The Hindu Editorial Analysis- 24th January 2025 | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

India’s winding road to ‘#EndTB’

Why in News?

 The article highlights the obstacles India faces in meeting its End TB targets due to the global TB burden, the prevalence of drug-resistant cases, and inherent gaps in the healthcare system. 

Tuberculosis: A Global and National Challenge

Tuberculosis (TB) is the top cause of death from an infectious disease worldwide. The End TB targets set ambitious goals for 2030, aiming for a 90% reduction in TB deaths, an 80% reduction in new cases, and zero catastrophic costs for families affected by TB. However, these targets are not close to being met. India had committed to achieving these targets by 2025 during a 2018 summit, but progress was hampered by the COVID-19 pandemic. The WHO Global Tuberculosis Report 2024 highlights that India is responsible for 26% of global TB cases and continues to struggle with high rates of drug-resistant TB and TB-related deaths.

Vulnerable Groups at Risk

• Vulnerable Groups at Risk:
  • Individuals with conditions like silicosis, undernutrition, and comorbidities such as diabetes are at higher risk for TB.
  • Migrant workers face difficulties accessing healthcare and continuing treatment when they return to their native places.
  • While addressing undernutrition is crucial, other contributing factors require multisectoral actions tailored to specific regions.

Achievements and Challenges in TB Treatment

• India’s National Tuberculosis Elimination Programme (NTEP) provides free and effective TB drugs, managing to initiate treatment in over 95% of notified cases.
• Nonetheless, a 2023 supply chain disruption caused a shortage of essential drugs, leading to treatment delays, increased risk of antibiotic resistance, and higher health costs for patients.

Focus on Extrapulmonary TB (EP-TB)

• Extrapulmonary TB (EP-TB) impacts organs other than the lungs, such as lymph nodes, kidneys, brain, and bones, constituting 24% of TB cases.
• EP-TB is frequently overlooked or diagnosed late due to non-specific symptoms that mimic other illnesses.
• There is a need for enhanced training of general practitioners to identify EP-TB early through basic tests and comprehensive clinical evaluations.

Gaps in Diagnosis and Healthcare Resources

• Research shows that only 35% of private practitioners and 75% of government doctors can accurately identify classical TB symptoms.
• A lack of trained personnel and restricted access to molecular testing methods like CBNAAT and Truenat contribute to diagnostic delays.
• Many testing facilities operate at the district level, and logistical challenges such as cartridge shortages and technician availability exacerbate the diagnostic issues.

Successful Interventions and Best Practices

• In Idukki, Kerala, a partnership with Kudumbashree, a women’s self-help network, has fostered substantial community involvement and advocacy, facilitating the achievement of TB targets.
• Advocacy efforts by political figures and sharing successful practices from different regions can bolster TB elimination initiatives.

Progress and Future Directions

• India has seen a 24% reduction in TB deaths since 2015, surpassing the global decline rate.
• Drawing lessons from countries like Vietnam, which successfully implemented active case finding among high-risk groups, could enhance TB intervention strategies in India.
• It is crucial for India to tailor its approaches and frameworks to address regional specificities and expedite progress towards TB elimination.

Conclusion

While the goal of meeting the End TB targets by 2025 is daunting due to underlying systemic challenges, advancements in case notification and a decline in TB deaths provide a glimmer of hope. To eradicate TB, it is essential to strengthen healthcare systems and promote community-driven initiatives.

A grey birthday for the Election Commission of India

Why is Electoral Roll Integrity Important?

• Foundation of Democracy: Electoral roll integrity is essential for ensuring free, fair, and transparent elections, which are the cornerstone of a functional democracy. Accurate voter lists reflect the true will of the people and prevent fraud.
• Historical Warning: Dr. B.R. Ambedkar, during the Constituent Assembly debates in 1949, warned about the dangers of manipulating electoral rolls. He stressed that interference by the executive in electoral rolls compromises democracy and highlighted the need for an independent Election Commission of India (ECI).

Significance of Electoral Rolls

• Inclusivity and Fairness: Electoral rolls ensure that all eligible citizens can participate in elections, safeguarding the principles of inclusivity and fairness.
• Trust in Outcomes: The accuracy and transparency of voter lists are crucial for building trust in electoral outcomes.

Challenges to Electoral Roll Integrity

• Ghost and Duplicate Voters: Fake or duplicate entries dilute genuine voter representation.
• Exclusion of Eligible Voters: Discrimination based on identity, language, or race can lead to the exclusion of eligible voters.
• Executive Interference: Manipulation of electoral rolls by political entities can skew election results.
• Technological Issues: Manual systems and outdated verification processes contribute to inaccuracies in electoral rolls.

Case Study: Maharashtra State Elections

• In 2024, Maharashtra’s electoral rolls reported a surge of 48 lakh new voters within six months.
• Concerns arose as registered voters surpassed the official adult population estimate, indicating potential inaccuracies.
• Analysis revealed patterns of dubious inclusions that appeared to favour a specific political alliance.

Solutions for Ensuring Electoral Roll Integrity

• Aadhaar-Based Verification: Link voter IDs with Aadhaar to eliminate ghost entries and ensure accurate voter registration through biometric authentication.
• Periodic Audits: Conduct regular and transparent audits of voter rolls by independent agencies to enhance accountability and trust.
• Technological Advancements: Utilize blockchain and artificial intelligence to improve data accuracy and reduce the risk of manipulation in electoral rolls.
• Voter Awareness Campaigns: Educate citizens about the voter registration process and encourage them to report discrepancies promptly to ensure accurate voter representation.

Conclusion

• Maintaining electoral roll integrity is crucial for preserving democratic values and upholding citizens’ rights.
•  Implementing robust verification methods, leveraging modern technology, and ensuring transparency are essential for fair electoral processes.

Is poverty being underestimated in India?

Why in News?

The article discusses the difficulties India faces in estimating poverty due to issues with data methodology and the changing definition of poverty. It also delves into the debates surrounding multidimensional poverty indices and official poverty lines.

Poverty Definition and Underestimation

• Traditional Definition: Poverty in India was traditionally defined by the expenditure needed to sustain a minimum calorie diet.
• Historical Measurement: From the late 1970s until 2005, poverty was measured using data from the National Sample Survey Office (NSSO), which was considered stable and reliable.
• Data Discrepancies: Over time, differences in consumption estimates between NSSO and National Accounts raised concerns about the accuracy of the data.
• Committee Recommendations: The Tendulkar Committee and subsequent methodologies introduced by NSSO aimed to enhance data collection, although some new methods resulted in inconsistencies.
• Evolving Methods: Poverty estimation methods have progressed, including the adoption of the multidimensional poverty index. However, outcomes still hinge on the chosen poverty line and the datasets employed.

Decline in Poverty

• Significant Reduction: Over the past two decades, poverty has significantly decreased, irrespective of the poverty line applied.
• Contributing Factors: Factors such as robust GDP growth, effective government programs, and enhancements in public delivery systems have played a crucial role in this decline.
• Policy Impact: The National Food Security Act, benefiting nearly 80 crore people, has been a pivotal policy measure in alleviating extreme poverty.
• Consistent Trends: Different poverty lines, including those from the Tendulkar and Rangarajan Committees, indicate similar trends in poverty reduction, approximately 17-18%.

Concerns with HCES Data

• Data Consistency Issues: There have been challenges in data consistency due to varying recall periods used in consumption surveys, making temporal comparisons difficult.
• Methodological Improvements: Despite advancements in methodology, many experts advocate for establishing a new poverty line aligned with the updated NSSO methodology for accurate comparisons.

Rural vs Urban Poverty

• Narrowing Gap: The disparity between rural and urban poverty is decreasing, with rural areas experiencing notable improvements.
• Outdated Definitions: The definition of rural areas, based on the 2011 Census, requires updating as numerous rural areas have transformed into urban or peri-urban regions.
• Changing Consumption Patterns: Rural consumption patterns have evolved, with food expenditure now constituting less than 50% of the overall consumption basket.
• Contributing Factors: Public policy interventions and the evolving nature of rural economies are significant contributors to the decline in rural poverty.

Revision of Poverty Line

• Need for Revision:. revision of the poverty line has been proposed, although opinions differ regarding the accuracy of current estimates, with some suggesting that the poverty rate could be higher than official figures.
• Methodological Consensus: The debate on revising the poverty line highlights the necessity for a unified methodology and consistent application of poverty criteria.
• Impact of Updated Methodologies: Utilizing updated methodologies in poverty estimation could lead to a revision of the poverty rate, but experts agree on the importance of a clear and agreed-upon methodology.

Criticism of Multidimensional Poverty Index

• Methodological Differences: The NITI Aayog’s multidimensional poverty index, which employs 12 indicators, has been criticized for its lack of comparability with the UNDP’s index, which uses 10 indicators.
• Customization Issues: While the UNDP’s index offers a general framework, it permits countries to tailor the indicators to their specific needs, as India has done by incorporating elements like bank accounts and maternal health.
• Indicator Reliability: Some experts contend that once a household attains access to essential services such as electricity or a bank account, these benefits cannot be revoked, potentially resulting in artificially low poverty estimates.
• Need for Income Vulnerability Assessment: There is a pressing need to assess income vulnerability to obtain a more precise understanding of poverty levels.

Conclusion

India has achieved remarkable advancements in reducing poverty; however, the methodology for estimating the poverty line requires standardization to ensure accurate and reliable comparisons.