Context

Recently, Influenza A H5N1 was detected in dairy cows in six States in the U.S.

• An emerging new lineage 2.3.4.4b of avian influenza has been spreading across the globe since late 2020, carried by migratory birds following specific routes.

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Avian Influenza A H5N1 Bird Flu

• H5N1 is a type of influenza virus that causes severe respiratory disease in birds.
• Transmission: Humans are also at risk but they rarely contract bird flu. 
  • Most of the cases of human infection involve people who have. prolonged or close exposure to H5N1-infected animals such as farm/poultry workers, are at a higher risk. 
• Cases of Human Infection: Human infections with H5N1 were first reported in 1997 during a poultry outbreak in Hong Kong.
  • There have been 887 cases of H5N1 between 2003 and 2024, of which 462 people died.
• Signs and Symptoms: Mild illness, manifested through eye redness (conjunctivitis) or mild flu-like upper respiratory symptoms, to severe (such as pneumonia requiring hospitalisation).
• Treatment: The antiviral Oseltamivir
  • There are also vaccine candidates that have been developed, but not readily available, for H5N1.
• Mortality: This could be as high as 60 per cent.
• Potential of Pandemic: Avian influenza is not on the WHO priority list of pathogens of pandemic potential.

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Context

The Department of Archaeology and Museums has unearthed a coin hoard at the Phanigiri Buddhist site in the Suryapet district (Telangana).

• According to the archaeologists, the coins belong to the Ikshvaku period, dated between the 3rd century and the 4th century Common Era.
• The coins have an elephant symbol on the obverse and the Ujjain symbol on the reverse.

Phanigiri: A Buddhist Site in Telangana

• Location: The Phanigiri is an important Buddhist site.
  • It is situated in Nagaram Mandal, Suryapet district, on the left side of the Bikkeru Rivulet, a tributary of Musi.
• According to etymology, in Sanskrit, Phani means snake, and Giri means hilltop.

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• Discovery of Earlier Excavations: a Mahastupa, apsidal Chaityagrihas, Votive stupas, pillared congregation halls, Viharas, platforms with staircases at various levels, an octagonal stupa chaitya, a 24-pillared mandapam, and a circular chaitya.
• Cultural Materials Found: Terracotta beads, semi-precious beads, iron objects, Brahmi label inscriptions, and a holy relic casket. All the cultural material dates from the 1st century BCE to the 4th century CE.
• The toranas discovered at Phanigiri show that Mahayana and Hinayana schools coexist here.

Other Important Sites In Region

Vardhamanukota, Gajula Banda, Tirumalagiri, Nagaram, Singaram, Aravapalli, Ayyavaripalli, Arlagaddagudem, and Yeleswaram.

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About the Ikshvaku Period

• The Ikshvaku dynasty (c. 225-340 A.D) was a feudatory tribe under the patronage of the great Satavahana Empire that ruled the Andhra region, the delta of the Krishna and Godavari rivers on the east coast, situating their capital at Dharanikota (present-day Amravati).

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Context

According to the India TB Report 2024, 79% of presumptive TB testing was still carried out using 100-year-old sputum smear microscopy and just 21% of cases were detected using a molecular test.

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National Strategic Plan for TB Elimination 2017-25

• The National Strategic Plan 2017-2025 wanted to reduce the number of  who are offered sputum smear microscopy from over 9.1 million in 2015 to 5.1 million in 2023 while increasing the number of molecular tests from 40,000 in 2015 to over 14.7 million in 2023. 
• However, as per the India TB report, in 2023, India was far from reaching the ambitious target set by NSP 2017-2025. 

About Sputum Smear Microscopy

• Sputum smear microscopy has been the primary method for diagnosis of pulmonary tuberculosis.
• It is a simple, rapid and inexpensive technique that is highly specific in areas with a very high prevalence of tuberculosis.
• It also identifies the most infectious patients and is widely applicable in various populations with different socio-economic levels 3,4,5.
  • Hence, it has been an integral part of the global strategy for TB control. 

Limitations of Sputum Smear Microscopy

• Low Sensitivity: The sensitivity is grossly compromised when the bacterial load is less than 10,000 organisms/ml sputum sample
• Inefficient: a poor track record in extra-pulmonary tuberculosis, pediatric tuberculosis and patients co-infected with HIV and tuberculosis.
• Requirement of serial sputum examinations: some patients who do not come back for repeated sputum examinations become “diagnostic defaulters’’.

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Alternative Methods: Molecular Biology Diagnostic Techniques

• Xpert MTB/RIF: 

  • It is the most widely used detection method in molecular diagnostics. 
  • It is a semi-nested real-time fluorescent PCR for the detection of M. tuberculosis and rifampin resistance simultaneously.

• Loop-Mediated Isothermal Amplification:

  • This is a type of Nucleic Acid Amplification Test that employs DNA polymerase and a set of specially designed primers to detect the presence of pathogenic DNA from a patient sample.

• Digital PCR:

• • Digital PCR (dPCR) is a new type of nucleic acid quantification technology that requires very small amounts of target molecules, and it performs absolute quantification without the need for a standard curve.
  • Therefore, dPCR is precise and sensitive, and most importantly, it can detect single copies of DNA.

Immunological Diagnostic Techniques

• Tuberculin Skin Test and Interferon-γ Release Assay:

  • The tuberculin skin test and the subsequent widely used tuberculin protein derivative test play an important role in the auxiliary diagnosis of TB, especially in paediatrics TB. 
    • However, these approaches are neither able to effectively distinguish the positive results due to BCG vaccination or M. tuberculosis infection nor provide reliable results for potential immunocompromised TB patients.

• Immuno-PCR

  • The Immuno-PCR (I-PCR) assay detects potential mycobacterial antigens and circulating antibodies in the body fluids of TB patients. Thus, it can be used as a new diagnostic approach for TB. 
    • I-PCR based on magnetic beads (MBs)/ gold nanoparticles (GNPs) in liquid form produces a reduced background signal, and the automated one-step I-PCR also shortens the detection time.

• Lateral Flow Urine Lipoarabinomannan Assay: 

• • It is a key lipopolysaccharide and pathogenic factor present in the cell wall of mycobacteria, with a representative structural epitope of M. tuberculosis.

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Context

Parcels of degraded forest land close to 3,853 hectares have been identified by 10 states to be made available to earn and potentially trade green credits.

• Union Environment Ministry announced the rules for its Green Credit Programme (GCP) Chhattisgarh and Madhya Pradesh alone account for up to 40% of the available forest land.

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The Green Credit Programme (GCP)

• Green Credit Programme Launched by: The Ministry of Environment, Forest and Climate Change in line with the  Lifestyle for Environment (LiFe) movement at the recent COP28 in Dubai.
• Administered by: The Indian Council of Forestry Research and Education (ICFRE).
• Green Credit Programme Aim: To  Generate Green Credits through plantation on degraded wasteland with its initial phase focusing on water conservation and afforestation.
• Green Credit Programme Features: 
  • Creation of a land bank: Registered and approved entities ( individuals, groups, public and private sector units) can pay to finance afforestation projects in specific tracts of degraded forest and wasteland. 
  • State forest departments will carry out the actual afforestation.
  • Each planted tree would be worth one ‘green credit’ after two years of planting and an evaluation by the International Council of Forestry Research and Education (ICFRE). 
  • Offsetting mechanism: Companies can then use these green credits to offset some of their obligations under India’s compensatory afforestation laws.
  • A Market-based Approach: The Green Credit Programme creates a market-based incentive for environment-positive actions like water conservation or soil improvements, apart from just carbon emission reductions.

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Concerns Regarding Green Credit Programme

• Increased Risk of more forest land diversion: The Green Credit Programme facilitates the creation of land banks by linking them to compensatory afforestation activities, which could enable more diversion of forest land to commercial entities.
• No economies of scale: The Indian market being undeveloped with a restricted number of participants could lead to inefficient transactions due to an unbalance in the number of buyers and sellers.
• Market volatility: Green Credit Programme would cause the value of green credits to fluctuate in value and result in businesses facing uncertainties related to their environmental investments. 
  • It would slow down the programme’s efficiency, with delays in receiving credit and receiving revenues from trades, and affect its success. 
• Risk of Greenwashing:  For efficient administration of the scheme, stronger regulations are needed to guarantee ongoing monitoring and validation of claims, which would otherwise risk mere greenwashing.
• No standard unit of measurement: The green credit system does not yet have a standard unit of measurement, unlike the carbon market (prices a standard unit per tonne of carbon emitted ), as it is complicated to determine as they are accrued from various activities and across different sectors. 

Also Read: Green Credit Rules May Damage Forests: Say Experts

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Context

India has emerged as the world’s fastest growing major economy in 2023, according to the United Nations.

• India’s Economic growth rate is  6.8% in FY 2023, with formal unemployment at a 12-year low of 4.1%.

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Key Highlights of the United Nations Survey

India’s Economy

• World’s Fastest growing major economy: India achieved an impressive economic growth rate of 6.8% in FY 2023, making it the world’s fastest growing major economy though economic revival was concentrated in few large economies.
  • Domestically driven growth: India’s economic success is primarily driven by domestic factors, with less reliance on external exposure to developed nations or China.
    • Infrastructure boost: Government spending on infrastructure played a significant role in propelling growth, with gross fixed capital formation increasing by 6%, reaching  34% of GDP in the final quarter of FY23.
    • Favorable demographics: India’s young population (600 million youth aged 15-24 years) presents a tremendous opportunity to boost domestic demand.
      • This demographic advantage contrasts with rapidly aging populations in some regional economies like China, Japan, and South Korea.
• Gender equality gap: The UN urges India to improve gender equality and integrate women’s participation in the workforce, particularly in sectors like manufacturing and tourism. 
  • This requires better data collection and analysis to inform gender-inclusive economic policies.
• GST reforms success: The UN commends India’s Goods and Services Tax (GST) reform for simplifying the indirect tax system and reducing compliance burdens.
• Rice export ban impact: In July 2023, India temporarily banned some rice exports, which made the prices of food rise even higher in the region.
  • This happened at a time when food prices were already high due to weather issues caused by El Nino.
• Climate change concerns: The UN warns that India could lose 5.8% of daily working hours due to heat stress by 2030, especially impacting outdoor workers in agriculture and construction. 
  • This highlights the need for climate change mitigation efforts.

Global Economy 

• Output Growth in Other Economies: 

  • The growth of output was slow in other economies because of high living cost, rise in economic uncertainty, and weak external demand. 

• Income Inequality/ People’s Purchasing Power:

  • High inflation and poor job opportunities have decreased individual’s buying capacity and their ability to face shocks. 
    • COVID 19 pandemic and high cost of living are the major factors behind rising  income inequality. These pushed around 42 million more people in the poverty cycle. 

• Global Near-term Economic Outlook: 

• • Inflation is still high. In addition to it, fiscal conditions are also not favourable. Apart from this, there are various risks such as the impact of China’s economic slowdown, rise in geopolitical tensions, and trade disruptions in the Asia-Pacific region. 

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• High borrowing costs in Asia Pacific Region:  

  • During 2019 to 2022, interest payment of the government was about 28 and 38 percent of public spending on education and health care. 
    • ESCAP analysis: According to this analysis, there is a need to manage sustained macroeconomic and inflation stability, strong fiscal positions and financial market liquidity as these are crucial in keeping low borrowing rates. 

• Global Working Hour Loss:

  • Globally, about 2.2% of working hours are estimated to be lost due to rising temperatures.
  • In developing countries, total output losses due to heat stress are estimated to range from 1.5% to 4.0% of GDP annually.

• Labor Productivity and Social Welfare Strategies:  

  • Nations with limited savings should focus on raising productivity by making investments in education, skills training, technology adoption, and infrastructure development. 
    • It will help in reducing precautionary savings and boost financial accessibility and literacy.

Benefits of India’s Strong Economic Performance in 2023 (as per the UN Report):

• Low Unemployment: India’s impressive growth rate will create more jobs, investment, and overall prosperity, leading to a fall in unemployment rate.
• Strong domestic demand: A large young population creates a strong domestic market for businesses to sell to within India.
• Less reliance on external factors: India’s economic success is less vulnerable to global slowdowns or trade issues compared to other economies.
• Simpler tax system: The GST reforms has streamlined the tax system, making it easier for businesses to operate.

Challenges for India to Address

India has various challenges to face 

• Climate change: Rising heat stress could significantly impact worker productivity, particularly in outdoor jobs.
• Gender equality gap: There is a need to improve gender equality and integrate women’s participation in the workforce for full utilization of women’s talents in the workforce to increase economic potential.
• Food security: The rice export ban highlights the need for India to ensure food security for its own population.

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Context

Nepal’s parliament has approved the BIMSTEC regional grouping’s charter.

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Nepal’s Lower House Endorses the BIMSTEC Charter

• Endorsement of BIMSTEC Charter: Except for Nepal, the other six member nations of BIMSTEC have already endorsed the BIMSTEC Charter.
  • BIMSTEC charter can only be enforced after its endorsement by Parliament of a particular country.

BIMSTEC Charter

• About: The BIMSTEC Charter was signed and adopted during the Fifth BIMSTEC Summit held in virtual format in Colombo, Sri Lanka,  on 30 March 2022.
• Foundational document: The Charter serves as the foundational document, setting out principles and structures for cooperation among member states.

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About BIMSTEC

• Genesis: BIMSTEC was formed in 1997 to enhance regional cooperation on issues like economic prosperity, social progress, scientific achievement, peace, stability and connectivity. 
• Secretariat: Dhaka, Bangladesh.
• Membership: It has a total of seven member countries: Five from South Asia, including Bangladesh, Bhutan, India, Nepal, and Sri Lanka; Two from Southeast Asia, including Myanmar and Thailand.

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Context

The Institute for Human Development and the International Labour Organization (ILO) recently released the India Employment Report 2024.

• The research is mostly based on data analysis from the National Sample Surveys and Periodic Labour Force Surveys conducted between 2000 and 2022.

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Key highlights of the India Employment Report 2024

• Shifting of Workforce in Non-farm Sectors: The 2000- 2019 period witnessed gradual and continuous shift of the workforce away from agriculture into non-farm sectors, a trend which is still continuing.
• Employment trends in India: Employment in India is primarily self-employment and casual employment with approximately 82 percent of the workforce works in the informal sector, with approximately 90 percent informally employed.
• Stagnant Wages: While casual laborer salaries rose modestly between 2012 and 2022, regular workers’ actual wages remained stagnant or fell.
• The rate of youth not in employment, education or training: South Asia with an average of 29.2% between 2010 and 2019 have the highest rate of youth outside employment, training and education.

Outlook on Women Employment in India

• Female Labour Force Participation Rate: The Female Labour Force Participation Rate (LFPR) was 37 in 2023 as compared to 78.5 for Males. The world women LFPR rate is 49 as per the World Bank.

• • The female Female Labour Force Participation Rate (LFPR) had been steadily declining since 2000 and touched 24.5 in 2019, before inching up, particularly in rural areas. 
• Uptick in Participation: Women accounted  for the largest share in the increase in self-employment and unpaid family work.
  • Nearly two-thirds of the incremental employment after 2019 comprised self-employed workers, among whom unpaid (women) family workers predominate.
  • The share of regular work, which steadily increased after 2000, started declining after 2018.
• The rate of youth not in employment, education or training: India also has a large share of youth not in employment, education or training but  the rate is higher among young women than men.

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Reasons for Low Women’s Participation

• Gross enrollment in higher education: The GER among women was 47.3 per cent in the 2021-22 period, therefore delaying entering into labourforce.
• Overall scarcity of paid work: India’s growth pattern has not been job intensive with limited skilled jobs preferring Males over Females.
• Indian social norms: Women are seen as the primary caregivers at home which restricts their mobility limiting their freedom to take up available opportunities.
  • Women’s  choices have often been limited by marriage and responsibility for the home and family.
• Limited option: Concerns over public safety and lack of transport also confine women to looking for work close to home, further limiting their options.
• Supply  and Demand Arithmetic for female labor: These include women’s opportunities for combining paid work and a family, decisions relating to education and childrearing, technical innovations, laws and norms, and the structural transformation of the economy.

What Needs to Change?

• Focus growth in labour intensive sectors: Policies that promote labor intensive sectors (in both manufacturing and relatively higher productivity services) are needed like Textiles and IT.
• Increase in Public investment: Public Investment for safety (eg: street lighting and CCTVs) and transport (affordable last mile public transport connectivity)  is as  critical as is public investment in affordable child and elderly care.
• Safe Accomodation: Investments in the construction of working women hostels to enable easy movement for work away from home
• Recognising unpaid care work as a form of economic activity.

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Context

The United Nations Human Rights Council (UNHRC) has passed a resolution to protect the rights of intersex individuals.

•  The resolution was spearheaded by Finland, South Africa, Chile, and Australia.

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UN Human Rights Council Adopts Landmark Resolution For Intersex Rights

• The resolution is titled “Combating Discrimination, Violence, and Harmful Practices against Intersex Persons.
• Key Objectives: To combat discrimination, violence, and harmful practices against intersex individuals and to address the underlying causes of such mistreatment.
• Example of Good practices adopted by nations: 
  • Several nations such as Australia, Malta, and Spain have made legislation to protect the interest of intersex individuals from discrimination. 
  • Similarly, Kenya and Portugal have taken various measures to protect the rights of intersex children in areas of healthcare, education, and social protection. 
  • Several nations like Mexico and South Africa have amended and included intersex within anti-discrimination statutes to ensure equality in legal frameworks.

About Intersex Individuals

• Intersex is when someone is born with reproductive or sexual parts that don’t fit typical definitions of male or female.
• Intersex can be divided into four categories:
  • 46, XX intersex
  • 46, XY intersex
  • True gonadal intersex
  • Complex or undetermined intersex
• Currently, 1.7% of newborns are intersex.
• Example:  
  • Penis with Female Hormone Levels
  • Absence of Penis but Male Traits
  • Outwardly Female, Male-Typical Anatomy Inside: Some individuals may have a female appearance externally but predominantly male-typical internal anatomy.
  • Blend of Male and Female Genital Characteristics.
  • Mosaic Genetics: In some cases, individuals may have mosaic genetics, where certain cells contain XX chromosomes (typically female) while others contain XY chromosomes (typically male).

Causes of Intersex Traits

• Intersex traits are estimated to occur in 1% to 2% of the population, making it more common than having red hair or being an identical twin.
• Underlying Factors:
  • Genetic conditions that disrupt hormone levels during fetal development.
  • Exposure to hormones from medications or other sources during early stages of development.
  • Random variations in chromosomes occurring at conception.

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Challenges faced by Intersex People

• Prejudice and Discrimination: 

  • These people face discrimination in the society due to non-alignment of their body with societal norms of sex and gender.
    • Violence, and even infanticide: In various nations, people having visible intersex traits, such as ambiguous genitalia, face abandonment and violence.
      • Intersex infanticide is prevalent in the southern and eastern Africa, South Asia, Brazil, and China.

• Unnecessary medical intervention: 

  • These people have to go through medical treatment due to People’ belief that intersex people need to be “fixed.”
    • In this process, many young children get traumatized due to the experiences in medical procedures. 

• Legal Identity: 

  • These people face problems in getting identity as society segregates intersex babies and people based on gender.
    • Many a time, organizations prohibit them to issue identification which prevent them from doing jobs, opening bank accounts and getting higher education. 

Impact of Resolution on the life of Intersex Persons

• Increased awareness and recognition: The resolution brings greater visibility to the issue of intersex people and their human rights. This can help to combat stigma and discrimination.
• Protection from harmful practices: The resolution calls on states to address violence and harmful practices against intersex people, such as medically unnecessary surgeries on infants. 
  • This can help to protect intersex people from physical and psychological harm.
• Improved access to healthcare: The resolution emphasizes the right of intersex people to the highest attainable standard of health. 
  • This could lead to better access to healthcare services that are sensitive to the needs of intersex people.
• Empowerment and self-determination: The resolution calls on states to respect the autonomy and bodily integrity of intersex people. 
  • This can empower intersex people to make their own decisions about their bodies and their lives.
• Foundation for further progress: This resolution is a significant step forward, but it’s just the beginning.
  • It can pave the way for further legal and policy changes that protect the rights of intersex people around the world.

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Context

Marine researchers along the Visakhapatnam coastline in Andhra Pradesh reported an occurrence of a bloom of venomous jellyfish.

• Pelagia noctiluca, has been identified as the species behind this particular phenomenon.

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About Pelagia Noctiluca

• Pelagia noctiluca is a venomous jellyfish species.
• Common Names: mauve stinger or purple-striped jellyfish
• Lifespan: Two to six months

Features

• Venomous Nature: Its venomous nature can induce various health issues such as diarrhea, severe pain, vomiting, and potentially life-threatening anaphylactic shock.
  • Anaphylactic shock is a severe and potentially life-threatening allergic reaction that can develop rapidly in response to an allergen. 
• Global Distribution: Tropical and warm-temperature seas
• Distinctive Features: Unlike many other jellyfish species, Pelagia noctiluca has stingers not only on its tentacles but also on its bell.

• • Bioluminescence: One of the unique characteristics of Pelagia noctiluca is its ability to produce light in the dark, making it bioluminescent.

• Jellyfish Blooms:

  • Jellyfish blooms occur when species populations rapidly increase due to heightened reproduction rates.
  • Causes: Rising ocean temperatures contribute to frequent jellyfish blooms by creating favorable breeding conditions.

Implications of the Recent Jellyfish Bloom Along the Visakhapatnam Coastline

Ecological Implications:

• Threat to human health: The Pelagia noctiluca jellyfish is venomous and can cause serious health problems, including allergic reactions, in humans.
• Disruption to the ecosystem: Jellyfish blooms can  disrupt the food chain and impact other marine life.
  • Potential impact on prey populations: The  Pelagia noctiluca jellyfish feeds on plankton and small fish larvae. 
  • Oxygen Depletion and Hypoxia: As jellyfish die and sink to the ocean floor, they decompose.
  • This decomposition process consumes oxygen, leading to localized oxygen depletion in the water column.
  • In extreme cases, this can result in hypoxic zones, where oxygen levels are too low to support most marine life.

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Economic Implications:

• Impact on Tourism and Coastal Economy:
  • Blooms of venomous jellyfish can deter tourists from visiting affected beaches.
    • It can result in economic losses for hotels, restaurants, and other tourism-related businesses.
• Impact on Fishing Industry:
  • Depletion of fish larvae and disruption of the food chain due to jellyfish blooms can lead to decreased fish populations, resulting in lower catches and income for fishermen.
• Beach Management Expenses:
  • Depending on the severity of the bloom, resources may be required for beach closures, signage, or mitigation efforts, leading to additional expenses for local governments.

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Context

World Health Day which is observed every year on April 7 emphasizing on the issue of health equity for global health and justice. 

World Health Day 2024 & World Health Organization (WHO)

• World Health Day is observed annually on April 7th.
  • World Health Day 2024 theme is “My Health, My Right”.
• WHO was established on October 24, 1945.
• The WHO Constitution came into effect on April 7, 1948.
• WHO began functioning in 1951 after acquiring sufficient resources, emerging from the merger of the Health Organisation of the League of Nations and other entities.
• India became a member of WHO on January 12, 1948.

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Human Health

• Human Health as Fundamental Right: The World Health Organization (WHO) has declared health to be a fundamental human right.
• Disparity in Healthcare Access: However, there is an alarming gap in health-care access, highlighted by the COVID-19 epidemic, environmental crises, and growing socio-economic gaps. 
• Even though over 140 nations recognise health as a constitutional right, the WHO Council on the Economics of Health for All reports that more than half the world’s population needs complete access to essential health services.

What is Health Equity?

• About: It ensures that every person has an equal opportunity to achieve their highest health potential, no matter what their circumstances. 
• Addressing Root Cause of Health Inequity: It addresses the root causes of health inequities such as poverty, discrimination, limited access to high-quality education, a healthy diet, clean water, fresh air, and housing, and merely grants equal access to health care. 
  • For example, a child born into poverty in a rural area has no access to clean water, wholesome food, or immunisations, which lays the foundation for chronic health problems.
  • These differences are made worse by pandemics, climate change, and sociopolitical unrest. 
• Health as a Human Right: Health as a human right must be seen as the freedom, where every citizen has the possibility to achieve health and wellness as part of their rights to access to public health.

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India’s Health Equity Challenge

• Poor Budgetary Funding: 

  • The combined budget for the Ministry of Health and Family Welfare and the Ministry of AYUSH) is a meagre 0.27% of the gross domestic product (GDP) estimate for 2024–25.
    • Experts have suggested the health budget should be at least 3 percent of GDP.
    • The National Health Policy 2017 put the target for increasing the budget to at least 2.5 percent of GDP by 2025. 

• Infrastructure Gaps: 

• • India’s hospital bed density is 1.3 beds/1,000 population, which is significantly below the recommended 3 beds/1,000 population mark — a deficit of nearly 24 lakh beds. 
    • In urban areas, more than 70 per cent of the bed capacity expansion in the last decade has been by the private sector. Moreover, there is a slowdown in fresh investments, especially in tier 2, 3 cities and beyond.

• Disparities in Healthcare Sector: 

  • Rural-Urban Divide: Access to health care in rural areas is significantly less than in metropolitan areas. Social and economic barriers exacerbate this disparity.
    • A study titled Bharat Health Index (BHI) 2023 stated that only 25 per cent of the semi-rural and rural population in India have access to modern healthcare within their localities. 
  • Disparities across caste and gender: National Family Health Survey (NFHS)-5 (2019-21) data indicates that Scheduled Castes and Scheduled Tribes experience higher child mortality and lower immunisation rates. 
    • Moreover, 59% of women in the lowest wealth bracket suffer from anaemia, almost double the rate in the highest quintile.
  • Health Disparities in Urban Slums: According to the 2011 Census, urban slums make up over 17% of India’s metropolitan areas, and exhibit serious health disparities. 
    • Health risks are increased by overcrowding, poor sanitation, and restricted access to clean water. 
    • According to the Indian Council of Medical Research, infectious diseases, such as tuberculosis, are 1.5 times more common in slums than in non-slum areas.
    • India has a large migrant population: the total number of inter-State migrant workers was about 41 million (Census 2011), and the total migration rate was 28.9% (Periodic Labour Force Survey, 2020-21). 

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• Shortage of Healthcare Personnel: 

  • There is a large number of vacancies against sanctioned posts at various levels of the public health system.
    • Over 75% of health-care professionals work in metropolitan regions, which only account for 27% of the population; the shortage is particularly severe in rural areas. 
    • A critical shortage of doctors exacerbates these issues, with WHO data indicating only 0.8 doctors per 1,000 people, which is below the advised ratio. 

• Inadequate Regulation of Private Sector: 

  • Private healthcare accounts for around 70% of healthcare utilization in the country and is allowed to make high profits, because it is inadequately regulated and often charges patients exorbitant rates.
  • The Clinical Establishments (Central Government) Rules, 2012 specify that all healthcare providers must display their rates and should charge standard rates as determined by the government from time to time. 
  • However, these legal provisions are yet to be implemented.

• Mental Health Issues: 

• • Suicide in the young is a major public health problem in India. 1% of all suicides are by young people below the age of 30. 
    • India has the highest number of suicides in the world. The National Crime Records Bureau (NCRB) reports that 1.71 lakh people died by suicide in 2022.

• Issue of Hidden Hunger: 

  • As per the Ministry of Health and Family Welfare, there is prevalence of anaemia in:
    • 58.6  per cent among children aged 6-59 months
    • 53.1 per cent in women aged 15-49 years
    • 50.4 per cent in pregnant women aged 15-49 years
    • 22.7 per cent in men aged 15-49 years.

Government Initiatives to Public Health

• Ayushman Bharat Programme:  It provides for holistic and integrated health care and is the principal vehicle for achieving Universal Health Coverage (UHC). Components include:
  • Health and Wellness Centre component (AB-HWC): It provides essential primary and community health services such as maternal, neonatal and child health services including immunization and nutrition.
  • AB-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): It provides free and cashless care to about 500 million poor and deprived people for secondary and tertiary hospitalization care.
• Strengthening of Tertiary Care for Cancer Scheme: It is being implemented to support setting up of State Cancer Institutes (SCI) and Tertiary Care Cancer Centres (TCCC) in different parts of the country. 
• Financial assistance: Financial assistance to patients living below poverty line for life threatening diseases under the schemes such as Rashtriya Arogya Nidhi (RAN), Health Minister’s Cancer Patient Fund (HMCPF) and Health Minister’s Discretionary Grant (HMDG) is provided.
• Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets: These have been opened to make available drugs and implants for Cardiovascular Diseases (CVDs), Cancer and Diabetes at discounted prices to the patients.
• Janani Shishu Suraksha Karyakram (JSSK): Under this,  free drugs, free diagnostics, free blood and diet, free transport from home to institution is provided.
• Rashtriya Bal Swasthya Karyakram (RBSK): It provides newborn and child health screening and early interventions services free of cost for birth defects, diseases, deficiencies and developmental delays.
• National Suicide Prevention Strategy for India: It aims to reduce suicide by 10% by 2030 by leveraging educational institutions and youth organisations to promote mental health.

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Role of Technology in Improving Health Outcomes

• Tracking Health Metrics: With the use of mobile apps and remote monitoring devices, individuals can easily track their health metrics and receive personalised recommendations without having to visit a doctor. 
  • This saves time and money and allows for better management of chronic conditions.
• Promote preventive care through data analysis: By collecting real-time data from various sources like fitness trackers, smart scales, and blood glucose monitors, and with the use of Artificial Intelligence and Machine Learning, the patterns can be identified that indicate potential health risks. 
  • This information can then be used by individuals to make necessary lifestyle changes or it can be shared with healthcare professionals for more targeted treatment plans.
• Diagnosis and treatment: For instance, imaging technologies such as MRI and CT scans allow for earlier detection of illnesses with higher precision than ever before. 
  • Robotic surgery techniques have improved surgical outcomes by increasing accuracy while minimising invasiveness.

Way Forward

• Implementation of Universal Health Coverage (UHC): Given that health is a state subject and the Universal Health Coverage (UHC) policy is envisaged at the national level, there is a necessity for discussions on implementation strategies.
  • Reducing out-of-pocket expenditure: The reimbursement processes for reducing out-of-pocket expenditure needs to be simplified. 
    • The design of cash transfers and reimbursement in India’s public healthcare system needs adaptation for migrant and marginalised communities.
• Robust healthcare infrastructure: This includes building state-of-the-art hospitals, expanding healthcare networks, and ensuring that healthcare services are accessible to all citizens. 
• Raising Health Literacy: Achieving health equity requires raising health literacy. India should turn health equality into a shared, community-driven goal by including health education in the NHM, enabling its people to seek equitable care and make educated health decisions.
• Investment in Preventive Care: Preventive care and public health initiatives should be prioritised to reduce the burden of diseases and promote overall wellness. 
  • These initiatives include vaccination drives, disease surveillance, and health education campaigns that target various age groups and communities.
• Ensuring transparency of Healthcare Rates:   It is high time that transparency of healthcare rates be ensured, and standardisation of rates be implemented in an appropriate manner. 
  • This can be ensured when the Clinical Establishment Rules are implemented or when State governments adopt improved Acts of their own.
• Standard Protocols to check irrational healthcare interventions: Standard protocols are needed to check irrational healthcare interventions, which are currently promoted on a wide scale due to commercial considerations. 
  • For example, the proportion of caesarean deliveries in India in private hospitals (48%) is three times higher compared to public hospitals (14%).
  • In private hospitals, the share is far in excess of the medically recommended norm for caesarean sections (10-15% of all deliveries).
• Enforcement of Patient Rights Charter: The complete Patient Rights Charter (not a diluted version as observed in some hospitals) must be effectively enforced in all healthcare facilities across the country, so that patients and their caregivers can obtain care in a conducive environment. 
• Community-based primary healthcare: The community-based primary health care should be implemented in urban and peri-urban areas with seamless referral systems. It may include:
  • Strengthening primary healthcare through the 1.7 lakh Health and Wellness Centres (now renamed as Ayushman Arogya Mandirs).
  • Creating a mechanism to cover OPD care under health insurance.
• Grievance redressal systems: User-friendly grievance redressal systems should be operationalised from district level upwards to ensure justice for patients with serious complaints related to private hospitals.

Conclusion

Prioritising good health and well-being is critical for achieving sustainable development goals at both the local and global levels. It not only improves the quality of life for individuals but also contributes to creating more equitable, resilient, and sustainable communities. In an interconnected world, it is essential to recognise the importance of global collaboration in healthcare. With the collective knowledge, resources, and best practices of various nations, we can achieve a sustainable future for all.

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