World AIDS Day 2020
World AIDS Day is observed on 1st December every year worldwide.
➤ Key Points
- It was founded in 1988 by the World Health Organization (WHO) and was the first-ever global health day with a motto of raising public awareness about Acquired Immunodeficiency Syndrome (AIDS).
- AIDS is a pandemic disease caused by the infection Human Immunodeficiency Virus (HIV), which damages the human immune system. o In 2019, 6,90,000 people died from HIV-related causes and 1.7 million people were newly infected, with nearly 62% of these new infections occurring among key populations and their partners.
➤ Theme for 2020
- "Global solidarity, resilient HIV services."
- On World AIDS Day 2020, WHO is calling on global leaders and citizens to rally for "global solidarity" to overcome the challenges posed by Covid-19 on the HIV response.
- HIV prevention, testing, treatment and care services are all being disrupted particularly in countries with fragile health systems.
- Slowing progress means the world will be missing the "90-90-90" targets for 2020, which were to ensure that: 90% of people living with HIV are aware of their status, 90% of people diagnosed with HIV are receiving treatment, and 90% of all people receiving treatment have achieved viral suppression.
- Any slowing down in providing these services will leave many vulnerable populations at greater risk of HIV infection and AIDS-related deaths and missing these intermediate targets will make it difficult to achieve the target of eliminating AIDS by 2030.
- In 2020, the International Year of the Nurse and the Midwife, it calls for more protection and support to these health workers who have long been on the frontline of HIV service delivery.
- It reminds the public and government that HIV has not gone away and there is still a vital need to raise money, increase awareness, fight prejudice and improve education.
- It is an opportunity to show solidarity with the millions of people living with HIV worldwide.
Global Teacher Prize 2020
Ranjitsinh Disale, a primary teacher from Maharashtra's Solapur, has won the Global Teacher Prize 2020.
➤ Global Teacher Prize
- It is a 1 million dollar award presented annually to an exceptional teacher who has made an outstanding contribution to their profession.
- Founder: Varkey Foundation, which is a global charitable foundation focused on improving the standards of education. The award is organised in partnership with UNESCO.
(i) It serves to underline educators' importance and the fact that, throughout the world, their efforts deserve to be recognised and celebrated.
(ii) It seeks to acknowledge the impacts of the very best teachers not only on their students but on the communities around them. Inadequate education is a major factor behind the world's social, political, economic and health issues today. Education has the power to reduce poverty, prejudice and conflict.
➤ Ranjitsinh Disale's Contribution
- He changed a dilapidated school to a school that became the first in Maharashtra to introduce Quick Response (QR) Codes.
- A QR code is a type of barcode that contains a matrix of dots. It can be scanned using a QR scanner or a smartphone with a built-in camera.
- He translated the class textbooks into his pupils' mother tongue and embedded them with unique QR codes to give students access to audio poems, video lectures, stories, and assignments.
- He is also passionate about building peace between young people across conflict zones. His 'Let's Cross the Borders' project connects young people from India and Pakistan, Palestine and Israel, Iraq and Iran and the USA and North Korea.
➤ Impact of Disale's Efforts
- There are now no reported teenage marriages in the village and 100% attendance of girls at the school.
- The state government announced in 2017 that they would introduce QR coded textbooks across the state for all grades.
- In 2018, it was announced that all NCERT textbooks would have embedded QR Codes.
Some Indian initiatives to Improve Education Sector
➤ National Education Policy 2020
- The teacher must be at the centre of the fundamental reforms in the education system.
- The new education policy must help recruit the very best and brightest to enter the teaching profession at all levels, by ensuring livelihood, respect, dignity, and autonomy, while also instilling in the system basic methods of quality control and accountability.
➤ Revitalising Infrastructure and Systems in Education (RISE) by 2022
- Focuses on qualitatively upgrading India's research and academic infrastructure to global best standards by 2022.
➤ UGC's Learning Outcome-based Curriculum Framework (LOCF)
- LOCF guidelines, issued by UGC in 2018, aim to specify what graduates are expected to know, understand and be able to do at the end of their study programme. This is to make students an active learner and teacher a good facilitator.
➤ Global Initiative for Academics Network (GIAN)
- The programme seeks to invite distinguished academicians, entrepreneurs, scientists, experts from premier institutions from across the world, to teach in the higher educational institutions in India.
➤ All India Survey on Higher Education (AISHE)
- The main objectives of the survey are to identify & capture all the institutions of higher learning in the country; and collect the data from all the higher education institutions on various aspects of higher education.
- It was launched in 2015 with an aim to promote self-learning among the school students.
- The portal hosts various school teachers, researchers, experts, parents, and most importantly students who can access the facility of resolving their queries.
➤ Global Initiative
- Global Education Monitoring Report: It is released by the United Nations Educational, Scientific and Cultural Organization (UNESCO) which aims to monitor progress towards the education targets in the Sustainable Development Goals (SDG-4).
Initiatives to Eliminate Manual Scavenging
Recently, the government has announced two major initiatives for ending the hazardous practice of manual cleaning of septic tanks and sewer lines and making the mechanised cleaning must.
- The Ministry of Social Justice and Empowerment will amend the law for making machine cleaning mandatory, whereas the Ministry of Housing and Urban Affairs has launched the Safaimitra Suraksha Challenge.
➤ Amending the Law
- Introduction of the Prohibition of Employment as Manual Scavengers and their Rehabilitation (Amendment) Bill, 2020 as a part of the Social Justice and Empowerment Ministry's National Action Plan.
- The plan aims to modernise existing sewage system and coverage of non-sewered areas; setting up of faecal sludge and septage management system for mechanised cleaning of septic tanks, transportation and treatment of faecal sludge; equipping the municipalities, and setting up of Sanitation Response Units (SRUs) with helplines.
➤ Changes Brought by the Bill
- Mechanised Cleaning: Completely mechanise sewer cleaning and provide better protection at work and compensation in case of accidents.
- Penalty: Make the law banning manual scavenging more stringent by increasing the imprisonment term and the fine amount.
- Currently, engaging any person for hazardous cleaning of sewers and septic tanks by any person or agency is punishable with imprisonment of up to five years or a fine of up to Rs. 5 lakh or both.
- Funds: They will be provided directly to the sanitation workers and not to the municipalities or contractors to purchase the machinery.
➤ Safaimitra Suraksha Challenge
- Launch: The challenge was launched among 243 major cities on World Toilet Day (19th November).
- It aims to prevent hazardous cleaning of sewers and septic tanks and promote their mechanized cleaning.
- The Government launched this challenge for all states to make sewer-cleaning mechanised by April 2021, if any human needs to enter a sewer line in case of unavoidable emergency, proper gear and oxygen tanks, etc. are to be provided.
- Eligibility: The state capitals, urban local bodies and smart cities will be eligible to participate.
- Prize: Cities will be awarded in three sub-categories, with a population of more than 10 lakhs, 3-10 lakhs and up to 3 lakhs, with total prize money of Rs. 52 crores to be given to winning cities across all categories. Manual Scavenging
- Definition: Manual scavenging is defined as "the manual removal of human excrement from public streets and dry latrines, cleaning septic tanks, gutters and sewers".
➤ Reasons for the Prevalence
- Indifferent Attitude: A number of independent surveys have talked about the continued reluctance on the part of state governments to admit that the practice prevails under their watch.
- Issue due to Outsourcing: Many times local bodies outsource sewer cleaning tasks to private contractors. However, many of them fly-bynight operators, do not maintain proper rolls of sanitation workers.
- In case after case of workers being asphyxiated to death, these contractors have denied any association with the deceased.
- Social Issue: The practice is driven by caste, class and income divides.
- It is linked to India's caste system where so-called lower castes are expected to perform this job.
- The law has ended manual scavenging as a form of employment, however, the stigma and discrimination associated with it still linger on, which makes it difficult for liberated manual scavengers to secure alternative livelihoods.
- As per the National Commission for Safai Karamcharis (NCSK), a total of 631 people have died in the country while cleaning sewers and septic tanks in the last 10 years.
- Despite the introduction of several mechanised systems for sewage cleaning, human intervention in the process still continues.
- Proper Identification: States need to accurately enumerate workers in cleaning toxic sludge.
- Empowering Local Administration: With Swachh Bharat Mission identified as a top priority area by the 15th Finance Commission, and funds available for smart cities and urban development providing for a strong case to address the problem of manual scavenging.
- Social Sentisitation: To address the social sanction behind manual scavenging, it is required first to acknowledge and then understand how and why manual scavenging continues to be embedded in the caste system.
- Need For a Stringent Law: If a law creates a statutory obligation to provide sanitation services on the part of state agencies, it will create a situation in which these workers' rights will not hang in the air.
➤ Related Initiatives
- Article 21 of the Constitution guarantees the’ Right to Life' and that also with dignity.
- In 1989, the Prevention of Atrocities Act became an integrated guard for sanitation workers; more than 90% of people employed as manual scavengers belonged to the Scheduled Caste. This became an important landmark to free manual scavengers from designated traditional occupations.
- In 1993, the Government of India enacted the Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, which prohibited manual scavengers' employment for manually cleaning dry latrines and also the construction of dry toilets (that do not operate with a flush).
- The Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act, 2013 prohibits construction or maintenance of insanitary latrines, and employment of any person for manual scavenging or hazardous cleaning of sewers and septic tanks.
- It also provides measures for rehabilitation of persons identified as manual scavengers by a Municipality.
- In 2014, a Supreme Court order made it mandatory for the government to identify all those who died in sewage work since 1993 and provide Rs. 10 lakh to their families.
United Nations Population Award 2020
Recently, HelpAge India has been presented the UN Population Award for 2020 in the institutional category.
- Bhutan's Queen Mother Gyalyum Sangay Choden Wangchuck has been awarded the United Nations Population Award in the individual category for 2020 to work on sexual health and ending gender violence.
➤ United Nations Population Award
- Each year, the Committee for the United Nations Population Award honours an individual and/ or institution in recognition of outstanding contributions to population and reproductive health issues and solutions.
- The General Assembly established the Award in 1981 and was first presented in 1983. It consists of a gold medal, a diploma and a monetary prize.
- The United Nations Population Fund (UNFPA) serves as its secretariat.
➤ HelpAge India
- It is a leading charity in India working with and for disadvantaged elderly for nearly 4 decades. It was set up in 1978 and is registered under the Societies' Registration Act of 1860.
- For the first time in the history of the UN Population Award, the honour is being conferred on an Indian institution.
- Only two Indians have been awarded in the past four decades since the award was established in 1981: former Prime Minister Indira Gandhi in 1983 and industrialist-philanthropist J.R.D.Tata in 1992.
Surgery and Ayurveda
Recently, a government notification listed out specific surgical procedures that a postgraduate medical student of Ayurveda must be practically trained to acquaint with and independently perform.
- The notification has been criticised by the Indian Medical Association (IMA).
- IMA is a national voluntary organisation of Doctors of Modern Scientific System of Medicine, which looks after the interest of doctors and the well-being of the community at large.
➤ History of Surgery in Ayurveda
- The Rigveda is the earliest account of ancient Indian civilization which mentions that Ashwini Kumaras known as Dev Vaidya were the chief surgeons of Vedic periods, who had performed rare legendary surgical operations. Many Granthas and Samhitas are dealing with Ayurveda; among them, Charak Samhita, Sushruta Samhita, and Ashtanga Sangraha are the three main pillars of Ayurveda.
- Charak Samhita and Ashtanga Samhita mainly deal with medicine knowledge while Sushrutaa Samhita deals mainly with surgical knowledge.
- Sushruta is the father of surgery, his works are compiled as Sushrutaa Samhita. He described 60 types of upakarma for the treatment of wounds, 120 surgical instruments and 300 surgical procedures.
- Sushruta considered surgery the first and foremost branch of medicine and stated that surgery has the superior advantage of producing instantaneous effects by means of surgical instruments and appliances and hence is the highest in value of all the medical tantras.
- The Current Debate: It revolves around allowing postgraduate students in Ayurveda undergoing 'Shalya' (general surgery) and 'Shalakya' (dealing with eye, ear, nose, throat, head and neck, oro-dentistry) to perform 58 specified surgical procedures.
➤ Arguments in Favour
- There are two branches of surgery in Ayurveda, Shalya Tantra and Shalakya Tantra. All postgraduate students of Ayurveda have to study these courses, and some go on to specialise in these and become Ayurveda surgeons.
- Postgraduate education in Ayurveda is guided by the Indian Medical Central Council (Post Graduate Education) Regulations.
- The 2016 regulations allow postgraduate students to specialise in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology).
- Students of these three disciplines are granted MS (Master in Surgery in Ayurveda) degrees.
- The process of education, internship and learning for Ayurveda students is similar to that of Modern Medicine students.
- Medico-legal issues, surgical ethics and informed consent is also part of the course apart from teaching Sushruta's surgical principles and practices.
- For several surgeries, Ayurvedic procedures almost exactly match those of modern medicine, however, there is significant divergence in post-operative care.
- National Institute of Ayurveda in Jaipur, claims that at least 1,000 major surgeries are performed every year at the hospital.
- As per the Ayurveda practitioners, the latest notification just brings clarity to the skills that an Ayurveda practitioner possesses.
- A patient is usually not clear whether an Ayurvedic practitioner has the necessary skill to perform one of these operations, after the notification, they know exactly what an Ayurveda doctor is capable of.
- IMA doctors claim that the new notification gives the impression that the skills or training of the Ayurveda doctor in performing modern surgeries are the same as those practising modern medicine which is misleading and an encroachment into the jurisdiction and competencies of modern medicine.
- Just because Ayurveda institutions prescribe textbooks from modern medicine, or that they carry out surgeries with the help of practitioners of modern medicine, is not reason enough to allow this encroachment.
- IMA doctors have asked the Central Council of Indian Medicine (CCIM- functions under the Ministry of Ayush) to explain, with proof, how each of the procedures mentioned in Ayurveda literature is equivalent to the modern surgical procedures.
- Surgery involves technical expertise developed through many workshops to standardise training and impart it. The infrastructure of training, research and exchange of knowledge in modern medicine is much better evolved than in Ayurveda.
- Government-funded Ayurvedic colleges are not equipped with the necessary infrastructure, skilled manpower and supporting staff to impart quality training.
➤ Gaps in Healthcare Infrastructure
- According to research earlier this year by Brookings Institute, a US-based policy organization, the country has only 0.55 beds per 1,000 people.
- According to a government statement in Parliament in 2019, there is only one modern medicine doctor for every 1,445 Indians.
- The World Health Organisation's norm is one doctor per 1,000 people.
- The shortage of allopathic doctors, including surgeons, is compounded by the concentration of medical colleges in the Southern States and the unwillingness of doctors to serve in rural areas despite measures such as compulsory rural internships.
➤ Government initiative to resolve the problem
- AYUSH Health and Wellness Centres (AYUSH HWCs) is an Ayushman Bharat component. Suggestions
- The government has to take steps to improve healthcare service however it should make sure that safety standards should not be compromised while inducting Ayurveda practitioners to perform surgery.
- Government should rethink and introduce bridge courses as mentioned in the National Medical Commission (NMC) Bill 2017 which should be aimed to serve an important part of a broader effort to empower and better utilise Ayush practitioners' capabilities for healthcare delivery.
- Government needs to explore creative ways of addressing this gap by evidence-based approaches, such as task-sharing, supported by efficient and quality referral mechanisms.
- India should achieve Medical pluralism which is already a reality in several countries like China, Japan, etc.
- The need of the hour is an adequate investment, for creating a health system that can withstand any kind of public health emergencies, deliver universal health coverage and meet the targets of the Sustainable Development Goals.
Human Rights Day
Human Rights Day is observed every year on 10th December.
- It marks the day when the United Nations General Assembly (UNGA) adopted the Universal Declaration of Human Rights (UDHR), in 1948.
- The UDHR established a set of common basic values regarding the view of human beings and the relationship between the state and the individual.
- 2020 Theme: Recover Better-Stand Up for Human Rights.
➤ Human Rights
- These are rights inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion, or any other status.
- These include the right to life and liberty, freedom from slavery and torture, freedom of opinion and expression, the right to work and education, and many more.
- Nelson Mandela has stated, "To deny people their human rights is to challenge their very humanity".
International Conventions and Bodies Related to Human Rights
➤ Universal Declaration of Human Rights
- The 30 rights and freedoms include civil and political rights, like the right to life, liberty, free speech and privacy and economic, social and cultural rights, like the right to social security, health and education, etc. India took an active part in the drafting of the UDHR.
- The declaration is not a treaty, so it does not directly create legal obligations for countries.
- The UDHR, together with the International Covenant on Civil and Political Rights (ICCPR) and its two Optional Protocols (on the complaints procedure and on the death penalty) and the International Covenant on Economic, Social and Cultural Rights and its Optional Protocol, form the so-called International Bill of Human Rights.
➤ Other Conventions
- These include the Convention on the Prevention and Punishment of the Crime of Genocide (1948), the International Convention on the Elimination of All Forms of Racial Discrimination (1965), the Convention on the Elimination of All Forms of Discrimination against Women (1979), the Convention on the Rights of the Child (1989) and the Convention on the Rights of Persons with Disabilities (2006), among others. India is a party to all these conventions
India's Stabilising Population: NFHS-5
Recent data from National Family Health Survey-5 (NFHS-5) shows that India's population is stabilising as the Total Fertility Rate (TFR) is on the decline.
- During NFHS-3 and 4, conducted between 2005 and 2016, there was a decline in the use of modern contraception methods (oral pills, condoms, intrauterine devices) across 12 of 22 States and UTs.
- While, in NFHS-5, 11 of 12 States where there was a slump earlier, saw an increase in their use.
➤ NFHS- 5 Data
- Total Fertility Rate (TFR): The total fertility rate in a specific year is defined as the total number of children that would be born to each woman if she were to live to the end of her child-bearing years and give birth to children in alignment with the prevailing age-specific fertility rates.
- TFR indicates the average number of children expected to be born to a woman during her reproductive span of 15-49 years.
- The TFR across most Indian states declined in the past half-a-decade, more so among urban women. This implies that India's population is stabilizing.
- Sikkim recorded the lowest TFR, with one woman bearing 1.1 children on average. Bihar recorded the highest TFR of 3 children per woman.
- In 19 of the 22 surveyed states, TFRs were found to be 'below-replacement level'.
- Replacement level fertility is the total fertility rate that is the average number of children born per woman. A population exactly replaces itself from one generation to the next, without migration.
- This rate is roughly 2.1 children per woman for most countries, although it may modestly vary with mortality rates.
- Overall Contraceptive Prevalence Rate (CPR) has increased substantially in most States/UTs and it is the highest in Himachal Pradesh and West Bengal (74%).
- Female sterilization continues to dominate as the modern method of contraception in states like Andhra Pradesh (98%), Telangana (93%), Kerala (88%), Karnataka (84%), Bihar (78%) and Maharashtra (77%).
- The data implies that most States have attained replacement level fertility. o NFHS-5 provides evidence of an increase in the use of modern contraceptives in rural and urban areas, an improvement in these demands being met, and a decline in the average number of children borne by a woman.
➤ Measures for Population Control
- Prime Minister's Appeal: During his Independence Day Speech in 2019, the Prime Minister appealed to the country that population control was a form of patriotism.
- Mission Parivar Vikas- The Government has launched Mission Parivar Vikas in 2017 for substantially increasing access to contraceptives and family planning services in146 high fertility districts with TFR of 3 and above in seven high focus states.
➤ National Family Planning Indemnity Scheme (NFPIS)
- This scheme was launched in the year 2005 under this scheme clients are insured in the eventualities of death, complication and failure following sterilization.
- Compensation scheme for sterilization acceptors - Under the scheme Ministry of Health and Family Welfare provides compensation for loss of wages to the beneficiary and also to the service provider (& team) for conducting sterilizations from the year 2014.
- As the data from NFHS-5 prove that the country's population is stabilising, the government's appeal for population reduction and fears over a "population explosion" and calls for a "two-child policy" appears to be misguided.
➤ National Family Health Survey
- NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
- Phase-I provides data for 22 states/UTs and the fieldwork in the remaining 14 (Phase-II) States/UTs is under progress.
- All NFHSs have been conducted under the stewardship of the Ministry of Health and Family Welfare, Government of India, with the International Institute for Population Sciences (IIPS) Mumbai, serving as the nodal agency.
- India's population has already crossed 125 crores and India is expected to surpass the world's most populous nation-China in the next couple of decades.
- However, restricted child policy will create a shortage of educated young people needed to carry on India's technological revolution.
- The problems like gender imbalance, undocumented children, etc. faced by China (as a result of the one-child policy) might be experienced by India as well.
- The data in NFHS-5 gives requisite input for strengthening existing programmes and evolving new strategies for policy intervention.
- The government and authorities should make required changes to the current policies and programs following the data given by NFHS-5.