Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
General Studies 1
Rajya Sabha standing committee’s report on Surrogacy Bill
The Rajya Sabha standing committee’s report, having heard a wide cross section of society on the matter of surrogacy, has criticized the surrogacy bill and called for its redrafting. The standing committee’s report is noteworthy not only because of its content, but also the fact that the content of the report is informed by the wide variety of voices they have chosen to hear on the matter.
Issues with the bill:
It is a bill that reinforces every patriarchal and paternalistic notion of what women can and cannot do with their bodies. Far from “regulating” (as the term is properly understood), it is a bill to control women’s bodies and what they choose to do with it.
The 228th Report of the Law Commission of India recommended that a bill makes the rights of surrogate women clear, but the belief that making a profit out of this activity is somehow unacceptable suggests that some forms of women’s labour are clearly less morally acceptable than others. The report clearly favours “altruistic” surrogacy over “commercial” surrogacy. Both these terms need some unpacking.
The term “commercialization” in the context of surrogacy is a cause of concern. It suggests a distaste of women using their bodies in a particular manner to make a living. There is no justification as to why commercialization of surrogacy is intolerable. One weak defence offered is that a ban is necessary to prevent “misuse.” Not only does this completely devalue the labour and pain that a pregnant woman undergoes, but also the very real economic costs of a pregnancy.
The surrogacy bill correctly points out by the standing committee as that of families in a patriarchal society forcing women to suffer the costs and pains of surrogacy with no recompense. It destroys the notion that there is anything inherently “altruistic” about surrogacy simply because the parties are related. It understands that, in a society where deeply unequal power relation exist in families, altruism is far less likely than coercion.
Though the bill provides for the payment of medical expenses, insurance coverage, etc, this does not take away from the fact that the woman does not actually get compensated for the labour involved in a pregnancy. Indeed, as the standing committee rightly points out, “altruistic surrogacy,” as defined in Clause 2(b) of the bill, probably amounts to forced labour prohibited under Article 23 of the Constitution.
While several judgments of high courts across the country have agreed that women who have children through surrogates are entitled to maternity benefits allowed to them under the law, there is no clarity on whether the same would be available for the surrogates themselves. The standing committee has rightly pointed out this gap and recommended that the law clarify that maternity benefits should be available to both the birth mothers and surrogate mothers.
Surrogacy needs regulation:
The standing committee too recognizes the very real difficulties and problems that can arise with regard to surrogacy. Indian courts have had to face difficult issues regarding what needs to be done when parents who wanted a child through surrogacy no longer want the child, and the birth mother cannot or will not bring up that child.
In Baby Manji Yamada v Union of India (2008), problems that can be caused by the absence of clear demarcation of rights and liabilities of parties were highlighted. Here, a child born to an Indian surrogate mother was abandoned when her intended Japanese parents divorced and refused to take custody of the child. After the courts stepped in and put the matter before the National Commission for Protection of Child Rights, it was eventually resolved with the grandmother receiving the custody of the baby.
The Surrogacy (Regulation) Bill, 2016, introduced ostensibly to provide a legal framework for surrogacy in India, is a regressive legislation that seeks to control women’s bodies. By limiting surrogacy to “altruistic surrogacy” only, it creates space for women being pressured to bear children for family members. While provisions of the law relating to adoption and childcare can be pressed into use, a law that clearly lays down the rights and obligations of all parties in clear and simple terms is definitely necessary. The hearings in the committees should also be given wide viewership through live audiovisual recordings, subject, of course, to concerns of privacy, confidentiality and secrecy. This would provide a platform for a truly participative democracy.
Connecting the dots:
The Rajya Sabha standing committee’s report, having heard a wide cross section of society on the matter of surrogacy, has criticized the surrogacy bill and called for its redrafting. Discuss its recommendations.
TOPIC: General Studies 2
Issues relating to development and management of Social Sector/Services relating to Health.
Development processes and the development industry the role of NGOs, SHGs, various groups and associations, donors, charities, institutional and other stakeholders.
Rising H1N1 Cases
The reported cases and deaths due to the spread of H1N1 virus are on the rise in comparison with previous years’ records. The number of influenza A (H1N1) virus cases and deaths reported from across India this year has already crossed 19,000 and 900, respectively. In the last month or so there has been a sharp increase in the number of cases and deaths. Gujarat is the worst-affected, with about 250 deaths recorded so far: Rajasthan, Punjab and Maharashtra and Delhi too have been badly hit. The number of H1N1 cases in the southern States is also high compared with last year, with Tamil Nadu reporting nearly 3,000 cases about a month ago.
What is H1N1?
Influenza A (H1N1) virus is the subtype of influenza A virus that was the most common cause of human influenza in 2009. H1N1 flu is also known as swine flu caused by swine influenza virus that is endemic in pigs.
According to the Pune-based National Institute of Virology, the virus has not undergone any significant mutation and the virulence has remained nearly unchanged. It has however undergone point mutations which resulted in a new strain — the Michigan strain — replacing the California strain that has been prevalent since the 2009 pandemic. It is a highly contagious disease and can easily spread from a patient through saliva and mucus.
While both strains were co-circulating last year, as per surveillance data only the Michigan strain has been circulating this year.
The increased caseload and mortality this year compared with last year could be because pre-existing immunity through exposure to the California strain is no longer effective, and people are therefore not immune to the new strain.
While earlier vaccinations made people immune to the California strain, the circulation of the new strain is the cause of increased caseload and mortality.
Despite the high numbers, there is no system in place to release data periodically and frequently. Compare this with the regular updates provided by the U.S. Centers for Disease Control and Prevention, especially during an epidemic.
There has also been a near-complete failure on the part of governments to spread awareness about prevention strategies.
Uptake of influenza vaccination by people, especially by those belonging to the high-risk category, has been extremely poor, with only about 10,000-12,000 doses of H1N1 vaccine sold in the last six months by the Pune-based vaccine manufacturer. Since the 2009 pandemic, H1N1 has become a seasonal flu virus strain in India even when the temperature soars during the summer months.
Database – The numbers in the official report do not reflect the true reality. This is because it is not mandatory for the private hospitals to disclose all the deaths and the people affected, to the government’s database.
The government should do everything possible to take both preventive and curative measures to fight swine flu.
More research is needed to fully understand the epidemiology of H1N1 caused by the Michigan strain, and who may be more vulnerable.
Also, the composition of the swine flu vaccine will require changes as per the World Health Organization’s (WHO) recommendation.
There is a need for a system to record and release the actual number of cases for making appropriate response.
Prevention – Being a communicable disease, swine flu can best be prevented with awareness generation by the governments.
Uptake of influenza vaccination by people, health-care workers and especially by those belonging to the high-risk category, can go a long way in reducing the cases. High-risk categories include pregnant women, very young and old people, those who have had organ transplantation and those with certain underlying illnesses. They must be focused upon. Vaccination of health-care workers and people in high-risk categories is the only way to reduce the toll.
Government should ensure that there are enough vaccines in various health centres.
Keeping the environment clean to address poor hygiene and sanitation
Sufficient lab facilities to diagnose H1N1 cases among both hospitalised and non-hospitalized population is essential.
The high H1N1 flu toll points to a failure to put necessary systems and precautions in place. The guidelines for H1N1 vaccination of people belonging to high-risk categories such as pregnant women, very young and old people and those with certain underlying illnesses were released last month by the Health Ministry. It must be implemented in letter and spirit. Also, urgent measures are needed to ramp up preparedness in dealing with epidemics.
Connecting the dots:
The reported cases and deaths due to the spread of H1N1 virus are on the rise in comparison with previous years’ records. Discuss the reasons behind it. Also elaborate on what preventive steps should be taken by the government.