Strengthening the Fight Against Tuberculosis (TB)

 Even though the war against tuberculosis (TB) has been ongoing for more than 30 years since it was deemed a worldwide health emergency, the 2030 deadline for its eradication remains undetermined. To achieve the aim of eradicating TB by 2030, the fight against the disease requires a renewed focus on three crucial areas, namely vaccine development, the discovery of novel therapeutic drugs, and enhanced diagnostics.

Background

The 1993 World Development Report noted that adult TB treatment was the best investment out of all developmental strategies at the time the World Health Organization designated TB a worldwide health emergency.

Since then, there has been a lack of urgency and a delayed worldwide response to TB.

Global Fund

The Global Fund to Fight AIDS, TB, and Malaria was created in response to the call for action against TB at the G7 summit in Okinawa, Japan, in 2001.

The Global Fund has become the single largest channel of additional funding for global TB control.

However, it faces constraints due to zero-sum games from donor constituents and competition between the three diseases it finances.

StopTB Partnership

The StopTB Partnership was constituted to mobilize and marshal a disparate set of actors towards the goal of ending TB.

It has been adapting to changes, such as using molecular diagnostic tools developed to respond to bioterrorism to diagnose TB and using social safety programs to address the poverty drivers of the TB epidemic.

Three key areas that need attention

Vaccine development:

The development of an adult TB vaccine is the first area that needs urgent attention.

The current vaccine is 100 years old, and the development and wide use of an adult TB vaccine are essential to ending TB.

COVID-19 vaccine development process provides insights into accelerating the process.

India’s capabilities can play a significant role in vaccine development and equitable distribution.

Newer therapeutic agents for TB:

A few new anti-TB drugs are available but face cost and production constraints.

Shorter, injection-free regimens are needed to improve compliance and reduce patient fatigue.

A continuous pipeline of new drugs is essential to combat drug resistance.

Improved diagnostics:

AI-assisted handheld radiology and passive surveillance of cough sounds can revolutionize TB diagnostics.

Incentivize biotech startups to disrupt the complexity and price barriers of molecular testing.

Old Pension Scheme (OPS): A Call for Equitable Distribution of Resources

India is seeing an increase in demand for the old pension scheme (OPS), especially after certain states declared plans to switch back to it. Inefficiency and worries about the budget deficit are the main foci of the mainstream criticism of OPS. However, it is imperative to look at the policy from the perspectives of class and welfare.

Describe pension.

A pension is a retirement program that gives people a regular income stream once they leave their jobs or professions. It is intended to provide a consistent income throughout retirement and may be supported by companies, governmental bodies, or unions.

What is Old Pension Scheme (OPS)?

The OPS, also known as the Defined Benefit Pension System, is a pension plan provided by the government for its employees in India.

Under the OPS, retired government employees receive a fixed monthly pension based on their last drawn salary and years of service.

This pension is funded by the government and paid out of its current revenues, leading to increased pension liabilities.

Analyzing the Impact of OPS on India’s Socio-Economic Landscape

Inequality and Regressive Redistribution: Under the National Pension System (NPS), the Sixth Pay Commission increased the basic salary of government employees to cover pension contributions and promote post-retirement savings. As a result, the salary of a government employee is higher than the income of more than 90% of the population. The OPS thus acts as a regressive redistribution mechanism favoring a better-off class.

Rising Pension Liabilities: Pension liabilities of the government increased substantially due to the Sixth pay matrix, reaching 9% of total state expenditure. By 2050, pension expenditure will account for 19.4% of total state expenditures, assuming the current growth rate remains constant.

Disproportionate Burden on the Lower Class: The bottom 50% of the population faces the inequitable burden of indirect taxation, six times more than their income. Due to OPS, they must bear the burden of supporting government employees’ pensions, which could push them further into poverty.

Expenditure Challenges and Public Goods: As India’s population ages and public provision of education and healthcare becomes more critical, OPS poses expenditure challenges for providing public goods. This situation compels governments to compress already low social sector expenditures, pushing marginalized groups into further destitution.

Monopolization of Future Labor Markets: The OPS facilitates the monopolization of future labor markets in the private sector by a proprietary class, allowing supervisory bureaucracy to consolidate its position and emerge as a dominant group.

Recommendations for Equitable Resource Distribution

Opposition to the OPS should focus on equitable distribution of resources and expansion of universal provisions of public goods.

Implement a participatory pension system for government employees to provide more egalitarian outcomes.

Tweak the NPS to provide a guaranteed monthly return for lower-rung employees.

Address unequal pay among various ranks of employees through administrative reforms.

Advocate for progressive taxation of the top 10% and a rationalization of political executives’ pensions and profligacy.

Rajasthan becomes first state to guarantee Right to Health

The Right to Health (RTH) was approved by the Rajasthan Assembly despite doctors’ ongoing opposition to the Bill and demands for its total retraction.

Right to Health (RTH): A theoretical understanding

Everyone has the right to the best possible level of bodily and mental health, which is a fundamental human right.

It is a fundamental component of the right to a minimum standard of living and is protected by international human rights legislation.

Area of RTH

RTH addresses a range of health-related topics, including:

Access to healthcare services, clean water and sanitation, adequate nutrition, healthy living and working conditions, health education, and disease prevention.

Accessible, affordable, and quality healthcare services,

Eliminating barriers to healthcare access

Informed consent to medical treatment and accessing information about their health.

What is the Rajasthan Right to Health Bill?

Free treatment: RTH gives every resident of the state the right to avail free Out Patient Department (OPD) services and In Patient Department (IPD) services at all public health facilities and select private facilities.

Wider scope of healthcare: Free healthcare services will include consultation, drugs, diagnostics, emergency transport, procedures, and emergency care. However, there are conditions specified in the rules that will be formulated.

Free emergency treatment: Residents are entitled to emergency treatment and care without prepayment of fees or charges.

No delay in treatment: Hospitals cannot delay treatment on grounds of police clearance in medico-legal cases.

State reimbursement of charges: After emergency care and stabilisation, if patients do not pay requisite charges, healthcare providers can receive proper reimbursement from the state government.

Existing schemes in Rajasthan

The flagship Chiranjeevi Health Insurance Scheme provides free treatment up to Rs 10 lakh, which has been increased to Rs 25 lakh in the latest budget.

The Rajasthan Government Health Scheme covers government employees, ministers, current and former MLAs, etc.

The Nishulk Nirogi Rajasthan scheme provides free OPD and IPD services in government hospitals and covers about 1,600 medicines, 928 surgicals, and 185 sutures.

The Free Test scheme provides up to 90 free tests in government hospitals and has benefited 2.93 crore persons between March-December 2022.

Need for the RTH Scheme

The state prioritizes healthcare and wants Rajasthan to be a great example of good health.

The Health Minister has received many complaints about private hospitals asking for money from patients who have the Chiranjeevi card.

So, they are bringing in a new law to stop this.

The new law will make sure that future governments follow it and provide free healthcare to everyone.

Controversy with the RTH Law: Emergency Care Provisions

Emergency care was a contentious issue in the RTH.

The clause states that people have the right to emergency treatment and care for accidental emergency, emergency due to snake bite/animal bite and any other emergency decided by the State Health Authority under prescribed emergency circumstances.

Emergency treatment and care can be availed without prepayment of requisite fee or charges.

Public or private health institutions qualified to provide such care or treatment according to their level of health care can offer emergency care.

 Criminalization of Marital Rape

A number of petitions asking for the criminalization of marital rape have been accepted by the Supreme Court.

What Is Domestic Violence?

The act of having sex with one’s spouse against her will is known as marital rape.

It is a sign of sexual abuse much like domestic abuse is.

For the victim, it is frequently a recurring act of violence that takes place in abusive relationships.

Condition in India

Historically considered as right of the spouses, this is now widely classified as rape by many societies around the world.

In India, marital rape is not a criminal offense (as protected under IPC section 375).

India is one of fifty countries that have not yet outlawed marital rape.

Recent observations by Delhi HC

Spousal intimacy: In a marriage, conjugal expectation is a two-way street, where “consent is given as a part of spousal intimacy although the will to engage may be absent”.

Need for written agreement: If every such case is treated as marital rape, then the only way partners in a marriage may survive would be by drawing up a detailed written agreement.

Burden of evidentiary record: This would lead to creating a detailed evidentiary record of every act of intimacy and/or by inviting a third party to act as a witness.

Defying marital obligations: The HC said that marriage was accompanied by obligations that the partners had to bear, including conjugal expectations, financial obligations and, finally, duty towards progeny.

Sexual liberty of spouses: The bench also underlined the signs of injury on a partner need not necessarily mean there had been non-consensual sex as “in the age of sexual liberation”, injuries could be a sign of “passion”.

Cruelty not rape: Forced sexual intercourse between a husband and wife cannot be treated as rape. At worst, it can be treated as sexual abuse found in Section 3 of the Domestic Violence Act.

Clash of ego: A wife cannot prescribe a particular punishment that can be imposed on the husband ‘to satisfy her ego’,” the HC said.

Reasons for rebuttal of this concept

The reluctance to define non-consensual sex between married couples as a crime and to prosecute has been attributed to:

Traditional views of marriage

Interpretations of religious doctrines

Ideas about male and female sexuality

Cultural expectations of subordination of a wife to her husband

It is widely held that a husband cannot be guilty of any sexual act committed by himself upon his lawful wife their on account of their mutual matrimonial consent.

Why it must be a crime?

Associated physical violence: Rape by a spouse, partner or ex-partner is more often associated with physical violence.

Mental harassment: There is research showing that marital rape can be more emotionally and physically damaging than rape by a stranger.

Compulsive relationship: Marital rape may occur as part of an abusive relationship.

Revengeful nature: Furthermore, marital rape is rarely a one-time event, but a repeated if not frequent occurrence.

Obligation on women: In the case of marital rape the victim often has no choice but to continue living with their spouse.

Violation of fundamental rights

Marital rape is considered as a violation of FR guaranteed under Article 14 of the Indian constitution which guarantees the equal protection of laws to all persons.

By depriving married women of an effective penal remedy against forced sexual intercourse, it violates their right to privacy and bodily integrity, aspects of the right to life and personal liberty under Article 21.

Problems in prosecuting marital rape

Lack of awareness: A lack of public awareness, as well as reluctance or outright refusal of authorities to prosecute is common globally.

Gender norms: Additionally, gender norms that place wives in subservient positions to their husbands, make it more difficult for women to recognize such rape.

Acceptability of the concept: Another problem results from prevailing social norms that exist.

Present regulations in India

Indian Penal Code criminalizes rape in most cases, although marital rape is not illegal when the woman is over the age of 18.

However, until 2017, men married to those between 15 and 18 could not be convicted of rape.

Marital rape of an adult wife, who is unofficially or officially separated, is a criminal offence punishable by 2 to 7 year in prison; it is not dealt by normal rape laws which stipulate the possibility of a death sentence.

According to the Protection of Women From Domestic Violence Act (2005), other married women subject to such crime by their husband may demand for financial compensation.

They also have the right to continue to live in their marital household if they wish, or may approach shelter or aid homes.

However, marital rape is still not a criminal offence in this case and is only a misdemeanour.

Chinese firm to build Solomon Islands Port Project

An important port in the Solomon Islands, Honiara, will be developed by a Chinese business with official backing. For China, which is attempting to establish a strategic presence in the South Pacific, this is a significant achievement.

Why talk about this?

Following the signing of a covert security agreement between the Solomon Islands and Beijing in 2022, the Solomon Islands have become a focal point in the diplomatic dispute between China and the US.

This has sparked worries that China might be setting up a permanent naval station there.

Concerning Solomon Islands

Oceania’s Solomon Islands, a sovereign state made up of six major islands and more than 900 smaller ones.

Its capital, Honiara, is located on the largest island, Guadalcanal.

It is part of the ethnically Melanesian group of islands in the Pacific and lies between Papua New Guinea and Vanuatu.

The country takes its name from the Solomon Islands archipelago, which is a collection of Melanesian islands that also includes the North Solomon Islands (a part of Papua New Guinea).

It excludes outlying islands, such as the Santa Cruz Islands and Rennell and Bellona.

How did China enter the picture?

Earlier this year, the Solomon Islands established a security agreement with China, saying it needed Beijing’s assistance with its domestic security situation.

But the announcement had rattled the west, esp. the US, Australia and others in the Indo-Pacific region.

The concerns were that the agreement could potentially lead to a Chinese military base on the island nation and a gain in power-projection capabilities.

At that time, following intense scrutiny, the Solomon Islands had denied that the agreement would allow China to establish a naval base.

What is the Solomon Islands’ stance?

The government has asked all partner countries with plans to conduct naval visits or patrols to put them on hold until a revised national mechanism is in place.

The revised national mechanism applied to all foreign vessels seeking access to the country’s ports.

The nation wanted to build up its own naval capacity.

It has some unfortunate experiences of foreign naval vessels entering its waters without any diplomatic clearance.

What is behind China’s growing influence in the region?

There is no dispute that China has been rapidly increasing its presence and influence in the region for over three decades, particularly in the South Pacific.

Certainly Beijing views the Pacific Island region as an important component of its Belt and Road Initiative (BRI).

Specifically, it sees the region as a critical air freight hub in its so-called Air Silk Road, which connects Asia with Central and South America.

Concerns of the West

The port project could open the door to a Chinese naval base, which would significantly extend China’s military reach in the South Pacific.”

It is likely that this security agreement between China and the Solomon Islands has been driven by, what the CFR calls, Beijing’s “sense of vulnerability” in the region.

Sharda Peeth

Home Minister said that the government will move forward to open Sharda Peeth on the lines of the Kartarpur corridor.

Why in news?

Activists request that the Sharda Peeth corridor should be made operational on the lines of Nankana Sahib Gurudwaras and the Kartarpur corridor in Pakistan.

Sharda Peeth is a Hindu temple located in the Neelam Valley in Pakistan-occupied Kashmir.

It is considered one of the 18 Maha Shakti Peethas, or major shrines, of the Hindu goddess Shakti.

The temple is an important pilgrimage site for Hindus, particularly those from the Kashmir Valley.

History and Significance

The temple is believed to have been established in the 6th century CE by Adi Shankaracharya, a famous Hindu philosopher and saint.

Sharda Peeth became an important center of learning and scholarship during the medieval period, attracting scholars from all over India and even from as far as Central Asia.

The temple was destroyed several times by invading armies and underwent major renovations and restorations under various rulers over the centuries.

The temple’s importance declined during the colonial period and it fell into disrepair in the years following India’s partition in 1947.

Current rundown state and Controversy

Sharda Peeth is now located in a remote and inaccessible part of Pakistan-administered Kashmir and has become a subject of political and religious controversy.

The Indian government has long sought to open a pilgrimage corridor to Sharda Peeth for Hindu devotees, but this has been complicated by the ongoing conflict and tension between India and Pakistan over Kashmir.

In recent years, there have been calls for the temple to be handed over to India or for it to be converted into a museum that can be visited by people from both sides of the border.