DAILY MAINS NEWSLETTER FOR UPSC | 11 MAY 2021|RaghukulCS

Daily Mains Newsletter For UPSC
| RaghukulCS

11 May 2021

Index

Mains Value Addition

Mains Analysis

Topic No

Topic Name

Source

1

Decoding inequality in a digital world

The Hindu

2

The Middle East reset

Indian Express

Mains Value Addition

A national health service in India

Syllabus -Issues relating to development and management of Social Sector/Services relating to Health

Analysis: –

  • India’s healthcare providers, however, have the task of serving 1.4 billion people, for the overwhelming majority of whom sickness or serious injury of any kind is a matter of lifelong dread.
  • Medical expenses constitute the major reason for personal debt in India, whether the causes are episodic afflictions or, for example, those caused by environmental conditions which none can escape, such as air pollution (which the journal Lancet Planetary Health says this accounted for 1.7 million deaths in India in 2019; the annual business cost of air pollution is currently estimated at $95 billion, which is about 3% of India’s GDP).
  • In effect, COVID-19 may bring about serious consideration of an Indian national health service.
  • National public discussion of that would be almost unprecedented in India, but the idea itself is not new.
  • In 1946, the civil servant Sir Joseph Bhore submitted to the then government a detailed proposal for a national health service broadly modelled on the British National Health Service or NHS, which was on the way towards legislative approval in Britain.
  • Bhore went further by recommending that preventive and curative medicine be integrated at all levels.

How the National Task Force on oxygen supply must guide Covid response

Syllabus -Issues relating to development and management of Social Sector/Services relating to Health

Analysis: –

  • In the wake of the oxygen supply crisis in Covid-19 management in India, the Supreme Court has set up a 12-member National Task Force (NTF) to guide, inter alia, the central government allocation of medical oxygen to the states.
  • The task force will work with senior officials of NITI Aayog, the Ministry of Home Affairs and the Department of Promotion of Industry and Internal Trade as well as the All-India Institute of Medical Sciences, the Indian Council of Medical Research and the Directorate General of Health Services.
  • The Supreme Court has also mandated that the task force may constitute more sub-groups on specialised areas or regions to assist in its work and also to consider, if appropriate, seeking the assistance of experts both within and outside government in areas such as critical care, infectious disease modelling, clinical virology and immunology, and epidemiology/ public health.
  • The rationale for setting up the task force has been to facilitate a public health response to the pandemic based upon scientific and specialised domain knowledge.
  • It is hoped that the establishment of the NTF will help the decision-makers with inputs that can enable them to go beyond ad hoc solutions to the unprecedented challenge.
  • In the 12-point terms of reference (ToR) of the NTF, the first five points focus on oxygen supply, including, deciding on a methodology for the scientific allocation of oxygen to states and facilitating audits (of oxygen supply, distribution and utilisation) by sub-groups within each state and UTs.

Mains Analysis

Decoding inequality in a digital world

Why in News?

Technological changes in education and health are worsening inequities.

Syllabus–GS 3: Inclusive Growth, Science and Technology

  • Virginia Eubanks’ widely acclaimed book, Automating Inequality, alerted us to the ways that automated decision-making tools exacerbated inequalities, especially by raising the barrier for people to receive services they are entitled to.
  • The novel coronavirus pandemic has accelerated the use of digital technologies in India, even for essential services such as health and education, where access to them might be poor.
  • Economic inequality has increased: people whose jobs and salaries are protected, face no economic fallout. The bulk of the Indian population, is suffering a huge economic setback.
  • Several surveys conducted over the past 12 months suggest widespread job losses and income shocks among those who did not lose jobs.
  • The major channels of economic and social mobility i.e. Health and Education have got
  • a setback thus increased unaccessibilty leading to more inequality.
  • Data from various national level sample surveys reveals that switch to online education for the most vulnerable has not been seamless.
  • According to National Sample Survey data from 2017, only 6% rural households and 25% urban households have a computer. Access to Internet facilities is not universal either: 17% in rural areas and 42% in urban areas.
  • Smartphones with data has improved access over the past four years, yet a significant number of the most vulnerable are struggling.
  • Surveys by the National Council of Educational Research and Training (NCERT), the Azim Premji Foundation, ASER and Oxfam suggest that between 27% and 60% could not access online classes for a range of reasons: lack of devices, shared devices, inability to buy “data packs”, etc.
  • There is a lack of learning environment at home for many households live in small
  • dweelings, additionally girls also face the burden of domestic chores.
  • Peer learning suffered due to closure of schools and universities.
  • Health care faces the similar challenges. India’s abysmally low public spending on health (barely 1% of GDP).
  • As a result, the share of ‘out of pocket’ (OOP) health expenditure in India was over 60% in 2018. Even in a highly privatised health system such as the United States, OOP was merely 10% .
  • The private health sector in India is poorly regulated in practice. As a result the poor at a disadvantage in accessing good health care.
  • Right now, the focus is on the shortage of essentials: drugs, hospital beds, oxygen, vaccines. In several instances, developing an app is being seen as a solution for allocation of various health services. But this is not a panacea more needs to be done.
  • Patients are being charged heftily by private health services, and a black market has developed for scarce services (such as oxygen). The solution to such corrupt practices would be to clamp down on the handful who indulge in them.
  • Platform- and app-based solutions can exclude the poor entirely, or squeeze their access to scarce health services further.

In other spheres (e.g., vaccination) too, digital technologies are creating extra hurdles. The use of CoWIN to book a slot makes it that much harder for those without phones, computers and the

  • Data from various national level sample surveys reveals that switch to online education for the most vulnerable has not been seamless.
  • According to National Sample Survey data from 2017, only 6% rural households and 25% urban households have a computer. Access to Internet facilities is not universal either: 17% in rural areas and 42% in urban areas.
  • Smartphones with data has improved access over the past four years, yet a significant number of the most vulnerable are struggling.
  • Surveys by the National Council of Educational Research and Training (NCERT), the Azim Premji Foundation, ASER and Oxfam suggest that between 27% and 60% could not access online classes for a range of reasons: lack of devices, shared devices, inability to buy “data packs”, etc.
  • There is a lack of learning environment at home for many households live in small
  • dweelings, additionally girls also face the burden of domestic chores.
  • Peer learning suffered due to closure of schools and universities.
  • Health care faces the similar challenges. India’s abysmally low public spending on health (barely 1% of GDP).
  • As a result, the share of ‘out of pocket’ (OOP) health expenditure in India was over 60% in 2018. Even in a highly privatised health system such as the United States, OOP was merely 10% .
  • The private health sector in India is poorly regulated in practice. As a result the poor at a disadvantage in accessing good health care.
  • Right now, the focus is on the shortage of essentials: drugs, hospital beds, oxygen, vaccines. In several instances, developing an app is being seen as a solution for allocation of various health services. But this is not a panacea more needs to be done.
  • Patients are being charged heftily by private health services, and a black market has developed for scarce services (such as oxygen). The solution to such corrupt practices would be to clamp down on the handful who indulge in them.
  • Platform- and app-based solutions can exclude the poor entirely, or squeeze their access to scarce health services further.
  • In other spheres (e.g., vaccination) too, digital technologies are creating extra hurdles. The use of CoWIN to book a slot makes it that much harder for those without phones, computers and the Internet. Non availability of website in local languages is also a barrier to many.

    Online sharks

    • Interoperability can be achieved by decentralising digital storage as France and Taiwan have done. Yet, the Indian government is intent on creating a centralised database.

    Gender Inequality in India

    • This digital divide between rural and urban regions exacerbates many other social divides present in Indian society.
    • In fact, India’s digital divide contributes to social gender inequality. For example, 36% of Indian males have mobile internet access compared to only 16% of females.
    • This inequality of digital access across genders creates greater dependence on men for women who often rely financially on their spouses in the Indian family dynamic.
    • These women would, therefore, not be able to afford a device on their own.
    • In addition, as the male head of the family is often the only member to possess a digital device, women rely on their spouses to have internet connectivity.
    • This limits what and for how long they may use these devices. Some villages even limit women’s use of mobile phones, further hindering their connectivity to social media and educational resources and information. This diminishes women’s overall digital empowerment and independence.
    • By limiting women’s freedom to use the internet, these villages also restrict the possibility of individual growth and evolution of perspective by blocking access to the digital global network.

    Way Forward: –

    • Health expenditure on basic health services (ward staff, nurses, doctors, laboratory technicians, medicines, beds, oxygen, ventilators) needs to be increased, apps such as Aarogya Setu, Aadhaar and digital health IDs can improve little.
    • Laws against medical malpractices needed to be enforced strictly, digital solutions may obfuscate and distract us from the real problem. We need political, not technocratic, solutions.
    • We need to learn from past experience of Aadhar which caused welfare exclusion of many. Thus pandemic should not repeat the same.

    Question: –

    The digital divide in India is challenging the nation’s current educational and health initiatives. Critically evaluate the statement.

     

  • The digital health ID project faces the challenge of breach of data and thus ending up private entities while we lack proper data privacy law.We need decentralised database for better access and protection of data.

The Middle East reset

Why in News?

Editorial on American role in Afghanistan and middle east.

Syllabus– GS2: India & Its Neighbourhood Relations

  • As the last American troops begin to leave Afghanistan and the US turns away from the Middle East to the Indo-Pacific, there is a scramble to redo the foreign policy maths in the region.
  • Since it replaced Britain as the major external power in Greater Middle East half a century ago, America has been the pivot around which the regional politics has played out.
  • The old colonial powers of Europe deferred to American leadership in the region. Russia and China, in contrast, sought to chip away at US dominance.
  • Many regional actors sought alliances with America to secure themselves against ambitious or troublesome neighbours. Others sought to balance against America.
  • But as Washington recasts its role in the region, new realignments have become inevitable.

Brief Background: The Power Game in the Region

  • Before the 1970s, Britain is the major external power in Greater Middle East Region.
  • But half a century ago, the USA replaced it & has been playing a pivot role in regional politics.
  • While the old European powers deferred to American leadership, both Russia & China sought to chip away at US dominance in the region.
  • Many regional actors sought alliances with the USA to secure themselves while some sought to balance against it.
  • But as Washington recasts its role in the region, new realignments have become inevitable.

What Changed USA stances?

  • From Israel’s security to regional peace & stamping out terrorism are no longer compelling factors demanding massive USA’s military, political & diplomatic investments in the region.
  • After prolonged intervention in the region, the US realized that it can’t fix centuries-old conflicts in the region.
  • As global power equations are changing, the battle arena has been shifted to Indo-pacific that demands the US to counter assertive China.

US departure from Afghanistan: Changing Regional Equations

  • With the US exit, the regional actors either need alternate powers or reduced tensions with their neighbours.
  • Although Russia & China have regional ambitions neither can bring the kind of strategic heft the US brought.
  • It forces regional actors in adapting to live with neighbours.
  • Turkey figured out that its troubled economy can’t sustain the ambitious regional policies.
  • After years of efforts in challenging Saudi leadership & destabilizing Egypt, Turkey has started to amend with both nations.
  • After prolonged intense hostility, Saudi & Iran are exploring ways to reduce bilateral tensions & proxy wars in the region.
  • Saudi is trying to heal the internal Gulf rift by reaching out to Qatar.
  • All these changes come at a time when Arab states normalize ties with Israel.
  • India has been pragmatic by emphasizing good relations with all the regional actors except Turkey that has turned hostile to India in the recent past.
  • India’s expansion of ties with most regional actors may encourage Turkey to take a fresh look towards India.
  • But Pakistan has struggled to recalibrate its policies towards the Middle East.
  • Despite benefits arising from it, Pakistan is unable to overcome domestic ideological opposition to establish diplomatic ties with Israel.
  • It also fell between the stools in coping with regional rivalries in the Middle East.
  • The rivalry with Saudi & UAE brought Pakistan to its knees & with great efforts Pakistan mend its ties with Gulf nations.
  • Pakistan’s about-turn on Saudi underlines that the Subcontinent does not have the luxury of relying on old ideological tropes in a region that is undergoing a major transformation.
  • Nationalism, Economic interests & Regime security trumped transcendental ideologies.

 For India & Pakistan:

  • The regional reset in the Middle East has coincided with efforts by India & Pakistan to cool their tensions.
  • The ceasefire agreement on the Line of Control in Kashmir.
  • Pakistan’s changed stances on the Kashmir issue.
  • For very different reasons, both nations long assumed that the US role in the greater Middle East unchanging.
  • For very different reasons, both nations long assumed that the US role in the greater Middle East unchanging.
  • At this juncture, US departure from Afghanistan poses major challenges to the Subcontinent.
  • For India, US military presence would have kept a check on extremist forces & created a conducive environment for India’s role in Afghan.
  • For Pakistan, The presence keeps the US utterly dependent on Pakistan for geographic access & operational support, which would be mobilized against India.
  • Now with the US leaving, Both nations have to live with the consequences that include the triumphal return of the Taliban to power.
  • The prospect of trans-border links between the Taliban & other extremist forces in the region is a challenge that South Asian nations will have to confront.

Way-Ahead:

  • A state that cedes power to the extremism of any kind courts the danger of being consumed by it.
  • The need of the hour is that both India & Pakistan must come to terms with the changing dynamics in Greater Middle East.
  • Unless the regional actors collaborate on countering extremism & terrorism, every one of them will be weakened.

 Question: –

India & Pakistan long assumed that American role in the Middle East was unchanging, both must now imagine a region that is not micromanaged by the US. Discuss.

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