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Contents
National Task Force for Transparent Oxygen Allocation
Source: Indian Express
Syllabus: GS 2 – Issues relating to development and management of Social Sector/Services relating to Health
Synopsis
The supreme court has constituted a National Task Force for transparent oxygen allocation. It is a 12 member body constituted to guide the central government allocation of medical oxygen to the states. Further, it will also recommend a framework for broader pandemic preparedness and response.
Background
- The second wave of the Covid-19 pandemic has crippled the healthcare system in India.
- The situation is worse in the domain of oxygen supply. Due to acute shortages, the toll of preventable deaths has increased.
- In this scenario, the supreme court has set up a National Task Force for transparent oxygen allocation.
About the National Task Force for transparent oxygen allocation:
- It is a 12 member body constituted to guide the central government’s allocation of medical oxygen to the states.
- It has 10 members who are leading clinicians, critical care specialists, and virologists. Along with this, there are 2 government officials – Secretary, Ministry of Health, and Cabinet Secretary.
- It is established for a period of six months.
Working and Mandate of Task Force:
- It will work as per its 12 point terms of reference.
- The first five points focus on oxygen supply. This includes:
- Deciding on a methodology for the scientific allocation of oxygen to states
- Facilitating audits (of oxygen supply, distribution, and utilization) by sub-groups within each state and UTs.
- The 6th point allows it to review and suggest measures necessary for ensuring the availability of essential drugs and medicines.
- The remaining 6 points are aimed at the broader pandemic preparedness and response. This includes planning and adopting remedial measures:
- To ensure preparedness for present and future emergencies;
- To facilitate the use of technology;
- Furthermore, to suggest augmenting the availability of trained doctors, nurses, and paramedical staff;
- Also, to promote evidence-based research and enhance effective response to the pandemic;
- To facilitate sharing of best practices across the nation to promote knowledge about management of the pandemic
- Lastly, to make recommendations in regard to other issues of pressing national concerns.
- It can constitute more sub-groups in specialized areas or regions to assist in its work.
- It can seek assistance from experts both within and outside government in areas such as clinical virology and immunology, epidemiology/ public health, etc.
Benefits of Creating such a task force:
- First, it will facilitate a public health response to the pandemic based upon scientific and specialized domain knowledge.
- Second, it will give inputs to decision-makers. These inputs will enable them to go beyond ad hoc solutions to unprecedented challenges.
- Third, it will alter the techno-bureaucratic nature of policy decisions by ensuring the participation of independent subject experts.
- Fourth, it will give suggestions to improve state-level public healthcare systems. As it looks at the shortage of medical oxygen through a broader lens of pandemic preparedness and response.
- The state-level health care system currently has:
- Insufficient planning, delayed procurement, and weakness of supply chain management.
- Insufficient government funding
- absence of sufficient and trained human resources
- high out-of-pocket expenditure (around 30-40%)
- The state-level health care system currently has:
Way Forward:
- The members of NTF have the needed qualification and expertise to advise on clinical matters and oxygen supply. However, they may need to proactively co-opt experts from other fields for giving suggestions on broad issues in a short time. This involves experts from medical procurement and supply; pharmacology, free medicines, and diagnostics, etc.
- Further, the task force should refrain from giving a mere medicalized response to a public health challenge. The focus should be on creating a healthcare system that can keep people healthy and respond to future epidemics and pandemics.
U.S Exit from Greater Middle East Will Alter Regional Relations
Source: Indian Express
Syllabus: GS 2 – Effect of policies and politics of developed and developing countries on India’s interests
Synopsis: The future US exit from the greater Middle East region is altering the relationships among the regional powers. In this regard, both India and Pakistan must come to terms with the changing dynamics.
Background
- The US will soon withdraw its last forces from Afghanistan in September 2021. The country is also shifting its focus from the Middle East region to Indo-Pacific.
- The US has played a pivotal role in the greater Middle East region in the last 50 years.
- It is a vaguely defined region comprising the “Arab world” plus Afghanistan, Iran, Israel, and Turkey.
- Many regional actors sought alliances with America to secure themselves against ambitious or troublesome neighbors (like Saudi Arabia, U.A.E). Similarly, others (like Russia, China) sought to balance against America.
- The withdrawal will simply alter the regional equations and induce the creation of new realignments.
Why is the US withdrawing?
- First, the country has failed to solve centuries-old conflicts in the region even after decades of presence.
- Second, there are very few compelling factors that can compel the US to incur huge military, political and diplomatic investments in the region.
- Third, the rising Chinese assertiveness has compelled it to focus its resources on the Indo-Pacific region.
Realizing the reality of withdrawal, countries have started to alter their relationship with neighboring countries or search for alternate patrons.
Attempts towards improving the relationship among the Middle East countries:
- Turkey is focusing on establishing peace with Saudi Arabia and Egypt. Although it had tried to trouble them using other Muslim countries.
- Saudi Arabia and Iran are now exploring means to reduce bilateral tensions and moderate their proxy wars in the region.
- Saudi Arabia has also refrained from isolating Qatar from the Gulf region.
- Similarly, UAE, Bahrain, Morocco, and Sudan are trying to normalize their hostilities with Israel. These 4 Arab states recognized Israel as an independent state in 2020.
How India and Pakistan have responded?
- India’s approach towards Middle East countries:
- The country has maintained its approach of dealing with all the gulf countries, without focusing on their regional rivalries.
- There has been a little friction in the relationship with Turkey owing to the policies of President Erdogan. However, India is hopeful of improving the relations post the withdrawal.
- Pakistan’s Approach towards Middle East countries:
- The country has struggled to adopt a pragmatic policy due to domestic politics and ideological considerations.
- For instance, it has not established diplomatic ties with Israel. Despite knowing that a normal relationship with the Jewish state serves Pakistan’s interest.
- Earlier, the country tried to construct a new Islamic bloc with Turkey and Malaysia in order to overpower the Saudi-led bloc. However, its huge economic dependence on Saudi Arabia and UAE induced it to establish good relations with them.
- The country has struggled to adopt a pragmatic policy due to domestic politics and ideological considerations.
- Bilateral Relations:
- Some experts believe that Pakistan is now adopting a softer stance towards India as its relevance will get reduced post-U.S withdrawal.
- Both the countries have maintained the February 2021 ceasefire along the Line of Control.
- Pakistan is also trying to delink the question of India’s 2019 constitutional changes in Kashmir from the normalization of bilateral relations.
Despite improvement in bilateral relations, both countries want US forces to stay in Afghanistan.
Why do India and Pakistan want the U.S forces to stay in Afghanistan?
- India – The presence would keep a check on the rise of extremist forces like the Taliban. This would have enabled India to play a greater role in Afghanistan.
- Pakistan – The presence would sustain the dependence of the US on Pakistan for geographic access and operational support in combating terrorism. This dependence can, later on, be used as a bargaining chip in International relations.
- Further, the trans-border links between the Taliban and other extremist forces in South Asia would be strengthened without US forces. It is extremely worrisome as the region is already surrounded by a significant degree of terrorism as testified by the May 2021 attack on the former president of the Maldives.
Way Forward:
- The South Asian states must collaborate on countering extremism and terrorism, else every one of them will be weakened.
- They should realize that the national interest of the state must prevail over all other considerations, including religious ones.
- The middle eastern countries should also cooperate on pragmatic lines rather than working on old ideological tropes like pan-Islamism, pan-Arabism, or anti-Americanism.
Time to Revive the Plan for Indian National Health Services
Source: The Hindu
Gs2: Issues Relating to Development and Management of Social Sector/Services relating to Health.
Synopsis: The pandemic has broadly highlighted the inadequacy in our health care system and has brought serious consideration for the formation of the Indian national health services.
Background
- There has been a coordinated effort from medical staff, the Centre, the state, and other state institutions to control the Pandemic. For instance,
- The railways are running special trains carrying oxygen supplies.
- The military is involved in medical supply chains.
- The Karnataka government has ordered private hospitals above a certain size to reserve 75% of their beds for COVID-19 patients, who will be paid for under a public scheme
- Despite these measures, the Indian healthcare system is struggling to control the Pandemic.
Issues in the Indian health care system
- Inadequate public health expenditure: India spends nearly 1% of GDP.
- Inadequate public health providers: for instance, in certain rural areas the doctor-population ratio is over 1:40,000
- High out-of-pocket expenditure: Medical expenses constitute the major reason for personal debt in India.
- Systemic issues: Highly fragmented, corruption, urban-centered, elite-focused.
To address the issues ailing our health care system, India needs to form Indian National Health services, in line with British National Health Service.
How the British National Health Service function?
- The service is funded entirely from Public money (Taxation). The budget includes a payment to general practitioners, most of whom remain private providers but are paid by the state for treating NHS patients
- All hospital treatment and medicines are free, as are outpatient and follow-up appointments.
- The NHS is the largest employer in the U.K. and Its current budget is about 7.6% of GDP. Despite being large in scale, it provides highly localized access to care.
- The formation of the British National Health Service has resulted in providing top-class universal healthcare, including training and research. However, some issues like subjective preference to patients of different social classes still exist.
- In India, during 1946, the civil servant Sir Joseph Bhore proposed Indian national health services broadly modeled on the lines of the British National Health Service or NHS.
- He further recommended the integration of preventive and curative medicines at all levels.
Impacts of Digital inequality on Health and Education
Source: The Hindu
Gs2:Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.
Synopsis: Digital inequality or Unequal access to digital platform is worsening inequalities in accessing public goods such as Education and Health.
Facts on Digital inequality in India
- Inequality in access to digital devices: According to National Sample Survey (2017), only 6% of rural households and 25% of urban households have a computer.
- Inequality in access to Internet Services: Only 17% in rural areas and 42% in urban areas have access to internet.
- Due to the prevailing inequality in digital access, the digital solutions offered for providing basic services such as health and education have failed.
Reasons behind Digital inequality in education
- Lack of access to online classes: According to the Azim Premji Foundation, ASER and Oxfam report, between 27% and 60% could not access online classes, due to lack of devices, shared devices, inability to buy “data packs”, etc.
- Loss of Lives: a college student studying in Delhi and a 16-year-old in Goa committed suicide as their family could not afford to repair the phone they used.
- Lack of learning environment at home: a quiet space to study is a luxury for many. For instance, 25% of Indians lived in single-room dwellings in 2017-19. Further, girls at home are burdened with domestic chores.
- Advantages in Peer learning is forgiven: For instance, even students with issues in English language found easy to pick up the language with the help of peers. Now, online education has deprived them this advantage.
Reasons behind Digital inequality in health
India’s Poor population is at a disadvantage in accessing good health care due to the following reasons,
- One, very low public spending on health (nearly 1% of GDP). This has contributed to the high share of ‘out of pocket’ (OOP) health expenditure in India was over 60% in 2018.
- Even in the United States, where health system is highly privatised, OOP was merely 10%.
- Two, the private health sector in India is poorly regulated. As a result, they charge exorbitant prices and has contributed towards the development of black market for scarce services
- Three, shortage of essentials such as drugs, hospital beds, oxygen, vaccines etc.,
To overcome the above challenges, the government chose to promote Digital health services as a solution. However, digital health services have resulted in unequal access to health care due to the following reason.
- Exclusion: Platform- and app-based solutions can exclude the poor entirely thereby denying their right to access health care. For instance,
- People with knowledge of technology are at advantage to access digital health services, compared to the vulnerable populations without digital knowledge. For example, in the case of CoWIN, it is much harder for people without phones, computers, and the Internet to book slots.
- Language barrier: The website is only available in English, restricting the use for the mass non-English population.
- Privacy violation: For example, the push towards digital health ID databases may result in health records being used by private entities without our consent.
Way forward
- Need to increase spending on health to 3% of GDP to reduce 50% of out-of-pocket expenditure as per Economic survey 2021.
- Need to enforce laws against medical malpractices strictly.
- To ensure Patient privacy, decentralized digital storage followed in countries like France and Taiwan should be created rather than creating a centralized database for digital health records.
Issues Associated with IPR Waiver to Covid Vaccine
Source: click here
Syllabus: GS 3
Synopsis: IPR waiver will not bring instant benefits. Thus, efforts must be made to share the excess stockpiles of vaccines lying with the developed countries.
Introduction
The Biden administration announced that it would support a waiver on intellectual property rights (IPR) for the production of COVID-19 vaccines.
- The original plan, for TRIPS waiver for Covid vaccines, was drafted at the WTO by India and South Africa last year.
- During the 2020 U.S. presidential election, Joe Biden made a promise to share vaccine technology with countries that needed it if he won. He was expecting the deep gap of inequality in vaccine access.
How has the world reacted to this stance?
This policy stance of US has been rejected by major EU nations and met with counter-suggestion.
- The first refusal came from Germany. They said that it would create major complications for the production of vaccines, the major pharma corporations resonated with this view.
- French President Emmanuel Macron was relatively less antagonistic to considering the proposal. However, he lashed out at the Anglo-Saxons for hindering vaccine availability globally by blocking the export of ingredients.
- There is some substance to the argument that an IPR waiver may not fully resolve the vaccine shortage issue in countries suffering the worst of the pandemic now, even if it were to become a reality.
What should be done?
- Firstly, the grant of a waiver would have to be supplemented by technology transfer. It will provide the pharmaceutical manufacturers with the required trained personnel, raw materials, and high-tech equipment and production know-how.
- Secondly, after tech transfer, there must be a scientific criterion to test the safety, immunogenicity, and protective efficacy of the vaccine developed by these generic manufacturers.
- Thirdly, the effect on global supply chains for vaccine production should be inspected so major troubles might be avoided.
- Lastly, other options to instantly address vaccine shortages should be considered. Developed nations should share a considerably greater part of their vaccine stockpiles, particularly in cases where the latter exceed projected domestic needs.
Conclusion
- There is a rumor that Mr. Biden’s waiver announcement might be a tactic to persuade pharmaceutical companies to accept less painful measures. This includes
- sharing some of their technology willingly,
- agreeing to joint ventures to increase global production expeditiously, and
- simply producing more doses at affordable prices to donate directly to where the need is most severe, especially in India.