IASbaba’s Daily Current Affairs (Prelims + Mains

Focus)- 1st January 2018

Archives

(PRELIMS+MAINS FOCUS)

Pradhan Mantri Awas Yojana (PMAY): Making ‘Housing for all’ a reality by 2022 

Part of: Mains GS Paper II- Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes.

Key pointers:

• The Pradhan Mantri Awas Yojana (PMAY) has recently expanded its scope to cater to the housing needs of the mid-income group, besides the economically weaker sections (EWS) and low-income group (LIG). The scheme originally was meant to cover people in the EWS and LIG sections, but now covers the mid-income group (MIG) as well.
• The government envisages building affordable pucca houses with water facility, sanitation and electricity supply round-the-clock.
• PMAY comprises four key aspects.
  One, it aims to transform slum areas by building homes for slum dwellers in collaboration with private developers.
  Two, it plans to give a credit-linked subsidy to weaker and mid income sections on loans taken for new construction or renovation of existing homes.
  Three, the Centre will chip in with financial assistance for affordable housing projects done in partnership with States/Union Territories for the EWS.
  Four, it will extend direct financial assistance of Rs. 1.5 lakh to EWS.

The country is estimated to have a shortage of nearly 20 million housing units needed by the rural and urban poor. The PMAY aims to address this shortfall.

Article link: Click here 

Arunachal Pradesh declared Open Defecation Free state 

Part of: Mains GS Paper II- Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Key pointers:

• Arunachal Pradesh emerged as the second State in the Northeast, after Sikkim, to be declared Open Defecation Free.
• Arunachal has 21 districts and the State attained the feat much before the national deadline of October 2, 2019.
• The project undertaken under Swachh Bharat Mission (Gramin) SBM (G) saw the light of day only after the State government extended an incentive of Rs 8,000 per toilet. This is in addition to the Centre’s support of Rs 12,000, raising the grant for constructing a toilet to Rs 20,000.
• The State government also launched Swachh Arunachal Mission on October 2 this year at Tawang which envisaged the Swachh Protocol (Cleanliness Protocol) aimed at ensuring sustainability of assets created under SBM (Gramin).

Article link: Click here

Indian women can go on haj without male companion

Part of: Mains GS Paper I- Social issues

Key pointers:

• In his last Mann Ki Baat address of the year, Prime Minister Narendra Modi reached out to Muslim women, highlighting his government’s attempt at facilitating women’s travel for Haj pilgrimage without a male companion.
• Even in many Islamic countries this practice does not exist.
• According to the Ministry of Minority Affairs, now Muslim women aged above 45 will be allowed to go for the pilgrimage without ‘mahram’ in a group of at least four.
• The PM said removal of the restriction of having a male guardian or ‘mahram’ may appear as a “small thing”, but such issues “have a far reaching impact on our image as a society”.

Article link: Click here

(MAINS FOCUS)

HEALTH/ETHICS

TOPIC:

General studies 2:

• Issues relating to development and management of social sector/services relating to Health , Education, Human Resources
• Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

General studies 4:

• Ethics and human interface
• Probity in governance

Clinical trials: Lured by blood money

Introduction:

The below article deals with concerns/issues in clinical trials in India and provides suggestions for the same.

Basics:

• The goal of clinical research is to develop generalizable knowledge that improves human health or increases understanding of human biology. People who participate in clinical research make it possible to secure that knowledge.
• The path to finding out if a new drug or treatment is safe or effective, for example, is to test it on patient volunteers.
• But by placing some people at risk of harm for the good of others, clinical research has the potential to exploit patient volunteers.

As the demand grows for newer and better drugs for an expanding range of conditions, so too does the need for clinical testing.

‘Health as a commodity, repositions ethics within an economic framework’, and human experimentation is no exception. Profits, rather than people, become the prime consideration.

Concerns:

1. Over-volunteering for clinical trials

• In India, there is a trend of growing number of people who are over-volunteering for clinical trials in order to supplement their income.

2. Deceiving for personal gain

• There is even greater problem when volunteers who are desperate for money deceive investigators, lying about their age, health or other medications, just so they can participate.
• It isn’t uncommon for volunteers to break trial rules and lie. Even though clinical research organisations (CROs) screen for infections such as HIV and hepatitis, and illnesses like anaemia and diabetes, they cannot catch everything.
• This disturbing trend is putting at risk the health of serial volunteers as well as the reliability of trial data.

There are instances where volunteers (especially from Hyderabad, Karimnagar, and Mumbai) participating in over 30 studies in a decade, and to have broken rules to make a quick buck. This included hopping from one trial to another without a three-month gap in between, drinking alcohol, and hiding one’s health history. Such behaviour can distort trial data.

• Unsafe drugs can make their way into the market as a result, or safe drugs can get rejected. This is why volunteer honesty is paramount.

3. Large demand for volunteers

• As said earlier, as the demand grows for newer and better drugs for an expanding range of conditions, so too does the need for clinical testing.
• Drug companies are drawn to India for several reasons, including a technically competent workforce, patient availability, low costs and a friendly drug-control system.
• Regulations have become more stringent in the developed world. Hence, all drug-makers are moving clinical trials to global south, as greater availability of “naive” participants, fewer regulatory safeguards, high levels of poverty and illiteracy, combined with an almost blind faith in Western medicine, provide an almost endless supply of “willing” volunteers in countries such as Africa, China, India and parts of Eurasia. “It’s a big business”.
• The large demand for volunteers and the supply of willing subjects has spawned a bustling marketplace for participation in clinical trials. Dozens of groups on the instant messaging platform WhatsApp, with telltale names like “Anytime Money”, share information about ongoing studies. Around half-a-dozen advertisements for volunteers for trials turn up on the group each day.

4. Over-representation of low-income groups

• The big problem plaguing clinical research is an over-representation of low-income groups among trial subjects. Especially the vulnerable class of people, because of their poverty and low levels of education.

5. Unethical clinical trials

• The once booming clinical trials in India came under the Supreme Court scrutiny in 2013, after at least 370 deaths were attributed to Serious Adverse Events (SEAs) during such trials.
• Between 2005 and 2012 the deaths of 2,644 Indian subjects were linked to unethical clinical trials.
• Trials conducted in various parts of the country had violated patient rights as informed consent was not taken, and the patients subjected to clinical trials included newborns, children, pregnant women and mentally challenged persons are often exploited.
• There are instances of pharma-company agents exploiting gullible young people.

6. Poor regulation

• Under the Indian Drugs and Cosmetics Act, an independent body of doctors and laypersons, known as an ethics committee, must oversee a trial to make sure the rights of such groups are safeguarded. But bioethicists say this isn’t happening.
• Drugs and Cosmetics Act requires every trial death to be investigated, even if it is not related to the drug. This is also not happening.

Solutions:

1. One potential solution is a national registry of trial volunteers, which will alert a CRO when someone signs up for two studies simultaneously. But this will need work, because volunteer privacy cannot be compromised. So regulators need to create a system that anonymises each participant’s data.
2. Another option is to pay volunteers less, taking away the financial incentive to fudge their participation history. But this measure, in isolation, would reduce trial participation dramatically: an unacceptable side-effect because clinical trials are essential to drug research.
3. A third, more sustainable solution is to encourage a wider cross-section of society to participate in research on human subjects. Society at large must realise the valuable service that clinical research subjects perform by making drugs safe for the rest of us. It is imperative that this burden not fall completely on the vulnerable groups. Instead, the educated and affluent, who have greater access to the drugs that emerge from clinical research, must grasp the criticality of this research and pull their weight. Selectiveness in recruiting subjects for clinical trials leads not only to human rights violations but also to bad science. Civil society’s vigilance is vital.
4. In any trial that relies heavily on vulnerable groups like daily wage earners, the ethics committee should mandatorily choose to monitor subjects intensively, and counsel them on health risks. For instance, by meeting participants and administering questionnaires to gauge their awareness.
5. Volunteers often keep their families in the dark, leaving them without a safety net when they fall ill or are exploited. The only way to tackle this trend in its entirety is through social campaigns to improve awareness.
6. For every clinical trial, the Drugs and Cosmetics Act requires participants to receive a copy of an informed consent form, which explains the trial protocol in great detail. This needs to be strictly followed.

Recent steps:

• From April, companies and organisations that have registered for clinical trials in India will have to disclose the outcomes of their tests within a year of completing them.
• Globally less than 60% of clinical trial outcomes are disclosed.
• Currently, all trials in India are registered on the Clinical Trials Registry — India (CTRI). The Clinical Trials Registry encourages the registration of all clinical trials conducted in India before the enrolment of the first participant. The registry is meant to bring transparency to clinical trials conducted in India.
• The court asked the government to set in place a proper mechanism to regulate trials. This led to measures which required that compensation be paid to patients affected by trials and that there was audio-visual proof that participants had indeed consented to take part in a trial.

Conclusion:

Clinical trials involving human subjects have long been a flashpoint between bioethicists and clinical research organisations (CROs) in India. Landmark amendments to the Drugs and Cosmetics Act in 2013 led to better protection of vulnerable groups such as illiterate people, but more regulation is needed to ensure truly ethical research.

While CROs have argued that more rules will stifle the industry, the truth is that ethical science is often better science.

Efforts should be made for a safer, transparent and continuous monitoring mechanism.

The line should be drawn for this, that the trials on the name of academic should not be misused and diverted for commercial purposes.

Local activism and human rights agendas can effectively challenge, to some degree, the harmful outcomes of the market and to protect, against the exploitation of vulnerable people in clinical trials.

Connecting the dots:

• Before a drug is approved, it is required to be supported by clinical trials conducted by medical experts. Critically discuss the various issues involved.
• Critically examine the ethical issues during the conduct of clinical trials.
• The burden of volunteering for clinical trials must not fall only on the poor and vulnerable. Do you agree? Elucidate your opinion.

NATIONAL

TOPIC: General Studies 3:

• Infrastructure: Energy
• Indian Economy and issues relating to planning, mobilization of resources, growth, development and employment.

Energy Security: Challenges and Way forward

Introduction:

India is on its way to becoming a global economic powerhouse, and energy will lie at the heart of this transformation. The stakes could not be higher to bolster economic growth and enhance living conditions for this nation of 1.3 billion people, which uses just 6% of the world’s energy. Unreliable electrical supplies hinder India’s development. Further, India is home to eleven of the world’s twenty most-polluted cities, according to the World Health Organization.

What is energy security?

Energy security is the association between national security and the availability of natural resources for energy consumption.

Challenges:

• The energy conundrum is how to provide universal access to affordable and reliable energy on one hand, and the imperative to weaken the linkage between economic growth, energy demand and environmental degradation on the other.
• The imbalances in the energy value chain. There is currently, for example, surplus generating power capacity but approximately 40 per cent of the country still faces power shortages and/or has no access to electricity.
• There are leakages across the transmission and distribution chain. The government is familiar with the problems. But they have difficulty implementing the solutions because of competitive Centre-state politics, status quo-driven vested interests and lack of resources.
• The growing bonhomie between Russia and China and their increasing engagement with the energy sector in the Middle East present India with an opportunity and a threat.
  An opportunity to move into the space vacated by the US.
  Also, the opportunity to resurrect economically compelling projects of mutual interest to all three countries (transnational gas pipelines).
  A threat in that China will use its economic weight to secure oil on preferential, exclusionary terms to the possible detriment of India’s supply relations.

Way ahead:

• Securing fossil fuels along with a focus on “clean” renewables is the need of the hour.
  An integrated planning process that factors in the implications of decisions concerning fossil fuels on renewables and vice versa, and by developing a policy mindset that enables the fulfillment of short-term objectives without compromising longer-term goals.
• The short-term challenge is to correct the imbalances in the energy value chain, to minimise avoidable losses and create a unified energy market.
• The “successful” conclusion of GST offers a direction to solve the transmission and distribution losses. The government could contemplate something similar for the energy sector. A nationwide system brings in a simplified, transparent and national regulatory tariff and policy platform.
• The medium-to-long-term challenge is to redesign and restructure the institutions of energy governance to enable and facilitate holistic energy planning and an integrated energy market.
  As a first step in that direction, the government should consider legislating an “energy responsibility and security act”. This will raise public awareness on the interconnections between the various components of energy and between energy and the rest of the economy.
• Cities are the reasons for surging energy demand and air pollution. The government should devolve the energy administration of cities to an autonomous and constitutionally safeguarded “city energy ombudsman”.
  These ombudsmen should be empowered to tackle issues related to energy efficiency, demand conservation, waste management, urban redesign and transportation and to develop and implement focused, small-scale and distributed solutions.
• India imports more than 80 per cent of its crude oil requirements. The international oil market is, therefore, a matter of strategic and commercial significance.
  India should thus hedge against unexpected volatility.
• China and Russia’s growing involvement in the Middle East means we need to proactively reduce our import dependence on the region.
• Exploration and production is a long-gestation, capital-intensive and high-risk business; India does not have undiscovered reserves of “low-cost, easy oil”.
  The ONGC should broaden its footprint to become a world-class energy company.
  It should contemplate integration with not just the downstream petroleum companies but also the renewables companies.
• The government has set ambitious targets for renewables and electric vehicles.
  It will have to invest in supportive infrastructure, regulations, skills and innovation.
  Niti Aayog must carry out a detailed study on what will be required to shift from the incumbent fossil fuel energy system to a “clean energy” system.

Conclusion:

Energy security is a sine qua non for a nation like India, which its huge population is aspiring to grow at a faster pace. But for this to happen the baove mentioned steps must be taken.

Connecting the dots:

• What do you mean by the term energy security? Discuss the challenges in making India energy secure and the way forward.

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