The healthcare delivery and services landscape in India has evolved significantly over the years. However, India’s healthcare system suffers from various issues like high costs, inconsistent quality, inaccessibility to timely care etc. In this section, we will provide you with the updates, concepts and issues related to health care system in India.

Health and related issues in news for UPSC/IAS Examination

• “Health infrastructure” has increased 45-fold during the pandemic: Centre

  What is the News?

  The Government of India has informed the Supreme Court about the status of India’s Healthcare infrastructure to tackle the Covid-19 pandemic.

  India’s Healthcare Infrastructure Status:

  • India’s Health Infrastructure has increased up to 45-fold to tackle the successive waves of the COVID-19 pandemic.
  • The total cumulative vaccine coverage was 27.23 crore doses as of June 19, 2021.
  • The total intensive care unit(ICU) beds had increased by 45-fold from a baseline of 2,500 to around 1.13 lakh.
  • The total isolation beds (excluding ICU beds) had climbed 42-fold, from 41,000 to 17.17 lakh.
  • Oxygen-supported beds have multiplied 7.5-fold from 50,000 to around 3.81 lakh.
  • Around 1.5 lakh health personnel had been engaged on the ground to tackle the Covid-19 pandemic.
  • The insurance coverage was given to 22.12 lakhs health care workers, including ASHA workers fighting COVID-19.
  • Testing capacity had been increased from 30,000 tests a day in April 2020 to a high of 22 lakh tests daily.

  Source: The Hindu

  Read Also :-Revitalizing Coal Bed Methane in India

• Vaccination policy of India – Issues & Suggestions

  Synopsis: The vaccination policy of India should maintain a balance between the achievement of health goals and demands of supply constraints.

  Introduction 

  Vaccines are a proven shield against the SARS-CoV-2 virus. They have prevented serious illness and death. A study of data from the UK collected between December 1, 2020, and April 30, 2021, showed that the AstraZeneca vaccine had an effectiveness of 64% after one dose and 79% after two doses, in protecting against severe illness and death.

  • Effectiveness of AstraZeneca vaccine: A report by Public Health England showed that the AstraZeneca vaccine had an effectiveness of 71% after one dose and 92% after two doses in guarding against hospitalization due to the delta variant.
  • Effectiveness of COVISHIELD in India: The first report of vaccine effectiveness from India, told an analysis of 8,991 staff who had been vaccinated between January 21, 2021, and April 30, 2021, mostly with Covishield. The protective effect of vaccination was 92% against the need for oxygen and 94% against the need for intensive care.
    • No deaths were reported, but about 10% of those who had received one or two doses were infected.
    • These data from the United Kingdom and India show that the Covishield vaccine is working against the delta variant.

  What are the issues with the current vaccination policy of India?

  • Too much focus on herd immunity. When vaccines seemed to be somewhere in the future with doubts over timing or supply, discussions on the pandemic focused on ‘herd immunity’ (the percentage of the population that needed to be infected or vaccinated in order to slow the spread of infection)
  • The opening of age tiers led to issues of supply. A road map of the availability of vaccines and their supply to individual States is not clear.
  • The Swedish strategy of limited restrictions and the Great Barrington declaration attracted much criticism. Many scientific commentators considered it is cruel to follow a strategy that meant that a lot of people would get infected with the virus.
  • Anti-science statements made by some people have led to a situation where the public is confused as to how best to cope with the coronavirus. Uncertainty on vaccine availability, doubt, fear, anxiety and depression are widespread.

  Also read: What is herd immunity?

  Suggestions to improve vaccination policy of India

  Different needs at different levels require policy approaches that balance the achievement of health and societal goals with the potential impact and the needs of supply constraints.

  • Vaccinating a large number of people: The strategy needs to achieve maximum impact. We need to vaccinate a large proportion of the population and extend it at a later stage to children to both prevent disease and slow spread.
  • Plan for children as well: The advent of the delta variant made it clear that the previous plan to vaccinate a smaller part of the population is not right, and reaching up to 85% of the population might be required. This means that along with all adults, we should be planning for children as well to achieve Universal Vaccination.
  • Vaccinating the high-risk group first: We must vaccinate those most at risk from serious illness and death first based on the principles of public health. The high rates of previous waves in India may make it possible to immunize a large part of our population with a single dose, at least initially.
  • Ensuring expansive reach of the vaccine: The vaccine should reach every village. Community leaders should be empowered with information and tools to broadcast the message that the vaccine saves lives. 
    • The central government has centralized vaccine purchase, but it must revisit the private sector allocation and give distribution to States, providing support when requested. The CoWIN app must not be a limiting factor in access to the vaccine.
  • An adaptive vaccination policy: The vaccination policy must be adapted quickly to changing circumstances. We must create models to find a suitable vaccination strategy for younger populations.
    • If cases are climbing in a particular region, we should direct vaccine doses there to protect as much of the population. High vaccination coverage in cities may protect rural areas. The Government must trust its citizens and share the information as it is a notable aspect of the pandemic.
  • Open sharing of the data: The Government must trust its citizens and share the information that is solely available to it. A notable aspect of the pandemic is the absence of credible data from the government. This has led to speculative ideas based on poor or poorly understood information and misinformation.

  Conclusion
  Addressing the pandemic must include a strategy that ensures maximum impact. This can be done with an expansive vaccination policy that adapts itself on the go and covers the needs of every section of our society.

  Source: Click here

• PM launches crash-course program to train 1 lakh Covid-19 frontline workers

  ---

  What is the news?

  Prime Minister has launched a “customized crash course programme for Covid-19 frontline workers”.

  About the Crash Course Programme for Covid-19 Frontline Workers

  • Aim: The programme aims to create skilled non-medical healthcare workers to fill the present and future needs of manpower in the health sector.
    • This will be done by providing fresh skills and upskills to over one lakh Covid warriors across the country.
  • Nodal Scheme: The course has been designed under the Central Component of Pradhan Mantri Kaushal Vikas Yojana 3.0.

  Key Features of the Scheme

  • Firstly, the programme would be available at 111 training centers across 26 states in the country.
  • Secondly, the Covid warriors will be trained under six modules. These modules include:
    • Home Care Support
    • Basic Care Support
    • Advanced Care Support
    • Emergency Care Support
    • Sample Collection Support and
    • Medical Equipment Support.
  • Lastly, the trained workers will then assist doctors in the treatment of COVID 19 patients.

  Source: India Today

• Role of disruptive technologies in improving the health sector

  Synopsis: Application of future Digital technologies in the health sector can lead to accessible, affordable, and quality health care. Further, it can reduce human involvement in risky functions.

  Background

  • Human involvement in diagnosis, treatment, and hospital care of infected patients puts them at greater risk of contracting the disease. For instance, many frontline warriors fighting COVID-19 have lost their lives.
  • In this context, technologies such as artificial intelligence (AI), autonomous systems, blockchain, cloud and quantum computing, data analytics, 5G can help in addressing the issue.
  • The new technologies can improve the welfare of societies and reduce the impact of communicable diseases. Further, it can reduce the chances of hospital staff contracting the infection.

  Recent developments regarding the use of disruptive technologies for hospital care

  1. One, according to global media reports, some established innovative field hospitals are using robots to care for COVID-19 affected patients.
  2. Two, hospitals in China, are using 5G-powered temperature measurement devices at the entrance to flag patients who have fever-like symptoms.
  3. Three, some robots are being used to measure heart rates and blood oxygen levels through smart bracelets.
  4. Four, In India too, the Sawai Man Singh government hospital in Jaipur held trials with a humanoid robot to deliver medicines and food to hospitalized COVID-19 patients

  How new technologies can improve the hospital ecosystem?

  • One, Blockchain technology can help in addressing the interoperability challenges that health information and technology systems face.
    • The health blockchain will contain a complete indexed history of all medical data, including formal medical records and health data. Data will be sourced from mobile applications and wearable sensors. This will help in seamless medical attention.
    • Further, it allows for storing of data in a secured and authenticated network. Thereby, it will prevent erosion of Individuals’ privacy and ensure data security.
  • Two, Big data analytics can help improve patient-based services such as early disease detection.
  • Three, AI and the Internet of Medical Things, or IoMT can support medical care delivery in dispersed and complex environments through Medical autonomous systems.
  • Four, Cloud computing can facilitate collaboration and data exchanges between doctors, departments, and even institutions and medical providers. It will enable the best treatment.

  Read Also :-Digital nation: On delivery of citizen services 

  How Digital technologies can be utilized to achieve “Universal health coverage” in India?

  1. India needs to own its digital health strategy that works and leads towards universal health coverage and person-centered care.
  2. India’s digital health strategy should emphasize the ethical appropriateness of digital technologies, across the digital divide, and ensure inclusion across the economy.
  3. Online consultation through video conferencing should be made a key part of India’s digital health strategy.
  4. Moreover, digital health strategy should  utilise available local knowledge. Primary health centres in India should examine traditional knowledge and experience and then use it along with modern technology.
     • There are many instances where traditional knowledge has been utilised for preventing diseases.
     • For example, in Indonesia, where the experience of backyard poultry farmers was used to tackle bird flu.
     • Another example is the Ebola virus outbreak in Africa, where communities proactively helped curtail the spread much before government health teams arrived.

  Challenges in developing Digital health strategy

  • Standardisation of health data,
  • Information sharing between Organisations
  • Data security and data privacy, and
  • High investments.

  India’s efforts in this direction should involve synchronization and integration, developing a template for sharing data, and reengineering many of the institutional and structural arrangements in the medical sector.

  Source: The Hindu

  Read Also :-Making Education Accessible and Affordable 

• Achievements of India’s Vaccination Drive

  Synopsis: The COVID-19 vaccination drive demonstrates that India has become Atmanirbhar in vaccination campaigns of the future.

  Contents

  • 1 Introduction:
  • 2 Delayed vaccination drives for Polio:
  • 3 Other examples of delayed vaccination drives:
  • 4 India’s vaccination drive at present:

  Introduction:

  Recently, the Indian Prime Minister talked about the past vaccination campaigns in India. He mentioned that earlier India has to wait for decades to procure vaccines from foreign countries. As they need to complete their vaccination programs first before selling vaccines to countries like India.

  Furthermore, indigenous manufacturing of vaccines not only started late but also fell short of the demand in India for a long time. This forced the government to continue relying on imports.

  Delayed vaccination drives for Polio:

  Infectious diseases posed an enormous challenge to Independent India. This along with the delayed vaccination drives took countless lives. For example,

  • The Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) were licensed abroad in 1955 and 1961, respectively. But it took two decades for India to start polio vaccination drives.
  • The OPV was introduced in India through the Expanded Programme on Immunisation (EPI) in urban and rural populations in 1978 and 1981, respectively.
  • Prior to this EPI programme, India witnessed more than 10,000 officially recorded cases of polio annually.
  • Moreover, India had to rely on imports for both OPV and IPV.
    • The OPV was produced by the Pasteur Institute of India, Tamil Nadu, but the Health Ministry closed down this unit in 1974.
    • The IPV could not be manufactured as it was licensed only in 2006.

  Other examples of delayed vaccination drives:

  This is just one example. But the majority of Indian vaccination drives followed this pattern only.

  • Delayed vaccination drives for Hepatitis B
    • India started mass vaccination for Hepatitis B two decades after commercial availability of the vaccine in the U.S. in 1982.
    • The Hepatitis B vaccination was introduced in India’s Universal Immunisation Programme in 2002 only. Even then also, it was introduced only in 14 cities.
  • Delayed vaccination drives for smallpox
    • In 1962, almost a decade after North America and Europe eradicated smallpox, India launched the National Smallpox Eradication Program.
    • India had an adequate stock of domestically produced low-potency liquid vaccine. But for the highly potent freeze-dried vaccine, India completely depended on the Soviet Union and the World Health Organization (WHO)
    • Further, India also had to rely on the WHO for bifurcated needles required for the smallpox vaccine.
    • This led to higher disease outbreak in certain regions. For example, States like Bihar and West Bengal witnessed a smallpox outbreak in 1974 which led to the death of close to 31,000 people.

  India’s vaccination drive at present:

  India drastically reduced the shortage of indigenously manufactured vaccines. This led to reduced dependence on other countries for India’s Covid-19 vaccination drives.

  • Increased manufacturing capability: In a single day, up to 4.3 million beneficiaries received the COVID-19 vaccines and India already administered more than 25 crores of Covid-19 doses.
    • India is one of the few countries across the globe with an indigenously developed vaccine.
    • Indian companies not only fulfill the domestic demand for bifurcated needles but also supplying syringes for COVID-19 vaccination to countries.
  • Reduced geographical limitation: At present, India’s Covid-19 vaccination drives not focused on a particular region. Instead, citizens across the country are simultaneously getting vaccinated.
  • Eliminated global-domestic time gap: India started its vaccination drives at par with the developed countries. Covishield and Covaxin, manufactured in India, have been available to the people since January 16, 2021.

  COVID-19 vaccination drive demonstrates that India has become Atmanirbhar in vaccination against infectious diseases. Further, the government also decided to conduct free of cost vaccination drives. This marks a complete shift in India’s future vaccination drives.

  Source: The Hindu

  Read Also :-Atmanirbhar Bharat Rozgar Yojana

• Issues in Vaccine Procurement Policy

  Synopsis:

  The recent decision of the Centre to solely procure the vaccines for the states has been welcomed by experts and healthcare professionals. However, retaining a 25% quota towards the private sector seems inappropriate and should be reconsidered.  

  Background:

  • The union government has again taken the responsibility for procuring vaccines for the states under the liberalised vaccine policy.
  • Nonetheless, experts have objected to retaining the 25% procurement quota for the private sector.

  Read Also :-Issues faced by Nursing sector in India

  Issues associated with 25% quota:

  • First, the private sector possesses fewer vaccination centres than its approved procurement quota. This may create a demand-supply mismatch and result in inequitable distribution.
  • Second, the quota is based on a mistaken assumption of an inflated ‘middle class’. The assumption is that 25% of the population is willing and able to pay for a commodity for which social benefits exceed private benefits. 
    • However, in reality, the affluent form only a small fraction of the uppermost 25% of our population.
  • Third, markets tend to under-produce commodities having significant positive externalities. This is true for preventive measures like vaccines which have lower private demand than curative services. 
    • Hence, it would be very difficult to generate demand for vaccinating in private hospitals.
  • Fourth, the top 25% have better access to government vaccination centres. They may choose to get free vaccination, which may have a ‘crowding out’ effect for the poorer sections.
  • Fifth, it would not be possible to attain herd immunity even if 60-80% of the population gets vaccinated. As there would be the existence of grave disparities along geographic and socioeconomic lines. 

  Read Also :-Right to Education is set to expand its horizon

  Way Forward:

  • The government should increase its share of procurement by reducing the 25% quota for the private sector.
    • The loss of revenue to vaccine producers from differential pricing of the private sector can be compensated by increased support through Government subsidies.
  • The government should refrain from an ‘all or none approach’ towards the private sector. Where some governments often impose unreasonable and unfavorable pricing restrictions and other governments give too much freedom. There is a need for a balanced approach.
  • The focus must be on creating a strategic purchasing framework that could utilize the strengths of the private sector which includes innovative processes and efficiency. 
  • It must engage with both small and big private players, and create a more decentralized and accountable procurement system.

  Source: Click Here

  Read Also :-Centre Should Relook its Vaccine Policy

• Need for Equity-focused Vaccination Plan in Vaccine Drive

  Synopsis:

  To control the Covid-19 pandemic, India needs an equity-focused vaccination plan and a road map to provide equity and justice in vaccination.

  Contents

  • 1 Introduction:
  • 2 What is an equity-focused vaccination plan?
  • 3 Challenges in providing equity-focused vaccination plan
  • 4 How to improve the equity-focused vaccination plan?
  • 5 Conclusion:

  Introduction:

  According to WHO’s strategic advisory group of experts on immunisation, prioritizing socio-demographic groups is essential for universal vaccination. So, an equity-focused vaccination plan is essential for controlling the pandemic.

  What is an equity-focused vaccination plan?

  Instead of focussing on vaccinating the public, the plan facilitates vaccinating vulnerable sections of society. This plan should include the following sectors of people to prevent disease and death among them. Such as, prioritizing the poor, religious minorities, socially disadvantaged castes, Adivasi communities, those living in remote areas, urban slums, and women.

  • For example, the Chhattisgarh government prioritised ration cardholders in vaccination.
    • Under this, the Chhattisgarh government vaccinated high-risk persons such as the poor, people who live in multi-generation for the same house, larger household.
    • Further, these are the people who lack access to mobile phones and the Internet (Crucial for registering vaccines).

  Challenges in providing equity-focused vaccination plan

  1. Lack of data on various parameters: India’s Covid-19 impact data does not provide the impact of virus infection among gender, caste, religious, and indigenous identities. Though crowd-sourced data is available, they too lack geographic and other meta-data for tests conducted in India.
  2. Vaccination through digital registration: Digital technologies can create a digital divide among age, gender, economic dimensions, rural-urban differences. The government’s CoWIN data also shows inequitable vaccination between tribal and non-tribal areas.
  3. Role of developed countries: The developed countries do not always help other countries in vaccination drives. For example, During the 2009 H1N1 flu pandemic, wealthy countries secured more doses than they need to vaccinate every member of their population. Similar such behavior is also observed in the Covid-19 pandemic also. Poor countries in the world depend on the mercy of the European Union and the United States for vaccinating their population.

  Read Also :-India Needs an Effective Vaccine Policy

  How to improve the equity-focused vaccination plan?

  1. Trying out vaccination camps or door-to-door campaigns: Vulnerable sections of people often have poor access and low levels of trust in the healthcare system. So, the camps and campaigns can provide the following advantages. Such as,
     • Older adults can get the vaccine from their homes.
     • Essential workers will not face any interruption in their service delivery.
     • Similarly, the poor and vulnerable people will not face any loss in daily wages 
  2. The government can try women-only vaccine days to ensure that women are getting equal importance in vaccination. Women are often neglected in vaccine drive for reasons such as, they are not the breadwinner of the family, historically marginalized stature of women, etc. But this might lead to gender inequities in vaccine uptake. This will only lead to more Covid-19 infection among women
     • For example, During the 1918 influenza pandemic in India, the mortality rate of women is higher than men.
  3. The government has to ensure vaccinating older people completely before opening vaccination to younger adults.
  4. In Indian villages, Accredited Social Health Activists (ASHAs) and Auxiliary Nurse-Midwives (ANMs) have enough experience and expertise with pulse polio vaccination and newborn vaccination. So, the government has to utilize its expertise to vaccinate Indian villages.
  5. Local governments and municipalities should prioritise vaccines for historically marginalised persons in the locality. Such as,
     • Adivasi’s communities often live in remote and forested areas. The government should prioritize these regions.
     • Religious minority areas such as Muslim-dominated tier-3 cities and villages should also get priority on vaccination drive.
  6. At the global level: WHO is consistently highlighted vaccine equity at global level. The COVAX facility can play a greater role in the equity distribution of vaccines around the world. The world leaders also need to follow the lead of WHO in vaccination and ensure global solidarity in this pandemic.

  Conclusion:

  The central procurement of vaccines and providing free vaccines are not alone enough to vaccinate the entire population. So, refocused rejuvenated local, national, and global vaccination campaigns alone can provide equity-focused vaccination in the world.

  Read Also :-Why IITs Demand for Priority Vaccination is not Justified?

  Source: The Hindu

• Single dose of vaccine can’t control Delta Variant: Global Study on vaccines

  Contents

  • 1 Synopsis:
  • 2 Background:
  • 3 About the Delta Variant:
  • 4 Data shown by various studies on vaccines:

  Synopsis:

  The data from clinical trials and post-vaccination study on vaccines shows that the Dominant delta variant of Covid-19 can’t be easily controlled by a single dose of vaccine. The countries must administer two doses of vaccine and should reduce the time gap between them.

  Background:

  • The WHO has recently given a new classification to SARS-CoV-2 variants of interest (VOI) and variants of concern (VOC) on the basis of Greek letters. The objective was to create easy-to-pronounce and non-stigmatising labels for VOI and VOC.
  • However, the established nomenclature systems for naming and tracking of SARS-CoV-2 genetic lineages by GISAID, Nextstrain and Pango will remain in use for scientific research.
  • The new classification is as follows:
    • VOC B.1.1.7 will be called Alpha Variant. It was the earliest documented in the United Kingdom (September 2020).
    • VOC B.1.351 will be called Beta Variant. It was the earliest documented in South Africa (May 2020).
    • VOC P.1 will be called Gamma Variant. It was the earliest documented in Brazil (November 2020).
    • VOC B.1.617.2 will be called Delta Variant. It was the earliest documented in India (October 2020).

  About the Delta Variant:

  • It was first identified in Maharashtra and is believed to be responsible for the severe second wave in India.
  • It has now spread to most parts of India and also been identified in many other countries.
  • The rapid expansion has induced the WHO to graduate it from a “variant of interest” (VOI) to a “variant of concern” (VOC) category.

  Scientists have undertaken various studies to address 3 major questions surrounding the delta VOC – 

  1. Is it more infectious than the prevalent virus?
  2. Is it more lethal than the previous virus?
  3. Does the delta variant is more resistant to the effect of vaccines? 

  Data shown by various studies on vaccines:

  Read Also :-What are “Variants of Concern” (VoC)?

  • Results of Study conducted by Indian SARS-CoV-2 Genomic Consortia (INSACOG) and the National Centre for Disease Control (NCDC):
    • The Delta variant is the “prime reason” behind the second wave, though the wave may have been initiated by the Alpha variant.
    • The Delta Variant has become dominant even in Britain, where scientists have recently noted that it is 50% more infectious than the Alpha variant.
  • Results of study on vaccines conducted by Public Health England:
    • A single dose of the AstraZeneca vaccine provided 33% efficacy against the Delta variant, while it was 51% against the Alpha variant.
    • The second dose improved the efficacy to 60% against the Delta variant and to 66% against the Alpha variant.
    • Further, two doses of Pfizer-BioNtech vaccine provided much higher levels of protection than two doses of the AstraZeneca vaccine.
  • Results of a British study on vaccines published in Lancet Journal:
    • Merely 32%of the vaccinated individuals had adequate antibody levels against the Delta variant after the first dose of the Pfizer vaccine. It was 25% against the beta variant.
    • The antibody levels rose after the second dose. However, they were far below the levels obtained against the initial variant of the Covid-19 virus.
  • Results of a study on vaccines conducted by the Pasteur Institute, France:
    • The Delta variant showed reduced response to both the vaccines (Pfizer and Astrazeneca). It was resistant to neutralisation by some monoclonal antibodies targeting the Spike protein.
    • The study concluded that a single dose of the Astrazeneca vaccine will not display optimal protection against the delta variant.

  Lessons learnt from the various study on vaccines:

  • First, the Delta variant is the most infectious variant in circulation. However, there is not much convincing evidence to prove it is more deadlier than the previous variants.
  • Second, vaccines have diminished efficacy against the delta variant. Further, a single dose of either the AstraZeneca or the Pfizer-BioNTech vaccine does not provide adequate protection against the Delta variant.
  • Third, a shortened dosing interval is recommended to deal with the Delta variant. Britain has already reduced the interval to 8 weeks from earlier 12 weeks.

  Source: The Indian Express

• India’s response to shocks – 1962 war to COVID pandemic

  Synopsis- The article distinguishes between the Center’s reaction to the current pandemic and its responses to shocks in Indian History.

  Three criteria to analyze Indian government’s response

  • The team
  • The science
  • The organizational innovations put together

  List of previous shocks and the India’s response

  • First, 1962’s Sino-India War-
    • Response- Defence reform
      • The new defence minister was appointed.
      • The financial allocation for the defence was increased
      • Alters India’s understanding of the world and foreign policy in a fundamental way.

  • Second, 1966 Severe Drought – In 1966, due to drought, food grain production fell by 20 per cent. Foreign food aid came to the rescue of the starving population.
    • Team- Indira Gandhi (PM), C Subramaniam (agriculture minister) and M S Swaminathan (scientist).
    • Response-
      • Start of Green Revolution.
      • Science and technology were relied on and organizational innovations like the Food Corporation of India [FCI] were made.

  • Third, 1975 National Emergency, political shock
    • Team- Indira Gandhi (PM) and Sanjay Gandhi.
    • Response-
      • The harsh family planning programme was launched by PM Indira Gandhi on her son’s insistence. Despite the efforts to create awareness and support for sterilization [surgery to make a person or animal unable to produce offspring], the camps were receiving a lukewarm response.

  • Fourth, 1991, External sector shock
    • Team- P V Narasimha Rao (PM), Manmohan Singh (FM), M S Ahluwalia (finance secretary) and S S Tarapore (from the RBI).
    • Response-
      • S S Tarapore played a key role by not acceding to the capital account convertibility requirement of the IMF.
      • Response to the shock, in this case, was that both policy and organizational change was brought about slowly, without disrupting the economy.

  • Lastly, India’s response to the COVID-19 Pandemic
    • Team- No clarity about who is in the team.
    • Response-
      • Not clear if the Covid-19 task force and control room in the Niti Aayog are the same.
      • Mismanagement in providing information regarding Covid-19 response.
      • There are some vaccine-related issues such as the gap between the two shots and taking two different vaccines. This contributes to vaccine hesitancy.
      • Confusion related to vaccine procurement.
      • Allowing huge gathering such as Kumbh Mela, election rallies were obvious cases of not following science.
      • Few cases of which reveal the unimportance the government gives to science.

  Conclusion
  There is a drastic difference between the handling of COVID-19 pandemic shock from the previous shocks. The government needs to improve on all three criteria.

  Source- The Indian Express

• NITI Aayog launches “Surakshit Hum Surakshit Tum Abhiyaan”

  Contents

  • 1
  • 2 What is the news?
  • 3 About Surakshit Hum Surakshit Tum Abhiyaan:
  • 4 About Transformation of Aspirational Districts programme (TADP):

  What is the news?

  Surakshit Hum Surakshit Tum Abhiyaan’ has been launched by NITI Aayog and Piramal Foundation.

  About Surakshit Hum Surakshit Tum Abhiyaan:

  • Surakshit Hum Surakshit Tum Abhiyaan has been launched in 112 aspirational districts.
  • Aim: To assist district administrations in providing home-care support to COVID-19 patients who are asymptomatic or have mild symptoms.
  • Features of the initiative:
    • Firstly, the initiative will be led by district magistrates in partnership with local NGOs.
    • Secondly, the NGOs will help mobilise local volunteers. They shall be trained so that they can provide support to affected families by educating them to follow Covid-19 protocols. They shall also be trained to provide psycho-social support and timely updates about patients to the administration.
    • Thirdly, local leaders, civil societies and volunteers will also work with district administrations to address emerging problems across key focus areas of the Aspirational Districts Programme.
  • Significance of the campaign: The Surakshit Hum Surakshit Tum Abhiyaan campaign is expected to contribute to district preparedness for managing nearly 70% of COVID cases at home. Hence, it shall reduce pressure on the healthcare system and curbing the spread of fear among the people.

  Read Also :-What is National Nutrition Mission?

  About Transformation of Aspirational Districts programme (TADP):

  • The TADP programme was launched in 2018. It is coordinated by Niti Aayog with support from Central Ministries and the State Governments.
  • Aim: To quickly and effectively transform underdeveloped districts. This will be done by focusing on the strength of each district, identifying easily achievable areas for immediate improvement, measuring progress and then ranking them.
  • Features: it is based on three broad principles:
    • Convergence (of Central & State Schemes),
    • Collaboration (of Central, State level ‘Prabhari’ Officers & District Collectors), and
    • Competition among districts driven by a mass Movement.
  • Themes: The programme focuses on 5 main themes:
    • Nutrition
    • Education
    • Agriculture & Water Resources
    • Financial Inclusion & Skill Development
    • Basic Infrastructure.
  • Ranking: Each district is ranked based on 49 performance indicators identified across the above 5 core themes. The main objective of the rankings is to measure progress and rank districts to spur a sense of competition among states.

  Source: The Hindu 

• Covid-19 vaccines are safe for “inflammatory bowel disease” patients: New research

  Contents

  • 1
  • 2 What is the News?
  • 3 About the Research:
  • 4 Inflammatory bowel disease(IBD):

  What is the News?

  According to a study published in the American Journal of Gastroenterology, Pfizer or Moderna Covid-19 vaccines are safe for patients with inflammatory bowel diseases(IBD). They do not appear to have an increased risk of side effects from Covid vaccines.

  About the Research:

  • Researchers evaluated the post-vaccination side effects in 246 adult inflammatory bowel diseases(IBD) Covid-19 vaccine patients.
  • These patients most often reported pain and swelling at the injection site after vaccination. This is followed by reasons such as fatigue, headache and dizziness, fever and chills and gastrointestinal symptoms.
  • However, most of these side effects were mild and lasted only a few days.

  Inflammatory bowel disease(IBD):

  • Inflammatory bowel disease(IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract.
  • Types: The two most common IBDs are ulcerative colitis (UC) and Crohn’s disease:
    • Ulcerative Colitis(UC) involves inflammation of the large intestine.
    • Crohn’s disease can cause inflammation in any part of the digestive tract. However, it mostly affects the tail end of the small intestine.
  • Causes of IBDs: Family history and genetics, Weak Immune System, Smoking, Ethnicity, Age and Environmental Factors among others.
  • Treatment: Treatment may include immunosuppressive drugs to control the inflammation.

  Source: Indian Express

• “Aducanumab” approved by USFDA for “Alzheimer’s disease”

  Contents

  • 1
  • 2 What is the News?
  • 3 How does Aducanumab drug work?
  • 4 About Alzheimer’s Disease:

  What is the News?

  “Aducanumab”, a new drug for the treatment of Alzheimer’s disease, has been approved by the US Food and Drug Administration (FDA)

  How does Aducanumab drug work?

  • Aducanumab is a monoclonal antibody drug that aims at altering the course of Alzheimer disease by slowing the deterioration of brain function.
    • Monoclonal Antibodies are man-made proteins that act like human antibodies in the immune system. They are made by cloning a unique white blood cell.
  • The drug does this by reducing the presence of amyloid-beta, a protein that forms plaques in the brain.
  • Significance: Since there is no treatment so far, the drug that can slow down Alzheimer’s disease holds much promise and is a ray of hope.
  • Concerns:
    • High Cost: The company has said that the average wholesale cost of the drug would be $56,000 (over Rs 40 lakh) per year.
    • Ineffective Studies: The studies on the drug didn’t clearly show that people were likely to have fewer symptoms of Alzheimer’s disease if they were taking the drug. Hence, not all experts agreed that Aducanumab deserved approval.

  About Alzheimer’s Disease:

  • Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die.
  • The disease is the most common cause of dementia — a continuous decline in thinking, behavioural and social skills that affect a person’s ability to function independently.
  • Caused by: Alzheimer’s disease is thought to be caused by the abnormal build-up of proteins in and around brain cells.
    • One of the proteins involved is called amyloid, deposits of which form plaques around brain cells.
    • The other protein is called tau, deposits of which form tangles within brain cells.
  • Vulnerability: Alzheimer disease most commonly affects older adults, but it can also affect people in their 30s or 40s.
  • Cases:
    • According to WHO estimates for 2017, dementia affects approximately 50 million people worldwide, a number that is projected to grow to 82 million by 2030.
    • In India, it is estimated that 5.3 million people (1 in 27) above the age of 60 have dementia in 2020. This is projected to rise to 7.6 million by 2030.

   Source: Indian Express

• How can India address its mental healthcare problem?

  Synopsis: Evaluation of India’s state of mental health care and suggestions to improve them.

  Background

  • Recent reports published in Lancet revealed that one in seven people in India had a mental disorder ranging from mild to severe in 2017.
    • Mental illnesses include anxiety disorders, psychotic disorders, mood disorders, substance use disorders, personality disorders and eating disorders.
  • Despite having the necessary components to address the mental healthcare issues, more needs to be done in the context of COVID-19 that has exacerbated mental illnesses.

  The mental healthcare situation in India

  • The situation is bad especially in the southern states as compared to the northern states due to the nature of development, modernization, urbanization etc.,
  • Sharp gender divide: Depressive disorders are more prevalent among females than males due to sexual abuse, gender discrimination, stress due to antenatal and postnatal issues etc

  Contents

  • 1 Why mental healthcare situation is bad in India?
  • 2 Why Mental Health needs to be given priority?
  • 3 Government measures on mental health care
  • 4 What more steps can be taken?

  Why mental healthcare situation is bad in India?

  • Inadequate public spending on Mental Health: India spends around 1.3% of total health expenditure on mental health, whereas, in developed countries, it ranges from 3% to 15%.
  • Inadequate infrastructure for Mental Health: For Instance, the share of mental hospitals per 1,00,000 population is as low as 0.01 according to the WHO.
  • Similarly, India fares poorly in the distribution of mental health units, mental health outpatient facilities, community residential facilities etc.,
  • Inadequate Mental health resources: Nurses, social workers and psychologists working in the mental health sector in India are way less compared to other countries. For instance, leading countries have 222.6 psychologists per 1,00,000 population whereas India has only 0.069, per 1,00,000 population.

  Why Mental Health needs to be given priority?

  • One, Causative factor for suicides. The majority of suicides in the world are related to psychiatric problems or mental illnesses. India’s suicide rate was 16.3 per 1,00,000 in 2016 that is very high compared to the Global suicide rate of 10.6 per 1,00,000 population.
  • Two, a significant contributor to the total disease burden in India. For instance, the proportional contribution of mental disorders to the total disease burden had doubled between 1990 and 2017.
  • Three reduces longevity. According to the World Health Organization (WHO), there is a 10-25-year life expectancy reduction in patients with severe mental disorders.

  Government measures on mental health care

  • India has rightly enacted the following policies to cater to the needs of the population suffering from Mental illness:
    • The National Mental Health Policy (NMHP) in 2014,
    • Rights-based Mental Healthcare Act in 2017,
    • National Adolescent Health Programme
    • Ayushman Bharat

  More needs to be done.

  What more steps can be taken?

  In order to further address mental health issues and promote mental healthcare, India needs to do the following,

  • One, reduce the treatment gap for mental disorders. For instance, Telemedicine can be promoted to reduce the gap.
  • Two, increase the number of personnel in the mental healthcare sector.
  • Three, remove stigmatization by reducing discriminatory attitudes.
  • Four, devise an integrated approach for detecting, treating, and managing patient needs.
  • Five, increase counselling facilities, especially in rural areas, with special support for women through the provision of women doctors.
  • Six, leverage the benefits of technology. The application of big data and crowdsourcing ideas can help to make informed decision-making.
  • Seven, focus on community-based programmes. For Instance, School-based programmes on mental health can improve the mental health of children.
  • Eight, create mental health awareness through traditional media, government programmes, the education system, industry, and social media.

  Source: The Hindu

• Prudent Approach towards the Downward Trajectory of Second Wave

  Contents

  • 1 Synopsis:
  • 2 Background:
  • 3 Understanding the Downward Trajectory of Second Wave:
  • 4 Suggestions to capitalise the downward Trajectory of Second Wave:

  Synopsis:

  India has witnessed a decline in Covid-19 cases since the last month, thereby indicating a downward trajectory of the second wave. It presents an opportunity to effectively prepare for the upcoming third wave through universal vaccination and accommodative reforms.

  Background:

  • The second wave of pandemic left a more brutal impact on India than the first wave, with cases touching the 4 lakh/day mark. Rural India was hurt significantly and many districts reported higher fatality rates than the national average.
  • However, the cumulative Covid-19 cases have now declined by 72 % from the peak in May. 

  Understanding the Downward Trajectory of Second Wave:

  • The decline is mainly caused by a decrease in urban cases while the rural cases are still on the rise as shown by the 14-day moving average of the top 20 districts. 
  • The percentage of daily new cases from rural areas is still at 52.8 percent. A high prevalence of cases in the rural area indicates that:
    • The GDP loss due to the current wave will be much lower than that in the first wave. This is because these rural districts account for a lower share of economic activity.
  • There is also a subtle change in India’s vaccination policy. Now India is prioritising people receiving the first dose.
    • This would bring down the magnitude of serious cases in the country and ensure better preparation for the 3rd wave.

  Read Also :-Measures to Control the Covid-19 Second Wave

  Suggestions to capitalise the downward Trajectory of Second Wave:

  • The government should step up the vaccination drive as currently, around 16% of people have received the first dose and only 3% have been fully vaccinated. For the US, these numbers are 89.4 and 44.1 respectively.
    • India must opt for an advanced procurement strategy like that adopted by developed nations to inoculate its remaining population, especially the 12-17 age bracket.
    • There should be a centralised vaccine procurement along with a centralised pricing strategy.
  • The rollout of a compassionate fiscal policy at both the central and state levels is also desired for reducing the stress of the common man and businesses. This would include rationalisation of fuel prices, tax holidays, electricity rebates for MSMEs etc.
  • There should be prudent adoption of the best administrative practices at state and local level. The Centre should now collect and collate such systems and make them available to state governments to strengthen the health infrastructure. This includes:
    • “Mumbai model” of oxygen distribution under the able administrator, Iqbal Chahal.
    • “Ernakulam’s war room model” that oversees the entire city and allows for resources to be shifted swiftly between hotspots. 
    • Telephone-based triaging systems of Tamil Nadu and Karnataka.
      • Triage systems are methods for systematic prioritizing of patients’ treatment according to how urgent they need care.
  • The operations of local bodies should be digitalised to ensure better resource allocation and greater accountability.

  Source: The Indian Express 

• Mitigating the third wave requires a focus on DOTS

  Synopsis:

  India is witnessing a softening of the second wave. Nonetheless, the anticipation of the 3rd wave is quite high. Therefore, it is imperative for India to focus on reducing the reproduction number (R). This in turn calls for focusing on its determinants i.e. DOTS for Mitigating the third wave

  Contents

  • 1 Background:
  • 2 About Reproduction number (R):
  • 3 What led R to increase earlier this year resulting in a second wave?
  • 4 Suggestions for Mitigating the third wave:

  Background:

  • India witnessed a brutal impact of the second wave of the pandemic in May 2021, with cases crossing the 4 lakh mark in one day.
  • The situation has now eased and the number of cases has come down below the 1.5 lakh mark. The second wave appears to be abating due to a reduced reproduction number.

  About Reproduction number (R):

  • It refers to the average number of new infections arising from one infected individual.
  • R greater than 1 implies that infected individuals infect more than one person on average, and we observe increasing cases. When it is less than 1, cases are declining.
  • It is dependent on Four Factors, summarised by the acronym DOTS: 
    • Duration a person is infectious 
    • Opportunities for infected individuals to spread the infection to others; 
    • the probability of Transmission of infection if given an opportunity 
    • the average Susceptibility of a population or subpopulation 

  What led R to increase earlier this year resulting in a second wave?

  • Susceptibility: It was quite high at the start of the year. This is evident from the results from a national seroprevalence survey done in December 2020 and January 2021. They indicate roughly 25% of the population had antibodies to the virus that causes COVID-19.
    • Further, less than 1% of the total population had received two doses of the vaccine till March 2021.
  • Opportunity for Transmission: By January 2020, people perceived that they had won the battle over the pandemic. They were eager to get back to life and work. Eventually, this increased the social mixing and the occurrence of large gatherings that might have facilitated a second wave.
  • Probability of Transmission: A fall in Covid-19 appropriate behaviour was witnessed in early 2021 like not wearing masks in public, not properly sanitizing oneself etc. Further new variants with higher transmissibility potential emerged.
    • For instance,  B.1.617.2 (the delta variant) is known to possess higher transmissibility potential, twice than the Covid-19 variants circulating in 2020. It has emerged as the dominant variant in India and UK during their second wave.
  • Duration of infectiousness: It may have enhanced with the emergence of new variants however more research is needed on this front.

   Read Also :-War against tuberculosis in India: an overview 

  Therefore, it is now imperative that we need to focus on DOTS for Mitigating the third wave.

  Suggestions for Mitigating the third wave:

  • The government must build well-designed seroprevalence surveys to understand how much of the population remains susceptible and where they reside. These should accommodate the complexities of new variants and the occurrence of reinfections.
  • The focus should be on increased use of face masks and improved ventilation for reducing the transmission. The country can learn from the Bangladesh model in which the distribution of free masks coupled with community monitors delivered positive results. 
  • Temporary solutions like lockdowns and a ban on mass gatherings should be used to focus on slowing the transmission rate.
  • The magnitude of the susceptible population can be brought down by substantially increasing the immunisation coverage. Currently, only 3% of the population has received both doses.
  • The isolation and quarantining guidelines should be revised periodically as per the changing duration of infectiousness.

  Source: The Hindu 

• Global studies on “vulnerability of animals to Covid-19”

  Contents

  • 1
  • 2 What is the news?
  • 3 Mechanism of Coronavirus Infection:
  • 4 Global studies on vulnerability of animals to Covid-19:
  • 5 A study by PNAS, a research journal of US:
  • 6 A study by the University of Bologna regarding vulnerability of animals to Covid-19:

  What is the news?

  A lion at Chennai’s Vandalur Zoo has died of suspected coronavirus infection. Similarly, a tiger died at Jharkhand’s Bhagwan Birsa Biological Park after suffering from fever. This sparked the debate regarding the study of the vulnerability of animals to Covid-19.

  Mechanism of Coronavirus Infection:

  • The coronavirus initiates infection using the spike protein on its surface. On the surface of the human cell are proteins called ACE2 receptors. The spike protein binds with the ACE2 receptor, then invades the cell and goes on to replicate.
  • Different species express ACE2 to different extents and this plays a key role in determining how much a species is susceptible to coronavirus infection.

  Global studies on vulnerability of animals to Covid-19:

  A study by PLOS Computational Biology regarding vulnerability of animals to Covid-19:

  • Research: In December 2020, researchers looked at the ACE2 receptors of 10 different species and compared their affinity for binding with the virus spike protein.
  • Method: The researchers used computer modelling to test this. They compared the “codon adaptation index” which is a measure of how efficiently the virus replicates after entering the cell.
  • Findings: The most vulnerable species to coronavirus infection next to humans are ferrets followed by cats and civets.

  Read Also :-National Climate Vulnerability Assessment Report

  A study by PNAS, a research journal of US:

  Researchers studied a detailed genomic analysis of the relative coronavirus risks faced by 410 species.

  • Method: In humans, 25 amino acids of ACE2 are important for the virus to bind with the cell. The researchers used modelling to evaluate how many of these 25 are found in the ACE2 of other species. The more the matches with the human ACE2, the lower the risk of infection.
  • Findings:
    • At very high risk are primates such as chimpanzee, rhesus macaque.
    • At high risk are species such as blue-eyed black lemur.
    • Cats were found to have medium risk, while dogs had a low risk.

  Read Also :-Reducing the vulnerabilities of urban employment

  A study by the University of Bologna regarding vulnerability of animals to Covid-19:

  • Researchers at the University of Bologna collected tissues from six cats and a tiger. They found wide expression of ACE2 in their gastrointestinal tracts. This was more prominent in the cats than in the tiger.

  Source: Indian Express

   

• “Revised Vaccine Procurement Policy” allows central procurement of vaccines

  Contents

  • 1
  • 2 What is the News?
  • 3 About Revised Vaccine Procurement Policy:
  • 4 Free for All Vaccine:
  • 5 Extension of Pradhan Mantri Garib Kalyan Yojana:
  • 6 Reasons for announcing revised Vaccine Procurement Policy

  What is the News?

  The government of India has announced a revised Vaccine Procurement Policy and also several relief measures to tackle the Covid-19 pandemic.

  About Revised Vaccine Procurement Policy:

  • The Central Government will go back to a system of centralised procurement of vaccines against COVID-19.
  • Under this, the central government will now buy 75% of the total production of the vaccine producers and provide it to the states free of cost.
  • However, the system of 25% vaccines being procured directly by the private hospitals will continue.
    • State governments will monitor that only ₹150 service charge is levied by the private hospitals over the decided price of the vaccines.

  Free for All Vaccine:

  • Until now, the Central Government used to provide free vaccines to everyone aged 45 and above.
  • However, from now on, the Centre will give free vaccines to all in the 18-44 age group starting June 21.

  Extension of Pradhan Mantri Garib Kalyan Yojana:

  • The government of India has announced the extension of the free ration distribution scheme for 80 crore beneficiaries under the Pradhan Mantri Garib Kalyan Yojana till November 2021.

  Reasons for announcing revised Vaccine Procurement Policy

  • These new announcements came after the Supreme Court had asked the Centre to file an affidavit on how the sum of ₹35,000 crores allocated in the Union Budget for vaccines has been spent so far.
  • The apex court also asked why these funds cannot be used for giving free vaccination for those in the age group of 18 to 44 years.
  • Moreover, the court observed that the Centre’s policy of not providing free vaccines to this particular age group was prima facie arbitrary and irrational.

  Source: The Hindu

   

• How COVID -19 can be addressed via COVID-19 appropriate behaviour?

  Synopsis- Adoption of COVID-19 appropriate behaviour is the best way to reduce transmission of the Covid-19 pandemic.

  Contents

  • 1 Introduction-
  • 2 What is behavioural science?
  • 3 How behavioural science methods can be used in COVID-19 prevention?
  • 4 Way forward

  Introduction-

  • One of the key causes of COVID-19’s second wave in India has been the carelessness and reckless behaviour of few people. They have consistently violated Covid-19 guidelines of wearing masks and social distancing.
  • According to KAP [knowledge, attitudes and practices] survey, from July 2020 to March 2021, India witnessed a 5% drop in mask-wearing.
  • Relying entirely on medical science, especially treatment, is not a viable strategy for dealing with the epidemic.

  Therefore, Covid-19 appropriate behaviour is a must to reduce transmission.

  Read Also :–How to Prevent 3rd Wave of Covid-19?

  What is behavioural science?

  Behavioural science is a field of study that blends findings from social and cognitive psychology, neuroscience, and behavioural economics to make sense of human behaviour.

  • With an evidence-based approach, behavioural scientists unpack what makes individuals tick: from motivations and aspirations to cognitive biases and social influences.

  How behavioural science methods can be used in COVID-19 prevention?

  1. Create awareness about masks
     • Provide basic information regarding who should wear them, when and where.
     • Also, provide clarity on what types of masks are most effective, how to wear a mask correctly, and when to double mask.
  2. Information should be tailored accordingly to people-The government has to communicate with each group of people and provide information accordingly. But it should not discount or put down people’s beliefs or misconceptions. The government has to counter them with credible facts.
  3. Need to communicate the benefits of mask-wearing – The state should share testimonials, infographics and statistics that explain how masks have prevented infection transmission.
     • The government can share testimonials from people who wear masks regularly and explaining how they have managed to avoid getting infected could help.
  4. Role model leadership – Leaders at every level should play their role in influencing people for mask-wearing and vaccinations.
  5. Need of responsible media–
     • The media needs to maintain a high standard and report on much more than just struggling hospitals, the oxygen crisis and vaccine and drug shortages. Instead, they have to participate in fighting misinformation and disinformation.

  Way forward

  • People have to be aware and sensitive about COVID-19 appropriate behaviour. Till everyone will not get vaccinated, behaviour change is the most effective measure to deal with COVID-19.
  • Stringent implementation of public health and social measures remain the key to stop virus transmission.

  Source- The Hindu

• How can India tackle the third wave of COVID?

  Synopsis: To control the third wave, the decision-making on vaccines should be filled by a spirit of cooperative federalism and guided by scientists.

  Introduction 

  Vaccines have become the focus of pandemic policy. Effective vaccine policy over the next few months will require huge efforts to boost vaccine supply. Distribution of existing supplies, helped by science, data and cooperation, can also play an important role. 

  What are the challenges India is likely to face?

  India is going to face major vaccine shortages over the next 6-12 months. However, distributing the limited vaccine supply in a balanced, targeted way could help India save many lives and help prevent a deadly third wave.

  • Vaccine supply and allocation are disordered currently. There are multiple decision-makers, rules are uncertain, messages are contradicting. Such conditions worsen the problem of a vaccine shortage. 
  • Challenges in continuing the current policy: 
    • Serious shortage in vaccine availability. 
    • Higher infections rates in India.
      • At the end-December 2020, the third national seroprevalence survey suggested that the actual infection rate was 21.5 per cent, that is over 1 in 5 people in India had been exposed to the virus by the end-2020. Thus, a possible infection rate of over 50% or above 700 million people in June.

  Advanced countries with successful vaccine programmes like Israel, the US and UK had adopted a similar strategy. They first vaccinated essential workers and then used age as parameters to decide vaccination in the initial stages. 

  What should India do to prevent the third wave?

  Centralization of the vaccine policy is a must. Vaccines should be free for all and the costs must be borne by the Centre. However, these measures may not be sufficient in the short run.

  • Focus on uninfected and vulnerable: Latest research suggests that prior infection offers protection for some time. This immunity increases strongly with at least one dose of the vaccine. This gives the government some time to focus on the uninfected and vulnerable as the immediate priority.
  • Widespread testing: Vaccinating the uninfected will require detailed data on infection rates, demography and vaccination status. Widespread testing needs to be done. 
  • A larger share of the limited vaccines could be devoted to geographies that currently have less infection rates.
  • Partial dosing or vaccine mixing could also be explored.
  • Expert guidance: A technical team of scientists, epidemiologists, statisticians etc should design a plan to decide on the most effective allocation of existing vaccines. 
    • The team should report to a group involving the prime minister and all the chief ministers.

  Decision-making on vaccines should be filled with a spirit of cooperative federalism and be guided by scientists. Trust, transparency and technical reason must guide this process.

  Conclusion
  The government should make efforts to increase the supply of vaccines. Once the supply of vaccines becomes sufficient, the need for allocation and prioritization will decline. Until then, it is vital to use data and science to reduce the magnitude and costs of vaccine shortages 

  Source: click here

• Lab leak theory of Coronavirus needs credible investigation

  Synopsis: The theory that Coronavirus could have been man-made from Wuhan Institute of Virology is increasing. So, adequate studies are necessary regarding the Lab leak theory of Coronavirus.

  Background

  • When the Covid-19 became a pandemic, China promoted the narrative that the virus had a natural origin, and it got spread from a wet market in Wuhan. This was done to avoid any scrutiny on researches being carried out in the Wuhan Institute of Virology (WIV).
  • Soon, the idea of a Lab leak theory of Coronavirus was discredited as a conspiracy theory and most experts embraced the natural spread narrative.
  • Even the findings of the WHO on the origins of the SARS-CoV-2 virus (coronavirus) dismissed the lab leak as “extremely unlikely”.
  • However, recent developments point out the possibility that coronavirus could have originated from a lab leak, either intentionally or unintentionally.
  • Recently, the U.S. President made an appeal to the U.S. intelligence community “to collect and analyse information so that, a definitive conclusion regarding the origin of the virus could be made.
  • Further, the publication by Nicholas Wade, titled the origin of COVID: Did people or nature open Pandora’s box at Wuhan?” has laid out a strong case for a fuller investigation into this event.

  Read Also :-India – China Informal Summit

  Arguments in support of lab leak theory of Coronavirus

  • First, advancement in biotechnology had made it possible to genetically engineer existing pathogens to make them more lethal and difficult to treat.
  • Second, in 2019, the head of corona virus-related research at WIV lab, in an interview, talked about the research carried out involving the creation of novel, life-threatening and pandemic-creating viruses.
  • Third, though The WIV operates a Biosafety level-4 (BSL-4) facility, many times the deficient safety standards had been reported by U.S. inspectors but no remedial measures were taken.
  • Fourth, China’s reluctance to share data, covering up facts and impeding investigation raises suspicion.
  • Fifth, the findings of WHO is also being discarded on the account that the inquiry team had persons with vest interests in the WIV experimentation.
  • Sixth, there are instances when Smallpox and other viruses have escaped from secured laboratories before.

   Read Also :-NGT Action On Vishakapatnam Gas Leak 

  Suggestions

  To prevent future pandemics or an event of Biowarfare, the 1972 Biological and Toxin Weapons Convention (BWC) needs to be strengthened by resolving the following drawbacks. Such as,

  • 1. The convention has no systems to verify compliance with its prohibitions. So, the global countries have to come together to build such a system
    2. The convention lacks enforcement mechanisms to penalize infringement of its provisions. So, the enforcement system has to be strengthened.

  Source: The Hindu

• Tackling pandemic in Rural India – Explained, pointwise

  Contents

  • 1 Introduction
  • 2 Impact of the pandemic in Rural India
  • 3 Need to give attention to Rural India during the Pandemic
  • 4 Government Initiatives towards the betterment of Rural India during the pandemic
  • 5 Challenges in vaccination and controlling the pandemic in rural India
  • 6 Suggestions to tackle the pandemic in Rural India
  • 7 Conclusion

  Introduction

  The impact of the pandemic in Rural India is quite high, especially the second wave. The positivity rate is quite high due to which India has witnessed the loss of many human lives. The situation becomes even more concerning when one looks at the dismal state of rural health infrastructure that is devoid of quality infrastructure and a sufficient number of healthcare professionals.

  The time is ripe for the government to focus on rural India and rural healthcare in particular if it seriously wants to defeat the pandemic and prepare the region for future challenges. For this, a host of new measures are desired including greater devolution of funds towards rural healthcare and robust training of healthcare functionaries in the rural region.

  Impact of the pandemic in Rural India

  • Loss of Human Lives: The first wave didn’t reach smaller towns and hinterland regions. However, this situation was reversed in the second wave. 
    • Health ministry data for the last two weeks of May found that 66 percent of the districts having a test positivity rate of 10 percent or more were rural. This automatically resulted in greater deaths in these regions.
  • Increasing Unemployment: Many rural people lost their jobs amongst the second wave of the Pandemic. According to the Centre for Monitoring Indian Economy (CMIE) data, the unemployment levels in rural India touched 14% in May 2021.
  • Reduction in Non-Farm activities: The pandemic didn’t brutally impact the agricultural output, but it left an impact on non-agricultural activities of the rural region. 
  • A rise in medical expenses: The poor state of the health care system induced a heavy financial burden on the rural masses. They had to travel long distances and pay hefty fees for getting treatment facilities. 
    • Many non-infected people created a buffer for future medical emergencies by reducing their demand for other products.
  • Psychological Stress: The first wave of the pandemic forced the migrants to travel 500-1000 km barefoot towards their homes. In the second wave, a lesser quota of vaccines was allocated to rural regions that created a feeling of being second class citizens in their own country. 
  • Education Divide: The pandemic enhanced the pace of digitalisation in the country. Both the teachers and students shifted towards the online medium. However, this progression enhanced the education divide in the country due to the poor availability of the internet, electricity and electronic gadgets in the rural regions.
  • Prevalence of Hunger and Malnutrition: Both of them are rising in rural regions as schemes like Mid-day meal have come to a halt in many states. Further loss of income has reduced access to quality food.

  Need to give attention to Rural India during the Pandemic

  • Population Size: Around 65% of the population resides in rural areas. If the country wants to control the pandemic and achieve herd immunity, then adequate vaccination in rural regions is the need of the hour.
  • Greater Vulnerability: The region comprises people who are not as affluent and resilient as their urban counterparts. Their ability to absorb extreme situations like a pandemic is very less due to inadequate financial cushions. 
    • Many in rural regions are hand to mouth workers who barely possess emergency funds of 2-4 days.  
  • Inadequate Health Care System: The rural health care system in India is not adequate or prepared to contain COVID-19 transmission. This can be seen more evidently in densely populated regions of northern states. As they face a shortage of doctors, hospital beds, and equipment.
    • As of March 2018, there was a shortfall in health care facilities in rural regions. It was 18% at the Sub-Centre level, 22% at the PHC (Primary Health care) level and 30% at the CHC (Community Health Care) level 
  • Country’s Economic Revival: The rural sector provides human resources for sectors such as retail, construction, manufacturing, hospitality, education and transportation. Further, continued consumption expenditure by the rural population creates demand for multiple goods and boosts the overall economy.
    • This is worrisome as India’s economy contracted by 7.3 percent in 2020-21, marking its worst performance in over four decades.
  • Reducing expenditure on healthcare: Robust Rural health infrastructure will help in treating the disease at the primary level. It will help us save a lot of money and resources that are further spent at secondary and tertiary level health care.

  Government Initiatives towards the betterment of Rural India during the pandemic

  • The E-Sanjeevani platform provides virtual consultations to patients including patient-to-provider and provider-to-provider consultation. 
    • Under this a hub and spoke model was used which connected smartphone equipped rural wellness centres to specialist doctors located in cities.
  • The government announced additional grains for the poor under the Pradhan Mantri Garib Kalyan Yojana.
  • The Centre had allocated 73,000 crore rupees for 2021-22 for MGNREGS (Mahatma Gandhi National Rural Employment Guarantee Scheme) and notified an annual increment of about 4% in wages.

  Challenges in vaccination and controlling the pandemic in rural India

  • Supply of Vaccines: The supply of vaccines has been biased towards the urban centres. 
    • The government allowed private sales of vaccines for adults aged under 45 years, this favoured residents of cities with larger private hospital networks. 
    • For the first four weeks of May, nine big cities (Delhi, Mumbai, Hyderabad etc.) gave 16 % more doses than all the combined rural districts.
  • Vaccine Hesitancy: It refers to delay in acceptance of vaccines or refusing vaccines despite their availability. The rate of vaccine hesitancy is higher in rural regions due to lower literacy levels.
  • Infrastructure Deficit: The rural regions have a scarcity of testing services, weak surveillance system and poor medical care. This creates an impediment in taking relevant measures towards the pandemic. 
  • Human Resource Constraints: Many health care providers in rural areas are unregistered and untrained and do not know what to do in such an emergency.
    • There is a shortfall of 81.8% specialists as compared to the requirement for existing CHCs.
  • Poor Approach: The State has focused more on curative care rather than preventive care. This enhances the burden on the rural healthcare system and puts a greater economic impact on the masses in terms of higher medical bills.
  • Sharing of Burden: The central government is taking lesser responsibility towards easing the situation arising from state lockdowns. Some states (such as Kerala and Tamil Nadu) have announced relief measures, but others have not done much. The latter ones are not in a position to do much because of their financial situation.

  Suggestions to tackle the pandemic in Rural India

  • The central government should ensure robust development of the rural health network (SHCs, PHCs and CHCs) by providing a greater amount of funds. 
  • The government should take active support from public-spirited citizens. For instance, Swasthya Kalyan Samitis, or SKSs were constituted for all CHCs and PHCs in haryana.
    • It allowed health providers to engage with all kinds of rural community organisations (panchayats, municipal bodies, non-governmental organisations etc.) and minimise the adverse impact of the pandemic on rural life.
  • Rural health networks should have access to the health data of people in their respective areas. This will enable them to identify those likely to slip into the secondary or tertiary care zone.
  • There is also a need to conduct Regular health camps. It will help us to identify those on the verge of developing tuberculosis, hypertension, diabetes or any diseases owing to their socio and economic conditions.
  • India can establish an independent team of experts under the aegis of the WHO. They will ensure adherence to recruitment standards, consent conditions, adverse event record management, and compensation standards. 
    • This will improve public confidence and provide enough data for the future policies of the government.
  • The center should do the bulk purchase of vaccines rather than leaving the states at their own mercy. Further voluntary licencing of patents must be encouraged to boost the production in a lesser time and attain the goal of universal vaccination.
  • The country should also adopt new methods like Remote shared medical appointments. This would allow virtual interaction of a doctor with multiple patients having similar issues, thereby saving cost and time.

  Conclusion

  The government should take immediate steps to control the pandemic in Rural India. They must use this as an opportunity to strengthen and improve the primary health care system in rural India, thereby preventing it from becoming the next Covid-19 hotbed.

• A study on “effectiveness of vaccines” found more anti-bodies from Covishield

  What is the news?

  A study was conducted by the healthcare workers (HCW) in India to understand the effectiveness of vaccines in India.

  About the effectiveness of vaccines:

  • The study involved 515 healthcare workers from 13 states and 22 cities, 305 male of whom were male.
  • These healthcare workers have been administered either of the two vaccines, Covishield and Covaxin. Further, they are chosen with or without a past history of Covid-19 infection.

   Read Also :-India approves COVID-19 vaccines Covishield

  Key Findings regarding the effectiveness of vaccines:

  • Higher Seropositivity: Among the 515 healthcare workers, 95% showed seropositivity (higher antibodies) after two doses of both vaccines.
    • Seropositivity: It refers to the presence of specific antibodies in an individual.
  • Higher Antibodies: Covishield vaccine has produced more antibodies than the Covaxin doses.
    • Antibody: It is a protein produced by the body’s immune system when it detects harmful substances called antigens.
  • Breakthrough infections: A total of 27 breakthrough infections (4.9%) were recorded among the respondents. However, there were relatively fewer instances of ‘breakthrough infections’ after taking Covaxin than Covishield.
    • Breakthrough infection: It is a case of illness in which a vaccinated individual becomes sick from the same disease for which the vaccine was administered.
  • Side Effects: There were mild to moderate adverse events associated with both the vaccines, but there were no serious side effects observed during the study.

  Source: The Hindu

• What is the “Delta variant of Covid-19”?

  Contents

  • 1
  • 2 What is the news?
  • 3 What is the Delta Variant of Covid-19?
  • 4 What is Variant of Concern (VOC)? 
  • 5 Why is Delta Variant more dangerous than other variants?
  • 6 What is a mutation?

  What is the news?

  As per a study carried out by INSACOG (the consortium of labs undertaking genome sequencing in India), Delta variant of Covid-19 is the primary cause of the second Covid-19 wave gripping the country presently.

  What is the Delta Variant of Covid-19?

  • The World Health Organization (WHO) has named B.1.617.1 variant as ‘Kappa‘ and B.1.617.2 variant as ‘Delta‘
    • These variants are sub-lineages of B.1.617 which was detected in India in 2021.
  • This new nomenclature for the various variants of the coronavirus using Greek alphabets was introduced to simplify public discussions and also help remove the stigma from the names.
  • Moreover, WHO has also categorized the Delta variant as a Variant of Concern (VOC).

  What is Variant of Concern (VOC)? 

  WHO classifies a variant as a VOC when it is associated with

  • An increase in transmissibility or detrimental change in Covid-19 epidemiology or
  • Increase in virulence (Ability to cause severe/life-threatening disease)
  • Decrease in the effectiveness of public health measures or available diagnostics, vaccines and therapeutics.

  Why is Delta Variant more dangerous than other variants?

  • This variant has multiple mutations that appear to give it an advantage over other strains.
  • The most important advantage is that the mutations may make the strain more transmissible.This will make the delta variant the most dangerous variant yet.
  • One study indicated that the Delta variant may be up to 50% more transmissible than the B.1.1.7 (U.K./Alpha) variant.

  What is a mutation?

  • A mutation means a change in the genetic sequence of the virus.
  • In the case of Covid-19, which is a Ribonucleic acid (RNA) virus, a mutation means a change in the sequence in which its molecules are arranged.
  • A mutation in an RNA virus often happens when the virus makes a mistake while it is making copies of itself.

  Source: Indian Express

• “Corbevax Vaccine” and its difference from other Covid-19 vaccines

  Contents

  • 1
  • 2 What is the News?
  • 3 About Corbevax Vaccine:
  • 4 What are Spike Proteins?
  • 5 Different types of Covid-19 vaccines:
  • 6 How is the Corbevax Vaccine different from these vaccines?

  
  What is the News?

  India has placed an advance order to block 300 million doses of a new Covid-19 vaccine, Corbevax from Hyderabad-based company Biological E.

  About Corbevax Vaccine:

  • Corbevax is a recombinant protein subunit vaccine. The vaccine is being indigenously produced by Biological E, Hyderabad-based Pharmaceutical company.
  • Made up of: The Corbevax vaccine is made up of a specific part of SARS-CoV-2 — the spike protein on the virus’s surface.
  • Administration of Vaccine: The vaccine will be administered in two doses. It is expected to be among the cheapest available in the country.

  What are Spike Proteins?

  • The members of the coronavirus family have sharp bumps that protrude from the surface of their outer envelopes. Those bumps are known as spike proteins.
  • These spike proteins allow the virus to enter the cells in the body so that it can replicate and cause disease.
  • However, in Corbevax Vaccine the spike protein alone is given to the body. So, it is not expected to be harmful as the rest of the virus is absent. The body is expected to develop an immune response against the injected spike protein.
  • Therefore, when the real virus attempts to infect the body, it will already have an immune response ready that will make it unlikely for the person to fall severely ill.

  Note: The technology to inject spike protein to develop immunity against a disease is not new. It has been used previously in making hepatitis B vaccines. However, Corbevax is the first vaccine made for COVID-19 to use this technology.

  Different types of Covid-19 vaccines:

  Vaccines are categorised on the basis of the development process adopted by scientists. For example:

  • Pfizer and Moderna vaccines developed in the US are mRNA vaccines. In this type, vaccines will carry the molecular instructions to make the protein in the body through a synthetic RNA of the virus. The host body uses this to produce the viral protein that is recognized and thereby making the body mount an immune response against the disease.
  • Johnson & Johnson, Sputnik V and AstraZeneca-Oxford University vaccine is a kind of viral vector vaccine. In this type, a modified version of other viruses (for example, adenovirus) is used. The virus can enter human cells but not replicate inside. A gene for the coronavirus vaccine was added into the adenovirus DNA, allowing the vaccine to target the spike proteins that SARS-CoV-2 uses to enter human cells.
  • Bharat Biotech’s Covaxin and Sinovac-CoronaVac is categorised as an inactivated vaccine. In this type, an inactivated live virus is used to create an immune response against the disease.

  How is the Corbevax Vaccine different from these vaccines?

  • Inactivated vaccines attempt to target the entire structure of the virus.
    • On the other hand, Corbevax like the mRNA and viral vector Covid-19 vaccines targets only the spike protein but in a different way.
  • Viral vectors and mRNA vaccines use a code to induce our cells to make the spike proteins against which the body has to build immunity.
    • On the other hand, in the case of Corbevax is actually giving the spike protein alone.

  Source: Indian Express

• India needs to strengthen the rural health infrastructure

  Synopsis: Rural health infrastructure (SHCs, PHCs and CHCs) needs to be Modernised to cater to the health needs of the 65% of the population living in rural areas

  Background

  • According to info, out of 139 crore population of India, at least 91 crore people are living in 649,481 villages.
  • The second wave of Covid-19 had impacted the rural community the most.
  • Further, there is a growing incidence of non-communicable diseases (NCDs) such as hypertension, diabetes, cancer and cardiovascular diseases in rural India. As per WHO, NCDs cause nearly about 5.87 million (60%) of all deaths in India.
  • Accordingly, there is a need to focus on strengthening the existing rural health infrastructure.
  • Prioritising the development of the rural health network (SHCs, PHCs and CHCs) will help in the effective delivery of Health services to rural people.

  Inadequate and poor health infrastructure in the rural areas

  According to the fact shared by the Union Minister of State for Health and Family Welfare in the Rajya Sabha. India is having inadequate PHCs, CHCs, specialists, etc.

  • Inadequate primary health centres (PHCs):  India has only 25,743 primary health centres (PHCs) though the estimated requirement of PHC’s in rural India is 29,337. (Shortfall of 3,594 units).
  • Inadequate community health centres (CHCs): Against the requirement of 7,322 CHC’s, rural India has only 5,624 community health centres (CHCs).
  • Inadequate specialists in CHC’s: Data on CHCs, show that, overall, there is a shortfall of 81.8% specialists as compared to the requirement for existing CHCs.
  • Inadequate infrastructure: According to the Human Development Report 2020, India has eight hospital beds for a population of 10,000 people, while China has 40 beds for the same number of people.

  Significance of rural health infrastructure in effective delivery of health Services

  1. Rural health networks will help to treat the diseases at the primary level. Further, it will also help us save a lot of money and the resources being spent at tertiary level health care.
     • For instance, if our Sub-HCs work effectively, there will be less pressure on PHCs. If the PHCs function well, then there will be minimal pressure on CHCs and so on.
  2. It will enable people’s participation in ensuring better functioning of rural health services.
     • For example, in case of Haryana, Swasthya Kalyan Samitis, or SKSs were constituted for all CHCs, PHCs.
     • It helped health providers  to engage with all kinds of rural community organisations (panchayats, gram Sabha, notified area committees, municipal bodies and non-governmental organisations) in minimising the adverse impact of the pandemic on rural life.

  Suggestions to improve rural health infrastructure:

  1. Rural health networks should have access to the health data of people in their respective areas. It will enable them to identify those likely to slip into the secondary or tertiary care zone.
  2. Need to conduct Regular health camps. It will help us to identify those on the verge of developing tuberculosis, hypertension, diabetes or any diseases owing to their socio and economic conditions.
  3. A CHC or referral centre should be modernized with effective and adequate health infrastructure. For example, A single CHC should have least 30 beds for indoor patients, operation theatre, labour room, X-ray machine, pathological laboratory, standby generators’ etc.,

  WHO states that ensuring accessibility, affordability and Quality are Key to achieve Universal Health Coverage. The government should strive to provide regular and comprehensive healthcare needs in rural areas guided by the World Health Organization (WHO)’s principle of Universal Health Coverage.

   

  Source: The Hindu

• “H10N3 strain of Bird Flu” – China reports first human case

  What is the News?

  A man in China’s eastern province has been confirmed as the first human case of infection with the H10N3 strain of bird flu.

  About H10N3 strain of Bird Flu:

  • H10N3 strain of bird flu is a subtype of the Influenza A virus which is commonly known as the bird flu virus.
  • The virus is normally fatal to wild birds and poultry because among animals it can be spread through respiratory droplets.
  • Risk: H10N3 is a low pathogenic or relatively less severe strain of the avian flu in poultry. Its risk of spreading on a large scale is very low.
  • Human-Human Transmission: There was no indication or cases of human-to-human transmission of the H10N3 virus.
  • Is it a Common Virus? H10N3 is not a very common virus and only around 160 isolates of the virus were reported in the 40 years to 2018.
    • However, still, flu viruses can mutate rapidly and mix with other strains circulating on farms or among migratory birds. This is known as reassortment. This reassortment can make genetic changes that pose a transmission threat to humans.

  Source: The Hindu

• Lessons from Naomi Osaka Episode

  Contents

  • 1 Synopsis:
  • 2 Background:
  • 3 Understanding the issue:
  • 4 Lessons from this episode:

  Synopsis:

  The withdrawal of Naomi Osaka from the French Open has raised the issue of the mental well-being of the athletes. The situation exposes the deep pressure through which an athlete has to go for fulfilling its commercial obligations.

  Background:

  • The world number 2 tennis player (Naomi Osaka) has withdrawn from the recent French Open tournament.
  • The withdrawal was on account of extreme mental stress and anxiety through which the athlete was going since the 2018 US Open tournament.

  Understanding the issue:

  • Naomi wrote about the compulsion to attend post-match press conferences four days before the onset of the French open tournament.
  • Later, she skipped her first post-match conference and was fined $15000.
  • Subsequently, a joint statement of 4 great slams threatened her with defaults and suspensions in future tournaments.
  • However, this statement backfired, and she withdrew from the tournament on account of severe mental stress posed by press conferences.

  Lessons from this episode:

  • First, the issue of mental stress and anxiety is present in almost every sporting event.
  • Second, the organizers’ insistence on media interaction may leave a deep impact on the mental well-being of an athlete.
    • The media doesn’t shy away from asking personal questions for raising the TRPs in their interview. This generates higher revenues but impairs the mental health of athletes.
  • Third, there are many athletes who are not as wealthy as Naomi. They are unable to quit the tournament and continue to face repeated mental stress.
  • Fourth, the instance shows the existence of a disconnect between how critics and spectators interpret the sport’s nature and what it actually is. The instance has once again proved that all that glitters is not gold. 

  Way Forward:

  • The rules pertaining to press conferences should change in an ever-evolving sport.
    • The focus should be on making the process more player-friendly and nurturing a connection with journalists based on trust and empathy.
  • Further, the issue presents an opportunity to augment conversation surrounding players’ mental health.

  Source: Click Here 

• Naomi Osaka Episode and Mental health in India – Explained, pointwise

  Contents

  • 1 Introduction
  • 2 Previous such examples of mental health issues
  • 3 What is Mental illness?
  • 4 India and Mental health
  • 5 Challenges in improving mental health in India
    • 5.1 Impact of Covid-19 on Mental Health
  • 6 Global steps to improve mental health
  • 7 Indian initiatives to improve mental health
  • 8 Suggestions to improve Mental health in India
  • 9 Conclusion

  Introduction

  According to the World Health Organization (WHO) estimate, mental health illness makes about 15% of the total disease conditions around the world. Mental illness needs psychological, emotional, and social well-being initiatives to get a cure. If not treated properly, it might even lead to suicidal behaviour among the individual.

  Recently, Japanese Tennis player Naomi Osaka’s decision to withdraw from the French Open citing depression put mental health issues in the spotlight once again. Earlier she issued a statement saying that she would not do press conferences at the French Open and ready to pay a fine for that. Committing to her statement, she refused to give an interview after the match. But the tennis officials issued a statement to give interview in future. The officials also mentioned that she might face expulsion from the present tournament and other Grand Slam events in case of failure to abide. Following that, she took a decision to withdraw from the current event altogether.

  Emotional and mental health is more important, as it impacts the thoughts, behaviours and emotions of an individual. But mental health issues generally don’t receive much attention unless some extreme events occurred. Both the individual and the government have to take the necessary steps to improve mental health.

  Previous such examples of mental health issues

  • Norwegian Prime Minister diagnosed with depression in 1998. After that he revealed his illness to the public and went on medical leave for three weeks, leaving an acting Prime Minister to carry out the national duty.
  • Bollywood actor Sushant Singh Rajput’s tragic death has triggered a much-needed conversation around mental health in India.
  • In recent years, several celebrities open up about their mental health concerns. Such as Deepika Padukone, J.K. Rowling, Beyonce and Meghan Markle.

  What is Mental illness?

  Mental illnesses are health conditions involving changes in a person’s emotion, thinking, or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems of functioning in social, work, or family activities. For example, people with bipolar disorder and schizophrenia are significantly disturbed, dangerous to themselves and others.

  Major factors contributing to mental health problems include,

  • Biological factors, such as genes or brain chemistry
  • Life experiences, such as trauma or abuse
  • Family history of mental health problems

  India and Mental health

  According to The Lancet report published in February 2020, there were 197.3 million people with mental disorders in India in 2017. The report also explains the following things,

  • The top mental illnesses were depressive disorder and anxiety disorder, impacting 45.7 million and 44.9 million respectively.
  • The contribution of mental health disorders to the total Disability-Adjusted Life Years (DALYs) in India increased from 2.5% in 1990 to 4.7% in 2017.
  • The Southern states namely Tamil Nadu, Kerala, Telangana, Karnataka, and Andhra Pradesh accounted for a higher prevalence of mental disorders.

  According to an estimate by the World Health Organization (WHO), India has one of the largest populations affected by mental health illness. So, in 2018 the WHO labelled India as the world’s ‘most depressing country’.

  Challenges in improving mental health in India

  1. Lack of resources:
     • The low proportion of mental health workforce: According to the WHO, there were 0·301 psychiatrists and 0·047 psychologists for every 100,000 patients suffering from a mental health disorder in India. This is a very low number compares to the number of mental health patients.
     • Low Budgetary allocation: India is barely spending 0.5% of the health budget on the mental health sector. For example, in the recent budget only Rs 40 crore has been allocated for the National Mental Health Programme among the total health sector allocation of Rs. 2.23 lakh crore.
  2. Lack of awareness and sensitivity about mental health issues: This is the first and foremost reason for high mental health illness in India. Apart from that, there is also a high prevalence of social stigma and abandonment of being mentally ill in India.
  3. Loss to Economy: According to WHO, the burden of mental disorders is maximal in young adults. As most of the population is young, delayed or non-treatment of mentally ill persons will result in economic loss in terms of man-days.
  4. Treatment gap: Most of the mental healthcare facilities are located in urban areas. According to estimates, nearly 92% of the people who need mental health care and treatment do not have access to any form of mental health care.
  5. High out-of-pocket expenditure: The Majority of mental health issues tend to increase during economic downturns. The insurance schemes also cover only physical injuries, not mental ones. This results in high out-of-pocket expenditure during economically distress time.
  6. Prone to abuse: Mentally ill patients are vulnerable to and usually suffer from physical abuse, sexual abuse, wrongful confinement, etc.

  Impact of Covid-19 on Mental Health

  Many Surveys have indicated that the pandemic is increasing mental health problems in India.

  • An integrated health care company, Practo reported a 665% jump in the number of mental health consultation.
  • Further, More than two-thirds of these consultations belongs to the age of 21-40.
  • Most commonly consulted mental health topics are anxiety, stress and panic attacks.

  Global steps to improve mental health

  • The Mental Health Atlas was launched by WHO in 2017.
  • WHO Special Initiative for Mental Health: It was launched in 2019. It aims to bring attention to the high global burden of disability arising from disorders of mental health. Further, the initiative also aims to accelerate a multi-sectoral response to improve care for mental health problems.
  • Target 3.4 and 3.5 of the Sustainable Development Goals talk about reducing mental health illness for the global community.

  Indian initiatives to improve mental health

  1. National Mental Health Programme (NMHP): India launched NMHP in 1982 to improve the status of mental health in India. It has three important components. Such as Treatment of the Mentally ill, Rehabilitation and Prevention and promotion of positive mental health.
  2. The Mental Health Care Act (MHCA) 2017: This Act repealed the Mental Health Act, 1987. The Act seeks to ensure the rights of the person with mental illness to receive care and to live a life with dignity. Few salient provisions of the Act are,
     • Central and State Mental Health Authorities: The Act established these authorities for regulation & coordination of mental health services in India.
     • Right to make an Advance Directive: Under this, every person can state how to be treated or not be treated for the illness during a future mental health situation.
     • Right to appoint a Nominated Representative: Every person also has the right to appoint a nominee to take, on his/her behalf, all health-related decisions.
     • Changes in Section 309 of the Indian Penal Code: This section of IPC criminalized the attempt to commit suicide. After the enactment of the Act, a person who attempts to commit suicide will be presumed as a person “suffering from severe stress’’. The person will also not subject to any investigation or prosecution.
  3. KIRAN helpline: It is a  24/7 toll-free helpline launched by the Ministry of Social Justice and Empowerment. This helpline provides support to people facing anxiety, stress, depression, suicidal thoughts, and other mental health concerns.
  4. Manodarpan Initiative: It is an initiative launched by the Ministry of Education under Atmanirbhar Bharat Abhiyan. The initiative provides psychosocial support to students, family members, and teachers for their mental health and well-being during the times of Covid-19.
  5. RAAH app: It is a mobile application that provides free information to the public on mental health care professionals and mental healthcare centres. The National Institute of Mental Health and Neuro-Sciences(NIMHANS) has compiled a one-stop source online mental health care directory.
  6. MANAS App: MANAS stands for Mental Health and Normalcy Augmentation System. It is a comprehensive, scalable, and national digital wellbeing platform. It has been developed to promote the mental well-being of Indian citizens.

  Suggestions to improve Mental health in India

  1. Increasing Awareness: The government has to increase mental health awareness and also take necessary steps to reduce social stigma. This will improve the timely undertaking of treatment.
  2. Increase budgetary allocation: The government has to increase the budgetary allocation to the mental health sector. The government also has to train the ground level (ASHA, ANM, AWW) workers to improve mental health among the public.
  3. Better coordination between Center-States: Healthcare is a state subject, so both Center and State should have better coordination
  4. Reducing out-of-pocket expenditure: The government has to provide financial support to reduce out of the pocket expenditure. Further, the government and private insurance policies should include mental health care in their insurance benefits.

  Conclusion

  According to the WHO, the countries have to act swiftly to improve mental health. Else in 2030, depression will be the leading illness globally. So, India has to take the necessary steps to improve the state of mental health. Increasing budgetary spending and creating awareness is the key to reduce mental illness.

• Need of Transparency in Covid related Policies

  Synopsis: Government should ensure transparency in the policies related to the Covid-19 pandemic in India. Official privacy on pandemic policies intensifies a crisis.

  Introduction 

  The government created the National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) in August 2020. It is a central agency to take decisions on all matters related to vaccine administration and rollout. 

  • The details of the NEGVAC’s meetings were asked under the Right to Information (RTI) Act  The Health Ministry responded that it does not know where the concerned documents are.
  • The information about the dates and minutes of meetings of other task forces constituted to deal with the pandemic was denied. The reason stated was “The information is not in the public domain”. 
    • The Memorandum of Understanding (MoU) between the ICMR and Bharat Biotech for the rollout of Covaxin was also not provided.
  • Such privacy runs through the full range of COVID-19- related matters. This includes vaccine manufacturing, pricing decisions, lockdown planning and running of the ₹10,000 crore-plus PM CARES fund. The officials are keeping the pandemic and vaccine policies a secret by avoiding the RTIs.

  Implications of Secrecy 

  • The government is denying information on important policies and decisions. Opacity serves as a cover for over-centralization and misgovernance.
  • Effective planning and management cannot happen in an opaque setting. As per experts, the Covid-19 related death toll also increased because of mismanagement and lack of preparation.
  • Confidentiality is reducing the ability of scientists, public health, and policy experts to give feedback and suggestions to the government. Over 900 scientists have appealed to the Prime Minister for access to information and data. 

  Amartya Sen wrote about famines in colonial India that mass hunger and death do not occur where information flows freely.

  Way forward

  • Sections 4 and 7 of the RTI Act provide for proactive and urgent disclosures where there are consequences for life and liberty.
  • The Supreme Court should order the government to suo motu reveal information related to COVID-19 policies under the above provisions. 

  Source: click here

• Twin challenge of COVID-19 Pandemic and Non-communicable diseases

  Synopsis – There is a correlation between Non-Communicable Diseases [NCD] mortality rates and COVID-19 case fatalities. Government should focus on reducing the impact of Non-Communicable Diseases(NCD).

  Contents

  • 1 Introduction-
  • 2 What is India’s NCD strategy?
  • 3 Suggestions to tackle the twin challenges of the COVID pandemic and NCD morbidities
  • 4 Way forward-

  Introduction-

  • Studies showed that over 70 per cent of mortalities associated with COVID are due to underlying non-communicable diseases (NCD) like diabetes, cardiovascular ailments, and cancer.
  • Prevention and control of NCDs have played a crucial role in the COVID-19 response.
    • For example- India’s previous efforts to minimize NCD-related deaths have resulted in lower Covid-19 case fatality rates.
    • At 1.16 percent, India’s COVID case fatality rate is approximately half that of the world average of 2.17 percent.
  • Every 10% reduction in the underlying NCD mortality rate results in a 20% reduction in COVID fatality rates.

  What is India’s NCD strategy?

  India developed a multi-sector NCD action plan to reduce the number of global premature deaths from NCDs by 25% by 2025.

  Major initiatives-

  • Strengthening health care system–
    • Atmanirbhar Swasth Bharat scheme – The government would invest around Rs 64,000 crore in rural and urban health and wellness Centers [HWC] as part of this programme.
    • Around 1,20,000 PHCs being converted into HWCs to provide primary care for NCD.

  • Providing financial protection –
    • PM’s health insurance scheme – The initiative covers 100 million of the most vulnerable population. It reduces out-of-pocket expenditures on health by expanding the scope of primary healthcare to include screening and diagnosis of NCD like CVD, cancer, and chronic respiratory diseases.

  • To address household air pollution –
    • PM Ujjwala Yojana – The use of LPG instead of polluting wood in 90 million households has reduced the risk of the chronic lung diseases and cancer that women were exposed to.

  Suggestions to tackle the twin challenges of the COVID pandemic and NCD morbidities

  • Ensuring universal access to screening for NCDs.
  • Using Artificial Intelligence with telemedicine to continue healthcare for NCD patients during lockdown.
  • Need to put focus on enhancing care policies for prevention and treatment, particularly in low- and middle-income countries to meet their UN SDGs to reduce NCD mortality by a third by 2030.

  Way forward-

  Achieving the SDG target by reducing one-third of premature mortalities due to NCD will make India more resilient to future viral pandemics. Thus, India must strengthen its health infrastructure through the Atmanirbhar Swasth Bharat programme.

  Source- The Indian Express

• Challenges of India’s COVID Diplomacy 2.0

  Synopsis: India’s Covid Diplomacy 2.0 is focused on managing many challenges. The majority of these challenges arise due to Covid mismanagement.

  Read– Proactive Diplomacy 

  Background

  • During the first wave of the pandemic, India’s Covid-19 diplomacy was focused on coordinating exports of COVID-19 medicines. Further, it focussed on the repatriation of Indians from abroad under ‘Vande Bharat Mission’ and exporting vaccines worldwide under ‘Vaccine Maitri’.
  • However, now, during the 2nd wave, the focus of India’s diplomacy or Covid Diplomacy 2.0 has changed due to Covid mismanagement.
  • Covid mismanagement has been the reason for Vaccine shortages in India. Three factors are responsible for this,
    • The failure of the Government to plan and place procurement orders in time.
    • The failure of the two India-based companies to produce vaccine doses they had committed to.
    • MEA’s focus on exporting, not importing, vaccines
  • Owing to Covid mismanagement strategies, The Ministry of External Affairs has had to deal with many challenges.

  What are the challenges facing India’s Covid Diplomacy 2.0?

  • First, the most urgent task for Indian diplomats was to deal with oxygen and medicine shortages. The Ministry of External Affairs has completed the task of bringing in supplies in a timely manner, and with success.
  • Second, the challenge of dealing with vaccine shortages in India.
  • Currently, India is looking to the U.S. for help to manage the vaccine shortages in India. Multiple options have been worked out to boost vaccine supply with the help of the U.S.
    1. One, requesting the U.S. to share a substantial portion of its stockpile of AstraZeneca doses.
    2. Two, requesting the U.S. to release more vaccine ingredients that are restricted for exports.
    3. Three, to buy more stock from the three U.S. manufacturers, Pfizer, Moderna, and Johnson & Johns
    4. Four, to encourage the production of these vaccines in India.
  • However, every option has its own challenges. For instance,
    • One, The U.S. government is holding up its AstraZeneca exports until it’s own United States Food and Drug Administration approves them.
    • Two, the U.S policy on releasing vaccine ingredients and components has not changed. Although it has supplied a small amount of vaccine ingredients and components.
    • Three, the Production of Johnson & Johnson single-dose vaccines in India will take time.
    • Four, even buying vaccines directly has its own challenges.
      • The U.S. companies are seeking a waiver on the need for bridge-trials prior to clearance as well as Emergency Use Authorisation prior to supplying them that goes against India’s principles.
      • Further, the U.S. manufacturers want centralised orders, with payments up-front. It will go against the center’s decision to decentralize vaccine procurement.
  • Third, Indian diplomats are faced with the challenge of convincing countries for a temporary TRIPS waiver at WTO. But, since WTO works on the basis of consensus, getting a Waiver on Intellectual Property rights will be a time taking process.
  • Fourth, regaining trust for India’s vaccine and pharmacy exports among neighbouring countries after the Vaccine collapse is a big challenge ahead. For instance, Bhutan was solely dependent on India for Vaccines was asked to arrange vaccines for themselves. India’s neighbors have now sought help from China and the U.S. to complete their vaccination drives.
  • Fifth, understanding the pathways of emergence” of SARS-CoV2 is significant to tackle the future Covid waves.
    • WHO has listed four possibilities Direct zoonotic transmission, an intermediate host, cold chain or transmission through food, or a laboratory incident.
    • The fourth possibility of being a laboratory incident has gained prominence after scientists and agencies around the world are calling for more research and transparency from China.
    • India is one of the largest victims of Covid19. Thus, it should seek for a more definitive answer at the global and demand accountability.

  Way forward

  • India should raise its voice for a stronger convention to regulate any research that could lead, by accident or design, to a pandemic.
  • It is necessary to revamp the 1972 Biological Weapons Convention to institute an implementation body to assess treaty compliance and build safer standards for the future.

  Source: The Hindu

• Pradhan Mantri Garib Kalyan Package Insurance Scheme for health workers fighting Covid-19

  Contents

  • 1
  • 2 What is the News?
  • 3 What is the New System for Quick Clearance of Claims?
  • 4 About Pradhan Mantri Garib Kalyan Package Insurance Scheme for health workers Fighting Covid-19:

  What is the News?

  The government of India has introduced a new system for quick clearance of claims under the “Pradhan Mantri Garib Kalyan Package(PMGKP) Insurance Scheme for health workers Fighting Covid-19”.

  What is the New System for Quick Clearance of Claims?

  • Under the New System, the District Collector will be certifying that the insurance claim in each case is in accordance with the guidelines of the scheme.
  • On the basis of this certificate of the Collector, the Insurance Company will approve and settle the claims within a period of 48 hours.
  • Further, the District Collector will also certify the claims even in the case of Central Government hospitals/ AIIMS/ Railways among others.

  About Pradhan Mantri Garib Kalyan Package Insurance Scheme for health workers Fighting Covid-19:

  • Launched by: It is a Central Sector Scheme launched by the Ministry of Health and Family Welfare in 2020.
  • Aim: To provide comprehensive personal accident insurance cover of Rs. 50 lakh to all healthcare providers who
    • Lost their life due to Covid-19
    • Accidental death on account of COVID-19 related duty.
  • Coverage of the Scheme:
    • All government health centres, wellness centres and hospitals of Centre as well as States has included under this scheme
    • Private hospital staff and retired/volunteer /local urban bodies/contracted/daily wageworker were also included in the scheme.
    • Safai karamcharis, ward-boys, nurses, ASHA workers and other health workers were also covered.
  • Implementation: The scheme is being implemented through an Insurance policy from the New India Assurance Company(NIACL).

  Source: PIB

   

• World Health Assembly Adopts New Resolution to End Malaria

  What is the News? The 74th World Health Assembly(WHA) has adopted a new resolution to end malaria. It will accelerate efforts towards this aim.

  Contents

  • 1 About the Resolution to End Malaria:
  • 2 About WHOs Global Malaria Program:
  • 3 Global Technical Strategy for malaria 2016–2030
  • 4 About Malaria:

  About the Resolution to End Malaria:

  • The resolution is led by the United States of America and Zambia.
  • The aim of the resolution is to urge the Member States to step up progress on containing the disease. It is in line with WHO’s updated global malaria strategy and the WHO Guidelines for malaria.
  • The resolution called on countries to expand investment, scale-up funding for a global response. Also, it will boost investment in the research and development of new tools.

  About WHOs Global Malaria Program:

  • The WHO Global Malaria Program is responsible for coordinating WHO’s global efforts to control and eliminate malaria.
  • The work of the program is guided by the “Global technical strategy for malaria 2016–2030”.

  Global Technical Strategy for malaria 2016–2030

  • The WHO’s global technical strategy was adopted by the World Health Assembly in 2015.
  • Aim: The strategy provides a technical framework for all malaria-endemic countries working towards malaria control and elimination.
  • Targets: Its global targets for 2030 include:
    • Reducing malaria case incidence by at least 90%.
    • Reducing malaria mortality rates by at least 90%.
    • Eliminating malaria in at least 35 countries.
    • Preventing a resurgence of malaria in all countries that are malaria-free.

  About Malaria:

  • Malaria is a disease caused by Plasmodium parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.
  • The disease claims more than 400,000 lives annually. In 2019, the world reported an estimated 229 million cases of malaria and 409,000 deaths.
  • However, an estimated 6 million deaths and 1.5 billion cases had been averted since 2000. But the global gains in combating malaria have leveled off in recent years.

  Source: Down To Earth

   

• “World No Tobacco Day” and “Tobacco Consumption” in India

  Contents

  • 1
  • 2 What is the News?
  • 3 About World No Tobacco Day:
  • 4 Tobacco Consumption in India:

  What is the News?

  Every year, on 31^st May, the World Health Organization (WHO) and global partners celebrate World No Tobacco Day (WNTD). This year, the WHO has honoured the health minister of India with the ‘WHO Director-General Special Recognition Award’ for his effort to control tobacco consumption in India.

  About World No Tobacco Day:

  • World No Tobacco Day is an annual event organised by the World Health Organisation(WHO) on May 31st.
  • Objective: The day aims to raise awareness about the harmful and deadly effects of tobacco use. Thereby, discouraging the use of tobacco in any form.
  • Theme: “Commit to Quit“. This theme aims to support 100 million people worldwide to give up tobacco through a range of initiatives and digital solutions.

  Tobacco Consumption in India:

  • Reduction in Tobacco Use: Due to the efforts of Central and State Governments, the prevalence of tobacco use has decreased by six percentage points from 34.6% in 2009-10 to 28.6% in 2016-17.
  • Deaths due to Tobacco Consumption: In India, every year more than 1.3 million deaths are attributable to tobacco use. This amounts to 3500 deaths per day due to tobacco consumption.
  • Risk of Covid-19: Tobacco smokers face a 40-50% higher risk of developing severe disease deaths from COVID-19.
  • Economic Cost: As per the WHO report, the economic burden of diseases and deaths attributable to tobacco use in India was as high as Rs. 1.77 lakh crores. This amounts to approx 1% of Indian GDP.

  Initiatives taken by India to Control Tobacco Consumption:

  • Cigarettes Act,1975: The act mandated the display of statutory health warnings in advertisement and on cartons and cigarette packages.
  • Cigarettes and other Tobacco Products Act(COTPA),2003: The act replaced the Cigarettes Act of 1975. It aims to provide smoke-free public places and also placed restrictions on tobacco advertising and promotion.
  • Prohibition of Electronic Cigarettes Bill, 2019: It aims to prohibit the Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement of e-Cigarettes.
  • National Health Policy 2017: It has set an ambitious target of reducing tobacco use by 30% by 2025.
  • Tobacco Quit line service -1800-112-356: It was initiated in 2016 to reach a large number of tobacco users. It aims to provide telephone-based information, advice, support, and referrals for tobacco cessation.
  • India has also signed the tobacco control provisions under the WHO Framework Convention on Tobacco Control (WHO FCTC).

  Source: TOI

   

• Supreme Court questions govt on its “Covid-19 vaccine policy”

  What is the News?

  The Supreme Court questioned the Centre on Covid-19 vaccine policy. It has also said that there needs to be a single price for vaccines across the Nation.

  What was the case?

  • The Supreme Court of India is hearing the suo moto case on Covid-19 issues (In Re-Distribution of Essential Services and Supplies During Pandemic).

  What are the issues raised by the Supreme Court?

   Vaccines Procurement:

  • The Supreme Court has asked the Central Government about the procurement policy of the Covid-19 vaccines adopted by the Central Government.
  • Currently, the Central Government procures just 50% of the vaccines while leaving the States to buy their own.
  • Further, the court also referred to Article 1 of the Constitution that says that India, that is Bharat, is a Union of States. It said that when the Constitution says that we follow the federal rule. Then the Government of India has to procure the vaccines and distribute them to states.

  Dual Pricing of Vaccines:

  • The Supreme court asked the Centre on the rationale for the dual pricing of vaccines for the Centre and States.
  • It said that there needs to be one price for vaccines across the Nation.

  Different Criteria for Age Groups:

  • The Supreme Court asked the Central Government about the rationale for giving different treatment to the age group 18-44 years as the Centre is giving free vaccines only to the 45+ age group.
  • The court also pointed out that it is the 18-44 age group which got badly affected in the second wave of the Covid-19 pandemic.

  Digital Divide and COWIN registration.

  • The Supreme court has also raised questions about making COWIN registration mandatory for getting vaccine slots.
  • The court asked the government to realise the digital divide prevailing in rural India. It said that the vaccination policy is entirely exclusionary of the rural areas.

  Source: The Hindu

• Jan 30 Declared World “Neglected Tropical Diseases” Day by WHA

  What is the News?

  The 74th World Health Assembly has declared January 30 as ‘World Neglected Tropical Diseases (NTD) Day.

  Contents

  • 1 About World Neglected Tropical Diseases (NTD) Day:
  • 2 About Neglected Tropical Diseases(NTD):
  • 3 About London Declaration:
  • 4 WHO’s New Roadmap for NTDs for 2021-30:

  About World Neglected Tropical Diseases (NTD) Day:

  • The first World Neglected Tropical Diseases(NTD) Day was celebrated informally in 2020.
  • UAE moved the proposal to recognize this day as ‘World NTD Day’
  • Significance: World NTD Day commemorates the simultaneous launch of the first NTD road map and the London Declaration on NTDs on 30 January 2012.

  About Neglected Tropical Diseases(NTD):

  • Firstly, Neglected Tropical Diseases(NTD) are a group of infections. These diseases are most common in the tropical regions of Africa, Asia, and the Americas among marginalized communities. The basic reason behind them is no access to clean water or safe ways to dispose of human waste.
  • Secondly, Caused by: A variety of pathogens such as viruses, bacteria, protozoa, and parasitic worms.
  • Thirdly, these diseases generally receive less funding for research and treatment than diseases like tuberculosis, HIV-AIDS, and malaria.
  • Fourthly, some examples of NTDs include snakebite envenomation, scabies, yaws, trachoma, Leishmaniasis, and Chagas disease.
  • Cases: NTDs affect more than a billion people globally. However, the diseases are preventable and treatable.

  About London Declaration:

  1. London Declaration on Neglected Tropical Diseases was a collaborative disease eradication program. It launched on 30 January 2012 in London.
  2. Based on: World Health Organization 2020 roadmap to eradicate or prevent transmission of neglected tropical diseases.
  3. This declaration aimed to eliminate or control 10 neglected diseases by 2020 by providing more than US$785 million to support research and development.
     • Great progress has been made since 2012, but not all the goals have been met by 2020.

  WHO’s New Roadmap for NTDs for 2021-30:

  • The World Health Organization(WHO) has launched a new road map to
    • prevent, control, eliminate and eradicate a set of 20 diseases termed neglected tropical diseases by 2030.
    • Reducing the number of people in need of NTD treatment by 90%.
    • Elimination of at least one NTD in more than 100 countries.
    • Complete elimination of dracunculiasis (guinea worm) and yaws
  • Strategy: The roadmap calls for three strategic changes in approach to end NTDs:
    1. From measuring process to measuring impact.
    2. From disease-specific planning and programming to collaborative work across sectors.
    3. Lastly, From externally driven agendas on programmes that are country-owned and country-financed.

  Source: Down To Earth

   

• Effects of Pandemic on Young Healthcare Workers

  Synopsis: Need to give attention to the requirements of the most vulnerable members of the caregiving team i.e. young healthcare workers.

  Introduction 

  young medical interns, postgraduates, nurses, physiotherapists, pharmacists, etc are at the lowest steps in the hierarchy of training. It seems fair from an academic view and is according to any professional training path. However, this structure is apathetic for young health care workers.

  • Even before the pandemic, duty hour restrictions were not followed for young healthcare workers. Sleep-deprived postgraduates used to work for 100-hours in a week. 
  • There is inconsistency in stipends rates. For example, Tamil Nadu and Himachal Pradesh offer the lowest monthly stipends to first-year residents at Rs 35-37,000.

  What are the adverse effects of the pandemic on young healthcare workers?

  During the pandemic, most public hospitals had young interns, postgraduates, nurses, and technicians staff in fever clinics, wards, and ICUs. They were overworked by the huge volume of patients. 

  1. Firstly, they are physically distressed by working for 8-12 hours in a stuffy PPE suit and tightly-fitted face mask. One cannot even take a toilet break.
     • It requires a tremendous cognitive effort to manage complex ventilator settings and drug interactions. Especially when the patient is admitted to the Covid-19 ward with multiple co-morbidities. 
  2. Secondly, as the second wave hit, hospitals increased their beds and ICU capacity. But the healthcare workers remained overstretched. The burden further increased by poorly-informed public health measures and an increase in public frustration and indifference. 
  3. Thirdly, the NEET postgraduate exams this year have been delayed. The shortage of workers will continue to overburden them.
  4. Fourthly, the growing amount of disinformation on social media which adds to distrust against doctors and nurses has left most trainees in an unfortunate position. They are defending their worth and the firmness of scientific evidence that updates medical practice. 
     • They also have to defend themselves against the several instances of violence and abuse by patient attendees.
  5. Fifthly, all of these factors have taken a toll on the well-being of young trainees. They are away from their families and the uncertainty about their safety amidst a global pandemic affects their mental health. 
  6. Sixthly, suicide has claimed the lives of students, interns, and postgraduates in the last year across the country. Reasons were the stress of persistent duty hours, (some even suffering from severe conditions themselves).

  The conclusion 

  • It is time we bring an end to our indifference towards young healthcare workers. There should be some amendments to the Epidemic Disease Act to protect frontline workers from exploitation. They should be provided with centrally-sponsored insurance schemes. 
  • Citizens must now speak out against the exploitation of young trainees. It should be a moral responsibility to end this toxic culture that feeds off public apathy.

  Source: click here

• Resolving bottlenecks in procuring Pfizer’s vaccine

  Synopsis – Pfizer has asked for certain conditions. They are in order to supply 5 million doses to India between July and October this year.

  Introduction

  • According to reports, Pfizer is ready to supply five crore doses of the mRNA vaccines [developed with the German company BioNTech] between July and October.
  • However, the company has requested certain protection from the Centre. It has done this with other 116 governments across the world, including the United States.
  • Therefore, to seal the deal, the pharmaceutical giant and the Indian government must quickly resolve their long-standing dispute over the protection.

  Pre-conditions to supply Vaccine to India:

  • Pfizer said that it will supply vaccine only to the central government, not to individual states. The company also refused to send vaccines directly to local governments citing its policy of dealing only with the Central government of various countries.
  • The company has also asked for protection from the Government of India. Such as, slots for testing of their vaccines in CDL (Central Drugs Laboratory).
  • The company is also requesting that it should not be liable for compensation in case of an adverse event.

  What needs to be done in order to increase procurement?

  1. Timely vaccination is the need of the hour to protect people against the coronavirus, thus the Centre needs to take charge of all procurement and negotiations with all vaccine suppliers, including domestic and foreign.
  2. The government has to consider the global situation in decision-making. Such as, around 14.7 crore doses of Pfizer vaccines have already been administered worldwide without any significant reports of adverse effects.

  Source-The Indian Express

• Need for real-time data on public health

   

  Synopsis: Having access to epidemiological real-time data on public health will help us to fight against the pandemic better by making informed choices.

  Background

  • The COVID-19 pandemic has highlighted the importance of data to governments in decision-making.
  • However, India lacks real-time data on public health and the provision of health services.
  • This necessitates the need for data transparency and data sharing in India to make informed decision-making.
  • Hence, India needs to create a charter for standardizing digital health data.

  How real-time data on public health can help fight against the Pandemic?

  • Firstly, it will help in data analysis and modelling. For instance, the epidemiological concept of flattening the curve and its predictions are results of data analysis and modelling.
    • Epidemiology refers to the study of medicine which deals with the incidence, distribution, and control of diseases.
  • Secondly, it allows us to measure our preparedness, and shape our responses to identify, manage, and care for new cases.
  • Thirdly, it will help to understand disease pathogenesis and severity. For example, Epidemic outbreak data like case data, medical and treatment data can be used to understand disease pathogenesis and severity.
  • Fourthly, it helps us to understand the transmissibility or infectivity of the virus. For example, comparing genome surveillance data with the magnitude of fatalities or recovery will help us to understand the transmissibility or infectivity of the virus.
  • Fifthly, it will help in predicting viral evolution and drug-treatment strategies. Surveillance through studying genome sequencing of the virus, along with epidemiological data allows us to identify the evolution of the virus after the rollout of vaccinations.

  Challenges in generating real-time data on public health

  • One, standardisation of data collection is the biggest challenge due to many operational constraints.
    • Ensuring data availability and quality under operational constraints is critical. This can be addressed by reducing errors and enabling transparency.
  • Second, concerns of privacy and security while sharing personal health data.
    • There is a need to build a systemic infrastructure with built-in safeguards. This will provide security and ensure privacy.

  Source: The Indian Express

• Role of AYUSH during pandemic and its challenges – Explained, Pointwise

  Contents

  • 1 Introduction
  • 2 What is AYUSH?
  • 3 Institutional Framework for AYUSH
  • 4 Role of AYUSH medicines used during pandemic
  • 5 Challenges faced by AYUSH medicines and practitioners
  • 6 Suggestions to improve the role of AYUSH
  • 7 Conclusion

  Introduction

  The COVID-19 pandemic has emerged as a public health challenge. The burden of disease and mortality is steadily increasing in many parts of the country. Several social and economic factors are leading to devastating situations. Effective management to address this infection is still evolving and attempts are being made to integrate traditional interventions along with standard care. 

  In this regard, India is using the AYUSH system of medicine to provide relief and alleviate some symptoms of COVID-19. The AYUSH system is not seen as a cure, rather it is being used for the management of asymptomatic and mild cases of Covid-19 and for prophylactic (preventive) care. But despite that the Role of AYUSH during the pandemic is indispensable. 

  What is AYUSH?

  • AYUSH stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.
  • These systems are based on traditional medical philosophies. They represent a way of healthy living with established concepts on prevention of diseases and promotion of health.
  • In 2015, the Ministry of Ayush had also included Sowa Rigpa into the AYUSH system.
  • Benefits of AYUSH system:
    • It is generally cheap and affordable
    • AYUSH medicines have lesser side effects than modern medicine.
    • It has proven to be effective in lifestyle diseases like diabetes and hypertension
    • It is used to provide healthcare in rural hinterlands where there is a shortage of allopathic doctors. 

  Institutional Framework for AYUSH

  • The Ministry of AYUSH is at the apex. It promotes and propagates Indian systems of Medicine and Homoeopathy.
  • The National Medicinal Plants Board (NMPB) coordinates activities relating to conservation, cultivation, marketing, export and policy-making for the development of the medicinal plant’s sector. 
  • The Central Council of Indian Medicine (CCIM) and the Central Council of Homoeopathy (CCH) are two statutory regulatory bodies. They are responsible for – 
    • laying down minimum standards of education, 
    • recommending recognition of medical qualifications, 
    • registering the practitioners and laying down ethical codes.
  • There are five research councils that undertake officially sponsored research activities.
  • The country also has eight National Institutes for teaching the AYUSH system. This includes the National Institute of Ayurveda, Jaipur; the National Institute of Siddha, Chennai etc. 
  • Four different Pharmacopoeia Committees work for preparing official formularies/pharmacopoeias(An official authoritative listing of drugs). They aim to evolve uniform standards in preparation for drugs in Ayurveda, Siddha, Unani and Homeopathy.

  Role of AYUSH medicines used during pandemic

  The role of AYUSH medicines increased significantly during the pandemic. The AYUSH medicines and techniques used during the pandemic are,

  • Ayush-64: It is an Ayurvedic drug developed by the Central Council for Research in Ayurvedic Sciences(CCRAS). It is the apex body for research in Ayurveda under the Ministry of Ayush.
    • The drug was originally developed in 1980 for the management of Malaria. It has now been used for Covid-19 as its ingredients showed notable antiviral, immune-modulator, and antipyretic (anti-fever) properties.
  • Kabasura Kudineer: It is a Siddha medicine for the treatment of fevers. It is now being used to treat asymptomatic, mild, and moderate COVID-19 infection cases.
    • It increases immunity and acts as an immune-modulator as this virus adversely affects the immune response.
  • Habb-e-Bukhar: It is an Unani drug given to Covid-19 patients who are undergoing high fever.  
  • Arsenicum album: It is a homoeopathy drug considered correcting inflammation in the body. It takes care of diarrhoea, cough and cold.
    • It is recommended for prophylactic (preventive) use against Covid-19. Further, it is also found to be useful in treating mucormycosis (fungal infection).
  • Yogic Protocols: They are used in the Covid-19 treatment centres to improve respiratory and cardiac efficiency, reduce stress and anxiety and enhance immunity. Asanas like Pranayama, Shavasana etc. are extremely beneficial in this regard.

  Challenges faced by AYUSH medicines and practitioners

  • The tussle with Allopathic care: Many allopathic doctors don’t believe in the traditional system. They question the credibility of AYUSH practitioners and are against their inclusion into the modern health care system.
    • For instance, the Indian Medical Association objected to a recent gazette notification by the Central Council of Indian Medicine (CCIM). As it allowed postgraduate Ayurvedic doctors to perform 58 basic surgeries.
  • Lacks in Validation: Scientific validation of AYUSH medicines has not progressed despite dedicated government expenditure. There are very few AYUSH treatments that have been successfully validated by well-designed randomised controlled trials (RCTs).
  • Poor Quality of Practitioners: The practitioners lack quality as Ayurvedic graduation and post graduation courses are often substandard and of poor quality.
    • Most AYUSH institutions would have to shut down if they were subjected to the same stringent norms that MBBS medical colleges are subjected to.
    • Further, due to poor economic opportunities, the AYUSH system fails to attract the country’s best talent.
  • Overuse of AYUSH medicine: They are sold as over the counter products and nutraceuticals to avoid regulation. Further, Ayurvedic stores do not even have a legal requirement of a pharmacist to dispense the medications unlike pharmacies selling modern medicine. This leads to greater consumption and enhanced self-medication.
    • There have been numerous cases of terminal liver failure and irreversible organ damage due to over consumption of herbal preparations.

  Suggestions to improve the role of AYUSH

  • Firstly, AYUSH practitioners should follow the instructions issued from time to time by the WHO, Ministry of Health & Family Welfare and Ministry of AYUSH. They should mould their advice as per the changing guidelines in order to administer proper treatment.
  • Secondly, the AYUSH sanjivani app’s data must be regularly assessed and evaluated in order to include/exclude the usage of traditional medicines in tackling the pandemic.
    • Sanjivani is a mobile app for impact assessment of the effectiveness, acceptance and usage of the different AYUSH advisories. 
  • Thirdly, the AYUSH medicines should be put through rigorous trials in order to be accepted as legitimate medications in the present times.
  • Fourthly, the governments must stop treating AYUSH education and practice with an excessively liberal mindset. They should subject them to the same stringent norms and requirements expected from practitioners of modern medicine.
  • Fifthly, the government should also focus on Capacity-building of licensed AYUSH practitioners through bridge training to meet India’s primary care needs. 
  • Sixthly, Cross-pathy between the traditional and modern systems should be allowed to fill the lacunae in respective systems. However, this must be done after due deliberation with experts from the respective systems.
  • Seventhly, the government should create courses that produce qualified pharmacists trained in AYUSH pharmacopeia, who can then be placed on thousands of AYUSH stores across the country.
  • Lastly, every formulation of AYUSH medicine must carry a label detailing its ingredients, side effects and other important information as is mandated for modern medicines.

  Conclusion

  The pandemic has made us realize that no single health care system can provide satisfactory answers to all the health needs of modern society. There is a need for an inclusive and integrated health care regime that could guide health policies and programs in the future. Medical pluralism is here to stay and the role of AYUSH sector has a critical role to play in the new and emerging situation.

• WHO report on “Origin of Covid-19”: India seeks more studies on virus

  Contents

  • 1
  • 2 What is the News?
  • 3 What did the Global Study on the Origin of Covid-19 found?
  • 4 India’s stand on WHO’s study:

  What is the News?

  India has welcomed the global study on the origin of Covid-19 convened by the World Health Organisation(WHO). However, India demanded initiating further studies in order to reach robust conclusions.

  WHO report on Origin of Covid-19:

  The report had listed “four pathways” or possible options that led to the Covid-19 pandemic:

  • A direct zoonotic transmission;
  • Introduction of the virus through another intermediate host or animal;
  • Introduction through the cold chain or food chain;
  • Laboratory incident.

  What did the Global Study on the Origin of Covid-19 found?

  • The study was conducted by the World Health Organisation(WHO) in association with China.
  • The study has said that direct zoonotic transmission or the introduction of the virus through another intermediate host or animal are the most likely theories of the origin of Covid-19.
  • Moreover, the introduction of the Covid-19 through the cold chain or food chain is also possible.
  • However, the lab leak theory of the virus was “extremely unlikely”. But there was a need for further research.

  India’s stand on WHO’s study:

  • India has called for a comprehensive and expert-led mechanism to investigate the origin of Covid-19 in cooperation with all stakeholders.
  • Further, India also demanded that the mechanism should be supported by an additional WHO mission. This mission should have the power to visit the Chinese sites for further studies.

  China’s stand on WHO’s study:

  • China has denied the theory that there was a leak from the Wuhan lab (research on zoonotic transmissions of coronaviruses was taking place).

  Source: The Hindu

• “Ayush Clinical Case Repository (ACCR) portal” and “Ayush Sanjivani App”

  Contents

  • 1 What is the News?
  • 2 About Ayush Clinical Case Repository(ACCR):
  • 3 Significance of this Portal:
  • 4 About Ayush Sanjivani app:

  What is the News?

  The Ministry of Ayush has launched two things. First, the Ayush Clinical Case Repository (ACCR) portal.  And second, the third version of the Ayush Sanjivani App.

  About Ayush Clinical Case Repository(ACCR):

  • Firstly, the Ministry of Ayush has conceptualized and developed the Ayush Clinical Case Repository(ACCR) Portal. It is a platform to support both Ayush practitioners and the public.
  • Secondly, Purpose: The portal aims at aggregating information about clinical outcomes achieved by Ayush practitioners on a large scale.

  Significance of this Portal:

  • Firstly, the portal will help the Ayush practitioners to know approaches adopted by their colleagues in the treatment of various patients.
  • Secondly, the public can also go through the portal to understand the strengths of various Ayush systems in the treatment of various diseases.
  • Lastly, the portal will not only benefit the Ayush practitioner and the public but will also help widen the research in the field of Ayush.

  About Ayush Sanjivani app:

  • Ayush Sanjivani app has been developed by the Ministry of Ayush and the Ministry of Electronics and Information Technology (MeitY).
    
  • Purpose: The app intends to generate a significant study and data regarding the efficacy of selected Ayush interventions. The data analyzed will be helpful for the further development of Ayush Systems.

  Source: PIB

• “Paediatric Inflammatory Multisystem Syndrome”

  Contents

  • 1
  • 2 What is the News?
  • 3 About Paediatric Inflammatory Multisystem Syndrome(PIMS-TS):
  • 4 About the Lancet Study:

  What is the News?

  According to a study by Lancet, the symptoms of a rare paediatric inflammatory multisystem syndrome(PIMS-TS) associated with SARS-CoV2 are resolved after six months.

  About Paediatric Inflammatory Multisystem Syndrome(PIMS-TS):

  • PIMS-TS is also known as a multisystem inflammatory syndrome in children (MIS-C). It is a rare condition associated with SARS-CoV-2 infection that was first defined in April 2020.
  • Caused by: It is not known what triggers the condition. But it is thought to be a rare immune overreaction that occurs in children approximately four to six weeks after mild or asymptomatic SARS-CoV-2 infection.
  • Symptoms: It includes fever, rash, eye infection, and gastrointestinal symptoms (e.g. diarrhoea, stomach ache, nausea). In some rare cases, the condition can lead to multi-organ failure.
  • Diagnosis: Currently, MIS-C is diagnosed based on symptoms together with laboratory tests that look for signs of inflammation in the body.
  • Treatment: Treatments currently include anti-coagulation to curb blood clotting, IV immunoglobulin and anti-inflammatory drugs.

  About the Lancet Study:

  • The Lancet study has been conducted on a small group of children affected with PIMS-TS.
  • The study has found that most gastrointestinal, heart and neurological symptoms in children are resolved within six months of the COVID-19 infection.
  • Moreover, the long-term damage to the organs is thought to be a rare occurrence.

  Source: Indian Express

• India’s Mucormycosis Threat

  Synopsis: There is a high incidence of Mucormycosis in India. Government should urgently look for solutions to limit the incidence of the disease.

  Background

  • The incidence of mucormycosis (a rare fungal infection) in patients who have been diagnosed and treated for COVID-19 is rising alarmingly in India.
  • For instance, according to a study published in Current Fungal Infection Reports the estimated burden of mucormycosis in India is 14 per 100,000. This is almost 70 times higher than what is reported in other countries.
  • Even, some States, including Tamil Nadu, have declared mucormycosis as a notifiable disease under the Epidemic Diseases Act.
  • Common use of Steroids such as Dexamethasone, methylprednisolone etc., in the treatment of COVID-19 is one of the major reasons for the cause of
  • So, to arrest this growing epidemic, Guidelines and protocols need to be adapted and modified rapidly

  About mucormycosis

  • Causes:
    • The most common cause is uncontrolled diabetes mellitus (raised blood sugars).
    • Other causes include the treatment of some cancers, steroids, chemotherapy or immunotherapy, and solid organ or stem-cell transplantations.
  • Occurrence:
    • The common sites of occurrence include rhino-cerebral involvement (i.e., the fungus can damage the nose, paranasal sinuses, the eyes, and the brain), and pulmonary involvement (i.e., the fungus can cause pneumonia).
  • Non-contagious:
    • Mucormycosis is not transmissible from one individual to the other.
  • Symptoms:
    • Facial swelling on one side,
    • Protrusion of the eyeball,
    • New-onset visual disturbances,
    • Headache and vomiting,
    • New onset swelling or ulcers with blackish discolouration, and prolonged fever.
  • Morbidity:
    • Mucormycosis have associations with very high morbidity and mortality.
  • Treatment:
    • It requires a multi-disciplinary team approach that includes microbiology, pathology, radiology, and other disciplines.
    • It includes Surgery along with administering of Anti-fungal drugs.

  Why mucormycosis is a concern for India?

  • First, one of the significant causes for mucormycosis is raised blood sugars and India is home to a large number of Diabetic patients.
    • For instance, according to a study in The Lancet, people with diabetes increased to 65 million in 2016 in India,
    • The highest prevalence of diabetes was observed in Tamil Nadu, Kerala, and Delhi. Further, there is an underlying higher genetic susceptibility to diabetes in Indians.
  • Second, apart from this natural cause of Diabetes, SARS-CoV-2 can potentially multiply in pancreatic cells and contribute to increased blood sugar levels in COVID-19 patients.
  • Third, during the treatment for Covid-19, there is administration of steroids to lower death rates by reducing the cytokine storm phase. However, steroids when used excessively or prematurely, and without medical supervision can also increase blood sugar levels.
  • Fourth, treatment for mucormycosis requires a multi-disciplinary team approach. However, a multi-disciplinary approach is not feasible on a large scale, especially in areas with limited medical access
  • Fifth, drugs available are either costly and out of access for the majority of Indians or produce side effects.
  • For instance, the standard drug is liposomal amphotericin B. But the price is exorbitant. Whereas, cheap drugs like Amphotericin B deoxycholate have associations with unfavourable toxicity, including kidney problems.

  What needs to be done?

  • One, Steroid use at home for COVID-19 should be only under the supervision of a healthcare worker.
  • Two, monitoring of capillary blood glucose is essential while administering steroids. Health authorities should arrange for blood glucose monitoring for patients at home on steroids.
    • Further, awareness campaigns on the importance of controlled blood sugar levels need to be promoted.
  • Three, widespread training of healthcare personnel including Accredited Social Health Activists (ASHAs) to raise awareness on mucormycosis while educating people locally.

  Source: The Hindu

• Preventive steps to avoid Mucormycosis or Black Fungus infections

  Contents

  • 1
  • 2 What is the News?
  • 3 About Mucormycosis:
  • 4 Preventive steps to avoid Mucormycosis:

  What is the News?

  Doctors have advised several preventive steps to be taken by Covid-19 patients to prevent Mucormycosis.

  About Mucormycosis:

  • Mucormycosis or Black Fungus is a rare fungal infection. A group of molds called mucormycetes is the reason behind it, which is abundant in the environment. These are present in the air, water and moist surfaces in damp places.
  • Non-Transmissible: Mucormycosis is not a communicable disease. Also, it does not spread from one person to another like Covid-19.
  • Vulnerable Group:
    • This infection does not usually infect healthy persons. However, it can cause severe infection in an immunocompromised person.
    • Moreover, it is also infecting COVID-19 patients prescribed steroids to control the infections or those who have uncontrolled diabetes.
  • Types of mucormycosis: Mucormycosis can be categorised depending on the organ of the human body it attacks:
    • Rhino orbital cerebral mucormycosis: It infects the nose, the orbit of the eye/eye socket, oral cavity. It can even spread to the brain.
    • Pulmonary mucormycosis: This fungal infection affects the lungs and causes fever, chest pain, cough and coughing of blood.
    • Gastrointestinal Mucormycosis: This fungus infection affects the gastrointestinal tract.
  • Treatment: The infection is often treated with antifungal medicine, usually amphotericin B.

  Preventive steps to avoid Mucormycosis:

  • Firstly, patients, especially those in the high-risk category for mucormycosis should avoid visiting damp and dusty places post Covid-19 recovery.
  • Secondly, it will take around four weeks for the effect of steroids administered to COVID-19 patients to wear off. So, it is important to keep oneself protected during this time.
  • Thirdly, patients should wear a three-ply mask and gloves and fully cover their legs and arms.
  • Fourthly, COVID-19 patients’ oxygen mask and cannula should be sterile to prevent mucormycosis.
  • Fifthly, there should be a regular check on the water used in oxygenation for any possible contamination.
  • Lastly, doctors and nurses should check for the symptoms in patients while treating patients with steroids or other immunosuppressive agents.

  Source: The Hindu

  ---

  First Case of “Yellow Fungus” detected in UP

• First Case of “Yellow Fungus” detected in UP

  What is the News?

  A COVID-19 patient in Ghaziabad has been diagnosed with a Yellow Fungus infection.

  About Yellow Fungus:

  • Yellow Fungus, also goes by its second name, mucor septic. It is a fungal infection that medical experts say generally does not occur in humans but in reptiles.
  • Causes:
    • Poor Hygiene
    • High levels of humidity beyond the 30-40% range
    • Old food and improper disposal also contribute to the growth of the fungus.
    • Excess use of steroids is also a possible reason in Covid-19 patients.
  • Symptoms:
    • Symptoms of yellow fungus are laziness, loss of appetite, or no appetite at all and weight loss.
    • In serious cases, yellow fungus can also cause leakage of pus and slow healing of the open wound or necrosis in which cells in living tissue die prematurely.
  • Treatment: Antifungal drug Amphotericin-B is being considered as a primary treatment of yellow fungus. The same injection is being used currently to treat black or white fungus cases in the country.

  Why is Yellow Fungus more dangerous than black and White Fungus?

  • Yellow fungus infections are not like black fungus infection and White Fungus infection. Instead, they are much more dangerous as it starts off internally. Thus, its diagnosis is very difficult.
  • Therefore, it remains critical that patients seek help for their infection as soon as they start observing symptoms.

  Source: TOI

  “Black Fungus Infection” Cases in Covid Patients

• EU leaders agree to donate 100 million doses of Covid-19 vaccines

  Contents

  • 1
  • 2 What is the News?
  • 3 Key Highlights of the Summit: During the Summit:
  • 4 About European Union(EU):

  What is the News?

  The European Union(EU) countries have gathered in Brussels, Belgium for a two-day summit. During the summit the EU leaders has agreed to donate 100 million doses of Covid-19 vaccines

  Key Highlights of the Summit: During the Summit:

  • Firstly, the European Union leaders have committed to donate at least 100 million doses of coronavirus vaccines to middle and low-income countries before the end of 2021.
  • Secondly, the EU will provide assistance to non-EU countries to help them develop local manufacturing capacity.
  • Thirdly, the EU has reiterated their support for the UN-backed COVAX programme.
    • COVAX program aims to ensure equitable access to COVID-19 shots for low-and middle-income countries.
  • Lastly, the summit did not mention anything about lifting the intellectual property rights of Covid-19 vaccines proposed by countries like India and South Africa.

  About European Union(EU):

  • European Union (EU) is a political and economic union of 27 member states primarily located in Europe.
  • The EU was created by the Maastricht Treaty. The treaty entered into force on November 1,1993.
  • The EU has developed an internal single market through a standardised system of laws that apply in all member states.
  • Five main bodies run the EU: the European Parliament, the Council of the Union, the European Commission, the Court of Justice, and the Court of Auditors.
  • Among EU countries, 19 use EURO as their official currency. 8 EU members (Bulgaria, Croatia, Czech Republic, Denmark, Hungary, Poland, Romania and Sweden) do not use the euro.
  • Significance: The EU was awarded the Nobel Prize for Peace in 2012, in recognition of the organization’s efforts to promote peace and democracy in Europe.
  • Headquarters: Brussels, Belgium.

  Source: The Hindu

   

• “One Health High-Level Expert Panel” – A WHO panel to investigate zoonotic diseases

  What is the News?

  The World Health Organization(WHO) has formed a One Health High-Level Expert Panel.

  About One Health High-Level Expert Panel:

  • Purpose: The panel has been formed to study the emergence and spread of zoonotic diseases. Such as H5N1, avian influenza, MERS, Ebola, Zika and possibly the novel coronavirus disease(COVID-19).
  • Mandate of the Panel:
    • Firstly, to consider the impact of human activity on the environment and wildlife habitats.
    • Secondly, to analyse the factors that lead to transmission of a disease from animal to human and vice versa
    • Thirdly, to develop risk assessment and surveillance frameworks;
    • Fourthly, to identify capacity gaps as well as agreement on good practices that help to prevent and prepare for zoonotic outbreaks.
  • Approach: The panel will operate under the One Health Approach. This approach recognizes the links between the health of people, animals, and the environment.
  • Advisory Role: The panel will advise four global agencies on how future outbreaks especially due to zoonotic diseases can be averted. These four organisations are:
    • Food and Agriculture Organization of the United Nations (FAO)
    • World Health Organization(WHO)
    • World Organisation for Animal Health(OIE) and
    • United Nations Environment Programme(UNEP).

  What is One Health Approach?

  

  • It is an approach that recognizes that the health of humans, animals, and ecosystems as interconnected one.
  • Hence, it involves applying a coordinated and multidisciplinary approach at the local, regional, national and global levels. It will address potential or existing risks that originate at the animal-human ecosystems interface.

  What are Zoonotic Diseases?

  • Zoonosis is an infectious disease that spreads from non-human to humans.
  • Zoonotic pathogens may be bacterial, viral, or parasitic. They can spread to humans through direct contact or through food, water, and the environment.
  • Three of every four infectious diseases are caused by zoonosis. Moreover, scientists across the world suspect COVID-19 is also a zoonosis disease.

  Source: Down To Earth

• Issues in Present Policy of Vaccine Procurement

  Synopsis: Analysis on issues associated with the Liberalised and Accelerated Phase 3 Strategy of COVID-19 Vaccination

  Background

  • Many State governments have resorted to floating global tenders for COVID-19 vaccines due to Covid vaccine shortage in India.
  • The Liberalised and Accelerated Phase 3 Strategy of COVID-19 Vaccination allows states to procure COVID-19 vaccines independently of the global market for people above the age of 18 years.
  • However, the Liberalised and Accelerated Phase 3 Strategy of COVID-19 Vaccination has many disadvantages.
  • A single global tender for vaccine procurement through the center will be more effective in the fight against the Covid-19 pandemic.

  What are the issues in the Liberalised and Accelerated Phase 3 Strategy of COVID-19 Vaccination?

  • First, the Liberalised and Accelerated Phase 3 Strategy of COVID-19 Vaccination allows all persons, above 18 years of age to get COVID-19 vaccine doses.
    • However, expanding eligibility in the absence of sufficient vaccine supplies will only spread vaccines thinly.
  • Second, the burden to procure vaccines for the population of the 18-44 years age group has been shifted to the States. This has many disadvantages,
    • One, determination of prices by an oligopolistic market favours unhealthy competition among States.
    • Two, States will have to procure doses at higher rates than a single national purchaser. As a result of the new strategy, each vaccine dose will be costlier in India than in any other part of the world.
  • All these issues will result in unequal distribution of vaccines among states (Vaccine inequity).

  What needs to be done?

  • One, government needs to revisit the vaccine policy and use the limited vaccine supply for the adult high-risk and vulnerable group of population.
  • Two, vaccination for the 18-44 years age group can be reconsidered when vaccine supply is likely to stabilise.
  • Three, Central government should coordinate with the States and make efforts to float a single global tender for vaccine procurement.
    • The fact that the federal government has provided vaccines free to all, even in the United States, should be an eye-opener for India.
    • Further, procurement of vaccines by the center and administration of vaccines by the states will ensure effective vaccine delivery. For instance, Polio.
    • This mechanism of division of labour among centre-state should not be disturbed. The current vaccine strategy burdens States with additional procurement responsibilities that need to be done away with.

  Article 21 of the Constitution guarantees the right to health. Right to health encompasses accessible, available, and affordable health care. Hence, it is the duty of the central government to ensure that COVID-19 vaccines are accessible, available, and affordable.

  Source: The Hindu

• Challenges in Vaccine Procurement in India – Explained, Pointwise

  Contents

  • 1 Introduction
  • 2 Present status of vaccine manufacturing in India
  • 3 Global Vaccine sources and producers
    • 3.1 Global Vaccine manufacturers and their type of vaccines
  • 4 Government initiatives in vaccine procurement
  • 5 Challenges in Vaccine procurement
    • 5.1 Challenges in distribution
  • 6 Suggestions
  • 7 Way forward

  Introduction

  According to the data from the Ministry of Health and Family welfare, so far, India has vaccinated only 417 million people (less than 3.1% of the population has received both doses). The population of India is 1.3 billion. If vaccines require two doses then India needs more than 2 billion doses across the nation. But neither the Covaxin nor the Covishield has that much production capacity to meet the world’s largest Covid-19 vaccination drive in India. So, India needs to do large-scale vaccine procurement to meet India’s ambition towards universal vaccination against Covid-19.

  Recently India started procuring Russia’s Sputnik-V vaccine in India. Apart from that, 10 states (Rajasthan, Madhya Pradesh, Uttarakhand, Tamil Nadu, Maharashtra, Karnataka, Andhra Pradesh, Telangana, Haryana, and Delhi) decided to procure vaccines globally as there is a shortage of vaccines in India. In this article, we will explain various issues associated with vaccine procurement in India.

  Present status of vaccine manufacturing in India

  1. Both Serum Institute of India and Bharat Biotech are providing vaccines to India in fight against Covid-19.
  2. The world’s largest vaccine maker, Serum Institute of India, initially promised to supply 100 million doses of vaccines a month. But in reality, it only provided between 50 million to 60 million doses.
  3. On the other hand, Bharat Biotech has a planned production capacity of 12.5 million a month. But their current production is somewhere between  1-5 million.
  4. So, India’s monthly Covid-19 vaccine manufacturing capacity is about 60-65 million doses only.
  5. The target of vaccination will require more than 1.5 billion doses. As Covaxin and Covishield require two doses. But the present production capacity cannot meet that amount in a short time.
  6. Moreover, according to the Ministry of External Affairs website, India almost exported vaccines to 95 countries in the world. As of May 11, India exported 663.698 lakh vaccine doses to foreign countries. Out of this, 16% was sent as aid, 54% as commercial supplies, and 30% as part of WHO’s COVAX program.
  7. So, technically the vaccine availability in India reduced further below the daily requirement of vaccines in India. For example, With only 20 million vaccine shots available for the entire month of May, many State governments have resorted to floating global tenders for COVID-19 vaccines.
  8. On May 1, the first consignment of the Sputnik V vaccine – 1.5 lakh doses – arrived in India. According to the health ministry’s website, the Vaccine is started administered to people recently.

  Global Vaccine sources and producers

  1. According to the Covid-19 vaccine market dashboard, 14 vaccines are licensed or approved for emergency/conditional use. These 14 vaccine prices range from $2 to $40. So far 12.2 billion doses have been administered. The majority of them occurred in developed countries. So, to achieve a similar feat India needs to procure from global players.

  

  Source: Our World in data

  Global Vaccine manufacturers and their type of vaccines

  Vaccine	Manufacturer	Type of Vaccine
  Coronavac	Sinovac (China)	Purified inactivated SARS-CoV-2 vaccine
  Sputnik-V	Gamaleya Institute (Russia)	Disabled Adenovirus vaccine
  Pfizer/BioNtech Comirnaty	Pfizer/BioNtech(US)	mRNA vaccine
  Covishield	AstraZeneca/Oxford/SII	Disabled Adenovirus vaccine
  Janssen	Johnson and Jonson(US)/Merck & Co	Disabled Adenovirus vaccine
  Convidecia	Cansino Biologics(China)	Disabled Adenovirus vaccine
  Moderna	Moderna Inc(USA)	mRNA vaccine

  • Globally developed countries hold huge stocks of Covid-19 vaccines. For example, Rich countries with 14% of the world’s population have secured 53% of the best vaccines. For example, The USA has committed stocks of 1.2 billion doses. Even though the population is around 300 million. But recently the US started to release vaccine stocks after global concerns. India can take opportunities on that and procure vaccines.
  • India can negotiate with vaccine manufacturers like Moderna, Pfizer etc for procuring vaccines.

  Government initiatives in vaccine procurement

  1. Changes in vaccination policy: The Government of India recently announced the fourth phase of its New  Covid-19 vaccine policy. The policy Liberalised and Accelerated vaccine procurement. Under the new rules, the Centre will procure only 50% of vaccines produced by manufacturers. The remaining 50% can be acquired by the states directly or by private hospitals and industrial establishments at a predecided price.
     • Apart from that, The Centre allowed the imported, fully ready-to-use vaccines to be entirely utilized in the other-than-Government of India channel.
     • Thus, if a foreign pharma giant brings its vaccine to India, it will be free to directly sell the entire stock in the open market at a competitive price.
  2. Talks with global manufacturers: According to the Ministry of External Affairs, India is in touch with US entities for procurement of vaccines and manufacturing them in the country to augment vaccine supply.
  3. Permitting the import of the Sputnik V vaccine: The central government allowed Russia’s Sputnik-V vaccine import into India.
  4. Raising issues in global forums: As the Intellectual Property Rights hinder the supply of vaccines, both India and South Africa have proposed to waive off IP rights like patents, copyright, and trademarks for prevention, containment, or treatment of Covid-19. Other developing countries started to co-sponsor India and South Africa requests. The TRIPS Council also discussed this issue both formally and informally.

  Challenges in Vaccine procurement

  1. Issues in permitting States to procure vaccines: As the central government left the states to decide the prices from foreign pharma companies, it is leading to various issues in procurement. Such as,
     1. Unhealthy competition among States: States will compete among each other for the limited vaccines. This will reduce cooperative federalism in India.
     2. Non-uniform vaccine prices and Higher cost of Vaccines: There is inexperience in States regarding international market and negotiation. Further, the States will have to procure doses at higher rates than a single national purchaser. As there is a competition of states involved. This leads to increased cost of each vaccine dose in India compares to any other part of the world. Also, the prices will essentially increase state government expenditure. For example, Recently Supreme Court noted, states are paying more – between 300 rupees to 400 rupees per dose – while the central government is paying 150 rupees.
     3. Detrimental to India’s image: As several states floating separate tenders to procure Covid-19 vaccines from abroad, This will be detrimental for India’s image in the world. Also, this will fracture India’s bargaining power.
     4. The difference in Covid-19 reduction rate among rich and poor states: Richer states will be better positioned in procuring the highest number of vaccine doses from abroad. So, they can reduce the Covid-19 caseload faster. On the other hand, Poor states might suffer more from the present and future Covid-19 waves.
     5. Against India’s Vaccination policy: In India, the Center procures vaccines and the States administer them. This helped India to deal with public health problems such as polio, etc. The new vaccination policy is a violation of India’s prior vaccination policies.

  2. Challenges in distribution
     

     1. Unequal distribution of cold storage facilities among states. Even if states procure vaccines, they cannot distribute the vaccines easily. For example, out of the 28,932 cold chain points, half are in the five southern states, Maharashtra and Gujarat. Whereas the eight states in the North and Odisha that account for over 40 percent of the country’s population have only 28 percent of the cold chain points.  
     2. The Issue of Vaccine wastage: According to the RTI information, India has wasted more than 44 lakh of 10 crore doses(Till April 11). Tamil Nadu wasted over 12 percent, followed by Haryana (9.74%), Punjab (8.12%).  Ideally, a vaccination center must have 10 recipients to make optimal use of a single 10-dose vial. If the person is not available then that vaccine vial becomes a waste.

  Suggestions

  1. Conducting a detailed demand-supply analysis: To conduct a calibrated expansion of the eligibility criteria India needs to conduct a detailed analysis including the vaccine manufacturers’ real-time production capability, the supply chain delays, etc.
  2. Change the vaccination policy: The Centre needs to take charge of all procurement and negotiations with all vaccine suppliers including domestic and foreign suppliers without any exception. Even the Supreme Court also raised issues in state procurement and called the central government to relook its procurement process.
  3. Work with domestic manufacturers to increase the supply: The Centre should seek clarity from Serum Institute of India and Bharat Biotech regarding their weekly schedule of supplies, production capacity, etc. This will help India to know the amount of vaccine shortage and plan India’s future procurements.
  4. Signing business deals with foreign manufacturers: India can also sign agreements with global vaccine manufacturers like Pfizer, Moderna, etc.  The government can include prior purchase agreements to strike a better and lower price in vaccine procurements.

  Way forward

  In conclusion, the government not only needs to focus on vaccine procurement. But also has to focus on monitoring the progress of domestic and foreign vaccines, tracking adverse events of vaccination, reviewing the performance of vaccine and sharing it with people to ensure public confidence. Further, it will also make India a step closer to Universal vaccination.

   

  Types of Vaccines: mRNA vaccines: It is a new type of vaccine to protect against infectious diseases. It does not use the conventional model to produce an immune response. mRNA vaccine carries the molecular instructions to make the protein in the body through a synthetic RNA of the virus. The host body uses this to produce the viral protein that is recognized and thereby making the body mount an immune response against the disease. Adeno Virus vaccines: In this type, a modified version of adenovirus is used. The virus can enter human cells but not replicate inside. A gene for the coronavirus vaccine was added into the adenovirus DNA, allowing the vaccine to target the spike proteins that SARS-CoV-2 uses to enter human cells. Inactivated SARS-CoV-2 vaccine: In this type, an inactivated live virus is used to create an immune response against the disease.

   

• “Global Health Summit 2021” adopted “Rome Declaration”

  Contents

  • 1
  • 2 What is the News?
  • 3 About Global Health Summit 2021:
  • 4 Rome Declaration:
  • 5 Key Features of the Rome Declaration:

  What is the News?

  The Virtual Global Health Summit 2021 is being held in Rome, Italy.

  About Global Health Summit 2021:

  • Global Health Summit was organised by Italy in its role as president of the G20 in partnership with the European Commission.
  • Purpose: The summit seeks to empower and enable stakeholders to address the challenges in the third sustainable development goal(SDG) of Health and Wellbeing for all.

  Rome Declaration:

  • The Rome Declaration was adopted at the Global Health Summit 2021.
  • Principles: The declaration is made up of 16 mutually agreed principles. These principles aim at guiding joint action to prevent future health crises and to build a safer, fairer and more equitable and sustainable world.

  Key Features of the Rome Declaration:

  • Firstly, to support and enhance the existing multilateral health architecture.
  • Secondly, to promote the multilateral trading system and global supply chains related to Health emergencies,
  • Thirdly, to enable equitable, affordable, timely global access to high-quality, safe, effective prevention, detection and response tools.
  • Fourthly, to support low and middle-income countries to build expertise and develop local and regional manufacturing capacities for tools.
  • Fifthly, to facilitate data sharing, capacity building, licensing agreements among stakeholders. Further, it aims to facilitate voluntary technology and know-how transfers on mutually agreed terms.
  • Sixthly, to invest in the worldwide health and care workforce
  • Seventhly, to increase the effectiveness of preparedness and response measures by promoting inclusive dialogue with local communities,
  • Lastly, to seek to ensure the effectiveness of financing mechanisms.

  Source: WHO

   

• ” Kyasanur Forest Disease” – ICMR-NIV Develops a New Point-of-Care Testing

  Contents

  • 1 What is the News?
  • 2 About Point-of-Care Test:
  • 3 Significance of Point of Care Test:
  • 4 About Kyasanur Forest disease:

  What is the News?

  A new point-of-care test has been developed for the rapid diagnosis of Kyasanur Forest Disease (KFD).

  About Point-of-Care Test:

  • Firstly, the Point-of-Care Test has been developed by the Indian Council of Medical Research (ICMR)-National Institute of Virology.
  • Secondly, the test kit includes a battery-operated Polymerase Chain Reaction (PCR). The analyser is portable and lightweight. The kit also has a universal cartridge-based sample pre-treatment kit and nucleic acid extraction device that aid in sample processing at the point of care.

  Significance of Point of Care Test:

  • The Point of Care tests would be beneficial for the diagnosis of KFD. It is because the outbreaks mainly happen in remote areas where there is a lack of well-equipped sample handling and laboratory testing facilities.
  • The test kit would also be useful in quick patient management and controlling the further spread of the virus.

  About Kyasanur Forest disease:

  • Firstly, the Kyasanur Forest disease is caused by a Kyasanur Forest disease virus. The disease primarily affects humans and monkeys.
  • Secondly, India: The disease was first identified in the Kyasanur forest of Shimoga district in Karnataka during an investigation of monkey mortalities in 1957.
  • Thirdly, Symptoms: The disease is characterized by chills, frontal headache, body ache, and high fever for five to 12 days with a case fatality rate of 3 to 5%.
  • Fourthly, Transmission:
    • Rodents, shrews, and monkeys are common hosts for KFDV after being bitten by an infected tick.
    • Transmission to humans may occur after a tick bite or contact with an infected animal, most importantly a sick or recently dead monkey.
  • Fifthly, Diagnosis: Diagnosis can be made in the early stage of illness. It can be done by molecular detection by PCR or virus isolation from blood.
  • Sixthly, Treatment: There is no specific treatment for KFD. A vaccine (Formalin inactivated KFDV vaccine) does exist for KFD and is used in endemic areas of India.

  Source: Indian Express

   

• Public Expenditure on Health Needs to be Reprioritised

  Synopsis:  Stimulating Economic growth and Mass vaccination are key to overcome the pandemic-induced economic crisis in India. Increasing public expenditure on health can help India recover from the economic crisis.

  Background

  • A nominal growth of 14.4% was assumed in the Union Budget. However, because of a prolonged lockdown, India will witness a fall in the nominal GDP numbers assumed in the Budget.
  • A reduction in nominal GDP numbers will lead to a lowering of tax and non-tax revenues. Whereas an increase in the fiscal deficit as compared to the budgeted magnitudes.
  • Hence, the fiscal projections of Centre’s 2021-22 Budget require recalibration. Further, the center needs to reprioritize expenditures.
  • The allocation for the health sector should be increased substantially by reprioritizing expenditures.

  Why the allocation for the health sector should be increased?

  • Firstly, need to strengthen the health care infrastructure in the country.
    • The second wave of the Covid19 has exposed India’s serious under-capacity in health infrastructure.
    • Given the possibility of a third COVID-19 wave, there is an urgent need to increase the health and related infrastructure. Such as the number of hospitals and hospital beds, sources of oxygen supplies, and the manufacture of COVID-19 vaccines and drugs.
  • Secondly, inadequate budgeting for health care.
    • Centre’s 2021-22 Budget for the Department of Health and Family Welfare is ₹7,597 crore less than the 2020-21 budget for Department of Health and Family Welfare.
    • The budget 2021-22 for health care is quite inadequate for an economy challenged by COVID-19 for two successive years.
    • Hence, the allocation for the health sector needs to be increased substantially by reprioritising expenditures.
  • Thirdly, investment in health care will have a multiplier effect on the economy. For example, Construction activities within the health sector will have high multipliers. Will benefit vulnerable groups of the society including migrant labour and the rural and urban unemployed
  • Fourthly, Speedy and larger vaccination coverage of the vulnerable population is key to minimise economic damage.

  Why Centre government should procure vaccines?

  • One, COVID-19 vaccination is characterised by strong inter-State positive externalities. This makes it primarily the responsibility of the central government.
  • Two, if the center becomes the sole agency for vaccine procurement, the economies of scale and the Centre’s bargaining power would keep the average vaccine price low.
  • Three, some smaller States may find procuring vaccines through a global tender a quite challenging.

  The Centre has had allocated ₹35,000 crore for vaccination as an amount to be transferred to the States. Rather than transferring the money to states, the central government should transfer the vaccines by acting as a single procurement agency for India.

  Source: The Hindu

• Voluntary Licensing Mechanism for Vaccines Will Ensure Social Justice

  Synopsis: Other alternatives available to boost Vaccine supply are less effective. But Voluntary licensing Mechanism for Covid 19 vaccines will lead to affordable and accessible vaccines.

  Contents

  • 1  Background
  • 2 How voluntary licensing can make medical drugs affordable?
  • 3 What are the issues in other alternative mechanisms?
  • 4 Way forward

   Background

  • Affordable vaccination is the key to achieve global herd immunity and to prevent new strains of COVID-19.
  • To make vaccines affordable there are multiple arrangements globally. Such as
    • Voluntarily licensing: Manufacturers can place their licensing agreements for which they owned patent rights in the UN-affiliated Medicines Patent Pool.
    • Compulsory licensing: Through TRIPS Waiver on Patent rights, for Covid-19 vaccines under WTO TRIPS agreement.
    • COVAX Program: It was established to purchase vaccine doses and donate them to low-income countries but does not involve modifying patent rights
    • WHO’s COVID-19 Technology Access Pool: a patent-sharing pool for Covid-19 products.
  • However, a voluntary licensing mechanism will be more effective in achieving the target of affordable and universal vaccination. Further, it has been successfully demonstrated in making AIDS drugs more affordable.

  How voluntary licensing can make medical drugs affordable?

  • The case study of AIDS drugs can better explain how voluntary licensing can make medical drugs/ vaccines more affordable.
  • During the 1990s, the WTO started implementing a global intellectual property regime known as the Trade-Related Aspects of Intellectual Property Rights agreement (TRIPS).
  • After that, there was anti-TRIPS activism around the globe due to fear of price rise of essential medicines because of the TRIPS agreement.
  • Responding to anti-TRIPS activism from low-income countries, some manufacturers who owned patent rights to produce AIDS drugs placed their licensing agreements in the UN-affiliated Medicines Patent Pool.
  • This allowed Several India-based companies to use the voluntary licences to manufacture these drugs on a massive scale and sell them at prices they determine.
  • This effort brought down the price of key AIDS medications in low-income countries. For instance, tenofovir, the first-line treatment for HIV/AIDS, has come down in price from $200-$500 per person per year to $39 per person per year in low-income countries.

  What are the issues in other alternative mechanisms?

  1. First, the Voluntary licensing mechanism will reduce the cost and time taken to manufacture vaccines compared to producing vaccines through a ‘Compulsory licensing agreement’.
     • Voluntary licensing enables goodwill among Patent right holding companies and general manufacturers.
     • It will enable easy flow of “technology transfer” thereby reducing the cost and time taken to manufacture vaccines.
       • About Compulsory licensing:
       • Compulsory licenses is a mechanism to override patent rights. It allows local production or import of drugs by generic manufacturers in the event of a public health crisis.
       • This right has been enshrined in the Doha Declaration addendum to the WTO’s TRIPS agreement.
       • This is what India and South Africa are lobbying for in the WTO, having recently been joined by the United States.
  2. Second, COVAX Programme faces the issue of underfunding. Also, Similar attempts like COVAX Programme during the AIDS crisis were chronically underfunded and had only minor effects on that pandemic compared to the voluntary licensing.
  3. Third, the WHO’s COVID-19 Technology Access Pool too faces issues similar to COVAX Programme. For instance, no patent holders have joined this effort. This is the reason why India and South Africa called on the WTO to temporarily waive patent protections for COVID-19.

  Way forward

  • Patents are not absolute ownership rights. They are a temporary contract that balances the public interest with the claims of the innovator.
  • Further, billions of dollars are spent through public money to develop COVID-19 vaccines.
  • Considering the above facts, patent owners should enable the mass production of affordable vaccines by granting voluntary licensing for Covid-19 vaccines.

  Source: The Hindu

  ---

   

  What is Compulsory Licensing?

• Why IITs Demand for Priority Vaccination is not Justified?

  Synopsis:  IITs are demanding priority vaccination. Their demand for vaccinating their staff and students against Covid-19 on a  should not be encouraged.

  Background

  • In a recent meeting with the Union education minister, the IIT directors have demanded for vaccinating their staff and students against Covid on a priority basis, so that they can resume classes.

  Why IIT’s demands should not be encouraged?

  • First, no person’s right to life is bigger than other persons. Though IITs are largely residential institutions, there are many other similar institutions. The risk of community infection is the same for all.
  • Second, IITs cannot demand priority on grounds of the nature of their work. They are not a frontline sector. Also, equally, everyone’s work is essential for the functioning and well-being of the community.
  • Third, to grant priority to a single interest group would open the floodgates to more such demands. With India facing a shortage of vaccines, such demands will reduce our vaccine distribution to complete chaos.
  • Fourth, vaccination is not a private but a public good. Vaccination protects not only the individual receiving it but everybody around them. India can be Pandemic free only when every individual is safe from the threat of the virus.
  • Fifth, it will deepen the endemic divisions of our society. For instance, distribution and administration of Covid vaccines are already heavily skewed in favour of the urban over the rural, the affluent over the poor, the digitally-enabled over the digitally-deprived. Any decision to promote subgroup interest will widen this gap further.

  IITs need to employ their combined expertise and authority more effectively to guide the nation’s struggle against Covid to general benefit, thus lessening the need for sectarian demands.

  Source: Indian Express

• Issues and Significance of Longer Vaccine Gaps

  Synopsis: Recently, the government introduced longer vaccine gaps for few reasons. But it fails to take other things into account.

  Contents

  • 1 Introduction:
  • 2 Two underlying principles behind longer vaccine gaps:
  • 3 Challenges with longer vaccine gaps:
  • 4 Way forward:

  Introduction:

  Recently the Indian government recommended a higher interval between two doses of the Covishield vaccine. Apart from that, the government also introduced few other changes. Such as,

  • Encouraging lactating women to take vaccines
  • 3-month waiting period before taking vaccines for the Covid-19 recovered persons (earlier it was four to eight weeks).
  • If the person gets Covid-19 infections after the first dose, s/he also needs to go through a three-month waiting period before taking the second dose of Covid-19 vaccine.
  • Increasing the vaccine gap between two doses from 12-16 weeks for Covishield.

  Two underlying principles behind longer vaccine gaps:

  1. To tackle the shortage in the vaccine:
     • Prior to second-wave, the government focussed on vaccinating vulnerable sections and frontline workers.
     • But during the second wave, the government allowed vaccine manufacturers to ‘free up’ vaccine supply. Under this, they can sell only 50% to Center and the rest on their own. But this policy did not improve access to all citizens.
     • So, the government introduced the higher vaccine gap.
  2. Best timing of the second dose for an optimal boost to the immune system:
     • Clinical trials of the AstraZeneca vaccine in the UK (18-55 years) showed that the binding antibodies (the ones that actually block viruses) were nearly twice high for persons who got their vaccine shots after 12 or more weeks.
     • Further, the vaccine also appeared to be more protective for persons above 18 with a longer dose interval.

  Challenges with longer vaccine gaps:

  A general policy for childhood vaccines in India is 4 to 8-week intervals. So, the 12-16 week difference is not a general one. Further, it also has many concerns. Such as,

  • Antibody levels are one of the key markers of protection. But, they are not the only ones. Cell-based immunity (immune system confers long-lived immunity) is not considered in scientific studies.
  • Duration of protection: At present, there is huge uncertainty about the duration of protection given by vaccines. For example, there are many pieces of evidence that exist for breakthrough infections and Covid-19 related deaths even after the second dose of vaccination. So, only more vaccination will provide greater clarity on the degree of protection.

  Way forward:

  The death tolls from India’s second wave continue to surpass similar daily figures from the U.S. and Brazil. Further, the policymakers have to remember that many Indians have still not been exposed to the virus and newer threatening variants are on the line.

  So the government has to aim for universal vaccination to prevent disease spread and death toll. The government has to accelerate vaccination drives and policy recommendations geared towards that goal.

  Source: The Hindu

• Pradhan Mantri Swasthya Suraksha Yojana

  What is the News? The Government of India has approved the setting up of 22 new regional AIIMS (All India Institute of Medical Sciences) under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) so far.

  About Pradhan Mantri Swasthya Suraksha Yojana(PMSSY):

  • Type: Central Sector Scheme
  • Nodal Ministry: The scheme was announced in 2003 by the Ministry of Health and Family Welfare.
  • Objective: To correct regional imbalances in the availability of affordable/reliable tertiary healthcare services. Moreover, It will also augment facilities for quality medical education in the country.
  • Components: The scheme has two components:
    • Setting up of new AIIMS-like Institutions and
    • Up-gradation of existing Government Medical Colleges /Institutions in a phased manner.

  Total AIIMS established: Total of 22 new AIIMS have been announced so far under this component:-

  • 6 AIIMS are already functional at Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur, and Rishikesh.
  • 16 more AIIMS are approved by the Cabinet. Among them, 7 AIIMS, have started OPD facility and MBBS classes while in 5 AIIMS only MBBS classes have started.

  Significance of the Scheme:

  • Setting up new AIIMS would not only transform health education and training. It will also address the shortfall of health care professionals in the region.
  • Further, their contribution becomes significant because they will serve areas where the health infrastructure is weak.

  Source: PIB

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  Central Government Schemes News

• What is “White Fungus” and How Dangerous is it?

  What is the News? New Cases of White Fungus from Covid-19 patients have been reported in states such as Bihar and others.

   About White Fungus:

  • White Fungus is also known as Candidiasis. It is a type of fungal infection caused by a yeast (a type of fungus) called Candida.
  • Candida normally lives on the skin and inside the body in places such as the mouth, throat, gut without causing any problems.
    • However, candida can cause infections if it grows out of control or if it enters deep into the body (for example, the bloodstream or internal organs like the kidney, heart, or brain).
  • Symptoms: Symptoms of white fungus vary depending on the area affected. Most infections result in minimal complications such as redness, itching, and discomfort. However, complications may be severe or even fatal if left untreated in certain populations.
  • Vulnerable Group: People with low immunity, pre-existing medical issues, people with diabetes, and people on or using steroids are at a high risk of contracting the infection.
    • COVID-19 patients on oxygen support can inhale these fungal spores if their ventilators and oxygen support equipment is not sanitised properly.
    • Risk is also increased by overuse of steroids and usage of tap water in the humidifier of oxygen cylinders.
  • Prevention:
    • Patients who are on oxygen or ventilators should be taken care of in terms of hygiene.
    • The tubes and equipment should be thoroughly cleaned. Only sterilized water should be used in oxygen cylinder humidifiers.
  • Treatment: It is not life-threatening. The treatment of White Fungus disease is mainly done through antifungal medicines. However, this changes if a person contracts severe disease and lungs are infected.

  Read about – Black Fungus

  Source: Indian Express

   

• Biomedical Waste Management during pandemic – Explained, Pointwise

  Contents

  • 1 Introduction
  • 2 Biomedical waste generation during the pandemic
  • 3 What is biomedical waste?
  • 4 Biomedical waste management rules in India
  • 5 Biomedical waste management practice in India
  • 6 Effects of biomedical waste in India
  • 7 Suggestions to improve biomedical waste management
  • 8 Conclusion

  Introduction

  Prior to the pandemic, India’s biomedical waste management capacity was already limited. Now, with the advent of the pandemic, biomedical waste generation has increased manifold. CPCB has given guidelines to discard the biomedical waste generated in Covid-19 camps and Covid-related material such as gloves and masks in households. However, the implementation of the guidelines is limited as local bodies are not equipped to handle biomedical waste, and even the public doesn’t have enough knowledge about segregating it. All this is leading to the piling up of biomedical waste.

  According to the environment ministry, nearly 146 tonnes of biomedical waste is generated per day in the country due to diagnostic activities and treatment of Covid-19 patients. Since India is fighting with the second wave of Covid-19 and still producing and using numerous masks, Personal Protection Equipments, etc. the medical waste generation is going to increase further. So, India needs practical solutions to tackle this silent menace created by the pandemic.

  Biomedical waste generation during the pandemic

  1. According to the Indian Medical Association (IMA), the quantity of Biomedical wastes generated per day in the country has almost doubled from 7.22 lakh kg in pre-Covid times to nearly 14 lakh kg now. This rise in waste generation is directly related to the number of Covid-19 cases in the country.
  2. The IMA also noted that the per-bed Biomedical waste generation was 250 grams per day before the pandemic. But today, per-bed Biomedical waste generation is around 400 grams per day.
  3. The majority of biomedical waste generated during the pandemic is related to Covid-19 treatment. Such as personal protective equipment (PPE), gloves, face masks, head cover, plastic coverall, hazmat suit, syringes, and other medical equipment used by both healthcare providers and patients.
  4. According to scientists, these biomedical wastes will take thousands of years to biodegrade. During the process, they will also release tonnes of microplastics into our environment.

  To tackle this menace the CPCB even launched a COVID19BWM App to track biomedical waste.

  What is biomedical waste?

  In simple terms, it means any waste generated during diagnosis, treatment, or immunization of human beings or animals or in research activities. Management of biomedical waste is an integral part of infection control and hygiene programs. Without proper treatment, these medical wastes can create an adverse impact on the environment and public health.

  Only about 10% – 25% of BMW is hazardous, and the remaining 75%–95% is non-hazardous. So, the segregation of biomedical waste is the key to its management.

  Biomedical waste management rules in India

  In July 1998 the government of India notified the biomedical waste management rules. There was modification of rules in 2000, 2003, and 2011. But the 2011 medical waste management rules remained as a draft due to a lack of consensus on categorization and standards.

  After the consensus and standardization, the Indian government released Biomedical Waste Management rules in 2016. The salient features of this rule are,

  1. Expansion of the ambit: The scope of the rules have been expanded to include various health camps such as vaccination camps, blood donation camps, and surgical camps
  2. Role of State governments: The State Government has to provide land for setting up a common biomedical waste treatment and disposal facility (CBMWTF). Apart from that, the State government will also have to set up a district-level committee (This committee shall submit its report to the State Pollution Control Board every 6 months).
  3. Segregation: Biomedical waste has been classified into 4 categories instead of the earlier 10 categories. This is to improve the segregation of waste at the source.
     • Yellow – This includes post-operated body parts, caps, masks, pathological wastes, bedding, placenta, plaster of Paris, etc
     • Red – This includes syringe, IV Sets, catheters, gloves, urine bags, blood bags, dialysis kits, etc
     • White – This category contains waste sharps including needles, syringes, etc.
     • Blue – This category contains glassware and metallic body implants
  4. Role of health care facilities: The health care facilities have a larger role in medical waste management. Such as,
     • Compulsory pretreatment of the laboratory, microbiological waste, and blood bags before disposal
     •  Phasing out chlorinated plastic bags, gloves, blood bags, etc
     • Maintaining a registry of biomedical wastes generated in their facility and updating them daily.

  Biomedical waste management practice in India

  1. The management of Biomedical wastes begins at the bedside of the patient. The hospitals categorize, segregate, pre-treat, and dispose of the medical waste in different containers.
  2. As per the 2016 rules, these wastes have to be treated and disposed of by Common Bio-medical Waste Treatment and Disposal Facility (CBWTF).
  3. In case, there is no CBWTF within the reach of a healthcare facility, then such healthcare facility should install a captive treatment and disposal facility.

  According to the government data, India had 200 authorized CBWTFs in 28 States in 2020 for the environmentally safe disposal of biomedical waste. The remaining states do not have such facilities.

  As per official government data for 2018, India generated 608 tonnes per day of Bio-medical Waste. Of that, 528 tonnes of waste was treated and disposed of properly. So, every day there are few tonnes of biomedical waste that went untreated. The impact of Covid-19 also affects the waste handling capacity of CBWTF and captive treatment centers.

  Effects of biomedical waste in India

  Pollution and health hazards are the two important impacts of medical wastes.

  Pollution due to biomedical waste

  1. Land Pollution: If not treated and dumped into landfills then there is a high chance for heavy metals like cadmium, lead, mercury, etc. get released. Further, there is a chance these metals get absorbed by plants and can then enter the food chain also.
  2. Air Pollution: Pathogens present in the waste can enter and remain in the air for a long period in the form of spores or pathogens. As the Covid-19 spread through the air, improper treating/not treating it might lead to a new wave of Covid-19.
  3. Radioactive pollution: Hospitals are increasingly using radioactive isotopes for diagnostic and therapeutic applications. The main radioisotopes used in hospitals are technetium-99m (Tc-99m), Iodine-131(I-131), etc. This radioactive material can come from research laboratories, ICUs in liquid form. These have carcinogenic properties.

  Health hazards due to biomedical waste

  1. Spread of infectious diseases: According to the WHO study, improper waste management is one of the major causes of an increase in infectious diseases globally. This is why the Covid-19 pandemic wastes require proper treatment.
  2. Operational health hazards: Improper handling of biomedical waste might lead to Injuries from sharps and exposure to harmful radioactive wastes. This will create issues for nurses, emergency medical personnel, sanitary workers.
  3. Increase antimicrobial resistance (AMR): The biomedical wastes aggravate the problem of AMR. Ever since the pandemic, the use of biocides (sanitizers, disinfectants, and antibiotics) increased manifold. If there is no proper treatment of biocides then the AMR will increase rapidly.

  Suggestions to improve biomedical waste management

  1. Improving the sustainability of the health care sector: The government has to move beyond monitoring and enforcement. Instead, the government has to invest along with the health service providers to scale up the proper treatment of biomedical waste.
  2. Equipping Municipalities and Panchayats: The government has to provide training to ground-level workers to segregate biomedical wastes. Further, the government can even allot sufficient funds through central funding from National Rural Health Mission (NRHM).
  3. Stringent actions against defaulters: The ill-operated health care facilities and CBWTFs have to be strictly punished. The government can even initiate the Extended Producer Responsibility (EPR) for producers of biomedical equipment.
  4. Trigger Innovation: The government can incentivise start-ups and Small and Medium Enterprises (SMEs) that offer solutions for waste segregation and treatment.
  5. Awareness campaigns for waste segregation in households: Due to home quarantine and home treatment many individuals do not use yellow and red color bags for segregating their medical wastes. So, during the supply of medicine, the health officials have to create awareness about waste segregation. They should also provide garbage bags(Red and Yellow) along with their medicines.

  Conclusion

  With the opening-up of vaccination for all above 18 years, the volume of infectious waste generated from the vaccination clinics will increase manifold. So, the government has to ensure proper awareness regarding waste segregation, and  creation of proper facilities to treat the medical waste in India.

• Government Advisory on Aerosol and Droplet Transmission of Covid-19

  What is the News?

  The government of India has issued an updated general advisory on Covid-19. It has warned that the SARS-CoV-2 virus can be transported through Droplets as well as in the form of Aerosols. It can infect people up to 10 meters away.

  Covid-19 Transmission: The different modes of transmission of the Covid-19 virus has been the subject of intense discussion since the start of the pandemic.

  Droplets Transmission: Initially, the suggestion was that the virus spreads predominantly through Droplets.

  • Droplets are large mucus or saliva particles heavier than air that fall toward the ground as soon as they’re expelled.
  • Droplet transmission typically occurs when a droplet containing a virus comes in contact with another person’s eyes, nose, or mouth.
  • These droplets, because of their large size, travel only short distances before falling on the ground. A person 6 feet (2 meters) away is considered safe from infection.

  Aerosol Transmission: Recently, scientists have been finding increasing evidence of the Covid virus traveling through aerosols as well:

  • An aerosol is a suspension of fine solid particles or liquid droplets in the air.
  • Aerosols can be natural or anthropogenic. Examples of natural aerosols are fog or mist, dust, forest exudates, and geyser steam. Examples of anthropogenic aerosols are particulate air pollutants and smoke.
  • Since aerosols are relatively light. They can carry the virus to much larger distances up to ten meters.
  • Moreover, aerosols can remain suspended in the air for several minutes or even hours. Thereby it greatly increases the chance of infecting a nearby person.

  Government Advisory:

  • The Government advisory asks people to keep their indoor spaces well-ventilated by keeping doors and windows open and using exhaust systems.
  • It stresses that the infection transmission risk was much lower in outdoor areas since there is easy dispersion of virus particles.
  • Moreover, it advises introducing outdoor air in offices, homes, and larger public spaces and measures to improve ventilation in these spaces. Advisory is the same for both urban and rural areas to curtail the spread of the disease.

  Source: The Hindu

• India Needs an Effective Vaccine Policy

  Synopsis: The surge in Covid-19 cases coupled with a limited supply of vaccines warrants the adoption of an effective vaccine policy by the country. The policy should prioritize groups, address hesitancy and formulate a more equitable distribution plan.

  Background:

  • The second wave of Covid-19 has shown that the virus is not going away in a short time. It may strike the country multiple times in the coming years.
  • In this scenario, the best possible way is to vaccinate the population in order to build effective immunity against the virus and reduce the death tolls. However, there are multiple concerns that demand changes to make vaccination policy effective. 

  Concerns regarding vaccine policy:

  • Limited Supply of Vaccines: The country is facing a shortage of vaccines due to production constraints and import resistances.
    • Technicalities of vaccine production make it likely that indigenous manufacturers will require 3 to 6 months to increase capacity significantly. 
      • For instance, the novel mRNA vaccine candidate (HGCO19) can’t be developed by Gennova Biopharmaceuticals Ltd. without support from HDT Biotech corporation, U.S.
    • Similarly, the enhancement of the import of vaccines can take place only after August 2021. It is when wealthy nations would have made substantial progress in the immunization of their populations.
  • Vaccine Hesitancy: People are showing unwillingness to vaccinate themselves as they doubt the efficacy of vaccines. 
    • One of the reasons is the halt in the use of the AstraZeneca vaccine (Covishield) by some countries due to concerns over blood clots, etc. It contributed to doubts about the safety of vaccines in India.
  • Target Groups: The limited supply has created a challenge of choosing amongst the multiple groups for vaccination. India needs to choose between the most vulnerable (elders, comorbidities patients) and the most valuable (working population). The former will reduce the death toll and the latter would be more beneficial for economic revival.
  • Distribution Concerns: The current policy has allowed vaccination for all adults however it does not tell the order of distribution. 
    • The state governments are now compelled to bear all the costs of vaccination. This may give an advantage to wealthier states over poor states.
    • Further, it allows market forces to decide on vaccine access for a substantial part of the population and calls for using technology (Co win portal) to get vaccinated. 
    • This has allowed the least vulnerable to get vaccinated early as they possess more resources.

  Way Forward:

  • The central government should pioneer in both – enhancing the supply and formulating a policy to ensure equitable access to vaccines.
    • It should avoid transferring expenses to State governments and shouldn’t allow the private sector to decide vaccine access.
  • The country should take the help of behavioral scientists to combat vaccine hesitancy and ensure that the population is vaccinated.
  • The target groups must be selected on the basis of vulnerability. However, if this is impractical, then some combination of the vulnerable and working population should be chosen. This should be worked out using data and the basis of the decision should be made public.

  Source: The Hindu  

• “Black Fungus” or Mucormycosis Declared an Epidemic by Rajasthan

  Contents

  • 1
  • 2 What is the News?
  • 3 What is Mucormycosis?
  • 4 What is Epidemic, Pandemic, and Endemic?

  What is the News?

  The Rajasthan government has declared Mucormycosis or black fungus as an epidemic and a notifiable disease.

  What is Mucormycosis?

  • Firstly, Mucormycosis or Black Fungus is a rare fungal infection. A group of molds called mucormycetes is the reason behind it, which is abundant in the environment.
  • Secondly, Transmission: It occurs through inhalation, inoculation, or ingestion of fungal spores from the environment. However, it does not spread between people or between people and animals.
  • Thirdly, Symptoms: Mucormycosis can affect different parts of the body, with different sets of symptoms. Some common symptoms are face numbness, nose obstructions on one side, swelling in the eyes, or pain.
  • Fourthly, Vulnerable People: It mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness.
  • Fifthly, Treatment: The infection is often treated with antifungal medicine, usually amphotericin B. However, the patients may eventually require surgery.

  What is Epidemic, Pandemic, and Endemic?

  • Epidemic is a disease that affects a large number of people within a community, population, or region.
  • Pandemic is an epidemic that’s spread over multiple countries or continents.
  • Endemic is something that belongs to a particular people or country.

  What is Notifiable Disease?

  • Notifiable Disease is any disease that the law requires to report to government authorities.
  • This will allow authorities to gather information to monitor the disease, and provides early warning of possible outbreaks.
  • The process will also help the government to keep track and formulate a plan for elimination and control. In less infectious conditions, it improves information about the burden and distribution of disease.
  • The Government of India has notified several diseases as Notifiable such as cholera, diphtheria, encephalitis, leprosy, meningitis, pertussis (whooping cough), plague, tuberculosis, AIDS, hepatitis, measles among others.

  Source: The Hindu

   

• Measures to Prevent Future Waves of Pandemic Disaster

  Synopsis: India needs to enhance its surveillance system, vaccinate its population, and reprioritise healthcare services. It will prevent future waves of pandemics.

  What measures should be taken to prevent future waves of pandemic disaster?

  • First, we need inputs of a strong surveillance system to identify or predict future waves. Identifying upcoming waves is very important in mitigating a catastrophe. The current disaster is mainly because of our failure to predict waves due to unreliable testing and under-reporting of cases and deaths. Hence, we need to improve on the following,
    • The Central and State government should use real-time data by encouraging reliable reporting and initiating standardised definitions.
    • There is a needs to strengthen review mechanisms. It will detect the outbreak in the initial stages and extinguish it before the pandemic spreads to other areas.
    • Simultaneously, genomic sequencing in real-time in the fixed proportion of samples needs to be prioritized. It will identify the Mutant variants causing outbreaks.
  • Second, ramping up vaccination manufacturing to ensure universal vaccination for all not only in India but globally. India has a proven capacity to scale up testing facilities within a short period of time. Thus,
    • The Central government should invite foreign manufacturing firms to collaborate with Indian firms under the ‘Make in India’ Programme’.
    • Fast-tracking the manufacture of all vaccines that has been approved for use by various regulatory authorities through a single-window clearance.
  • Third, since 2009, WHO had declared six public health emergencies of international concern. India cannot always rely on reactive systems for each pandemic. Hence, India needs to plan for preventing and managing pandemics in the future. Future plan should focus on,
    • Nearly 60% of known infectious diseases and up to 75% of new or emerging infectious diseases are zoonotic in origin. Adopting the ‘One Health’ agenda can prevent future pandemics. Because it ensures that environmental health and animal health are given similar priority as human health.
    • Greater financial allocations, increasing vaccination capacity, applied research, enhancing effective communication, and monitoring effectiveness will strengthen India’s role in the future for preventing and managing pandemics.
  • Finally, need to build a robust public health workforce to provide efficient public health responses.
    • Front-line workers play an indispensable part in surveillance, contract-tracing, and mobilising people for primary healthcare services, including vaccination. Hence, we need to ensure that one Accredited Social Health Activist (ASHA) worker is hired for every 1,000 people. Further, an Auxiliary Nurse Midwife (ANM) and nurse practitioner are hired for every 5,000 people.
    • To provide access to critical care capacity for all, we need to ensure at least one hospital with 100 beds. It should include beds with emergency and critical care services that caters to a population of 30,000-50,000.

  Source: The Hindu

• Role of ICMR in Facilitating Evidence-based Treatment

  Synopsis: ICMR must assess evidence and provide specific recommendation on treatment. An Evidence-based Treatment will build public trust in the health care system.

  Background

  • Drugs and therapies are being used for the Covid-19 treatment, without clear evidence. For instance, convalescent plasma therapy (CPT), Hydroxychloroquine, and the anti-parasitic drug, ivermectin.
  • Evidence-based ICMR guidelines can control this issue effectively.

   The case for non-evidence-based treatment: The Use of convalescent plasma therapy (CPT)

  1. Last year, the ICMR, based on its clinical trial results, demonstrated that CPT neither saves lives nor improves the patient’s condition. However, ICMR was ineffective in informing the public about the issue. This led to the widespread use of CPT in many states.
  2. In a recent statement, the ICMR recommended that the use of CPT  is advisable only in early moderate disease, or within seven days of symptoms.
  3. Finally, in its latest guidelines, The Indian Council of Medical Research (ICMR) has finally dropped its recommendation on use of convalescent plasma therapy (CPT) as treatment for moderate COVID-19.
  4. This comes after the results published by The Lancet. It found no effect of the use of CPT.
  5. Further, evidence is emerging that CPT may be contributing to the evolution of coronavirus mutations.

  What needs to be done?

  • Not only CPT, but many drugs such as Hydroxychloroquine and ivermectin also, continue to find a place for the treatment of mild disease. It is also despite a specific mention of “low certainty of evidence.
  • So, to avoid such situations in feature, the ICMR task force has to qualitatively assess evidence and be very specific with its recommendations.
  • Further, ICMR should publicize these guidelines at regular intervals to educate the public about the evolving nature of the treatment.
  • This will work better towards easing the pressure on doctors as well as in improving trust in systems

  Source: The Hindu

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  ICMR’s International Symposium on “One Health” in India

• Brain drain in the health sector – Explained, Pointwise

  Contents

  • 1 Introduction
  • 2 Status of brain drain in the health sector in India
  • 3 Reasons for brain drain in the health sector
    • 3.1 Push factors
    • 3.2 Pull factors
  • 4 Government measures to tackle the brain drain in the health sector
  • 5 Suggestions to reduce brain drain in the health sector
    • 5.1 National level practices:
    • 5.2 Global level changes
  • 6 Conclusion

  Introduction

  India is facing a health emergency due to Covid-19 Pandemic. At present, India is registering a little less than 3 lakh cases and more than 4,000 deaths in a day. Now, India is also undertaking one of the largest vaccination programs in the world. Management of this huge task would not have been possible without the contribution of health workers. The contribution of Indian health care workers amid the pandemic is extremely commendable.

  However, India is facing a shortage of health workers at this crucial point in time. The present workforce is overburdened with their work for more than a year. A part of this problem is due to a large-scale brain drain in the health sector. If India was able to retain its workforce, India’s health sector would have been in a better position now.

  Status of brain drain in the health sector in India

  As per government reports, India has 1.7 nurses per 1,000 population and a doctor to patient ratio of 1:1404. But both of these are well below the WHO norms. The WHO recommends three nurses per 1,000 population and a doctor to patient ratio of 1:1100. The distribution of doctors and nurses is also heavily skewed in favour of some regions. Higher concentration present in some urban pockets. Brain drain in the health sector is also the reason for this.

  • For several decades, India has been a major exporter of healthcare workers to developed nations. Indian health care workers are highly prevalent in the Gulf Cooperation Council (GCC) countries, Europe, and other English-speaking countries.
  • As per OECD data, around 69,000 Indian-trained doctors and  56,000 Indian-trained nurses worked in the UK, US, Canada, and Australia in 2017.
  • There is also a large-scale migration of health workers from India to the GCC countries. But there is no credible data available.
  • The British Association of Physicians of Indian Origin (BAPIO) estimates that the UK alone has more than 40,000 Indian doctors.

  According to the FICCI, The UK and the US are the top two destinations for foreign-trained doctors. Canada and Australia are other preferred destinations. Many developed and Gulf countries provide the red carpet for the best Indian doctors and nurses. India on the other hand not only facing challenges in retaining health professionals and also facing huge demand and supply gap in Doctors, nurses in rural areas.

  Reasons for brain drain in the health sector

  Like any migration trends, the migration of health professionals also has both push and pull factors.

  Push factors

  • Low Wages: Developed countries offer better wages compare to India. For example, nurses in India receive low wages in private sector outfits. Also, they have only less opportunity in the public sector(Low employment due to lower hospitals in the public sector). So, they generally migrate to developed countries that offer better wages.
  • Lack of government investment in health care: India’s health care investment to GDP ratio is just 1.2 per cent. This is the lowest figure if we compare spending by OECD and BRICS nations. This reduces better employment opportunities for health professionals.
  • Lack of health care educational Institutions: India only has around 550 institutions for MBBS education. So, Many Indian students prefer to study abroad due to high course fees, limited seats in government medical colleges, etc. Once they study abroad they prefer to pursue higher studies or practice abroad alone. China is attracting a lot of Indian students in this regard.
  • Other factors: This includes unethical practices of some Indian private hospitals, lack of government policy to protect the vulnerable is also a reason for a health care worker to move abroad.

  Pull factors

  • Access to advanced technology: Developed countries offer better opportunities to pursue research in health care. Health care professionals also get access to advance technology, research facilities and even get higher scholarship amounts for their research.
  • Better standard of living and life quality: Many developed and GCCs offer a higher salary, tax benefits, higher standard of living, etc. These act as a pull factor for Indian health care professionals.
  • Policies of developed countries: Developed countries adopted migrant-friendly policies towards health care professionals. For example, with the onset of the pandemic, there is a greater demand for healthcare workers across the world. The developed countries implemented various policies to retain health care employees. Such as,
    • OECD countries exempted travel bans for the health professionals with job offers.
    • Some countries processed visa applications of healthcare workers even during the lockdown period.
    • The UK has granted free one-year visa extensions to healthcare workers and their dependents
    • France has offered citizenship to frontline immigrant healthcare workers during the pandemic.

  Government measures to tackle the brain drain in the health sector

  The government introduced many schemes to retain the brain drain in the health sector. For example,

  • Stopped issuing NORI certificates: In 2014, India stopped issuing No Objection to Return to India (NORI) certificates to doctors migrating to the US. The US government requires a NORI certificate for doctors who seek to extend their stay beyond three years. As India stopped issuing these certificates, the Indian doctors will have to return to India after three years.
  • Inclusion of nurses in the Emigration Check Required (ECR) category: This policy requires nurses recruitment from other countries to be done only through the six state-related employment agencies. Further, this also makes it mandatory for the nurses to accept international contracts that are approved by the government. This increases the transparency in nursing recruitment and reduces the exploitation of nurses in the destination countries.

  But these policies fail to stop the brain drain from India and not focus on the long-term prevention of brain drain.

  Suggestions to reduce brain drain in the health sector

  National level practices:

  1. Adequate investment in the health sector: Indian Budget 2021 aims to increase the Health sector spending from 1.2 percent to 2.5 percent in three years. This will increase adequate health infrastructure, adequate employment opportunities, etc.
  2. Creating adequate health care institutions: The government has to allow private medical educational institutes to open up medical colleges along with capping the maximum fee per seat. Further, the government can ease land requirement norms for medical and nursing colleges and ease the teachers per students ratio for post-graduate medical courses.
  3. Bringing in cutting-edge technology labs: The government has to create more cutting-edge research facilities to bring back health care professionals to India. For example, About 20 NRI doctors from the US and Europe relocated to Kolkata to set up the West bank Hospital as it has high-tech equipment and facilities.
  4. The government also has to regulate any unethical practices, exploitation of nurses in private hospitals in India. The government can even incentives the whistleblowers of such malpractices by amending the whistleblowers’ Act.
  5. Engage in bilateral agreements: The government can sign bilateral agreements with countries like the US, the UK, Canada, Australia towards working on a policy of “brain-share”. For example, destination countries would be obliged to supply healthcare workers to India in times of need, crisis situations like a pandemic, etc.

  Global level changes

  1. Creating a code of conduct for ethical recruitment: The global countries have to come together and create a consensus code for ethically recruiting health care professionals. This will reduce the exploitation of health care worker abroad.
  2. Facilitating circular migration: Almost 37 percent of health care workers concentrated in North and South American countries. But they share only 10% of the global disease burden. On the other hand, countries in Africa and Asia share more disease burden and less health care worker presence. So, the world nations have to come together and facilitate circular migration of health care professionals in terms of crisis situations.

  Conclusion

  India needs systematic changes such as increased investment in health infrastructure,  ensuring decent pay to workers and building an overall environment to retain health care professionals. With the advent of the pandemic, India can import medical oxygen, import vaccine, but India cannot import health professionals. So, It is high time for Indian government to not only increase public spending but also increase the Doctor and nurses ratio and prevent brain drain in the health sector

• “SAMVEDNA Helpline”- Tele Counselling of Children Impacted by Covid-19

  Contents

  • 1
  • 2 What is the News?
  • 3 About SAMVEDNA:
  • 4 About National Commission for Protection of Child Rights(NCPCR)

  What is the News?

  Children impacted by the Covid-19 pandemic are being provided telecounseling through SAMVEDNA.

  About SAMVEDNA:

  • Firstly, SAMVEDNA stands for Sensitizing Action on Mental Health Vulnerability through Emotional Development and Necessary Acceptance.
  • Secondly, it is a toll-free helpline number that aims to provide psychological first-aid and emotional support to the COVID-19 affected children
  • Thirdly, the National Commission of Child Rights(NCPCR) provides the tele-counseling.
  • Fourthly, this tele-counselling service is available on a toll-free number 1800-121-2830. It is exclusive for children who are willing to talk and are in need of counselling.
  • Categories: Tele-counselling is provided to children under three categories:
    • children who are in quarantine/isolation/COVID care centres,
    • children who have COVID positive parents or family members and
    • Lastly, children who have lost their parents due to the pandemic.

  About National Commission for Protection of Child Rights(NCPCR)

  • NCPCR is a statutory body. It was established in 2007 under the Protection of Child Rights Act (CPCR), 2005.
  • Ministry: It is under the administrative control of the Ministry of Women & Child Development.
  • Mandate: It aims to ensure that all laws, policies, programmes and administrative mechanisms are in accordance with the child rights perspective as put forward in the Constitution of India and also the UN Convention on the Rights of the Child.

  Source: PIB

• Method to Estimate COVID-19 Deaths in India

  Synopsis: Instead, of calculating the ‘excess’ death at the national level, Excess death calculated at the District level will provide a more accurate estimation of COVID-19 deaths in India.

  Background

  • To understand the magnitude of the pandemic there is a need for estimating COVID-19 deaths globally and in India.
  • The most commonly used approach is the “excess” death approach. It is the difference between death in Normal years and deaths during the Covid-19 period.
  • Further, it includes deaths directly caused by COVID-19. It also includes deaths indirectly caused due to the lack of access to care for other diseases during the pandemic and the lockdown.
  • Based on the excess” death approach estimates have been released globally. However, India’s reported deaths contradict Global estimates.
  • At present India needs to rely on global estimates rather than India-specific data.
  • This is because of poor data availability for COVID-19 excess deaths, India has been classified in category 3 countries by WHO.
  • Category 3 constitutes countries where the data on deaths are not available or usable. Hence, they are forced to adopt an indirect approach of using data from other countries.
  • So, to have a reliable estimate for India on Covid deaths, India needs to calculate Excess death at the District level by analyzing the data from the Civil Registration System (CRS).

  What do the global estimates reveal about the Covid deaths?

  As far as now two estimates have been released globally.

  • One, the World Mortality Dataset. It is the largest international dataset of all-cause mortality in 89 countries. According to this dataset, researchers conclude that excess mortality exceeds the number of reported COVID-19 deaths in these countries by over 1.6 times.
  • Two, The Institute for Health Metrics and Evaluation (IHME). According to their findings, global COVID-19 deaths by May 3, 2021 is at 6.93 million. This is two times higher than the reported number of deaths of 3.24 million.
    • India accounted for about 10% of them at 6,54,395. This is about three times higher than the reported official figure.

  What needs to be done?

  India currently has only crude estimates based on the number of extra deaths reported as compared to previous years. To improve the accuracy of Covid death estimation, we need to do the following.

  • First, before estimating excess deaths a probable baseline should be defined. One can do it by estimating the mean and standard error based on data for the last five years to provide a probable range for a baseline.
  • Second, Civil Registration System (CRS) data of districts with an acceptable quality of registration should be analyzed to estimate the excess deaths in a given period.
    • There are enormous differences in the severity and timing of the epidemic. Therefore, the health system’s capacity within India combining data at higher levels is likely to lead to errors in estimation
  • Third, for districts that lack an acceptable quality of registration, we could use alternative approaches.
  • Finally, the long-term way out for India is to address the data limitations while academics work on refining their statistical approaches.

  Source: The Hindu

  Kerala Model to tackle the Covid-19 Pandemic in India

• No learning from the Spanish flu

  Synopsis: The governments of several countries have failed to understand and foresee human behaviour. This is even after they have witnessed a pandemic like the Spanish Flu in the past.

  Introduction 

  • The Spanish Flu of 1918 was the most severe pandemic in history. It lasted for 2 years, in 3 waves, with 500 million people infected and 50 million deaths. Most of the mortalities occurred in the 2nd wave. 
  • The people were fed up with the quarantine and social distancing measures. The people rejoiced in the streets as soon as the measures were lifted. After which the second wave occurred and claimed tens of millions of lives. 
  • According to James Harris, a historian at Ohio State University, the reason behind the spread of a second wave was that officials were reluctant to enforce restrictions during the war despite the presence of a new mutated strain.

  Why did the people not take lessons from the past?

  We haven’t learned from history to prevent millions of infections and deaths worldwide. 

  1. Firstly, Knowledge doesn’t change behavior. Having information about the Spanish flu is very different from having to live through a similar pandemic. For instance, being informed about the protectiveness of the masks doesn’t make people wear them. Similarly, knowing about social distancing doesn’t make people perform it.
  2. Secondly, in many countries, people were fed up with lockdowns, wearing masks, staying at home, and not socializing last year. Human beings are social animals. Social banishment has been proved to cause pain in the brain similar to putting up with physical pain.
  3. Thirdly, as soon as the number of cases began to decrease by the end of the first COVID-19 wave, governments and people across the globe started to let their guard down. Many businesses were allowed to restart. 
  4. For example, restaurants that were doubted to be one of the major centers for the spread of COVID-19 were given consent to open. Signs outside their doors read ‘No entry without a mask’, but visitors could remove their masks even while not eating once they were inside.
     • People could talk, laugh, sneeze, and cough in indoor non-ventilated spaces. These people knew about the threats of this behavior.  Some of them must have read about the Spanish flu. However, awareness and action often lie at opposing ends.

  Where did the governments go wrong?

  Everyone needs to contribute to breaking the chain of COVID-19 infections. However, the final duty of managing the pandemic cannot be on the people. It is the job of governments.

  • Governments of most nations failed to learn from the Spanish flu because they failed to realize and foresee human behavior. For instance, the government in India allowed election rallies and religious gatherings.
  • The government hesitated in imposing a lockdown despite the rise of new strains of the virus. Leaders were seen making speeches in crowds and conducting meetings without masks. 
  • Every politician wants to win over people and give them what they want. They declared victory prematurely and gave rise to policies that caused the second wave.

  The conclusion 

  • India had the opportunity to learn from the mistakes of other countries which opened up too soon after the first wave. But it didn’t. This has led to a huge rise in COVID-19 cases and deaths.
  • Overconfidence in the government’s ability to manage the pandemic and underestimation of the ability of COVID-19 to cause infections and deaths in the second wave led to the surge in infections. We have the benefit of curbing COVID-19 by vaccinating people now at least.

  Source: Click here

• Kerala Model to tackle the Covid-19 Pandemic in India

  Synopsis: The Kerala model provides a lot of lessons to the Center and the State governments to tackle the pandemic.

  Contents

  • 1 Introduction:
  • 2 Lockdown and prerequisites:
  • 3 Lessons from Kerala model to tackle the pandemic:
  • 4 Suggestions:

  Introduction:

  India at present is not only battling with Covid-19 cases but also battling with many associated issues. Such as floating dead bodies in the Ganges, the demand for medical oxygen and the challenges with the vaccination drive, etc. All these impact the health infrastructure of India a lot.

  Lockdown and prerequisites:

  With these challenging issues, there is a debate going to implement a national lockdown. Even if a national lockdown is not feasible, regional lockdowns/micro-containment zones are necessary. But before imposing them, there are a few things to consider.

  • The lockdown has to protect the interests of migrants and other worst affected sectors.
  • Adequate preparation and planning are required to ensure the proper continuation of lockdown.
  • The government has to provide an adequate time for the people to get themselves to prepare for the lockdown.

  Lessons from Kerala model to tackle the pandemic:

  The Kerala model provides lessons to not only implement the lockdown but also to tackle the pandemic effectively. The important initiatives are,

  • Transparency in governance: The government of Kerala provided daily press briefings. During that, the government reveals detailed information on the rate of infections and fatalities. Apart from that, the regular information includes the availability of beds, ICUs, oxygen, vaccines, and measures taken to deal with the pandemic.
    • All these increased public participation in controlling the pandemic. Further, the public also knows the gravity of the situation and built people’s trust and confidence in government measures.
    • So, the Central government and other state governments have to see transparency as an important part of the COVID-19 response toolkit.
  • Tackling Hunger: To tackle poverty and hunger, the Kerala government provided food kits to homes. Apart from that, Community kitchens and Janakeeya hotels(people’s hotels) have also opened to control hunger.
  • Providing adequate medical attention: The government of Delhi faced a lot of challenges in providing adequate medical facilities. As a result, people used personal networks to hunt for oxygen and beds in hospitals.
    • In contrast, the Kerala model created First-level treatment centers and second-level treatment centres. These models screened and treated people appropriate to their symptoms.
    • Only the most serious cases reach the district and specialty COVID-19 hospitals.
    • Further, Domiciliary care centres have also been created in Kerala to provide shelter, food, and treatment to those who do not have space at home to be quarantined. This prevented the migrant worker not to flee to their hometowns in panic.
    • In private hospitals, 50% of the beds have been declared as COVID-19 beds. Also, the government fixed the cost of RT-PCR testing and treatment charges in private hospitals at a reasonable level.
      • The private hospitals filed a PIL against fixing of price. But the Kerala High Court dismissed the petition.
    • Similar to the ‘Mumbai model’, beds are allotted through centralised control rooms in each district. These rooms also monitor the requirements of oxygen and ambulances.
  • Empowering the Local bodies: The Kerala model identified the Local Bodies as a first line of defence in the fight against COVID-19. They perform various functions in controlling the pandemic. Such as,
    • They look out for fresh infections amongst their constituencies and ensure the supply of medicines and provisions.
    • Panchayat members motivate people to get vaccinated
    • The Local body members also supervise the implementation of the lockdown in their locality.
    • Apart from that, they also set up help desks, providing ambulances facilities, and organising food packets.

  Suggestions:

  • The government has to understand that the battle against the Covid-19 is a long one. So, the Center and the States have to prepare for not only the second wave but for the third and fourth wave. To control them lockdowns will be inevitable until the progress of vaccination drives. The Kerala model has lessons for both lockdown and vaccination drives.
  • Twelve Opposition parties issued a joint letter to the Center. In that they demanded,
    • The government should initiate a free universal mass vaccination campaign.
    • Ensuring an uninterrupted supply of medical oxygen and vaccines.
    • Invoking compulsory licensing to expand domestic vaccine production.

  If the Centre provided these things and the other States adhere to the Kerala model then India can tackle the pandemic effectively.

  Source: The Hindu

• Centre releases “Covid-19 guidelines for rural areas”

  Contents

  • 1
  • 2 What is the News?
  • 3 About the Covid-19 guidelines for rural areas:
  • 4 Other Key Covid-19 guidelines for rural areas:

  What is the News?

  The Central Government has released new guidelines in the wake of the spread of coronavirus disease (Covid-19) in rural areas.

  About the Covid-19 guidelines for rural areas:

   Three Tier Structure: The guidelines recommend a three-tier structure to manage Covid-19 pandemic in rural areas:

  • Firstly, to establish 30-bed Covid Care Centres(CCCs) in villages to treat mild cases.
    • Transforming community halls and panchayat buildings into CCCs. These centres should also be equipped with at least two oxygen cylinders.
  • Secondly, Primary Health Centres (PHCs), Community Health Centres (CHCs) and Sub-district Hospitals shall handle moderate cases of the Covid-19 cases. Persons having an oxygen saturation level below 94 will be treated here.
  • Thirdly, district hospitals or private hospitals should manage severe cases with ambulances available for the rapid transport of patients.

  Other Key Covid-19 guidelines for rural areas:

  • Testing: Community Health Officers(CHOs) should be trained in performing Rapid Antigen Testing(RAT). These RAT kits should be provided at all public health facilities including Sub-centres (SCs) and PHCs.
  • Symptomatic Cases: The symptomatic cases can be treated at the village level after teleconsultation with the CHO. Further, the cases with comorbidity or low oxygen saturation will be sent to higher centres.
  • Surveillance: In every village, active surveillance should be done for influenza-like illness. This will periodically be held by ASHA workers. The Village Health Sanitation and Nutrition Committee(VHSNC) will help ASHA workers in this regard.
  • Ayush Doctors: Qualified AYUSH doctors, final year AYUSH students or final year B.Sc nurses may be considered to run the Covid Care Centres(CCCs).
  • Contract Tracing: The guidelines also focused on the need for contact tracing at every level.
  • Covid kit: Each Covid-19 household would get a “home isolation kit” with paracetamol, ivermectin, multivitamin tablets. The kit will also have provisions for periodic measurements of patients’ oxygen level and fever.

  Source: Indian Express

• US “CDC guidelines” for fully vaccinated people

  Contents

  • 1
  • 2 What is the News?
  • 3 About the CDC Guidelines:
  • 4 Places where the persons need to wear masks:

  What is the News?

  The US Centers for Disease Control and Prevention(CDC) said that fully vaccinated persons will no longer need their masks indoors and outdoors.

  About the CDC Guidelines:

  • US’s CDC guidelines said that a fully vaccinated person can take off his/her masks.
  • The new guidelines are only for people who are fully vaccinated. This includes condition like,
    • Two weeks have passed since the second shot of the two-dose vaccines.
    • Or if a person received a single dose of the Janssen vaccine.
  • The guidelines from the Centers for Disease Control(CDC) are just guidelines. State and local rules still apply.

  Places where the persons need to wear masks:

  • The guidelines say fully vaccinated people must still wear a mask. Especially in health care settings, transportation hubs such as airports and stations, and public transportation.

  Are these CDC guidelines based on science? The decision was taken based on the following reasons:

  • Current State of Pandemic in the US: The number of cases, hospitalizations and deaths in the United States have declined significantly in recent weeks.
  • Effective Vaccination: The US’s followed an effective vaccination policy. Further, some people are immune because of the previous coronavirus infection. So, the pandemic is gradually coming under control.
  • Study on vaccinated people: A study conducted at a major medical center in Israel found that out of 5,500 fully vaccinated workers, just eight people developed any COVID-19 symptoms.

  Source: Indian Express

• Issues With Technocratic Approach to Vaccination Drive

  .Synopsis – The current technocratic-based vaccination drive in India excludes the digitally illiterate population of the country. It is leading to substantial biases and inequality.

  Introduction-

  • The GOI launched CoWin portal to digitize the vaccination drive and made online registration mandatory for vaccination booking [18-44 age groups].
  • The approach has resulted in a digital divide among the rural population. Moreover, it also brought several other issues, such as vaccine exclusion and lack of privacy, with it.

  Key issues with the current technocratic based vaccination drive

  • Firstly, Lack of technical literacy –With no internet access and understanding of CoWin portal functions, the majority of India’s rural population is left out of COVID vaccination efforts.
    • Concerns-
      • Digital divide- Only 34.60 percent of the rural population has access to the internet.
      • Lesser registration through CoWin portal- According to CoWin data, only 2,52,96,511 of the 14,42,10,652 vaccine registrations [for 45-plus age group] were done through CoWin.

  • Secondly, the COWIN portal ignores data protection and cybersecurity- The CoWin website lacks a privacy policy, putting medical healthcare data at risk of disclosure through third-party providers.
    • The CoWin website is contrary to-
      • The Supreme Court’s right to privacy judgment
      • Also, the GOI’s departmental guidelines for official websites states that while collecting data, government websites “must incorporate a prominently displayed privacy statement…”.

  • Thirdly, Use of Facial recognition technologies FRT also poses a threat to privacy – The CEO of the National Health Authority said that Aadhaar-based FRT will soon replace biometric fingerprint or iris scan machines at Covid-19 vaccination centres. It will avoid infections.
    • The FRT will increase the risk of exclusion and discriminatory outcomes. Moreover, FRT is not an accurate mode of identification, thus affecting the proper dispensation of the shots.

  The technocratic approach is prioritizing data collection and efficiency over vaccine equity. It disregards the experience of public healthcare and digital rights experts. The present deployment of CoWin, is undermining the right to health, instead of augmenting it.

  Source-The Indian Express

  India’s vaccination strategy needs a course correction

• Bad Policy Making Aggravated the Pandemic Disaster in India

  Synopsis: Bad Policy-Making by the government during and before pandemic aggravated the Pandemic Disaster in India. Adherence to Key Principles of Healthcare, Economy, Data integrity, and Science would have limited the impact of the Pandemic in India.

  What are the key principles forgone by the government?

  • First, prioritizing universal health coverage instead of strengthening Public health facilities
    • India prioritized insurance coverage after 2014, for example, Ayushman Bharat. Whereas, international experience showed strengthening public health care is the right way.
    • For instance,
      • UK’s National Health Service Act revolutionized health care in the United Kingdom by delinking it from a person’s income.
      • Kerala’s heavy investment in public health care in the 1950s increased the capability of Human resources.
    • Even, the high-level expert group appointed by the Planning Commission concluded that progressive strengthening of public facilities is the only way to achieve universal health care.
  • Second, discarding the principles of Science worsened the Pandemic situation. There are instances when Science was least prioritized by the government,
    • Government representatives supporting Patanjali’s Ayurvedic cure for COVID-19.
    • Ignoring the Suggestions of public health expert or Scientists in Public policymaking related to Lockdown, organizing Kumbh mela, Election rallies
  • Third, Government’s apathy towards prioritising Data integrity. For instance,
    • One, evasion of Economic data: For example, Maximizing GDP numbers, employment statistics changing baselines, withholding periodic labor force surveys.
    • Two, under-reporting of Covid-19 infection and Deaths.
  • Fourth, negligence of Good economics principles. For instance, relying on Freebies rather than prioritizing sound Welfare economics like Institutionalising social security net.
    • According to the latest report by the Azim Premji University, 230 million Indians slipped below the poverty line during the pandemic.
    • Providing Social security net to the BPL population would have limited the Pandemic disaster in India.
    • Even the global experience from US, UK, Germany, and China proved the same. Yet, India discarded the global experience.

  Adherence to basic scientific and rational principles, helped India to effectively fight against smallpox and polio. This needs to be replicated now.

  Source: The Hindu

  Why India Should limit its Involvement With QUAD?

• State should form a joint committee to negotiate COVID vaccine price

  
  

  Synopsis- Vaccine Price, availability and affordability [for 18-44 age group] would require a coordinated effort from state governments.

  Introduction-

  • The central government has pulled out from the third phase of the vaccination drive. The center has provided state governments’ the full responsibility for vaccinating [a group that constitutes about 40 per cent of the population].
  • Now state governments have to procure vaccines directly. Further, they also need to compete with private players at the same time for a better price. As there is only a limited number of capacity and vaccine suppliers.

  How can the state bring down vaccine prices?

  In contrast to a market with multiple buyers, a single buyer can always negotiate a lower price for a product with one or more sellers. Thus, to bring down vaccine price, the State governments should form a consortium. There are some factors related to this. Such as,

  • Involvement of Pre-purchase agreements- This would tackle any uncertainties from the point of view of vaccine manufacturers. It will also allow for faster expansion of production capacity.
  • Delay in the formation of the consortium will impact the procurement – Any delays will strengthen the potential private buyers’ position. It will automatically weaken the position of the consortium to negotiate a lower price. This will result in,
    • Further, widening of vaccination gap between the rich and the poor – The price difference between the consortium’s agreed prices and private sellers is likely to encourage inequity and black marketing

  Thus, the formation of a consortium provides a mechanism to achieve affordable prices in India. Further, there is also a survey conducted on willingness to pay (WTP) for Covid-19 vaccines. 

  Key highlights of a survey on willingness to pay (WTP) for Covid-19 vaccines

  • The survey is conducted for WTP for two possible vaccine choice [one is 100 percent effective and the other is 70 percent effective]
    • The maximum WTP on average stood at Rs 140 for a 100 % effective vaccine, and at about Rs 109 for one with 70 % effectiveness.
    • Only 2 % were willing to pay Rs 600 or more to 100 % effective vaccine and 1.5 % were willing to pay the same amount for the other vaccine.

  • Nearly 66 % of the respondents experienced an income reduction of more than 50 percent as compared to the last year’s income levels. WTP also declined uniformly with the level of economic shock experienced.
  • So, the economic ability of these households to afford vaccination is severely restricted.
  • Apart from that, leaving sections of the eligible population out of vaccine coverage poses further risks of mutations in the virus.

  Suggestions to reduce Vaccine price and provide universal vaccination

  Shortage of the vaccine, poor administration and vaccine hesitancy is the reason for low rate of vaccination, therefore-

  • State governments must take immediate action to form a consortium and make provisions for further subsidization of the vaccine.
  • Implementing budgetary solutions like public health bonds will help to improve public finances.
  • Further, the government must focus on Universal vaccination. To achieve this, the center can allow State governments to exceed budget deficit targets.

  Source- The Indian Express