21 Feb 2020: UPSC Exam Comprehensive News Analysis

E. Editorials

Category: HEALTH

1. Gearing up to fight the next big viral outbreak

The editorial talks about the need for Indian States to regularly test their preparedness to not just diagnose and treat diseases, but also to prevent them.

Global Health Security Index:

• The GHS Index is the first comprehensive assessment of global health security capabilities in 195 countries.
• The World Health Organization (WHO)’s Global Health Security Index finds that no country is adequately prepared.
• It assesses 195 countries across six categories — prevention, early detection, rapid response, health system quality, standards, and the risk environment.
• India is ranked 57th. The U.S. is ranked first and China 51st.
• That the country scores around the global average is no comfort, because the global average is a low 40.2 out of 100, and India’s score is 46.5.

Case study: Thailand:

• Thailand is ranked sixth in the Health Security Index.
• It is the highest-ranking for an Asian country. This ranking says a great deal about the country’s track record in disease prevention, early detection, and rapid response linked to investments in its public health system.
• When the deadly Middle East Respiratory Syndrome (MERS), also caused by a coronavirus, broke out in 2015, Thailand quickly notified the WHO of its first confirmed case and acted transparently to arrest the spread.
• The steps taken by Thailand are in stark contrast to delayed notification by China’s officials of the recent outbreak.

The Indian Scenario:

• Health expenditure by the government in India is less than 1.5% of the Gross Domestic Product, which is low for a middle-income country. Spending at that level limits, among other things, the availability of health professionals during crises.
• According to WHO, India has only 80 doctors per 1,00,000 people.
• Indian States should regularly test their preparedness to not just diagnose and treat diseases, but also to prevent them.
• The influenza A (H1N1) outbreaks since 2009 in Rajasthan, Maharashtra, Tamil Nadu and other States have acutely underscored the need for better detection, awareness of symptoms and quarantining.
• The Pune-based National Institute of Virology has been designated as a WHO H5 reference laboratory. Yet, clearer protocols for all three types of surveillance are needed in all States, and these protocols need to be communicated to health professionals at all levels and the public in local languages.
• Each State in India should do stress tests to expose crucial gaps in areas such as adequacy and supply of diagnostic equipment, health facilities, hygienic practices, and prevention and treatment protocols.
• Alarming scenes of queues for medical products in Hong Kong and China highlight the need for strong supply chains for products that people need during health emergencies.

4-point health agenda:

The prospect of new outbreaks puts four items on the health agenda in the spotlight that require both immediate and longer-term action:

1. Early detection and prevention.
2. Better collaboration across health service providers.
3. More investment in health systems, outcomes, and education.
4. Better care of the environment and biodiversity, that directly affects people’s health safety.

Collaboration:

• China is realising, at a chilling cost to the safety of its health workers, the difficulty of ensuring enough supplies so that it can avert panic buying.
• This is where partnership can come in — partnerships between private and public sectors, and between countries — that can sustain supply chains and bolster the medical capacity of countries struggling to cope.
• In Asia, collaborative approaches exist, for example, for combating tuberculosis, AIDS and malaria. But more is needed to tackle health emergencies on the scale of the recent outbreak, particularly on funding.
• There could be an emergency loan facility, with a deferred drawdown option as the World Bank uses for disasters, natural or health, that can help augment own resources in times of a public health catastrophe.
• But the best defence of all is to invest more, and more efficiently, in health and education to prepare populations and strengthen health services.

Conclusion:

One lesson of the 2008 global financial crisis was the need for countries to conduct regular stress tests on their financial systems, an exercise that has proved valuable. Countries need to do the same for their preparedness to deal with health emergencies.

2. ART of life

Context:

The Union Cabinet has approved the Assisted Reproductive Technology (ART) Regulation Bill, 2020 to monitor medical procedures used to assist people to achieve pregnancy.

Legislations upholding reproductive rights and choices of women:

Together, the ART Bill; the Surrogacy Bill; the amendment to the Medical Termination of Pregnancy Act; and the older Pre-Conception and Pre-Natal Diagnostic Techniques Act present a bouquet of legislation that will have a positive impact on the reproductive rights and choices of women in India.

Need for regulation of Assisted Reproductive Technology (ART):

• The ART Bill, to regulate clinics offering fertility treatments, was first presented publicly in 2008.
• India has a rich history of employing ART, though the initial years went officially undocumented at that time.
• Since the 1970’s the industry has seen phenomenal growth, as infertility rates went up.
• A market projection (by Fortune Business Insights) said the size of the ART market is expected to reach $45 billion by 2026.
• Among Asian countries, India’s ART market is pegged at third position.
• A lack of regulation and the consequent laxity in operations drove a lot of traffic from other nations to India.
• Along with the relatively low costs, this led to the mushrooming of ART clinics across the country.
• This also led to a plethora of legal, social and ethical issues.
• It is at this juncture that the ART Bill has seen a fitting revival.

Important provisions:

• It seeks to regulate and monitor ART procedures.
• Mandates the establishment of a National Board and State Boards to lay down rules for implementation.
• It honours a long-pending demand for the creation of a national registry, and registration authority.
• The Bill already sets a comprehensive framework to operate on. Most significantly, the Bill recommends punishment, even jail time, for violations of the provisions.

This topic has been covered in the 20^th February 2020 Comprehensive News Analysis. Click here to read.

Way forward:

• Having come this far to ensure the reproductive rights of women, the state now has the thriving ART industry on a leash, and the Bill is its best chance to eliminate exploitation in the field.
• The Assisted Reproductive Techniques Bill is a much-needed complement to Surrogacy Bill.
• Since it does impinge on surrogacy too, the government must work on ensuring synchrony in both Bills.

Conclusion:

It is largely opined that the Assisted Reproductive Techniques (ART) Bill, came after the Surrogacy Bill that it should have preceded. Sometimes, the leash follows the dog, but given the importance of control, the sequence can seem insignificant. It only matters that there remains a good hold over the circumstances.