IAS UPSC Prelims and Mains Exam – 15th April 2019

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(PRELIMS + MAINS FOCUS)

India short of 6 lakh doctors, 2 million nurses: U.S. study

Part of: GS Prelims and Mains II – Health issue; Welfare/Social issue

In news:

According to report by the U.S.-based Center for Disease Dynamics, Economics & Policy (CDDEP) –

• India has a shortage of an estimated 600,000 doctors and 2 million nurses.
• Lack of staff who are properly trained in administering antibiotics is preventing patients from accessing life-saving drugs.
• High out-of-pocket medical costs to the patient are compounded by limited government spending for health services.
• In India, 65% of health expenditure is out-of-pocket, and such expenditures push some 57 million people into poverty each year.

Do you know?

• WHO recommends that out of pocket expenditure (OOPE) on health should not exceed 15-20 per cent.
• In India, there is one government doctor for every 10,189 people (the World Health Organisation (WHO) recommends a ratio of 1:1,000), or there is a deficit of 600,000 doctors, and the nurse:patient ratio is 1:483, implying a shortage of two million nurses.

Issue of EVM malfunctioning: Demand for verification of 50% of VVPAT machines

Part of: GS Mains II – National issue; Accountability and Transparency issues

In news:

• Leaders of major Opposition parties to move SC again for 50% of the Voter Verifiable Paper Audit Trail (VVPAT) machines with the Electronic Voting Machines (EVMs).
• Opposition parties argued that the confidence of voters can be gained only through paper trail. VVPAT ensures the accuracy of the voting system.

We had read recently that the SC had directed the Election Commission to increase random matching of VVPAT slips with EVMs from one polling booth to five booths in every Assembly segment to instil confidence in voters.

C-295 plane deal in final stages

Part of: GS Prelims and Mains III – Defence; Science and Tech

In news: Major IAF deals pending approval

• C-295 transport aircraft: Negotiations for the C-295 deal have been completed. However, the deal needs clearance from the Defence Acquisition Council (DAC) as there is a change from earlier parameters. C-295s to replace the ageing Avro fleet of Indian Air Force (IAF).
• Acceptance of Necessity (AoN) for 114 fighter jets and the fresh proposal for six mid-air refuellers are pending.

pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/04/15/DEL/Delhi/TH/5_07/d05dc3e7_2872648_101_mr.jpg

Oil consuming bacteria found below ocean

Part of: GS Prelims and Mains III – Environment and Biodiversity; pollution

In news:

• Scientists have discovered a unique oil eating bacteria in the Mariana Trench, the deepest part of the earth’s oceans.
• The findings may pave way for sustainable ways to clean up oils spills.

Miscellaneous

Animal in news: Yangtze giant softshell turtle

In news:

• The only known female member of one of the world’s rarest turtle species has died at a zoo in southern China.
• The animal was one of four Yangtze giant softshell turtles known to be remaining in the world.
• The Suzhou zoo, where the female turtle lived, also houses a male Yangtze giant softshell turtle.
• The other two live in Vietnam.

pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/04/15/DEL/Delhi/TH/5_18/38194107_2872537_1_mr.jpg

World’s largest plane makes first test flight

In news:

• The world’s largest aeroplane — with two fuselages and six Boeing 747 engines — made its first test flight on 14^th April, 2019 in California.
• The mega jet, called Stratolaunch, carried out its maiden voyage over the Mojave desert.
• It is designed to carry into space, and drop, a rocket that would in turn ignite to deploy satellites.
• It is supposed to provide a more flexible way to deploy satellites than vertical takeoff rockets because this way all that is needed is a long runway for takeoff.

Pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/04/15/DEL/Delhi/TH/5_18/38194107_2872540_1_mr.jpg

Do you know?

• Stratolaunch was financed by Paul Allen, a co-founder of Microsoftas a way to get into the market for launching small satellites. But Allen died in October of last year.

(MAINS FOCUS)

HEALTH ISSUE

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
• Issues relating to poverty and hunger
• Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes
  

Health of a nation: Need for a effective UHC

Key pointers:

• World Health Day is celebrated every year on 7^th April, under the sponsorship of the World Health Organization (WHO).
• 2019 WHD Theme: Universal Health Coverage: : everyone, everywhere
• Through this 2019 WHD theme, WHO sought to highlight the importance and urgency of achieving Universal Health Coverage (UHC).
• United Nations Sustainable Development Goals (SDGs) has also set a target that all countries must achieve UHC by 2030.
• India, too, accepted that target date while signing up to the SDGs.

Definition of UHC

• According to WHO, UHC “means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services from health promotion to prevention, treatment, rehabilitation and palliative care.”

Country’s performance or success of UHC depends on –

• How well UHC is defined and monitored?
• What services are to be universally provided?
• What level of financial protection is considered acceptable?
• Whether UHC will commence by offering the same set of services to the entire population and progressively expand the service package to all
• Or whether UHC first prioritise certain services to the poor and vulnerable sections, to ensure both access and affordability, while leaving the rest of the population for coverage at a later stage?
• Or whether UHC provide a basic package of services to all, with full financial protection, along with an additional set of publicly funded services to the poor and vulnerable sections.

These are all possible beginnings in the path of progressive universalisation that ultimately leads to UHC for everyone.

India’s UHC

• To meet the standard set by the WHO and the SDGs, India’s UHC should include all persons in a population, even if the service package is modest to begin with.
• In terms of financial protection, the WHO recommends that out of pocket expenditure (OOPE) on health should not exceed 15-20 per cent. And this requires a high level of public financing.
• Even countries which follow an insurance model have a high level of public funding to support several health services.
• Mandated contributory insurance model will not work in India which has over 90 per cent of the workforce in the informal sector.

How does India measure up presently and how can we achieve the 2030 target?

• India’s out of pocket expenditure (OOPE) on health is currently around 63 per cent (WHO recommends 15-20%)
• Impoverishment due to unaffordable healthcare expenditure affects 7 per cent of our population.
• Healthcare induced financial distress is a leading cause of suicide among farmers.
• Access to health services varies widely among states and between rural and urban populations.
• Qualified healthcare providers are in short supply nationally and those available are maldistributed.

It’s a long way before we reach the base camp of UHC, even as the ascent to the 2030 summit seems very steep.

The way ahead: What should India need to do?

• Public financing is the lifeline of UHC. Important to raise public spending on health to at least 2.5 per cent by 2022 and 3 per cent by 2024.
• Primary health care has to be recognised as the foundational basis of an efficient and equitable healthcare system. Primary care needs to be the fulcrum of UHC.
• Emergency health services are also a high priority, to provide the link between these services and also lifesaving care on location and during transport. All such services have to be provided free of cost.
• Right from start, UHC has to cover several services like commonly needed surgeries and treatments that can protect life.
• Government funded programmes should ensure that financial barriers should not stop access to needed advanced care.
• As UHC evolves, the poor and near-poor must get full cost coverage while others may seek protection through employer funded schemes or privately purchased insurance. Even for them, OOPE must remain low.
• The health work force has to be expanded to make available multi-layered, multi-skilled teams which can deliver the needed services.
• Basic and specialist doctors, nurses, nurse practitioners, physician assistants, pharmacists and an array of allied health professionals need to be developed in large numbers and deployed across the country. This needs reforms in health professional education, cadre planning and incentives for rural postings.
• UHC has to be cashless at the point of care and health benefits under the programme have to be available for access anywhere in the country.

Strengthening of primary care infrastructure and district hospitals has to be a government priority. Free provision of essential drugs and diagnostics at public healthcare facilities will have an immediate impact on OOPE.

Connecting the dots:

• What do you understand by universal health coverage? Explain the measures taken by the government to achieve universal health coverage in India.
• Discuss the merits and challenges associated with ‘Universal Health Coverage’. Analyse the ways to improve India’s health profile.
• The idea of a ‘Universal Health Coverage’ is gaining traction across the world. Do you think India is prepared to adopt this scheme? Critically evaluate.
• Why India’s health achievements are very modest and has poor health indicators compared to its neighbours? Examine. Also suggest ideas to improve the status of public healthcare in India.

NATIONAL/GOVERNANCE

TOPIC: General studies 2

• Important aspects of governance, transparency and accountability
• Separation of powers between various organs dispute redressal mechanisms and institutions.
• Government policies and interventions for development in various sectors and issues arising out of their design and implementation

‘Politicization’ of the military

Context:

In recent weeks, much has been written about the likely politicisation of the army, especially after more than 150 senior military veterans, including several former service chiefs, wrote a letter to the President expressing their anguish over the ‘politicisation’ of the military.

They requested him “to take all necessary steps to urgently direct all political parties that they must forthwith desist from using the military, military uniforms or symbols, and any actions by military formations or personnel, for political purposes or to further their political agendas”.

Why military should be kept out of politics?

• The President is the supreme commander of the armed forces, not the head of any political party or alliance in power, including the Prime Minister.
• The forces serve the nation and not the government in power.
• It has no role in government decision making nor interferes with its functioning. It only advices on military matters, for which it is the sole authority.
• Therefore, any politicization will lead to violation of the very secular environment and the vibrant democracy.
• Using military activities to shop for votes will lead to political mud-slinging, to the detriment of the honour and sanctity of the special forces.

The use of the armed forces as a political tool is just one side of the coin. Even more dangerous is the fact that it sends the signal to the top brass that there is nothing wrong in intermixing politics with the military.

The eventual lesson they will learn is that they can interfere in the political process with impunity since the civilian leadership has already legitimised the military’s use in the political realm.

Conclusion:

• In recent years, many senior serving officers have commented on important domestic and international issues, such as immigration and India-Pakistan relations, that until recently had been off limits for the military brass.
• This is an unprecedented development that needs to be reversed in order to preserve civilian supremacy over the armed forces and keep the political and military arenas distinct.
• Unlike the neighbouring countries, the Indian Armed Forces have practised the constitutionally mandated “civilian supremacy over the military,” even though the reciprocal dignity of the apolitical existence has not been maintained by the politicos in recent times.
• Therefore, the nexus between military and politics does not bode well for Indian democracy.

Politicisation of the armed forces is a self defeating exercise in a democracy and political parties who attempt it, do so at their own peril. Once the armed forces are politicised they become law unto themselves.

Connecting the dots:

• Changing the apolitical nature of the military forces is a dangerous trend and can have serious repercussions for democracy, the morale of soldiers and the security of the country. Elucidate.
• Discuss the need for keeping military or armed forces insulated from the effects of religion and politics.

(TEST YOUR KNOWLEDGE)

Model questions: (You can now post your answers in comment section)

Note:

• Featured Comments and comments Up-voted by IASbaba are the “correct answers”.
• IASbaba App users – Team IASbaba will provide correct answers in comment section. Kindly refer to it and update your answers.

Q.1) Which among the following helps to clean up oil spill in open sea or ocean?

1. Chemical dispersants
2. Biodegradation
3. Bioremediation
4. Bacteria

Choose the appropriate answer:

1. 1, 2 and 4
2. 1, 2 and 3
3. 1 and 2
4. 1, 2, 3 and 4

Q.2) The term ‘oil zapper’ is concerned with

1. Remediation of oily sludge and oil spills
2. Under­sea oil exploration
3. Genetically engineered high biofuel yielding maize variety
4. Technology to control the accidentally caused flames from oil wells

Q.3) Consider the following statements:

1. The Challenger Deep in the Mariana Trench is the deepest known point in Earth’s oceans.
2. Deep ocean trenches occur most along subduction zones.
3. Mariana Trench resulted from the Philippine Plate subducting under the Pacific Plate.

Which of the statements given above is/are correct?

1. 1 and 2 only
2. 2 only
3. 1 only
4. 1, 2 and 3

Q.4) Consider the following about Yangtze giant softshell turtles:

1. They are extremely rare species of softshell turtle found only in China.
2. It is listed as critically endangered in the IUCN Red List.

Which of the statements given above is/are correct?

1. 1 only
2. 2 only
3. Both 1 and 2
4. Neither 1 nor 2

Q.5) Consider the following statements and indentify the incorrect one –

1. World Health Day is celebrated every year on 7th April, under the sponsorship of the World Health Organization (WHO).
2. 2019 WHD Theme: Universal Health Coverage: : everyone, everywhere
3. UN SDG has set a target that all countries must achieve UHC by 2030.
4. None of the above

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