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India’s Net-Zero Transition Offers $12.7 Trillion Investment Opportunity

Context:

According to India’s New Energy Outlook report by BloombergNEF, India’s path towards a net-zero economy by 2050 presents an investment opportunity estimated at $12.7 trillion.

• Net Zero refers to the balance between the amount of greenhouse gas (GHG) that’s produced and the amount that’s removed from the atmosphere.

Changes in Energy Mix

• Wind and solar power capacity: It is projected to increase thirty-fold, reaching 2,998 gigawatts by 2050, contributing to 80% of the electricity supply.
• Other Sources: Nuclear power accounts for 9%, while the remainder is sourced from hydro, biomass, hydrogen-fired thermal plants, and thermal power plants equipped with CCS.

Investment Opportunities

• Net-Zero Emissions: Investment levels need to increase by 1.7 times, reaching an average of $438 billion annually and totalling $12.7 trillion by 2050.
• Increasing Demand: An investment of $7.6 trillion is projected in energy supply and demand from 2022 to 2050, averaging $262 billion annually.
• Electric Vehicle: The sales constitute a substantial portion of energy demand investment in both scenarios, with $3.9 trillion allocated for EV deployment.
• Fossil Fuels: To mitigate emissions from the remaining use of fossil fuels, India would require an investment of $870 billion. 
  • Significantly, investment in fossil-fuel power decreases from $317 billion to $142 billion.

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Context:

Commercial ships are facing delays to travel through the Panama Canal as a lengthy drought in the Central American country has led to lower the availability of water.

Reasons for Delays in Panama Canal:

• Drought Conditions: An extended drought in Central America has significantly reduced the availability of water required for vessels to pass through the canal’s locks.
• Capacity Restrictions: The Panama Canal Authority (ACP) has imposed restrictions on the number of vessels that can transit daily to and average of 32 from 36 and limited the maximum depth of ships allowed to navigate the canal.
• El Niño’s Impact: The return of the El Niño hot natural weather pattern is also making Panama and the surrounding region warmer and drier.

News Source: The Guardian

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Recently, the Finance Minister launched HSBC India’s Green Hydrogen Partnerships.

Types of hydrogen based on extraction method:

• Grey Hydrogen: It is produced via coal or lignite gasification (black or brown), or via a process called steam methane reformation (SMR) of natural gas or methane (grey). These tend to be mostly carbon-intensive processes.
• Blue Hydrogen: It is produced via natural gas or coal gasification combined with carbon capture storage (CCS) or carbon capture use (CCU) technologies to reduce carbon emissions.
• Green Hydrogen: It is produced using electrolysis of water with electricity generated by renewable energy. 
  • The carbon intensity ultimately depends on the carbon neutrality of the source of electricity (i.e. The more renewable energy there is in the electricity fuel mix, the greener the hydrogen produced).

Strategic Partnerships for Green Hydrogen Innovation:

• These partnerships involve collaboration with the Indian Institute of Technology, Bombay, and the Shakti Sustainable Energy Foundation (SSEF).
• Grant Support: ₹15 crore ($2 million)
• Objective: The projects will prioritize green hydrogen as a strategic alternative fuel and contribute to the development of a robust green hydrogen economy.
• Significance: 
  • Reduce the carbon intensity in the economy and create green job opportunities.
  • Counter climate change and build a low-carbon, self-reliant economy.
  • Bolster the government’s National Green Hydrogen Mission.
    • The National Hydrogen Energy Mission, announced in the 2021-22 union budget, paves the way for tapping alternative energy sources in India.

News Source: Livemint

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A study by the Indian Council of Medical Research published recently said that nearly 6.5% people hospitalized with Covid-19 died in the following year.

Key Findings of the Study on Post-Covid-19 Outcomes:

• The study examined data from 14,419 patients in 31 hospitals.
• 6.5% of those hospitalized with Covid-19 died within a year.
• A single dose of the vaccine before the infection reduced the number of deaths in the one-year period by 60%.
• 17.1% of participants reported post-Covid-19 conditions, including fatigue, breathlessness, and cognitive issues.
  • People with post-Covid-19 conditions were nearly three times more likely to die.
• The study used its own definition of post-Covid-19 conditions due to the absence of official definitions during patient enrollment.

Higher Risk of Mortality Factors:

• Comorbidities: Individuals with one comorbid condition were over 9 times more likely to die within a year.
• Gender: Men were 1.3 times more likely to experience mortality.
• Age: Those aged 60 and above faced a 2.6-fold increase in the likelihood of death.
• Children (0-18 years): At a 5.6 times higher risk of death between four weeks and one year after infection, and 1.7 times higher risk in the first four weeks post-hospitalization.
  • Comorbidities in children, such as malignancies and kidney disorders, contributed to their increased risk.

News Source: The Indian Express

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Murmansk, often referred to as the capital of the Arctic region and the starting point of the Northern Sea Route (NSR), is currently experiencing a notable increase in Indian participation in cargo transportation.

• During the initial seven months of 2023, India secured a significant portion, amounting to 35%, of the eight million tonnes of cargo that passed through the Murmansk port.

What is NSR?

• It is the shortest shipping route for freight transportation between Europe and countries of the Asia-Pacific region, straddles four seas of the Arctic Ocean. 
• Running to 5,600 km, the Route begins at the boundary between the Barents and the Kara seas (Kara Strait) and ends in the Bering Strait (Provideniya Bay).

NSR Development:

• NSR Development Targets:
  • The Russian government has approved a development plan for the NSR until 2035.
  • Targets include reaching cargo traffic volumes of 80 million tonnes by 2024 and 150 million tonnes by 2030.
• Russian-Indian Collaboration:
  • In March 2023, a Russian delegation engaged with the Indian business community in New Delhi and Mumbai to discuss NSR development.
  • The delegation pledged to ensure the availability of essential components for year-round NSR operation.

Factor for India’s participation in the development of the NSR:

• Rising Cargo Traffic Growth: India’s increasing imports of crude oil and coal from Russia make the NSR an attractive and reliable transportation route for these vital energy resources.
• Geographical Significance: India’s strategic geographical location near major sea trade routes makes the NSR an important transit route for its trade.
• Chennai-Vladivostok Maritime Corridor (CVMC): The CVMC project, stemming from a memorandum of intent signed between India and Russia in September 2019, is being explored as a way to connect with organized international container transit through the NSR.
  • The 10,500 km-long CVMC, passing through the Sea of Japan, the South China Sea, and Malacca Strait, significantly reduces transport time to 12 days compared to existing routes.
• Geostrategic Considerations: Experts highlight the potential for China and Russia to collectively influence the NSR, making India’s engagement in its development an essential strategic move.

News Source: The Hindu

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Context:

According to the National Medical Commission’s Registered Medical Practitioner (Professional Conduct) Regulations or NMC RMP Regulations 2023, doctors can now refuse treatment to the unruly and violent patients.

About The National Medical Commission Act, 2019:

• It was introduced to address various issues and challenges in the medical field, including improving the quality of medical education, enhancing access to healthcare services, and ensuring ethical and transparent practices.
• Key Provisions include:
  • Ethical and Professional Conduct: The Act emphasizes maintaining ethical and professional conduct among medical practitioners and includes provisions to address any deviations from these standards.
  • Community Health Providers: The Act introduces the concept of Community Health Providers who are allowed to practice limited medicine in underserved rural areas to address the shortage of doctors.
  • Formation of the National Medical Commission (NMC): NMC is an regulatory body which regulates medical education and medical professionals.
  • Establishment of Medical Advisory Council.
  • Reforms in Medical Education.

Refusing treatment is a complex issue that involves various stakeholders viz. doctors and healthcare professionals, patients and their families, healthcare institutions, medical associations and regulatory bodies, legal authorities, ethics committees, public opinion and media, religious and cultural communities, etc.

Arguments in Favour of the Regulation:

• Unruly Behaviour
  • Justice: If an unruly patient’s behaviour poses a threat to their own safety, the safety of healthcare staff, or the safety of other patients, refusing treatment might be justified as a means to mitigate these risks.
    • For example, a 21-year-old patient attacked a doctor with a knife during consultation at Delhi’s Sir Ganga Ram Hospital.
  • Dignity and Integrity: Unruly behaviour can sometimes cross ethical boundaries, leading to disrespectful or abusive treatment of healthcare staff. Doctors have a right to work in an environment that respects their dignity and professional integrity.
    • For example, a 40-year-old doctor on duty in a  hospital in Faridabad was assaulted by attendants of a patient as the doctor was attending to another patient, he could not immediately attend to the patient.
  • Brings Deterrence: Allowing unruly behaviour to go unchecked might enable a cycle of disruptive or non-compliant behaviour, which could negatively impact the patient’s overall health outcomes. By refusing treatment, the doctor may communicate that certain standards of behaviour are expected for a therapeutic relationship to proceed.
  • Right to Freedom to practise any profession: The regulations give the doctors the right to choose whom they will serve, except in case of a life-threatening emergency.

• Financial Constraints
  • Autonomy and Consent: Doctors are ethically obligated to provide patients with accurate information about their treatment options, including potential costs. 
    • If a patient cannot afford the treatment, the doctor might argue that proceeding with treatment without full financial transparency could undermine the patient’s autonomy and informed consent.
    • In extreme cases, relatives of patients have been known to hold doctors or hospital staff hostage, demanding treatment.
  • Professional Boundaries: Some proponents of this perspective argue that doctors have a professional duty to provide medical care and expertise, but they are not obligated to address broader societal issues such as patients’ financial difficulties.

• Ethical Boundaries: Doctors have ethical responsibilities not only toward their patients but also toward themselves, their families and the healthcare community.
  • For example, potential threats and violence have long-lasting impacts which manifests in the degradation of personal and professional relations.
• Objectivity: Taking decisions which are free from subjectivity caused by emotions, perceptions and individual bias is necessary for long term sustainability.
  • For example, Free medical care for a desperate patient may be ethical, but providing it to many patients may not be feasible for one provider.
• Selfless Duty: Medical practitioners often prioritize the well-being of their patients above their own comfort, personal time and space. However, the job can be thankless at times.
  • For example, During COVID-19 despite their selfless dedication, medical professionals were subjected to regular assaults and verbal abuse throughout the country.

Arguments against the Regulation

• Dedication and the Duty of Care: Dedication is the sense of deep rooted commitment to devote oneself to a cause.. This includes a duty to provide care to those in need, regardless of their financial status.

• • In India, out-of-pocket health expenditure accounts for more than half of total health expenditure pushing many households into poverty. This shows the dire need for empathy and compassion towards those in need.For example, Dr Ramanand Singh has been treating his patients for just Rs 50 for the past 35 years in Bihar. He even waives off his fees in cases where the patients cannot afford medical treatment. 
• Justice and Equity: The principle of justice requires that healthcare be distributed fairly and equitably. Denying treatment to a patient solely based on their inability to pay could be seen as unjust, perpetuating disparities in healthcare access.
• Hippocratic Oath: Physicians pledge to do what is in the best interest of their patients and to avoid causing harm. 
  • Physicians promise to treat all patients fairly, regardless of their background, and to provide care to the best of their abilities without bias.
• Unholy Nexuses: Many doctors form nexuses with drugmakers to prescribe specific drugs from their brand instead of generic drugs leads to considerable rise in treatment costs for patients.
  • For example, freebies given to doctors including travel expenses, gifts etc. by drugmakers is a common practice.Beneficence: It means kindness or generosity and this principle refers to the moral obligation to act in a manner that will benefit others.The principle of beneficence obligates doctors to act in the best interests of their patients and to promote their well-being. 
• Compassion: It is the desire to end someone’s suffering which forms the core principle of a medical practitioner. Refusing treatment to individuals on certain grounds could lead to the possibility of crisis of conscience among several practitioners.
  • Loss of Trust and Credibility: The medical profession relies on public trust, and denying treatment to those in need could erode that trust and damage the reputation of the medical community.
• Responsibility: Some argue that healthcare professionals have a broader social responsibility to address systemic issues in healthcare, including affordability and access. Refusing treatment might be seen as abdicating this responsibility.
• Undermining Right to Life: Providing a legal caveat for the registered physicians to refuse treatment is against the fundamental right guaranteed under Article 21 of the Constitution. 
  • Further, there is no specific definition of “abusive” in law as it is purely a subjective interpretation that may depend on the personal opinion of any individual.
  • Subjective interpretation may further lead to exclusion on the basis of race, religion, caste, sex etc.

What Should be Done?

• Persuasion: Influencing patients to follow prescribed norms for behaviour and ensuring smooth functioning.
  • For example, during COVID-19 pandemic, voice messages were circulated using caller tune to make people aware of the importance of vaccination and prevent attacks on health workers.
• Emotional Intelligence: Equipping and training medical personnel with necessary skills so that they can manage their emotions and try to avoid escalation of situation and providing practical solutions to the given problems.
• Transparent Approaches: Consider alternative approaches before refusing treatment. This might involve social workers, mental health professionals, or conflict resolution experts to address the underlying issues contributing to the unruly behaviour.
  • For example, Doctors in San Diego (USA) refer patients to low-cost family health centers that provide caring, affordable, high-quality health care and supportive services to everyone.
• Ethical Principles Balancing: Weigh the principles of patient autonomy, duty of care, patient safety, and respect for healthcare personnel’s well-being. Consider how refusing treatment aligns with these principles and what potential consequences might arise from the decision.
  • For example, Doctors Without Borders is a Nobel Peace Prize receiver charity that provides humanitarian medical care in conflict zones to all those in need of medical care, irrespective of the role played by them in the conflict. 
• Tolerance: Accepting actions and practices which may be considered to be incorrect but still tolerable to some extent that they should not be prohibited or penalised heavily.
  • For example, a significant number of the cases of unruly behaviour arises in situations which may not be considered as “common” and even the most well-behaved might behave in a way which is not acceptable in society due to the shock or intensity of the moment which one may not be able to handle.
• Consent: Communicating the decision clearly to the patient, and explaining the reasons behind it thus ensuring that the patient understands the potential consequences of their behaviour on their health and the doctor-patient relationship.
• Offering Continuity of Care: If possible, provide recommendations for alternative sources of care, whether within your healthcare institution or elsewhere. Ensure the patient’s ongoing health needs are addressed.

Conclusion

We must protect those who heal. Ethical decisions in healthcare are rarely black and white. It’s important to approach each situation with sensitivity, professionalism, and a commitment to upholding the well-being of patients, healthcare staff, and the broader community. Consulting with colleagues, supervisors, and ethics committees can provide valuable guidance in making these difficult decisions.

News Source: The Hindu

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Context:

Recently, during the 15th BRICS Summit, leaders decided to expand the grouping and admit six new members.

More on News

• Theme: “BRICS and Africa: Partnership for mutually accelerated growth, sustainable development and inclusive multilateralism”.
• Johannesburg Declaration II: It emphasizes inclusive multilateralism, peaceful development, sustainable growth, and people-to-people exchanges, while addressing global conflicts and promoting constructive dialogue and partnership for growth.
• BRICS Expansion: Argentina, Ethiopia, Iran, Saudi Arabia, Egypt and the United Arab Emirates are included as a new member in BRICS grouping.
  • Six new candidates will formally become members on Jan. 1, 2024.
• Aim: Increasing BRICS influence in advocating for the interests of the “Global South.”

About BRICS

• Formation of BRICS: The acronym was first introduced in 2001 by Jim O’Neill, to denote the group of fastest-growing economies that would dominate the world economy by 2050.
• About BRICS: It consists of Brazil, Russia, India, China, and South Africa, was previously known as BRIC before South Africa’s inclusion in 2010.
  • The first BRIC Summit was held in 2009 in Russia.
  • BRICS countries are united by their shared economic potential and their desire to play a more prominent role in the global economy. 
  • They are united by their common challenges, such as poverty, inequality and climate change.
• Goal: To highlight the issues of the global South and to challenge the Western hegemony in the global system.
• Significance: At present, the BRICS represents 41% of the global population, 24% of the global GDP, 16% of the global trade, 26% share in world land surface and has world populous and second most populous countries as its members.
  • Economic Significance: Trade by BRICS nations surged by 56% to reach $422 billion in the past five years. 

Need of Expansion:

• Changing Realities: Global institutions reflect the power realities of their creation, and as power realities change, their efficacy becomes contested. 
  • Example: Current evolution in global order has challenged the hegemony of the United Nations, the IMF, World Bank etc.
• Rise of Multipolar World: BRICS presented itself as a force for a “rebalancing” of the global order away from Western-dominated institutions. 
• Member countries and various multilateral groups are attempting to reshape the global order into a multipolar world, with voices from the Global South at the center of the international agenda.
  • Western powers posed a threat to both traditional values in developing countries and to the emergence of a multi-polar world where no one country or bloc dominated.

• Western Hegemony: Currently, Western countries dominate international bodies, such as the United Nations, the International Monetary Fund or the World Bank.
  • Indifference: The five BRICS nations, with a combined GDP larger than the G7 (purchasing power parity terms), currently hold only 15% of the voting power at the IMF.

India’s Interest in Expansion of BRICS

• Argentina: India has had a strategic partnership with Argentina since 2019. 
  • For Argentina, access to the New Development Bank, also called BRICS Bank, is particularly attractive as it struggles with depleted foreign reserves, high inflation and debt repayments to the International Monetary Fund.

• Egypt: Two countries signed a Friendship Treaty in 1955, and India’s support to Egypt, including during the Suez Canal crisis in 1956, eventually led to the Non-Aligned Movement in 1961, with both as founder members. 
  • They were also instrumental in the G-77 grouping and “South-South Cooperation” initiatives.
  • Earlier in 2023, India and Egypt also signed a strategic partnership. 
• Ethiopia: India looked at Ethiopia as one of the key African countries, especially as the seat of the African Union (AU). 
  • India has also supported Ethiopia’s position at the UN on issues from the Tigray crisis to the controversy over the Grand Ethiopian Renaissance Dam. 
  • India is also advocating for greater AU representation in the G-20 and UN.
• Iran: India and Iran have had a strategic partnership since 2003. 
  • Iran remains a crucial partner due to its proximity to Central Asia and its borders with Afghanistan and Pakistan. 
• Saudi Arabia: India signed a strategic partnership in 2010 and created a strategic partnership council in 2019.
• UAE:  In 2017, India and the UAE upgraded their relationship to a “Comprehensive Strategic Partnership.” 
  • In 2021, India participated in a quadrilateral meeting alongside the UAE, which has since evolved into the ‘i2u2’ grouping. 

Possible Concerns in BRICS:

• Effectiveness of New Development Bank (NDB): It has been sluggish in lending, especially after sanctions against founding member Russia.
  • NDB has promised to increase lending in local currencies as a means to reduce members’ vulnerability to dollar exchange rate fluctuations. But of nearly $33 billion in loans approved by the NDB, two-thirds were in dollars.
• Geo-Political Confrontation: 
  • India Vs China: New Delhi is more friendly to the West and has military deals with the United States, while it is in sometimes violent conflict with Beijing over their Himalayan border.
  • Saudi Vs Iran: Saudi Arabia will not want Iran to play any role in the matters of the Arab world. 
  • US sanctions on Iran will be a serious impediment on extending funds from NDB for development projects in Iran. 
  • South Africa fears BRICS membership expansion could diminish its influence, as other BRICS countries hold more influence due to its stalled economic and social progress.
• Fear of Sanction: There is a growing concern in the Global South that the US could use sanctions the way it has used sanctions  against Russia. 
• Anti Western Bloc: BRICS’s trajectory could be influenced by the countries joining, with Iran potentially following China and Russia’s lead, while Saudi Arabia, despite its relationship issues, may be less inclined towards an anti-Western bloc.

• • India, a founding member of the nonaligned movement during the Cold War, is cautious about the BRICS group becoming anti-Western. 
• Lack of Decision Making: BRICS operates through consensus, but increasing its members may make it more challenging to reach due to each country’s unique interests, priorities, and relationships.

Way Forward

• Strengthening the New Development Bank by bringing in more stakeholders and exploring the idea of a BRICS currency.
  • It could reduce the dollar’s dominance, and several BRICS nations have already begun their trade in local currencies.
• Strengthen Cohesion and Coordination: The BRICS countries have different political systems, economic models, and regional interests. 
  • BRICS countries need to overcome their differences and find common ground on key issues. 
  • Need to improve their communication and consultation mechanisms, both within the group and with other stakeholders.
• Expand the scope of cooperation: The BRICS countries need to increase their investment and commitment to platforms like NDB, Contingent Reserve Arrangement (CRA) etc and explore new areas of cooperation, such as trade, technology, health, education, culture, and security.

Conclusion

• BRICS expansion would bolster India’s push for UN reform, more representation of the global south and the expansion of the UN Security Council.
• BRICS expansion can set an example for the reform of other global institutions established in the twentieth century.

News Source: Indian Express

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