Down To Earth(July16-31 2023)

Antimicrobial resistance (AMR)

Context:

  • It is time to look at antibiotics as a global public good, which are getting increasingly ineffective in killing the microbes, and lead to some 5 million deaths in 2019.
  • This silent pandemic of antimicrobial resistance (AMR) is caused by overuse and misuse of antibiotics, which has made pathogens mutate and build defence mechanisms against these drugs.

Historical Background:

  • The post-Second World War saw mass production of penicillin — the first antibiotic, discovered in 1928 — and the world’s dependence on this line of medicines grew substantially. More discoveries were made in the decades that followed.
  • By the 1980s, there were no discoveries of novel classes of antimicrobials, and focus was shifted to reformulation of the same classes of drugs against which bacteria can develop resistance easily.
  • The problem is compounded because there are ‘priority pathogens’, sub-categorised into ‘critical’, ‘high’ and ‘medium’, as classified by the World Health Organization (WHO).
  • Most of these priority pathogens are Gram-negative bacteria that have complex cell walls and cause some of the worst infections in the world, including pneumonia.

About AMR:

  • It occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.
  • As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

What is the current Status?

  • WHO’s annual review of antimicrobial agents in different stages of drug development reveals that in the past five years, only two of the 12 antibiotics approved can be considered novel; and of these, only one is targeting a ‘critical’ priority pathogen.
  • The drug pipeline is drying up fast. For the past few years, only one or two antibiotics have made it to the stage of new drug application.
    1. There are just nine new drug candidates in phase 3 of clinical trials and most of them do not target critical priority pathogens.

       

Concerns:

  • Major pharmaceutical companies in the business of research, development and discoveries are opting out of this line of antibiotic medicines.
  • It would mean that in the years to come we are in for a triple jeopardy:
  1. The antibiotics we know today would be increasingly ineffective;
  2. There would be no new antibiotics available; and,
  3. There would be a critical need for access to these medicines for all.
  • As per WHO, 80% of the pre-clinical novel drug finds are in businesses with less than 50 employees. But as the drug moves up the ladder, the costs of development increase, and innovation falls through the cracks.

Why is Big Pharma not investing in R&D, or even taking the innovation from the small businesses to big markets?

  • A developing crisis: Most big pharmaceutical companies have all but quit research and development of new antibiotics since it is a low-return venture. Rapid rise of antimicrobial resistance means the old ammunition is misfiring. Without effective antibiotics, global healthcare will lose the treatment framework it stands on.
  • Economic reason: Pharmaceutical companies say the cost of development and associated risk are high.
  • Moral reason: The companies are exiting the critical antibiotic business when they are making record profits.
    1. However, there is much more profit in drugs that are used for treating diseases like cancer, diabetes and or orphan diseases that may afflict only a few million, but for which high-end medicines are necessary.

A way ahead:

  • We need new classes of antibiotics to address priority pathogens and to be accessible to people across the world.
  • Recently, the G-7 countries incentivise companies to invest in novel antibiotics has two imperatives:
  1. Their usage has to be limited and must be conserved. Misuse and overuse is creating the problem of AMR.
  2. Access to these antibiotics is to be ensured and will have to be affordable.
  • So, it is time to look at antibiotics as a global public good. This would perhaps mean new taxes — on profits of pharmaceutical firms —  and creation of conditions that ensure public research is used for common good.

Index to gauge farmer distress

Context:

  • The Central Research Institute for Dryland Agriculture (CRIDA), an institution under the Indian Council of Agricultural Research (ICAR) started working on a kind of an early warning system called ‘Farmers Distress Index’, a first of its kind for India.

About Farmers Distress Index:

  • It is an early warning system developed by the ICAR-CRIDA, with the aim to anticipate shocks faced by farmers like crop failure, income loss, market fluctuations and extreme weather damage — and facilitate action through a mobile and desktop application.
  • The index will try to prevent its spread from a few farmers to the village or block level by pre-warning different stakeholders, including central, state, local and also non-government agencies about the future occurrence of farmers distress in a particular block / district so that they can take timely preventive measures.

Methodology to track distress:

  • There will be 21 standardised questions to gauge early signs of distress, specifically to marginal and small farmers or tenant farmers and the answers will be mapped against seven indicators:
  1. Exposure to droughts, floods, crop failure due to pest attacks, livestock deaths;
  2. Debt;
  3. Adaptive capacity of farmer and local government through different schemes;
  4. Land holding and irrigation facilities;
  5. Sensitivity, mitigation and adaptation strategies like growing of contingency crops if main crop fails;
  6. Triggers for immediate distress like health-related expenditure; and,
  7. Socio-psychological factors and impacts.
  • The index will have values from 0 – 1.
    1. 0 – 0.5: low distress;
    2. 0.5 – 0.7: moderate distress; and
    3. 0.7 – 1: severe distress.

Significance:

  • Once CRIDA hands over the index to the Centre, it will be made available to government departments, nonprofits and universities to implement measures to alleviate the shocks identified.
  • The solutions being considered include direct money transfer, provisioning of work under the wage employment guarantee scheme and enhanced rationing under the public distribution system.

 

A job not done

Context:

  • Many states are launching urban employment guarantee schemes similar to MGNREGA.

Indira Gandhi Shahari Rozgar Yojana (IGRY):

  • Government of Rajasthan promised 100 days of assured unskilled employment to all urban dwellers who demand work, similar to the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA).
  • It was implemented by urban local bodies, such as municipal corporations, councils and nagar panchayats, who in turn hire educated youngsters as rozgar sahayaks (employment assistants) to sensitise people about the scheme and mates to oversee worksites.

States who launched their respective urban employment guarantee scheme:

  • Rajasthan is the most recent state to launch an urban employment guarantee scheme, i.e. IGRY, on the lines of MGNREGA.
  • Jharkhand and Odisha, started a similar programme in 2020 after the first wave of the covid-19 pandemic, which saw mass-scale reverse migration from urban to rural areas due to the unavailability of jobs.
  • Kerala was the first state to launch an urban employment guarantee scheme in 2011 to arrest unemployment, and followed by Himachal Pradesh in 2019.

Analysis of urban employment guarantee schemes:

A Good Start with some challenges:

  • Rajasthan launched IGRY with a budget outlay of `800 crore, which is the highest allocation for an urban employment guarantee scheme by any state. In 2023-24, the state government increased the number of guaranteed employment days from 100 to 125.
  • It recognises unskilled workers only, which has limited the scope of the scheme. The other challenges are wage amount, not lucrative enough for skilled or male labourers, payment delays and limited staff training.
  • Even the enrolled workers withdraw unexpectedly because of the availability of other work in urban areas. The seasonal unavailability of the required human power is also a challenge.

Mixed Impact:

  • Kerala’s Ayyankali Urban Employment Guarantee Scheme (AUEGS) has 0.32 million families as beneficiaries, as of now.
  • Though similar in design, MGNREGA and AUEGS have differences in implementation. While there is a strongly defined available workforce in rural areas, the poor urban population remains scattered, and very few people are opting for the scheme that involves huge risk and less payment.

Need a Fresh Look:

  • India has had several urban employment and skill development schemes both at the national and state levels, but none of them have been able to arrest the problem of urban unemployment in totality.
  • In April 2023, India’s urban unemployment rate stood at 9.8 percent, which is 2.5 percentage points more than rural unemployment, as per numbers released by business information company Centre for Monitoring Indian Economy.

 

  • In November 2020, development economist Jean Dreze proposed the Decentralised Urban Employment and Training (DUET) scheme for the country, in which he argued:
    1. Centre should issue job stamps and distribute them to approved public institutions — schools, colleges, hostels, shelters, jails, museums, municipalities, and so on.
    2. These institutions would be free to convert each job stamp into one person – day of work within a specified period, as long as they arrange the work.
    3. The wages would be paid by the government directly into the workers’ account on the presentation of job stamps, duly certified by the employer.
    4. To avoid collusion, employees would be assigned to employers by an independent placement agency.

India’s unemployment is highest in four decades:

  • There is a general consensus among the Parliamentarians and the people that unemployment is on the rise, especially among the youth. India has not seen such a high rate of unemployment in the past four decades or so. The current levels are comparable to what existed in the 1950s-70s.

A Way Forward:

  • India is fortunate to have a large working population. The country should focus on ways to harness the same and pivot development. Instead, the budget for the Mahatma Gandhi National Rural Employment Guarantee Act is going down. This will change only when people take up the cause and become the catalyst.
  • On August 5, 2022, Binoy Viswam, Member of Parliament, introduced a private bill, The Bhagat Singh National Urban Employment Guarantee Bill, currently pending for discussion in Rajya Sabha.
  • While the state schemes are a welcome step, they are unlikely to be as effective as MGNREGA, which is an Act passed by Parliament. The practical difference is that schemes can be discontinued or diluted by new governments.

Heal the system

Context:

  • Hurdles in practising Ayurveda are limiting its potential to help India improve healthcare access.
  • India’s traditional systems of medicine have seen increased focus in the last decade. The country currently relies on the practitioners of AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homeopathy and Sowa Rigpa) to improve healthcare coverage.

About:

  • Union Minister of State for Health and Family Welfare announced in the Rajya Sabha that the country had reached a doctor-population ratio of 1:834, which is better than the World Health Organization (WHO)’s recommended ratio of 1:1,000.
    1. This ratio was achieved by “assuming 80 percent availability of registered allopathic doctors (a total of 1.3 million) and 565,000 AYUSH doctors” in the country.
  • If one were to only consider 80 percent availability of the 1.3 million allopathic doctors for a population of 1.24 billion (as per Census 2011), the doctor-patient ratio would translate to 1:1,194.
  • Even as the Centre bets big on AYUSH practitioners — a majority of whom practise Ayurveda — the system currently in place in the country only raises concerns, particularly on the quality of education offered.

 

Question of Standard:

  • As per the data available with the National Commission for Indian System of Medicine (NCISM) under the Union Ayush Ministry, dedicated Ayurveda colleges in India have been on a rise, from 35 colleges in the 1940s to 453 colleges as of May 2022. Of these, 352 institutes are private.
  • The Central Council of Indian Medicine, a monitoring body set up in 1970 under the country’s first legislation for traditional medicine systems.
  • Over the years, the 1970 law was amended several times, and in 2020, the Centre introduced the NCISM Act, to repeal the 1970 law.
    1. In February 2023, NCISM released to public opinion a document to update the minimum standards.

Unclear Curriculum:

  • The Bachelor of Ayurvedic Medicine and Surgery (BAMS) course lasts five-and-a-half years, and includes a year-long internship — mirroring the Bachelor of Medicine and Bachelor of Surgery (MBBS). The teachings are largely based on a handful of texts.
  • There are 19 subjects taught in a BAMS course, such as Charak Samhita (an ancient medical treatise, taught in two parts), Prasuti evam Striroga (obstetrics and gynaecology), Bal Roga (paediatrics), and Rasashastra evam Bhaishajya Kalpana (pharmaceutical science).
  • Anatomy, physiology, pathology and the detailed pharmacology of herbs are not a part of the original texts. But knowledge of these aspects is also critical for Ayurvedic practitioners.
  • Almost no Ayurvedic text is available in its original form. Knowledge has evolved over a period of time, with several changes and redactions to these texts.
  • In an article published in the Indian Journal of Medical Ethics in July 2022, he says Ayurvedic texts state that blood is formed in the liver, spleen and stomach. This is taught in classes even today, despite modern medicine proving blood is formed in the bone marrow.

Lack of Patient Access:

  • The 2016 regulations say an institute must have a student-to-bed ratio of 1:1 and also has similar norms for out- and in-patient departments.
  • Customisation is the soul of Ayurveda clinical practice and the demand of the current era (in modern medicine) is standard operating protocols. This is why being an Ayurveda clinician is a difficult task.
  • The skill set needs to be reinvented and reintroduced so that students of the current programme can be armed to address the needs of society appropriately. This expertise should not be developed only for today but what will be required in the coming years.

Need For Direction:

  • To address the above hurdles, the Ayush Ministry in 2014 launched the National Ayush Mission, which includes targeted attention to strengthen educational systems. The scheme has been expanded till 2026. Under it:
    1. Kerala introduced an Ayush Policy in 2016 with the aim to elevate Ayush colleges to “premium quality” and promote academic and clinical research through a centralised facility.
    2. Uttarakhand made similar observations in its Ayush Policy in 2018 and outlined steps to upgrade medical education institutes and implement a robust regulatory framework to ensure standardised quality education.
    3. Maharashtra, Punjab, Tamil Nadu, Assam, Himachal Pradesh, Gujarat, Bihar and Uttar Pradesh have allowed Ayush practitioners to prescribe modern medicine.

Watered down

Context:

  • Most states have recently started reviving their small rivers, but the progress remains far from satisfactory.

About:

  • India has been cleaning up its polluted rivers for many decades now. In the past three years alone, the country has spent over 4,000 crore on two flagship programmes, namely Namami Gange and the National River Conservation Plan.
  • As per the data available with the Central Pollution Control Board, 46% of the 603 Indian rivers remain polluted in December 2022.

What are the issues?

  • India’s river cleanup drives have failed because the country has focused on major rivers alone. They were bound to fail because small rivers eventually merge with major rivers and pollute them.
  • Starting 2019, the focus has widened to include small rivers and tributaries in revival programmes.
  • Besides the two flagship schemes like Namami Gange and the National River Conservation Plan, several other programmes such as Swachh Bharat Mission, Smart Cities Mission have components to arrest river pollution.
  • Today, every state is working for the revival and restoration drives of small rivers in four states to gauge the progress and the challenges.

Uttar Pradesh:

  • In July 2022, the state government claimed 60 rivers had been revived in the previous five years. The reality, though, is quite different. One of the 60 rivers is Gomti, which, as per the 2022 CPCB report, is the fifth most polluted river in the country.
  • Even the cleaned rivers remain vulnerable. Aami, which flows through four districts in the state, was cleaned up early this year after protests and intervention by the National Green Tribunal.
  • Sarayan river in Lakhimpur Kheri district is classified as a nullah in the government records, but was found as a tributary of Gomti through satellite images which is 249 km long.

Bihar:

  • In 2020, East Champaran district cleaned up an 80-km stretch of Dhanauti river, a tributary of Burhi Gandak, after spending over `3 crore to desilt the riverbed and initiate plantation drives.

Madhya Pradesh:

  • The state has identified 12 districts for restoration works under the Namami Gange, and not even one river rejuvenation project has been picked up till date.
  • State hasn't worked for mandatory common effluent treatment plants in industrial areas.

Kerala:

  • The state has a good track record of rejuvenating small rivers through its Haritha Keralam Mission, which uses Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) funds for the works.
  • One of the flagship projects under the Haritha Kerala Mission is the linking of Pamba and Manimala rivers with an artificial channel, which remains clogged most of the year.
  • Cleaning midland stretches, streams, starting from the source and ensuring rejuvenation up to the point it drains into the sea or backwaters is required.

More give than take in secret trade deals

Context:

  • The secrecy over trade negotiations of India with the EU and the UK means citizens are not privy to the deals that affect them directly, and are being expedited to the benefit of both sides.
  • This turns into an impossible balancing act for Indian negotiators who have to weigh the benefits of giveaways in terms of a concession that would hurt their domestic industries and their citizens.

What are the issues?

  • The Free Trade Agreements (FTAs) are comprehensive deals, in which goods and services can be bought and sold across international borders with little or no government tariffs, quotas, subsidies, or prohibitions to inhibit their exchange.
  • Rich nations use FTAs to seek more concessions from developing countries, especially on Intellectual Property Rights (IPRs) that are required by the World Trade Organization.
  • The European Commission has recently notified its Carbon Border Adjustment Mechanism (CBAM), a measure that will affect a range of India’s metal exports to the EU. More products will be affected down the line.
    1. The EU describes CBAM as a ‘landmark tool’ to help fight climate change, and says it is a tool to put a ‘fair price on the carbon emitted during the production of carbon intensive goods that are entering the EU, and to encourage cleaner industrial production in non-EU countries’.
    2. Other countries have called CBAM a coercive and punitive measure.
    3. BASIC countries—the group of Brazil, South Africa, India and China—say it violates the principles of the UN Framework Convention on Climate Change (UNFCCC) as well as the nationally determined spirit of the Paris Agreement, and marked it as a unilateral proposal for introducing trade barriers.

Impacts on India:

  • The EU is also India’s third largest trading partner. The EU accounts for 14% of India’s exports while India comes up to 2% of the EU’s exports.
  • One analyst estimates that the implementation of CBAM would hit India's metal sector significantly, since 27 percent of India's exports of iron, steel, and aluminium products worth US $8.2 billion go to the EU.
  • In the context of the demand for regulatory data protection and patent extension, India is determined to protect the it’s generic drug industry and its public healthcare programmes which rely on inexpensive generic medicines.
    1. Data exclusivity or regulatory data protection, a type of intellectual property protection which ensures that a generic drug manufacturer cannot rely on an innovator firm’s data for a specific period for gaining drug approvals, has been on the table with the EU for a decade.

Cool Solutions

Context:

  • India can significantly reduce the energy consumed by its building and construction sector by promoting contextual cooling mechanisms.

About:

  • The building and construction sector has significant energy consumption and carbon footprint.
  • NITI Aayog estimates that 65% of the energy demand in India comes from space cooling and heating.
  • As per the Union Ministry of Environment, Forest and Climate Change, India is projected to see an 11-fold increase in cooling demand in buildings by 2037-38, compared to the 2017-18 baseline.
  • Recognising the above threat, the country in 2019 became one of the first in the world to bring out a Cooling Action Plan (ICAP), predicted:
    1. Potential reduction of around 20% in cooling load could be achieved by 2037-38, through climate-appropriate building envelopes.
    2. An additional 30% reduction in cooling energy can be achieved through improvements in cooling equipment efficiency and better servicing and operation and maintenance practices.

Potential Solutions:

  • For households: Thermal comfort revolves around heating and cooling in which humidity and air velocity are important attributes. For example, ceiling fan which does not reduce the temperature of the air but blows away the heat generated by equipment or human bodies, or the desert cooler, which apart from cooling also introduces humidity, and is especially useful during the hot and dry months.
  • However, large-scale spaces also require cooling solutions that are low in energy consumption and are applicable in varying contexts and climatic conditions. These include:
  1. Tapping the earth’s potential: The temperature below the Earth’s surface (nearly 4 metres) remains relatively constant throughout the year. The Earth can thus work as a heat sink or a heat source depending on the season and requirements.
    • Earth air tunnel: It cools the air without adding humidity. In this process, air travels through underground tunnels for around 100 metres before entering indoor spaces. The technology can reduce the temperature of the air by 10-12°C during the start of the summer season.

 

 

 

 

 

  1. Passive downdraft cooling: In this process, hot ambient air is made to enter from a central column fitted with water sprinklers. This creates a mist at the top of the tower, which helps cool the air.