(Topic: Government policies and interventions for development in various sectors and issues arising out of their design and implementation)
The new TB campaign aims to improve and expand the reach of TB care services across the country, by 2022. This includes preventive and promotive approaches, and proposes potentially transformative interventions such as engagement with private sector health care providers, inter-ministerial partnerships, corporate sector engagement, latent TB infection management, and community engagement. The interventions will be accompanied by a comprehensive, mass media and communications campaign to generate awareness about the disease and the free treatment services available under the government program.
Based on three strong pillars –
Clinical approach
Public health component
Active community participation: Multi-stakeholder and community participation shall form the pivot of the countrywide campaign
Other supporting elements of the campaign comprise private sector engagement, patient support, and political and administrative commitment at all levels.
Major Announcements by the Health Minister:
Also launched the National TB Prevalence Survey
Announced a partnership with the World Bank which is providing a $400 million credit for accelerating TB response in 9 states through private sector engagement and other critical interventions.
Launched an all oral regimen kit for multi-drug resistant TB patients which does not include injections which are painful and can have side effects
released the TB India Report (2019), the Work Place Policy Framework for TB, Operational Guideline for Employer Led Model on TB, Training module for transforming TB survivor to TB champion, and Elected Representative’s Handbook on TB.
Flagged off a van for the National TB Prevalence Survey. In all, 25 such vans will be part of the prevalence survey, which shall take 6 months and be carried out across the country. This shall present national and state level data, which will be used as a policy tool for further interventions.
Established patient forums in over 95 per cent of all districts in the first 100 days, which clearly shows our strong commitment to ending TB in the shortest time. These district forums will bring the voices of the affected to the fore, and highlight on-ground challenges faced by patients and their families in accessing TB care services
Reasons for the rising crisis
In addition to the failure of political machinery, the other major reasons for this are as follows:
Adult and child under-nutrition
Lack of active door-to-door detection
Shortage of drugs
Increasing Multi-Drug Resistant TB (MDR-TB) and Extensive Drug Resistant TB (XDR-TB)
Total Drug Resistant TB acting as an assured death warrant
Inadequate prescription by doctors and inadequate follow up of proper prescription by patients is aggravating the problem of antibiotic resistance
Disease becoming expensive and difficult to treat
Poor quality serological tests for diagnosis; poor quality diagnosis and treatment by medical practitioners
Delay in implementation of critical programmes under the Revised National TB Control Programme (RNTCP) such as expansion of the GeneXpert pilot programme, scaling up of drug sensitivity testing, and the introduction of a child-friendly paediatric TB drug.
India’s War on TB – The Way Forward
Countering Delay in Diagnosis:
To block transmission, treatment should begin as soon as a symptom shows up. As cough is a very common symptom of many diseases, doctors don’t think of TB until other treatments fail.
Partnership with the private sector is essential for early diagnosis of TB.
Universal primary health care, a basic human right, and a diagnostic algorithm for early diagnosis are essential for TB control.
To retard progression: Employ the biomedical method is drug treatment of latent TB. Experts recommend an age window of 5-10 years when all children must be screened with TST; those with latent TB must be treated to prevent progression.
Private Sector: The private sector has a very crucial role to play in checking the rise of TB as it is the first place a patient from an urban area visits. We need to make them a partner in this fight.
Strict guidelines need to be followed to report cases of TB to government.
Developing a comprehensive set of national guidelines could strengthen private sector engagement in TB
Efforts should be made to map and categorise private practitioners based on the nature of their education, experience and services provided.
Private hospitals need to be penalised for failure to report early TB cases to government. This will enhance the accountability of the private players.
If cannot provide free treatment, it needs to refer the patient to a government clinic.
Identification, focusing, messaging and testing (IFMeT): Key to successful private-public partnerships to fight TB
Strengthening research: We urgently require rapid and cost-effective point-of-care devices that can be deployed for TB diagnosis in different settings across the country.
Additionally, new drug regimens are necessary for responding to the spread of drug-resistant strains as is an effective vaccine for preventing TB in adults. It is a big challenge in current times, which is due to irregular treatment.
Operational research for optimising service delivery is also critical because it is often the case that diagnostics and drugs do not reach those who need them the most.
TB with other disease like HIV is difficult to treat and the research needs to be strengthened in this field.
The India TB Research and Development Corporation launched in 2016 must play a pivotal role in accelerating these efforts.
Technology: Technology has to be introduced and utilized in the most effective manner to ensure early access and monitoring.
Ending social stigma: TB is not a health issue alone. It is a broader societal challenge. Patients often hesitate to seek treatment or deny their condition altogether for fear of losing social standing. The consequence is that TB becomes a death sentence for many even though it is a fully curable illness. Women are disproportionately affected with estimates suggesting that 100,000 Indian women are asked to leave their homes every year after being diagnosed with TB.
Mass awareness campaigns like ‘TB Harega Desh Jeetega’ can play an important role in breaking social taboos.
Local communication channels such as community radios and street plays must also be leveraged.
Children should be engaged through anganwadis and schools for disseminating accurate messages about TB to their families.
Paediatric TB is often a neglected area. Children come from low socio-economic strata with social stigma and discrimination which needs to be de-stigmatised.
Major initiatives taken by India–
Shift to Daily regime of medication: With DOT Centres, the treatment will be at individual door level leading to no defaulter.
Cash benefit for TB patients & Medical Practitioner:
About 35 lakh identified Tuberculosis patients across the country will soon get Rs. 500 every month from the Centre as social support. The cash benefit for social support will cover loss of wages, travel and mainly nutrition.
INR 500/- to the private medical practitioner for notification of the disease
Will this work: Need to incentivise both the patients and the private practitioners as both the sides will ensure that they stand to gain from the treatment, which, in the long term, might lead to behavioural change.
Web-based Application – Nikshay: To enable health functionaries at various levels across the country to monitor TB cases in their areas
Patients receive daily SMSes to ensure they continue their medication.
The medicines come with a toll free number that is visible only after the medicine has been taken out of the foil pack; patients are required to give the number a missed call.
Every missed call is tracked, and when there are too many gaps, the patient is traced, often by treatment supervisors who travel to remote areas on bikes that the programme pays for.
Nikshay Poshan Yojana: A direct benefit transfer (DBT) scheme to provide nutritional support to TB patients. Under the scheme, TB patients have been receiving Rs. 500 per month for the entire duration of treatment. Since its inception, a total amount of Rs. 427crore has been paid to over 26 lakhs beneficiaries through direct transfers to their bank accounts.
Introduction of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT): It is a revolutionary rapid molecular test which simultaneously detects Mycobacterium tuberculosis and rifampicin drug resistance. This test is fully automated and provides results within two hours. It is a highly sensitive diagnostic tool and can be used in remote and rural areas without sophisticated infrastructure or specialised training.
Note: March 24th is celebrated as World Tuberculosis Day
Connecting the Dots:
Tuberculosis can be one of the major hurdles in converting the human capital in India to Demographic Dividend. Highlight the reasons for the rising TB problem and suggest measures to eliminate the problem.
TB remains one of the leading causes of death from any single infectious agent worldwide. Comment on the national and global efforts to eliminate the disease by 2035.
Discuss the measures taken by Government of India to control communicable diseases?
GS-3
Measures undertaken to boost coal production
(Topic: Energy)
Government is undertaking measures to ramp up the domestic coal production from the current level of 730 MT to 1149 MT by 2023 thereby eliminating the coal import except for the limited un-substitutable import.
Despite the push for renewable energy, the country will require base load capacity of coal-based generation for stability. Currently, coal occupies 55% share in primary energy supply and about 75% in electricity generation.
Government is opening new mines, expanding the capacity of existing mines and creating new evacuation infrastructure to ramp up the domestic coal production.
CIL alone is poised to commission 11 new coking coal washeries in a phased manner to meet the total demand of washed domestic coking coal of steel sector
Some other steps that the Government has taken:
Easing of mine plan approval,
Doing away with system of previous approval of Central Govt. for grant of mining lease,
Streamlining the grant of permits and clearances,
Greater coordination with State in matters relating to land acquisition,
Grant of lease,
Creation of sufficient coal evacuation infrastructure
Promotion of diversified use of coal such as conversion of coal to synthesis gas and subsequent use of the latter to produce methanol or fertilizers
National Centre for Clean Coal Research and Development (NCCCR&D)
Government of India through Department of Science & Technology, has set up the NCCCR&D as a national level consortium on clean coal R&D, led by the Indian Institute of Science (IISc)-Bengaluru.
The primary goal is to address several critical R&D challenges towards the development of clean coal technologies, in tandem with developing supercritical power plant technologies, both at the materials and system level.
Clean coal technology is a collection of technologies being developed in attempts to lessen the negative environmental impact of coal energy generation and to mitigate worldwide climate change.
The term “clean coal” has been applied to many technologies, ranging from wet scrubbers, which remove sulfur dioxide from coal-generated gas, to coal washing, which removes soil and rock from coal before it’s sent to a factory.
The research in clean coal domain could potentially be game changer for meeting the energy needs of the country in terms of higher efficiency and capacity at lower operating costs and size.
Connecting the Dots:
Discuss the significance of coal as an energy resource. What reforms are needed to cure the ailing coal sector?
What is the significance of coal for a developing economy? Is India endowed with good coal resources? Examine.
New leadership group announced at Climate Action Summit to drive industry transition to low-carbon economy
(Topic: Conservation, environmental pollution and degradation)
A new initiative was launched on 23rd September at the UN Climate Action Summit to help guide the world’s heaviest greenhouse gas emitting industries toward the low-carbon economy.
Countries that have come together: India and Sweden together with Argentina, Finland, France, Germany, Ireland, Luxembourg, the Netherlands, South Korea and the UK, as well as a group of companies including Dalmia Cement, DSM, Heathrow Airport, LKAB, Mahindra Group, Royal Schiphol Group, Scania, SpiceJet, SSAB, ThyssenKrupp and Vattenfall, announced a new Leadership Group for Industry Transition that will drive transformation in hard-to-decarbonize and energy-intensive sectors.
Who will support it? This global initiative will be supported by the
World Economic Forum
Energy Transitions Commission
Mission Innovation
Stockholm Environment Institute
European Climate Foundation among many others in an ambitious, public-private effort
… to ensure heavy industries and mobility companies can find a workable pathway to deliver on the Paris Agreement.
Why?
Industry sector emissions, including those from hard-to-abate and energy-intensive sectors like steel, cement, aluminum, aviation and shipping are expected to be responsible for 15.7Gt by 2050. The international collaboration between countries and industry groups is critical to establish workable policy frameworks and incentives, and to enable joint investment into low carbon infrastructure.
Modi Speaks
On Holistic Approach towards Health
Pillar 1: Preventive Health
Special emphasis on Yoga, Ayurveda and fitness
Building more than 1.25 lakh wellness centers.
Banned e-cigarette to save the younger generation from this serious threat.
Special emphasis on immunization – Addition of new vaccines
Pillar 2: Affordable Healthcare
Implemented the world’s largest health assurance scheme Ayushman Bharat
Under this, 500 million poor are being provided free treatment up to 500 thousand rupees per year. And in the last one year only 4.5 million people have been benefited from it.
Started more than five thousand special pharmacy stores where more than 800 essential medicines are being made available at affordable prices.
The cost of heart stent has been reduced by 80 percent and the cost of knee-implant by 50 to 70 percent.
Millions of people suffering from kidney problems are availing free dialysis facility in India.
Pillar 3: Improve the Supply Side
Historic steps for quality medical education in India, and for medical infrastructure. We have made radical reforms for the second sector.
Pillar 4: Mission Mode Intervention:
If mothers and children are healthy, then it can create the foundation to make the whole society healthy and hence initiatives like National Nutrition Campaign on mission mode.
Sustainable Development Goals aims to eliminate TB by 2030 but in India, we intend to achieve this in mission mode by 2025
Started a campaign against the diseases caused due to air pollution and the ones that are transferred from animals to humans.
During Climate Action Summit
Pledged that the share of non-fossil fuel will be increased, and by 2022 India’s renewable energy capacity would be increased to much beyond 175 GW, and later till 450 GW.
India plans to make the transport sector green through e-mobility and considerably increase the proportion of the biofuel blend in petrol and diesel.
Jal Jeevan mission has been launched for water conservation, rainwater harvesting and for the development of water resources and approximately 50 billion dollars is going to be spent on this in the next few years.
On the International forum, almost 80 countries have joined our International Solar Alliance campaign. India and Sweden together with other partners are launching the Leadership group within the Industry transition track. This initiative will provide a platform for governments and the private sector with opportunities for cooperation in the area of Technology innovation. This will help to develop low carbon pathways for industry.
In order to make our infrastructure disaster resilient, India is launching a Coalition for Disaster Resilient Infrastructure
The partnership of national governments, UN agencies and programmes, multilateral development banks, financing mechanisms, private sector, and knowledge institutions will promote the resilience of new and existing infrastructure systems to climate and disaster risks, thereby ensuring sustainable development.
Developed through consultations with more than 35 countries, CDRI envisions enabling measurable reduction in infrastructure losses from disasters, including extreme climate events. CDRI thus aims to enable the achievement of objectives of expanding universal access to basic services and enabling prosperity as enshrined in the Sustainable Development Goals, while also working at the intersection of the Sendai Framework for Disaster Risk Reduction and the Paris Climate Agreement.
Established as a platform for generating and exchanging knowledge, CDRI will conduct country-specific and global activities. CDRI will provide member countries technical support and capacity development, research and knowledge management, and advocacy and partnerships to facilitate and encourage investment in disaster resilient infrastructure systems.
In its formative stage, CDRI will focus on developing resilience in ecological infrastructure, social infrastructure with a concerted emphasis on health and education, and economic infrastructure with special attention to transportation, telecommunications, energy, and water.
Within 2-3 years, the coalition aims to have a 3-fold impact of achieving considerable changes in member countries’ policy frameworks, future infrastructure investments and high reduction in economic losses from climate-related events and natural disasters across sectors. CDRI will uphold the UN Agenda 2030 principle of leaving no one, no place, and no ecosystem behind, focusing on the most vulnerable regions and populations, while enabling inclusive and deliberative processes that recognize national and local efforts as primal.
Climate Action Summit
Finance: mobilizing public and private sources of finance to drive decarbonization of all priority sectors and advance resilience;
Energy Transition: accelerating the shift away from fossil fuels and towards renewable energy, as well as making significant gains in energy efficiency;
Industry Transition: transforming industries such as oil and gas, steel, cement, chemicals and information technology;
Nature-Based Solutions: reducing emissions, increasing sink capacity and enhancing resilience within and across forestry, agriculture, oceans and food systems, including through biodiversity conservation, leveraging supply chains and technology;
Cities and Local Action: advancing mitigation and resilience at urban and local levels, with a focus on new commitments on low-emission buildings, mass transport and urban infrastructure; and resilience for the urban poor;
Resilience and Adaptation: advancing global efforts to address and manage the impacts and risks of climate change, particularly in those communities and nations most vulnerable.
Mitigation Strategy: to generate momentum for ambitious NDCs and longterm strategies to achieve the goals of the Paris Agreement.
Youth Engagement and Public Mobilization: to mobilize people worldwide to take action on climate change and ensure that young people are integrated and represented across all aspects of the Summit, including the six transformational areas.
Social and Political Drivers: to advance commitments in areas that affect people’s well-being, such as reducing air pollution, generating decent jobs, and strengthening climate adaptation strategies and protect workers and vulnerable groups.
At United Nations General Assembly (UNGA)
HEALTH: 11 crore toilets have been constructed in five years and the biggest cleanliness drive had been launched. Ayushman Bharat health scheme, the world’s biggest health insurance scheme, offers 50 crore people free medical coverage of up to Rs 50 lakh.
SINGLE-USE PLASTIC: India is in the midst of a major drive to end the use of single-use plastic.
GLOBAL WARMING: Natural disasters all over the world have increased due to global warming. India was not a major contributor to global warming but is today one of the leading countries devoted to the solving the problem of global warming.
YUDH NOT BUDH: India is committed to world peace. Sacrifices made by Indian troops on UN Peacekeeping Missions cannot be matched by those from any other country. We are residents of a country that has given the world not yudh [wars] not budh [Gautam Buddha]
TERRORISM: Calling on the world to unite in the battle against terrorism, Prime Minister Narendra Modi said terrorism hurts the principles on which the United Nations was formed. For the sake of humanity, the entire world needs to unite to fight terrorism.
HARMONY AND PEACE: Ending his speech, PM Narendra Modi recalled a speech delivered by Swami Vivekananda in Chicago in 1893. In the speech, delivered at the World Parliament of Religions (1893), Swami Vivekananda gave the message of ‘harmony and peace, not dissension.” The world’s largest democracy still has the same message for the world: Harmony and peace.
Please Note:
HIKAA: The Cyclonic Storm ‘HIKAA’ over northeast and adjoining east central Arabian sea
‘Global Goal Keeper Award’ for Swachh Bharat Abhiyan: Narendra Modi
Exercise MALABAR: To strengthen India – Japan – US Naval cooperation and enhance interoperability based on shared values and principles.
Exercise KAZIND: Exercise KAZIND-2019 is the fourth edition of an annual event which is conducted alternatively in Kazakhstan and India.
The aim of this exercise is to conduct company level joint training with emphasis on counter terrorism operations in mountainous terrain.
During the exercise, aspects of emerging trends of global terrorism and hybrid warfare have also been included.
The joint military exercise will enhance the level of defence cooperation further fostering bilateral relations between the two nations.
National Water Mission Awards: NWM, Department of Water Resources, River Development & Ganga Rejuvenation, Ministry of Jal Shakti has initiated the ‘National Water Mission Awards’ to recognize excellence in water conservation, efficient water use and sustainable water management practices.
First Indigenous High Temperature Fuel Cell System: Developed by Council of Scientific and Industrial Research (CSIR) in partnership with Indian industries under India’s flagship program named “New Millennium Indian Technology Leadership Initiative (NMITLI)”
The 5.0 kW fuel cell system generates power in a green manner using methanol / bio-methane, with heat and water as bi-products for further use; amounting to greater than 70% efficiency, which otherwise may not be possible by other energy sources.
The Fuel Cells developed are based on High Temperature Proton Exchange Membrane (HTPEM) Technology. The development is most suitable for distributed stationary power applications like; for small offices, commercial units, data centers etc.; where highly reliable power is essential with simultaneous requirement for air-conditioning.
This system will also meet the requirement of efficient, clean and reliable backup power generator for telecom towers, remote locations and strategic applications as well. This development would replace Diesel Generating (DG) sets and help reduce India’s dependence on crude oil.
The Fuel Cells fit well in India’s mission of replacing diesel with green and alternate fuels. The development of fuel cell technology is indigenous and carries immense national importance in terms of non-grid energy security.
Government of India has instituted ‘Sardar Patel National Unity Award’ – Highest Civilian Award for contribution to Unity and Integrity of India.
The Award seeks to recognize notable and inspiring contributions to promote the cause of national unity and integrity and to reinforce the value of a strong and united India.
The award will be announced on the occasion of the National Unity Day, i.e. the birth anniversary of Sardar Patel on 31st October.
Edifice of modern India: The largest dry dock of Indian Navy – The Aircraft Carrier Dock at the Naval Dockyard in Mumbai
Launch of Navy’s first new stealth frigate, INS ‘Nilgiri’: INS Nilgiri is the first ship of Project17A.
Project 17A frigates are a design derivative of the Shivalik class stealth frigates with much more advanced stealth features and indigenous weapons and sensors.
These frigates are being built using integrated construction methodology.
The P17A frigates incorporate new design concepts for improved survivability, sea keeping, stealth and ship manoeuvrability.
National Launch of 10 Year Rural Sanitation Strategy (2019-2029)
By: The Department of Drinking Water and Sanitation (DDWS), Ministry of Jal Shakti
Focus on: Sustaining the sanitation behavior change that has been achieved under the Swachh Bharat Mission Grameen (SBM-G), ensuring that no one is left behind, and increasing access to solid and liquid waste management.
Link Vehicle Data to VAHAN database:
Ministry of Road Transport & Highways has reiterated the necessity of linking all vehicle data with VAHAN database to avoid harassment and inconvenience to citizens.
The States and Union Territories have been asked to ensure that all PUC centres upload emission test data electronically to VAHAN database as per guidelines issued in compliance with Supreme Court directions.
‘UMMID’ (Unique Methods of Management and treatment of Inherited Disorders) initiative: To tackle inherited genetic diseases of new born babies
UMMID Initiative is designed on the concept of ‘Prevention is better than Cure’. In India’s urban areas, congenital malformations and genetic disorders are the third most common cause of mortality in newborns. With a very large population and high birth rate, and consanguineous marriage favored in many communities, prevalence of genetic disorders is high in India
Aims:
To establish NIDAN Kendras to provide counselling, prenatal testing and diagnosis, management, and multidisciplinary care in Government Hospitals wherein the influx of patients is more
To produce skilled clinicians in Human Genetics
To undertake screening of pregnant women and new born babies for inherited genetic diseases in hospitals at aspirational districts
NIDAN (National Inherited Diseases Administration) Kendra will be established for genetic testing and counselling services.
Mochi Swabhimaan Initiative – a nationwide effort in which LSSC will support the cobbler community who provide leather-based services, with CSR funds ensuring they work in a dignified manner
Leather Sector is an Export driven sector and has the potential to create 2 million jobs in the next 5 years.
The Government of India had recently announced in the Budget of 2019 that export duty be rationalized on raw and semi-finished leather increasing opportunities in the sector.
