Indian Society and Social Issues: October 2023 UPSC Current Affairs | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly PDF Download

Avian Influenza

Avian influenza, commonly referred to as bird flu, has posed significant concerns for both animal and public health on a global scale. Among the various strains of avian influenza viruses, H5N1 has gained particular attention due to its high pathogenicity and the potential for human infection.
While Asia has long been considered the primary hub for the H5 influenza virus, a recent study published in Nature highlights a notable shift in the global distribution and ecology of highly pathogenic avian H5 influenza viruses. The epicenter of these viruses has expanded beyond Asia, now reaching new regions such as parts of Africa and Europe. This article explores the key findings of the study and discusses its implications for both public health and avian populations.

Rise of the Highly Pathogenic Avian H5N1 Virus

• Highly pathogenic avian influenza, H5N1, or HPAI H5N1, first emerged in China in 1996. It rapidly gained notoriety due to its severe impact on poultry populations and its potential to infect and cause severe illness in humans. 
• Since its emergence, H5N1 has been the subject of extensive research and surveillance efforts, aiming to understand its evolution, spread, and potential pandemic threat.
• Over the years, HPAI H5N1 has continued to evolve and spread globally. The scale of H5 outbreaks in wild birds and poultry has escalated beyond Asia since 2014, but until recently, the origins of these resurgences and the underlying evolutionary mechanisms remained unclear. 
• The recent study conducted by Dr. Vijaykrishna Dhanasekaran and his colleagues sheds light on these mysteries, offering valuable insights into the changing dynamics of avian influenza.

Examining the Changing Origins and Trends

To understand the shifting epicenter of highly pathogenic avian H5 influenza viruses, the research team analyzed epidemiological data collected by the Food and Agricultural Organization and the World Organization for Animal Health between 2005 and 2022. They also conducted a comprehensive analysis of more than 10,000 whole viral genomes, providing a robust dataset for their investigation.

Key Resurgent Events in 2016/17

One of the pivotal findings of this study is the identification of key resurgent events in 2016–17. Genome analysis revealed that the viral lineages responsible for these resurgences originated in Asia, specifically China. This finding highlights the ongoing significance of Asia as a breeding ground for avian influenza viruses, emphasizing the need for continuous surveillance and control measures in the region.

A Notable Shift Away from Asia

However, the most striking revelation from this study is the notable shift in the epicenter of H5 influenza viruses away from Asia and into other continents. The research team identified two new H5 viruses that emerged between 2020 and 2022, originating from African and European bird populations. This shift signifies a significant expansion of the virus’s geographic range, which has the potential to impact both avian and human populations.

Evolution Through Genetic Reassortment

Intriguingly, the two new H5 viruses that emerged in Africa and Europe were found to have evolved through genetic reassortment with low-pathogenic viral variants as they disseminated. Genetic reassortment is a process through which different influenza virus strains exchange genetic material, leading to the creation of new viral variants. This mechanism allows avian influenza viruses to adapt to different host species and environmental conditions, making them more resilient and unpredictable.

The Role of Wild Bird Populations

One of the key takeaways from this study is the increasing persistence of avian influenza in wild bird populations. The authors propose that this persistent presence of the virus in wild birds is driving the evolution and spread of new strains. Wild birds play a crucial role in the transmission of avian influenza viruses, acting as carriers that can spread the virus over vast distances. The adaptation and evolution of the virus within these populations can result in the emergence of more virulent and diverse strains.

Implications and Challenges

The findings of this study have significant implications for both animal and human health. The shift in the epicenter of H5 influenza viruses to new regions poses several challenges and concerns:

• Human Health Risk: The highly pathogenic avian H5N1 has the potential to infect humans, causing severe illness and even death. The shift of the epicenter to new regions increases the risk of human exposure to these viruses.
• Poultry Industry Impact: Avian influenza outbreaks can have devastating consequences for the poultry industry. The shift in the epicenter to new regions means that more countries and regions are at risk of experiencing economic losses due to outbreaks.
• Global Spread: The global dispersion of avian influenza viruses can lead to the emergence of new strains with unpredictable properties. This makes it challenging for health authorities to develop effective vaccines and control strategies.
• Wildlife Conservation: Avian influenza viruses can have a detrimental impact on wild bird populations. The increasing persistence of the virus in these populations raises concerns for wildlife conservation efforts.
• Control Strategies: The study underscores the continued relevance of elimination strategies to limit viral spread and control the prevalence of highly pathogenic avian influenza within global bird populations. Effective control measures, including surveillance, culling, and vaccination, are essential to prevent and contain outbreaks.
• Viral Evolution Understanding: Understanding the evolutionary dynamics of avian influenza viruses is crucial for mitigating and reacting to new strains. This knowledge can inform the development of vaccines and antiviral treatments to combat emerging threats.

Conclusion

Recent findings published in Nature regarding the shifting epicenter of highly pathogenic avian H5 influenza viruses represent a critical development in the ongoing battle against avian influenza. The expansion of the epicenter beyond Asia to new regions like Africa and Europe highlights the need for a global and coordinated effort to monitor, control, and prevent the spread of these viruses. As avian influenza continues to evolve and adapt, understanding its evolutionary mechanisms is crucial to safeguarding both animal and human populations. This study serves as a reminder that the threat of avian influenza remains a global concern, and proactive measures are necessary to address this ever-changing and potentially devastating public health challenge.

Cancer Cases and Cure in India

Cancer is a broad term encompassing a diverse range of diseases that can impact any part of the body, characterized by uncontrolled cell division. It poses a significant threat to public health, causing numerous fatalities annually. In 2020, cancer claimed nearly 10 million lives globally, constituting nearly one in six deaths. 
Predominant types include breast, lung, colon and rectum, and prostate cancers. Approximately one-third of cancer-related deaths are attributed to factors like tobacco use, elevated body mass index, alcohol consumption, insufficient fruit and vegetable intake, and inadequate physical activity. In low- and lower-middle-income countries, around 30% of cancer cases stem from infections such as human papillomavirus (HPV) and hepatitis. Early detection and effective treatment can lead to the successful cure of many cancers.

What is cancer?

Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. One defining feature of the disease is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs; the latter process is referred to as metastasis. Widespread metastases are the primary cause of death from cancer. Cancer begins when genetic changes interfere with this orderly process causing cells to start to grow uncontrollably.

• These cells may form a mass called a tumor. A tumor can be cancerous or benign.
• A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body.
• A benign tumor means the tumor can grow but will not spread.
• Some types of cancer do not form a tumor. These include leukemias, most types of lymphoma, and myeloma.

Types of cancer

Doctors divide cancer into types based on where it begins. Four main types of cancer are:

• Carcinomas: A carcinoma begins in the skin or the tissue that covers the surface of internal organs and glands. Carcinomas usually form solid tumors. They are the most common type of cancer. Examples of carcinomas include prostate, breast, lung, and colorectal.
• Sarcomas: A sarcoma begins in the tissues that support and connect the body. A sarcoma can develop in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartilage, or bone.
• Leukemias: Leukemia is a cancer of the blood. Leukemia begins when healthy blood cells change and grow uncontrollably. The 4 main types of leukemia are acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myeloid leukemia, and chronic myeloid leukemia.
• Lymphomas: Lymphoma is cancer that begins in the lymphatic system. The lymphatic system is a network of vessels and glands that help fight infection. There are 2 main types of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma.

There are many other types as well which do not fall under the above categories like the ones affecting the central nervous system.

How cancer spreads?

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body.

• During this process, the cancer cells grow and may develop into new tumors.
• This is known as metastasis.

One of the first places cancerous tumor often spreads is to the lymph nodes.

• Lymph nodes are tiny, bean-shaped organs that help fight infection.
• They are located in clusters in different parts of the body, such as the neck, groin area, and under the arms.

It may also spread through the bloodstream to distant parts of the body.

• These parts may include the bones, liver, lungs, or brain.
• Even if it spreads, it is still named for the area where it began.
• For example, if breast cancer spreads to the lungs, it is called metastatic breast cancer, not lung cancer.

What causes cancer?

Cancer arises from the transformation of normal cells into tumor cells in a multi-stage process that generally progresses from a pre-cancerous lesion to a malignant tumor.

These changes are the result of the interaction between a person’s genetic factors and three categories of external agents, including:

• physical carcinogens, such as ultraviolet and ionizing radiation;
• chemical carcinogens, such as asbestos, components of tobacco smoke, alcohol, aflatoxin (a food contaminant), and arsenic (a drinking water contaminant); and
• biological carcinogens, such as infections from certain viruses, bacteria, or parasites.

Tobacco use, alcohol consumption, unhealthy diet, physical inactivity, and air pollution are risk factors for the disease and other non-communicable diseases.

Prevention

The risk of cancerous tumor can be reduced by:

• not using tobacco;
• maintaining a healthy body weight;
• eating a healthy diet, including fruit and vegetables;
• doing physical activity regularly;
• avoiding or reducing consumption of alcohol;
• getting vaccinated against HPV and hepatitis B if you belong to a group for which vaccination is recommended;
• avoiding ultraviolet radiation exposure (which primarily results from exposure to the sun and artificial tanning devices) and/or using sun protection measures;
• ensuring safe and appropriate use of radiation in health care (for diagnostic and therapeutic purposes);
• minimizing occupational exposure to ionizing radiation; and
• reducing exposure to outdoor air pollution and indoor air pollution, including radon (a radioactive gas produced from the natural decay of uranium, which can accumulate in buildings — homes, schools, and workplaces).

Treatment

A correct cancer diagnosis is essential for appropriate and effective treatment because every cancer type requires a specific treatment regimen. Treatment usually includes surgery, radiotherapy, and/or systemic therapy (chemotherapy, hormonal treatments, targeted biological therapies)

• Some of the most common cancer types, such as breast cancer, cervical cancer, oral cancer, and colorectal cancer, have high cure probabilities when detected early and treated according to best practices.
• Some cancer types, such as testicular seminoma and different types of leukemia and lymphoma in children, also have high cure rates if appropriate treatment is provided, even when cancerous cells are present in other areas of the body.

There is a significant variation in treatment availability between countries of different income levels; comprehensive treatment is reportedly available in more than 90% of high-income countries but less than 15% of low-income countries.

Latest news

India is expected to roll out the indigenously developed CERVAVAC vaccine for the prevention of cervical cancer among girls aged 9-14 years through their schools by mid-2023.

• The decision was based on the National Technical Advisory Group for Immunisation (NTAGI) recommendation to introduce the Human Papillomavirus (HPV) Vaccine in the Universal Immunisation Programme.
• It is India’s first indigenously developed quadrivalent human papillomavirus (qHPV) vaccine that is said to be effective against four strains of the virus – Type 6, Type 11, Type 16, and Type 18.

Cervical cancer is the 4th most common type of cancer among women, globally and 2nd most common among women in India. But when diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively.

The burden of cancers in India

• Cancer cases in India saw an annual increase of 1.1-2% from 2010-2019, according to the Indian Council for Medical Research.
• A report on the 'Burden of cancers in India' identified seven major cancers contributing to over 40% of the total disease burden: lung, breast, esophagus, mouth, stomach, liver, and cervix uteri.
• The National Cancer Grid (NCG), initiated by the Government of India and the Tata Memorial Centre, aims to establish a nationwide network of cancer centers, research institutes, and patient groups.
• NCG's key objectives include setting uniform standards for cancer care, offering specialized training in oncology, and promoting collaborative research in basic, translational, and clinical aspects of cancer.
• Presently, NCG boasts a network of over 270 hospitals across India, facilitating comprehensive cancer care.
• To address Non-Communicable Diseases (NCDs), including cancer, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) has established 599 NCD Clinics at the District level and 3,274 at the Community Health Centre level.

Palliative Care

Why in News?

India, with nearly 20% of the world's population, faces a significant burden of non-communicable diseases. Conditions such as cancer, diabetes, hypertension, and respiratory diseases are on the rise, necessitating the need for palliative care.

• However, the availability and accessibility of palliative care in India are limited.

What is Palliative Care?

• Palliative care is explicitly recognized under the human right to health and it is a type of medical care that focuses on improving the quality of life for people with serious illnesses.
  • It helps to prevent suffering and aims to identify patients who may be receiving too many medical treatments that don't improve their quality of life and may cause financial strain on their families.
  • It is meant to address physical, psychological, spiritual, and social needs for people with conditions like heart failure, kidney failure, certain neurological diseases, cancer etc.
• According to WHO, each year an estimated 40 million people are in need of palliative care, 78% of whom live in low- and middle-income countries.
  • Also worldwide, only about 14% of people who need palliative care currently receive it.
• Furthermore, WHO explicitly recognized that palliative care is part of the comprehensive services required for NCDs through the Global Action Plan for the Prevention and Control of NCDs 2013–2020
  • In 2019, the World Health Assembly extended the WHO Global action plan for the prevention and control of NCDs 2013–2020 to 2030.

What is the Status of Palliative Care in India?

• Status:
  • Palliative care in India is primarily available in urban areas and at tertiary healthcare facilities. Only 1-2% of the estimated 7-10 million people in India who need palliative care have access to it.
• Palliative Care Programme in India:
  • Although no separate budget is allocated for the implementation of the National Palliative Care Program, palliative care is part of the ‘Mission Flexipool’ of National Health Mission (NHM).
  • National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke (NPCDCS) that was launched in 2010 and later revised as National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD), also aims to address the increasing burden of noncommunicable diseases in India, aims to provide promotive, preventive, and curative care across all levels of healthcare.
• Challenges:
  • Limited Awareness: There is a lack of awareness and understanding about palliative care among the general public and healthcare professionals.
  • Many people in India are not aware of the benefits of palliative care or confuse it with end-of-life care.
  • Inadequate Infrastructure and Insufficient Training: There is a shortage of dedicated palliative care centers, hospices, and trained healthcare professionals in India.
  • Also, healthcare professionals, including doctors, nurses, and other caregivers, often lack adequate training in palliative care.
  • This limits their ability to provide appropriate pain and symptom management and psychosocial support to the patient.
  • Lack of Attention Towards Pediatric Care: Paediatric palliative care has also been neglected for a long time. About 98% of children facing moderate to severe suffering during their end of life reside in lower and middle-income countries like India.
  • This could be due to diseases like cancer, birth defects, neurological conditions, etc.
  • The revised operational guidelines of NP-NCD have also not addressed this issue.
  • Limited Implementation of NPCC: The implementation of this program has been slow and uneven, resulting in limited progress in expanding palliative care services.

Way Forward

• Strengthening the implementation and monitoring of the NPPC at the state level with adequate funding, human resources, infrastructure etc.
• Developing and implementing national standards and guidelines for palliative care services and quality assurance.
• Enhancing the education and training of palliative care professionals and volunteers at various levels and settings.
• The 67^th World Health Assembly in 2014 urged the integration of palliative care into health systems at all levels.
• There is a need to improving the referral and linkage mechanisms between different levels and types of health care providers for palliative care

Granting Habitat Rights and Implications

Context

The Baiga Particularly Vulnerable Tribal Group (PVTG) in Chhattisgarh has been granted habitat rights, making it the second PVTG to receive such rights in the state. 

• Out of 75 PVTGs in India, only three have received habitat rights, including the Bharia PVTG in Madhya Pradesh, the Kamar tribe, and now the Baiga tribe in Chhattisgarh.

About Habitat Rights

• Habitat rights are granted under the Forest Rights Act and provide communities with rights over their customary territories, cultural practices, livelihood means, biodiversity knowledge, and protection of their natural and cultural heritage.
• Habitat rights help safeguard traditional livelihoods and ecological knowledge, and they empower PVTG communities to access government schemes and initiatives to develop their habitats.

PVTGs are a sub-classification of Scheduled Tribes in India. They are considered more vulnerable than regular Scheduled Tribes. 

PVTGs are characterized by:

• Declining or stagnant population
• Low level of literacy
• Pre-agricultural level of technology
• Economically backward

The Government of India renamed Primitive Tribal Groups (PTGs) as PVTGs in 2006. The Dhebar Commission created the PTG category in 1973

Global Hunger Index 2023

Why in News?

In the Global Hunger Index 2023, India ranked 111th out of 125 countries, indicating a serious level of hunger.

• Neighboring countries, such as Pakistan (102nd), Bangladesh (81st), Nepal (69th), and Sri Lanka (60th), scored better than India.

What are the Key Takeaways from GHI 2023?

India's GHI Score:

• Score Analysis:
  • India's GHI score 2023 stands at 28.7, categorized as "serious" on the GHI Severity of Hunger Scale.
  • This shows a slight improvement from its GHI 2015 score of 29.2, which was also deemed serious.
  • Also, compared to its alarming GHI scores of 38.4 in 2000 and 35.5 in 2008, India has made significant progress.
• Related Data and References:
  • Child stunting is prevalent at 35.5% ( India's National Family Health Survey(NFHS) 2019-2021)
  • The prevalence of undernourishment in India is 16.6% ( State of Food Security and Nutrition in the World report 2023 )
  • India's child wasting rate is a concerning 18.7% (India’s NFHS 2019-21), the highest among all countries in the report.
  • The under-five mortality rate stands at 3.1% (United Nations Inter-Agency Group for Child Mortality Estimation January 2023 )
• Global Hunger Trends:
  • According to the GHI 2023 report, Belarus, Bosnia & Herzegovina, Chile, China are among the top ranked countries (i.e., low level of hunger) and Yemen, Madagascar, Central African Republic are the bottom.
  • The GHI 2023 score for the world is 18.3, considered moderate, showing minimal improvement since 2015.
    • The prevalence of undernourishment has risen from 572 million to approximately 735 million people since 2017.
  • The GHI attributed the stagnation to various crises, including climate change, conflicts, economic shocks, the Covid-19 pandemic, and the Russia-Ukraine war.
    • These crises have exacerbated social and economic inequalities and hindered progress in reducing hunger worldwide.

What is the Indian Government’s Response to GHI Report 2023?

• Criticism of Methodology: The Ministry of Women and Child Development has raised concerns about the report's methodology, suggesting "serious methodological issues" and "malafide intent."
  • Data from the government's Poshan Tracker consistently shows child wasting prevalence below 7.2%, which contradicts the GHI's reported figure of 18.7%.
• Focus on Child Health: The government noted that three out of the four GHI indicators pertain to children's health and may not provide a complete representation of the entire population.
• Small Sample Size: The government expressed doubts about the accuracy of the "Proportion of Undernourished Population" indicator, as it is based on a small sample size opinion poll.
• Complex Factors: The government's argument is that indicators like stunting and wasting are outcomes of various complex factors, including sanitation, genetics, environment, and food utilization, and are not solely attributable to hunger.
  • The government also pointed out that child mortality may not solely be an outcome of hunger, indicating that other factors are at play.

What are the Other Terms Related to Hunger?

What are the Factors Responsible for Hunger in India?

• Socioeconomic Disparities and Poverty: Widespread poverty and socioeconomic disparities are fundamental determinants of hunger in India.
  • Poverty leads to inadequate food consumption and the inability to afford essential nutritional and healthcare services.
• Hidden Hunger: India is experiencing a severe micronutrient deficiency (also known as hidden hunger).
  • There are several causes of this problem, including poor diet, disease, and a failure to meet micronutrient needs during pregnancy and lactation.
• Inefficient Agricultural Practices and Food Distribution: Inefficiencies in agricultural practices, including suboptimal crop yields and post-harvest losses, also contribute to insufficient food availability.
  • Furthermore, subsequent leakages in food distribution and supply chain management restrict the flow of food to vulnerable populations, resulting in food scarcity and higher prices, which disproportionately affect the poor.
• Gender Inequality and Nutritional Disparities: Gender-based disparities exacerbate the problem of hunger and malnutrition in India.
  • Women and girls often experience unequal access to food within households, receiving smaller portions or lower-quality diets.
  • This inequity, coupled with the demands of maternal and child care, exposes them to higher nutritional risks, leading to chronic undernutrition.
• Climate Change and Environmental Stressors: India is susceptible to climate change-related environmental stressors, such as changing weather patterns, extreme weather events, and natural disasters.
  • These factors can disrupt agricultural production, leading to crop failures and food scarcity.
• Lack of Audit for Nutritional Programmes: Although a number of programmes with improving nutrition as their main component are planned in the country, there is minimal or no nutritional audit mechanism at local governance level.

Way Forward

• Social Audit and Awareness: Mandate social audits of the mid-day meal scheme in all districts, involving local authorities, alongside raising awareness on nutrition.
  • Utilize information technology for better program monitoring.
  • Establish community-driven nutrition education programs that raise awareness about balanced diets, food preparation, and the importance of nutrition in local languages, particularly targeting women and children.
• PDS Enhancement: Revamp the Public Distribution System (PDS) to enhance transparency, reliability, and affordability of nutritious food, benefiting the economically disadvantaged.
• Reducing Food Waste, Reducing Hunger: Address food wastage issues by improving warehousing and cold storage facilities.
  • According to the International Institute of Refrigeration, if developing countries had the same level of refrigeration infrastructure as developed countries, they would save 200 million tonnes of food or around 14% of their food supply, which can help in tackling hunger and malnutrition.
• Mobile Nutritional Clinics: Implement mobile nutritional clinics that visit remote and underserved areas to provide health assessments, dietary counseling, and supplementary feeding for children and pregnant women.

Scheduled Areas in India

Why in News?

India's Scheduled Tribes (STs) constitute 8.6% of the population, residing in various states and union territories. Article 244 of the Indian Constitution is a critical provision for the administration of Scheduled and Tribal Areas.

What are Scheduled Areas?

• About:
  • Scheduled Areas represent regions covering 11.3% of India's land area, inhabited by various ST communities comprising 8.6% of the country's population.
  • They are designated in 10 states under the Fifth schedule: Andhra Pradesh, Telangana, Odisha, Jharkhand, Chhattisgarh, Madhya Pradesh, Rajasthan, Gujarat, Maharashtra, and Himachal Pradesh.
  • 4 States under the Sixth Schedule: Assam, Meghalaya, Tripura and Mizoram.
  • In 2015, Kerala proposed to notify 2,133 habitations, five-gram panchayats, and two wards in five districts as Scheduled Areas; it awaits the Union government’s approval.
• Criteria for Identification:
  • The guiding norms for declaring an area as a Scheduled Area include significant tribal population, compactness, reasonable size, viability as an administrative entity, and economic backwardness compared to neighboring areas.
  • The 2002 Scheduled Areas and Scheduled Tribes Commission or the Bhuria Commission recommended considering areas with 40% or more tribal population according to the 1951 Census as Scheduled Areas.
• Constitutional Provisions and Governance:
  • Article 244 (1) applies the Fifth Schedule provisions to Scheduled Areas in states other than Assam, Meghalaya, Tripura, and Mizoram.
  • Article 244 (2) applies the Sixth Schedule to the aforementioned states.
  • Tribal Advisory Council: The President of India notifies Scheduled Areas, and states with Scheduled Areas establish a Tribal Advisory Council to advise the Governor on ST welfare matters.
  • Panchayats (Extension to Scheduled Areas) Act (PESA) of 1996: It empowers gram sabhas, granting them substantial authority through direct democracy, prioritizing Local Self-Governance.
  • In 1995, the Bhuria Committee, constituted to recommend provisions for the extension of panchayat raj to Scheduled Areas, recommended including these villages, but this is yet to be done.
  • The President of India notifies India’s Scheduled Areas. States with Scheduled Areas need to constitute a Tribal Advisory Council with up to 20 ST members.
  • They will advise the Governor on matters referred to them regarding ST welfare. The Governor will then submit a report every year to the president regarding the administration of Scheduled Areas.

What are the Concerns Related to Scheduled Areas?

• Despite demands from Adivasi organizations, a significant portion (59%) of India's ST population is outside the purview of Article 244, denying them rights protected under laws applicable to Scheduled Areas.
• The absence of viable ST-majority administrative units has been a common bureaucratic response, which has further led to demands for the denotification of parts of Scheduled Areas.
• They are denied rights under the laws applicable to Scheduled Areas, including the Right to Fair Compensation and Transparency in Land Acquisition, Rehabilitation and Resettlement Act 2013 and the Biological Diversity Act 2002.

Way Forward

• All habitations or groups of habitations outside Scheduled Areas in all States and Union Territories where STs are the largest social group will need to be notified as Scheduled Areas irrespective of their contiguity.
• The geographical limit of these villages will need to be extended to the ‘community forest resource’ area on forest land under the FRA (Forest Rights Act) 2006 wherever applicable, and to the customary boundary within revenue lands made possible through suitable amendments to the relevant State laws.
• The geographical limits of the revenue village, panchayat, taluka, and district will need to be redrawn so that these are fully Scheduled Areas.

World Mental Health Day

Why in News?

10^th October marks World Mental Health Day, a global initiative aimed at raising awareness about mental health issues and rallying support for mental health care worldwide.

• In the context of India, this day serves as a crucial reminder of the urgent need to address the mental health challenges faced by the country's burgeoning adolescent population (aged 10-19 years) which plays a pivotal role in its future prosperity and development.
• Theme for World Mental Health Day 2023: Mental health is a universal human right.

What is the Status of Mental Healthcare in India?

• About:
  • Mental health refers to a person's emotional, psychological, and social well-being, encompassing their overall mental and emotional state.
  • It involves a person's ability to cope with stress, manage their emotions, maintain healthy relationships, work productively, and make rational decisions.
  • Mental health is an integral part of overall health and well-being, just as important as physical health.
• Status in India:
  • In India, according to National Institute of Mental Health and Neuro-Sciences data, more than 80% of people do not access care services for a multitude of reasons, ranging from lack of knowledge, stigma and high cost of care.
  • The economic loss due to mental health conditions, between 2012-2030, is estimated at USD 1.03 trillion (WHO).
• Government Initiatives Related to Mental Health:
  • National Mental Health Programme (NMHP)
  • Ayushman Bharat – Health and Wellness Centres (AB-HWC)
  • National Tele Mental Health Programme
  • Kiran Helpline
  • Rashtriya Kishor Swasthya Karyakram
  • Yuva Spandana Yojana (Karnataka)
• Issues Surrounding Mental Health in India:
  • Limited Accessibility to Mental Healthcare: There is a shortage of mental health professionals in India, particularly in rural areas.
  • This scarcity results in unequal access to mental health services, with urban areas having more resources than rural ones.
  • Stigma and Lack of Awareness: Mental health issues in India are often stigmatized and misunderstood.
  • Many individuals and families hesitate to seek help due to fear of societal discrimination and lack of awareness about mental health conditions.
  • Vulnerability of Adolescents to Mental Health Challenges: Adolescence marks the transition from childhood to adulthood, laden with unique challenges, including body image issues and societal expectations.
  • Academic pressure, peer influence, and concerns about the future can significantly affect mental health during adolescence.
  • In India, adolescents with a reported prevalence of severe mental illness stands at 7.3%.
  • Gender Disparities: Gender plays a significant role in mental health disparities.
  • Women in India may face higher rates of depression, anxiety, and domestic violence, and they often have limited autonomy in seeking help.
  • According to recent report of NCRB, housewives constituted 50% of total suicides in India in 2021.
  • Economic Factors: Poverty and economic inequality can exacerbate mental health issues.
  • The stress of financial instability and limited educational opportunities can contribute to mental health problems.
  • Online and Social Media Influences: The influence of social media and online content on mental health is a growing concern.
  • Cyberbullying, social comparison, and the spread of misinformation can negatively impact mental well-being.
  • Aging Population and Geriatric Mental Health: India's aging population is growing, and there is a need for better mental health support for the elderly.
  • Loneliness, depression, and dementia are common concerns among older adults.
  • Disaster and Trauma: Natural disasters and other traumatic events can have lasting effects on mental health.
  • India is prone to disasters like floods and earthquakes, which can lead to trauma and post-traumatic stress disorder (PTSD).

Way Forward

• Shift to Convergent Model of Mental Health: Policymakers should move from the medical model to a convergent model of mental health that considers various factors influencing well-being throughout an individual's life.
  • For example, the successful implementation of the ‘Whole School, Whole Community, Whole Child’ model in the US, which embraces a holistic approach to children’s well-being by considering factors such as nutrition, physical activity, and emotional health within the school environment.
• Increased Mental Healthcare Infrastructure: Invest in building more mental health clinics and facilities, particularly in rural and underserved areas.
  • Train and recruit more mental health professionals, including psychiatrists, psychologists, and counselors.
  • Promote telemedicine and online mental health services to bridge the gap between urban and rural areas and increase accessibility.
• Integration with Primary Healthcare: There is a need to integrate mental health services into the existing primary healthcare system to ensure early detection and treatment.
  • Also, training primary care providers to identify and manage common mental health issues is equally important.
• Inclusion of Mental Health in Education: There is a need to incorporate mental health education into school curricula to promote early awareness and destigmatization.
• Mental Health Insurance Coverage: There is a need to expand mental health coverage under health insurance policies in a phase wise manner to make treatment more affordable and accessible.
  • Also, there is a need to implement policies that ensure insurance parity for mental health services.