and future health needs.
    • Accrediting and mapping health facilities expands access points, while defining service packages and increasing community awareness of entitlements enhances accountability.
    • Coordinated and sequenced actions at the local level are crucial for regulating patient flows and ensuring continuity of care.
  • Successful Models of Reform:
    • Successful examples of healthcare reform emphasize deliberate planning and execution.
    • Thailand’s Universal Health Coverage (UHC) launch in 2000 followed a strategic plan, including a strong human resource policy and significant budget allocation to build provincial-level health infrastructure.
    • In contrast, India’s UHC strategy has relied on purchasing services from a private sector operating on a fee-for-service model, exacerbating supply shortages, especially in specialists and nurses.
  • Challenges in Reforming India’s Health System:
    • Reforming India’s health system requires political will and a shift from a focus on high-end hospitals and technology to addressing foundational issues.
    • The reliance on the private sector, plagued by market failures and poor governance capacity, is seen as a less effective approach.
  • Essential Components of a ‘Fit for Purpose’ System:
    • Team-Based Approach: Redesigning medical curriculum to encourage teamwork and rural service.
    • Equitable Policies: Implementing equitable admission and human resource policies, including banning dual practice.
    • Operational Flexibilities: Embracing decentralization and operational flexibilities within an accountability framework.
    • Outcome-Based Evaluation: Establishing IT and monitoring systems to evaluate performance based on outcome data linked to financing.
    • Values-Centric Approach: Ensuring a values-centric system that respects equity, human dignity, and trust.
  • Understanding and Reforming the Current Healthcare System:
    • Key Objectives of Reform:
      • Effective reform efforts aim to reduce the demand for hospitalization by at least 30% through improved primary healthcare.
      • By promoting lifestyle changes in diet and exercise, reform initiatives seek to decrease disease incidence.
      • Reform efforts aim to mitigate out-of-pocket expenditures by optimizing drug and diagnostic usage.
    • Reforming the healthcare system is a complex endeavor that requires careful planning and implementation.
    • Each state possesses a different level of capability, necessitating tailored approaches.
    • Building a robust reform process will take time but is crucial for achieving sustainable improvements in healthcare outcomes.
  • Anticipated Impact of Reform: Successful reform efforts have the potential to significantly transform the healthcare landscape by:
    • Enhancing primary healthcare services and reducing reliance on hospitalization.
    • Promoting healthier lifestyles to combat disease incidence.
    • Alleviating financial burdens on individuals through optimized healthcare utilization.

Balancing Progress and Sustainability in Affordable Housing

(General Studies- Paper II and III)

Source : The Hindu

The interim Budget 2024 announced the construction of two crore additional houses over the next five years under the Pradhan MantriAwasYojanaGramin (PMAY-G), aligning with the ‘Housing for All’ initiative.

  • While commendable, this expansion prompts a critical examination of potential trade-offs with quality of life and environmental concerns, especially in the affordable housing sector.

Key Highlights

  • Affordable Housing Challenges:
    • The emphasis on mass production, speed, and cost-effectiveness in affordable housing sometimes comes at the expense of factors such as thermal comfort and the incorporation of low-carbon infrastructure.
    • The rapid expansion raises questions about the environmental impact and long-term sustainability of such projects.
    • The Light House Projects (LHPs) under the Global Housing Technology Challenge (GHTC) leverage modern technology and innovative processes to reduce construction time and create resilient and affordable houses.
    • Technologies like Mivan, utilizing advanced aluminum formwork, offer efficiency and lower environmental impact due to reduced wastage.
  • Environmental Trade-Offs and Challenges:
    • While these technologies enhance efficiency and reduce project duration and costs, they present a conundrum.
    • The extensive use of cement and steel without proper insulation increases heat gain, leading to thermal distress.
    • Occupants then resort to increased use of cooling appliances, contributing to higher electricity consumption and elevated greenhouse gas emissions during the operational stage.
    • The reliance on lower efficiency appliances due to cost considerations, despite the availability of high-efficiency options, highlights a critical paradox.
    • Technologies perceived as low-carbon alternatives unintentionally contribute to increased emissions during the operational phase, emphasizing the need for a balanced approach to sustainable affordable housing.
  • Addressing Rising Heat Stress and Cooling Demand:
    • The escalating global heat stress, particularly affecting vulnerable low-income communities with limited access to cooling amenities, underscores the importance of integrating passive design strategies for thermal comfort in housing.
    • As the demand for cooling rises, aligning the ‘Housing for All’ vision with broader environmental and climate goals becomes imperative.
    • Initiatives like Eco Niwas Samhita exemplify the implementation of guidelines embedded within building codes to refine building envelope characteristics based on specific climate zones.
    • The Smart Ghar III project in Rajkot serves as a successful affordable housing example, showcasing the achievement of indoor thermal comfort through passive design implementation.
  • Challenges in Implementation and Stakeholder Collaboration:
    • The multi-stakeholder nature of the building value chain, involving architects, engineers, contractors, material suppliers, and end-users, presents challenges in the effective implementation of passive designs.
    • Lack of awareness among end-users about the long-term benefits, such as reduced energy bills and improved comfort, poses a hurdle.
    • Encouraging adoption requires ecosystem changes, including raising awareness, fostering collaboration among stakeholders, and incentivizing developers to prioritize passive designs.
  • Paving the Way for Sustainable Housing
    • Recognizing the substantial contribution of the building sector to greenhouse gas (GHG) emissions, there is a pressing need to address the environmental impact of construction activities.
    • As the number of building stocks continues to rise, it becomes crucial to analyze the trade-offs between embodied and operational emissions for a comprehensive sustainability assessment.
    • To create resilient structures that not only provide shelter but also contribute positively to the environment, it is essential to weave environmental consciousness into housing initiatives.
    • By adopting this approach, homes become more than just living spaces; they become robust structures that enhance residents’ resilience to a warming climate.

What are the Light House Projects (LHPs)?

  • The Light House Projects (LHPs) are a part of the Global Housing Technology Challenge-India (GHTC-India) initiative, which was launched by the Ministry of Housing and Urban Affairs.
  • The GHTC-India aims to identify and mainstream the best available construction technologies from across the globe.
  • As part of this initiative, six LHPs using distinct technologies were finalized to showcase the use of these technologies for further mainstreaming in the country.
  • The LHPs are model housing projects built with shortlisted alternate technologies suitable to the geo-climatic and hazard conditions of the region.
  • They serve as live laboratories to promote widespread learning on the use of innovative construction technologies/systems on the ground and their mainstreaming in the Indian context.
  • The six Light House Projects are as follows:
    • Chennai, Tamil Nadu: Comprising 1,152 houses with all basic and social infrastructure facilities, it was completed in a record 12 months and was dedicated to the nation on May 26, 2022.
    • Rajkot, Gujarat: This project, consisting of 1,144 houses, was also completed and inaugurated by the Prime Minister on October 19, 2022.
    • Indore, Madhya Pradesh: In-progress, using the Prefabricated Sandwich Panel System.
    • Lucknow, Uttar Pradesh: In-progress, using the PVC Stay In Place Formwork System.
    • Ranchi, Jharkhand: In-progress, using the Precast Concrete Construction System – 3D Volumetric.
    • Agartala, Tripura: In-progress, using the Light Gauge Steel Structural System & Pre-engineered Steel Structural System.

What is Eco Niwas Samhita?

  • Eco Niwas Samhita is a series of codes developed by the Bureau of Energy Efficiency (BEE) under the Ministry of Power, India, to promote energy efficiency in residential buildings.
  • There are currently two parts to the Eco Niwas Samhita:
    • Eco Niwas Samhita 2018 (Part-I: Building Envelope):
      • This part sets minimum building envelope performance standards to limit heat gains (for cooling dominated climates) and to limit heat loss (for heating dominated climates), as well as for ensuring adequate natural ventilation and daylighting potential.
    • Eco Niwas Samhita 2021 (Code Compliance and Part-II: Electro-Mechanical and Renewable Energy Systems):
      • This part addresses electro-mechanical equipment for building operations, renewable energy generation, embodied energy of walling materials and structural systems, and includes five additional appendices focusing on annualized embodied energy, better construction practices, retrofitting of residential buildings, improved air cooling, and smart home concepts.
    • These codes apply to all residential use building projects built on plot areas greater than 500 square meters and are intended to guide building construction toward energy efficiency and reduce greenhouse gas emissions.

On financial devolution among States

(General Studies- Paper III)

Source : The Hindu

Opposition-ruled States, particularly in southern India, have raised concerns about the perceived imbalance in financial devolution, alleging a disparity in their share of tax revenue compared to their contribution to tax collection.

  • The divisible pool of taxes, as outlined in Article 270 of the Constitution, plays a key role in determining the distribution of net tax proceeds between the Centre and the States.

Key Highlights

  • Components of the Divisible Pool:
    • The divisible pool includes taxes like corporation tax, personal income tax, Central GST, and the Centre’s share of the Integrated Goods and Services Tax (IGST).
    • The Finance Commission (FC), constituted every five years under Article 280, provides recommendations on the division of these taxes.
    • Additionally, States receive grants-in-aid based on FC recommendations.
    • Notably, the divisible pool does not encompass cess and surcharge imposed by the Centre.
  • Role and Constitution of the Finance Commission:
    • The Finance Commission is exclusively constituted by the Union Government every five years.
    • Comprising a chairman and four other members appointed by the President, the FC plays a crucial role in recommending the distribution of tax proceeds.
    • The 16th Finance Commission, chaired by Dr. Arvind Panagariya, has been constituted for the period 2026-31.
  • Basis for Allocation in Financial Devolution:
    • Vertical Devolution (Share of States from Divisible Pool):
      • The share of States from the divisible pool, constituting 41% as per the 15th Finance Commission (FC) recommendation, forms the basis for vertical devolution.
      • This allocation is determined by considering various criteria, ensuring equitable distribution among States.
    • Horizontal Devolution (Distribution Among States):
      • The distribution among States is based on specific criteria outlined by the 15th FC.
    • These criteria include:
      • Income Distance: States with lower per capita income receive a higher share to maintain equity, measured by their distance from the State with the highest per capita income (Haryana).
      • Population: The population criterion is based on the 2011 Census, replacing the earlier weightage given to the 1971 Census.
      • Forest and Ecology: This criterion considers each State’s share of dense forest in the aggregate dense forest of all States.
      • Demographic Performance: Introduced to reward efforts in population control, States with a lower fertility ratio receive higher scores.
      • Tax Effort: States with higher tax collection efficiency are rewarded under this criterion.
    • The combination of these criteria ensures a comprehensive and fair distribution of financial resources among States, fostering equity and recognizing diverse socio-economic factors.

  • Issues in Financial Devolution:
    • Cess and Surcharge Concerns:
      • Around 23% of the Union government’s gross tax receipts for 2024-25 come from cess and surcharge, which does not form part of the divisible pool shared with States.
      • The State’s share in total tax receipts of the Centre is around 32%, falling short of the 41% recommended by the 15th Finance Commission (FC).
    • Regional Disparities in Returns:
      • The amount each State receives for every rupee contributed to Central taxes shows significant variation.
      • Industrially developed States receive less than a rupee for every rupee contributed, while States like Uttar Pradesh and Bihar receive more.
      • Variation is attributed to the concentration of corporations in certain State capitals and differences in GST collection among States.
    • Reduction in Southern States’ Share:
      • The percentage share in the divisible pool of taxes has been decreasing for southern States over the last six Finance Commissions.
      • This reduction is influenced by higher weightage given to equity and needs criteria (income gap, population, area, and forest) compared to efficiency criteria (demographic performance and tax effort).
    • Discrepancies in Grants-in-Aid:
      • Grants-in-aid recommended by the FC vary among States, including revenue deficit, sector-specific, and State-specific grants, as well as grants to local bodies based on population and area.
        • Balancing Fiscal Federalism: Reforms for Equitable Revenue Sharing
          • Addressing Imbalance:
            • States contribute 40% of the revenue and bear 60% of the expenditure, highlighting the need for a fair revenue-sharing mechanism.
            • The Finance Commission (FC) recommendations aim to assess this imbalance and propose equitable sharing.
          • Reforms for Equitable Distribution:
            • Enlarge the divisible pool by incorporating a portion of cess and surcharge, ensuring a more comprehensive sharing mechanism.
            • Gradually discontinue various cesses and surcharges, rationalizing tax slabs for a simplified taxation structure.
            • Increase the weightage for efficiency criteria in horizontal devolution, giving due consideration to GST contributions from States.
            • Include relative GST contribution from States as a criterion with appropriate weightage in future FCs.
            • Establish a more formal arrangement for State participation in the constitution and workings of the FC, similar to the GST council.
          • Collaborative Implementation:
            • Reforms should be implemented through collaborative discussions between the Centre and all States.
            • Upholding principles of fiscal federalism, States should ensure adequate resource devolution to local bodies for effective and accountable development.

About the Finance Commission

  • The Finance Commission is a constitutional body in India that plays a crucial role in the distribution of financial resources between the central government and the state governments.
  • Article 280:
    • This article empowers the President of India to constitute a Finance Commission to make recommendations regarding the distribution of the net proceeds of taxes between the Union (central government) and the states and the allocation of resources among the states.
  • Objectives and Functions:
    • Vertical Distribution: Recommending the distribution of net proceeds of taxes between the central government and the state governments.
    • Horizontal Distribution: Allocating resources among the states, considering factors such as population, area, fiscal capacity, and special needs.
    • Grants-in-Aid: Recommending grants-in-aid to be given to the states from the Consolidated Fund of India.
    • Review of Financial Position: Reviewing the financial position of the Union and the states and suggesting measures to improve fiscal discipline.
  • The Finance Commission is constituted every five years or earlier by the President of India, and it consists of a Chairman and four Members.
  • The Chairman should have had public affairs experience, and the Members should be or have been qualified as High Court judges, or be knowledgeable in finance or experienced in financial matters and are in administration, or possess knowledge in economics.
  • The recommendations made by the Finance Commission are of an advisory nature only, and the Commission has sufficient powers to exercise its functions within its activity domain.

What is Cess and Surcharge?

  • Cess:
    • A cess is a tax levied by the government for a particular purpose.
    • It is imposed over and above the existing taxes.
    • Cesses are usually earmarked for specific projects or programs, such as education, health, or infrastructure development.
    • Examples of cess in India include the Swachh Bharat Cess, KrishiKalyan Cess, and Education Cess.
  • Surcharge:
    • A surcharge is an additional charge or tax imposed on the existing tax liability of an individual or a company.
    • Surcharge is typically applied to high-income individuals or entities.
    • It is a percentage of the tax payable, and the rate may vary based on the income slab.
    • Surcharge is often used as a tool to collect additional revenue from those with higher incomes, and it may be imposed in addition to the regular income tax or corporate tax.
  • Note: Cess and surcharges are not included in the divisible pool of taxes.