Current Affairs 18 July 2023

CONTENTS

1. Diabetes Mellitus (DM) and Tuberculosis (TB)
2. Bird Flu
3. Black Sea Grain Deal
4. National Multidimensional Poverty Index
5. PM MITRA scheme
6. Exercise Nomadic Elephant

Diabetes Mellitus (DM) and Tuberculosis (TB)

Context:

For a very long time, India has been experiencing the burden of two severe Epidemics, Diabetes Mellitus (DM) and Tuberculosis (TB), however few know how deeply these diseases are interlinked.

Relevance:

GS II: Health

Dimensions of the Article:

1. Interlink between Diabetes Mellitus (DM) and Tuberculosis (TB)
2. What can be done to Tackle Both DM and TB?
3. Diabetes Mellitus (DM)
4. Tuberculosis

Interlink between Diabetes Mellitus (DM) and Tuberculosis (TB):

The presence of Diabetes Mellitus (DM) increases the risk of developing respiratory infections, and it is a major risk factor that affects the incidence and severity of Tuberculosis (TB).

Here are the key points highlighting the interlink between DM and TB:

Prevalence and Impact:

• Studies have shown a high prevalence of DM among individuals with TB. In one study conducted in Chennai, 25.3% of TB patients had DM, while 24.5% were found to be pre-diabetic.
• DM not only increases the risk of contracting TB but also impairs the recovery process and prolongs the time required for TB bacteria to be eliminated from the body.

Effect on Immunity:

• DM compromises the body’s cell-mediated immunity, which hampers its ability to fight infections, including TB.
• The weakened immune response in DM individuals makes them more susceptible to TB infection.

Altered Lung Environment:

• Uncontrolled DM affects the defense mechanisms in the lungs, creating an environment that promotes the invasion and establishment of TB bacteria.
• DM-induced changes in small blood vessels in the lungs and poor nutritional status further contribute to the favorable conditions for TB infection.

Treatment Outcomes:

• DM increases the likelihood of unfavorable treatment outcomes for TB, including treatment failure, relapse/reinfection, and even death.
• The coexistence of TB and DM can modify TB symptoms, radiological findings, treatment approaches, and final outcomes.

Impact on Health and Healthcare:

• The dual burden of DM and TB not only affects the health and survival of individuals but also poses a significant burden on healthcare systems, families, and communities.

What can be done to Tackle Both DM and TB?

To tackle both Diabetes Mellitus (DM) and Tuberculosis (TB), several measures can be taken. Here are key strategies to address these conditions comprehensively:

Integrated Care:

• Provide individualized care for patients with both DM and TB, ensuring that treatments for both conditions are integrated and coordinated.
• Foster collaboration and communication between healthcare providers managing DM and TB to optimize patient outcomes.

Patient Education and Support:

• Improve patient education on the importance of adherence to medication, regular monitoring, and healthy lifestyle practices for managing DM and TB.
• Provide counseling and support services to enhance patient motivation, engagement, and treatment adherence.
• Promote proper nutrition and address any nutritional deficiencies to support optimal response to TB treatment.

Strengthened Healthcare Programs:

• Strengthen healthcare programs for both DM and TB, including prevention, screening, diagnosis, and treatment services.
• Build resilient and integrated health systems that can effectively manage and provide comprehensive care for individuals with both conditions.
• Enhance collaboration between DM and TB programs, sharing data and best practices to improve outcomes and resource allocation.

Research and Evidence-Based Decision-Making:

• Invest in research to generate evidence on the best approaches for managing DM and TB in coexisting cases.
• Use research findings to inform evidence-based decision-making, policy development, and program implementation.
• Promote innovation and the development of new tools, technologies, and strategies for prevention, diagnosis, and treatment of DM and TB.

Community Engagement and Partnerships:

• Engage communities and raise awareness about the link between DM and TB, emphasizing prevention, early detection, and timely treatment.
• Foster partnerships between healthcare providers, policymakers, civil society organizations, and community leaders to address the dual burden of DM and TB effectively.

Diabetes Mellitus (DM)

• DM is a metabolic disorder characterized by high blood sugar levels due to insufficient insulin production or ineffective insulin utilization.
• The term Diabetes Mellitus is used to differentiate it from Diabetes Insipidus, a rare condition unrelated to blood glucose levels.
• Diabetes Insipidus also causes excessive urination, but it does not impact blood glucose levels.

Blood Glucose Levels and Classification

• Fasting blood glucose levels of 70–110 mg/dL are considered normal.
• Blood glucose levels between 100 and 125 mg/dL indicate prediabetes.
• A level of 126 mg/dL or higher signifies diabetes.

Types of Diabetes

Type 1 Diabetes

• In Type 1 Diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas.
• As a result, the pancreas produces little or no insulin.
• Only 5 to 10% of people with diabetes have Type 1.
• It typically develops before the age of 30 but can occur later in life.

 Type 2 Diabetes

• Type 2 Diabetes involves a combination of insulin resistance and inadequate insulin production.
• The pancreas initially compensates by producing extra insulin, but over time, insulin production declines.
• Type 2 Diabetes was previously uncommon in children but has become more prevalent.
• It primarily affects individuals over the age of 30 and is more common with increasing age.
• Approximately 26% of people aged 65 and older have Type 2 Diabetes.

Tuberculosis

• TB remains the world’s deadliest infectious killer.
• Each day, over 4000 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease
• TB is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
• Transmission: TB is spread from person to person through the air. When people with TB cough, sneeze or spit, they propel the TB germs into the air.
• Symptoms: Cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
• Treatment: TB is a treatable and curable disease. It is treated with a standard 6 month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer.
• Anti-TB medicines have been used for decades and strains that are resistant to 1 or more of the medicines have been documented in every country surveyed.
• Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most powerful, first-line anti-TB drugs. MDR-TB is treatable and curable by using second-line drugs.
• Extensively drug-resistant TB (XDR-TB) is a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options

-Source: The Hindu

Bird Flu

Context:

The recent surge in bird flu outbreaks among mammals has alarmed international agencies, including the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health(WOAH, founded as OIE).

Relevance:

GS II: Health

Dimensions of the Article:

1. Bird Flu (Avian Influenza)
2. Status of Bird Flu in India
3. Influenza Virus Types

Bird Flu (Avian Influenza)

• Bird flu, also known as Avian influenza, is a disease caused by infection with avian influenza Type A viruses.
• It primarily affects birds but can occasionally infect mammals through spillover.
• The most common type of bird flu virus is H5N1, which emerged in 1996/1997 and has caused significant outbreaks since then.

Bird Flu Outbreaks

• Since 2020, H5N1 avian influenza outbreaks have been reported in numerous countries across Africa, Asia, Europe, and the Americas
• These outbreaks have resulted in the death or culling of over 131 million domestic poultry in affected farms and villages. In 2023, additional outbreaks have been reported in 14 countries.

Spillover to Mammals

• In recent years, cases of avian flu in mammals have been observed in approximately 10 countries.
• Mammals affected include farmed mink, seals, sea lions, and cats.
• There is concern that infected mammals could serve as hosts for the mixing of influenza viruses, potentially leading to the emergence of new, more harmful viruses.

Risk to Humans

• While bird flu primarily affects birds and mammals, there have been only a few mild cases reported in humans who had close contact with infected birds.
• The World Health Organization (WHO) closely monitors these cases to assess the risk to human health.

Status of Bird Flu in India

• On September 3, 2019, the World Organization for Animal Health declared India free from Avian Influenza (H5N1).
• However, outbreaks of avian influenza H5N1 and H5N8 were reported in poultry in 15 states in India in December 2020 and early 2021.

Measures to Control Spread

To address the risks associated with bird flu outbreaks, international agencies such as FAO, WHO, and WOAH recommended the following measures:

• Sharing Genetic Data: Countries were urged to share genetic data of viruses from humans and animals in publicly accessible databases.
• Enhancing Biosecurity and Hygiene: Implementation of biosecurity measures and good hygiene practices in farms and poultry value chains.
• Rapid Detection and Response: Ensuring prompt detection, reporting, and response to animal outbreaks to prevent further spread.
• Strengthening Surveillance: Enhancing influenza surveillance in both animals and humans to monitor and track the disease.
• Thorough Investigations: Conducting comprehensive epidemiological and virological investigations around animal outbreaks and human infections.
• Collaboration: Promoting collaboration and coordination between the animal and human health sectors to effectively manage the disease.

Influenza Virus Types

• The influenza virus can be classified into four types, namely influenza A, B, C, and D.
• Influenza A and B are the two types that cause epidemic seasonal infections every year.
• Influenza C primarily occurs in humans, but it has also been reported in dogs and pigs.
• Influenza D is mainly found in cattle and is not known to cause illness in humans.

Avian Influenza Type A Viruses

• The type A influenza viruses are classified based on two proteins on their surface, namely Hemagglutinin (HA) and Neuraminidase (NA).
• There are around 18 subtypes of HA and 11 subtypes of NA.
• Several combinations of these two proteins are possible, such as H5N1, H7N2, H9N6, H17N10, H18N11, etc.
• All subtypes of influenza A viruses can infect birds, except subtypes H17N10 and H18N11, which have only been found in bats.

-Source: The Hindu

Black Sea Grain Deal

Context:

The last ship carrying grain from Ukraine, under a UN-brokered deal that guarantees its safe passage, left the port of Odesa. This deal was set to expire on July 17, and Russia has still not agreed to extend it.

Relevance:

GS II: International Relations

Dimensions of the Article:

1. What is the Black Sea Grain Initiative?
2. Importance of the Black Sea Grain Initiative:
3. Why has Russia not agreed to renew it?
4. About the Black Sea

What is the Black Sea Grain Initiative?

The Black Sea Grain Initiative is a response to supply chain disruptions caused by Russia’s actions in the Black Sea region, which have led to escalating food prices. Here are the key points about the initiative:

• Brokered by the UN and Turkey, the Black Sea Grain deal was signed in July 2022 in Istanbul.
• Initially set for a period of 120 days, with the option to extend or terminate after November, the deal aimed to establish a safe maritime humanitarian corridor for Ukrainian exports, particularly food grains.
• The corridor would operate from three key ports in Ukraine: Chornomorsk, Odesa, and Yuzhny/Pivdennyi.
• The primary objective of the initiative was to stabilize markets by ensuring an adequate supply of grains, thus limiting food price inflation.
• Ukraine is a major global exporter of wheat, maize, rapeseed, sunflower seeds, and sunflower oil.
• Its access to deep-sea ports in the Black Sea allows direct trade with Russia, Europe, and grain importers from West Asia and North Africa.
• Russia’s actions in Ukraine had disrupted this trade route, which previously facilitated the shipping of 75% of Ukraine’s agricultural exports.
• The Black Sea Grain Initiative aimed to address these disruptions and restore the flow of agricultural exports from Ukraine, thereby mitigating the impact on food prices and market stability.

Importance of the Black Sea Grain Initiative:

Supply of Grains:

• Approximately 10.1 million tonnes of grains have been shipped since the initiative started, ensuring a steady supply of food commodities.

Impact on Food Prices:

• The UN Food and Agricultural Organisation’s Food Price Index has shown a six-month consecutive decrease in food prices during the September assessment period.
• This indicates an improvement in the supply situation and the potential for further price drops.

Discouraging Hoarding:

• The initiative has compelled people who were hoarding grain to sell it, reducing the likelihood of profiteering during supply shortages.

Addressing the Cost of Living Crisis:

• The initiative has been credited with making a significant difference to the global cost of living crisis.

Distribution to Different Income Groups:

• About 44% of the shipments reached high-income countries, 28% reached low and lower-middle-income countries, and 27% reached upper-middle-income countries.
• This ensures a broad distribution of grains to meet the needs of different income groups.

Limitations in Addressing Global Hunger:

• Observers note that while the initiative has had a significant reach, it alone cannot solve the issue of global hunger.
• It can, however, prevent the global food crisis from worsening, particularly in the region that is yet to recover to previous production levels.

Why has Russia not agreed to renew it?

• Unmet Promises: Russia claims that the promises made to it under the deal have not been fulfilled. It believes that it is still facing challenges in exporting its agricultural products and fertilizers.
• Barriers on Export: Although there are no direct restrictions on Russia’s agricultural products, barriers related to payment platforms, insurance, shipping, and logistics have hindered its export activities. These obstacles have affected Russia’s ability to export its agricultural goods effectively.
• Concerns about Global Food Security: Russia initially agreed to the grain deal to contribute to global food security. However, it has expressed dissatisfaction that Ukraine has primarily exported to high- and middle-income countries instead of focusing on poorer nations.
• Impact on Food Prices: The United Nations acknowledges that while high- and middle-income countries have benefited from the cooling down of food prices, it also suggests that poorer countries have been assisted in terms of food availability and affordability.

About the Black Sea

• The Black Sea is a marginal sea of the Atlantic Ocean lying between Europe and Asia; east of the Balkans (Southeast Europe), south of the East European Plain in Eastern Europe, west of the Caucasus, and north of Anatolia in Western Asia.
• The Black Sea is bordered by Bulgaria, Georgia, Romania, Russia, Turkey, and Ukraine.
• The Black Sea ultimately drains into the Mediterranean Sea, via the Turkish Straits and the Aegean Sea.
• The Bosporus Strait connects it to the small Sea of Marmara which in turn is connected to the Aegean Sea via the Strait of the Dardanelles. To the north, the Black Sea is connected to the Sea of Azov by the Kerch Strait.

-Source: Indian Express

National Multidimensional Poverty Index

Context:

According to the ‘National Multidimensional Poverty Index: A Progress Review 2023, India has registered a significant decline of 9.89 percentage points in the number of multidimensionally poor, from 24.85% in 2015-16 to 14.96% in 2019-2021.

Relevance:

GS III: Indian Economy

Dimensions of the Article:

1. Key Findings on Multidimensional Poverty
2. About the National Multidimensional Poverty Index (MPI)

Key Findings on Multidimensional Poverty:

Decline in Poverty:

• Approximately 13.5 crore people have moved out of multidimensional poverty during the assessed period.
• Rural areas have witnessed the fastest decline in poverty, from 32.59% to 19.28%, with significant progress in states like Bihar, Uttar Pradesh, Madhya Pradesh, Odisha, and Rajasthan.
• Delhi, Kerala, Goa, and Tamil Nadu have the lowest number of people facing multidimensional poverty.

States with High Multidimensional Poverty:

• Bihar, Jharkhand, Meghalaya, Uttar Pradesh, and Madhya Pradesh, along with the Union Territories, have a high percentage of the population facing multidimensional poverty.

Decrease in Urban Multidimensional Poverty:

• Multidimensional poverty in urban areas has also seen a decrease, from 8.65% to 5.27% during the assessed period.
• Significant Progress in Uttar Pradesh:
• Uttar Pradesh has registered the largest decline in the number of poor, with 3.43 crore people escaping multidimensional poverty.

Reduction in MPI Value and Intensity of Poverty:

• The MPI value has nearly halved, from 0.117 to 0.066, between 2015-16 and 2019-21.
• The intensity of poverty has reduced from 47% to 44% during the same period.

About the National Multidimensional Poverty Index (MPI):

• The MPI is based on the latest National Family Health Survey of 2019-21 and represents the second edition of the index.

Parameters:

• The report examines 12 parameters related to health, education, and standard of living to determine multidimensional poverty.
• These parameters include nutrition, child and adolescent mortality, maternal health, years of schooling, school attendance, cooking fuel, sanitation, drinking water, electricity, housing, assets, and bank accounts.

Methodology:

• The report follows the Alkire-Foster methodology, which was developed by the Oxford Poverty and Human Development Initiative (OPHI) and the United Nations Development Programme (UNDP).
• This methodology provides a comprehensive approach to measuring multidimensional poverty by considering multiple dimensions and deprivations.

-Source: The Hindu

PM MITRA Scheme

Context:

Recently, the Prime Minister of India has lauded the foundation stone laying of 2 mega textile parks in Maharashtra and Gujarat under the PM Mega Integrated Textile Regions and Apparel (PM MITRA) scheme.

Relevance:

GS-III: Industry and Infrastructure (Textile Industry, Government Policies and Initiatives, Industrial Policy)

Dimensions of the Article:

1. About PM Mega Investment Textiles Parks (PM MITRA) scheme
2. Aims and Significance of MITRA
3. Significance of Textile Sector in India

About PM Mega Investment Textiles Parks (PM MITRA) scheme

• The PM Mega Investment Textiles Parks (PM MITRA) scheme was launched in 2020 with a plan to establish Seven textile parks which will have a world-class infrastructure over three years.
• These parks will also have plug-and-play facilities (business facilities will be available ready-made) to help create global champions in exports in the textile sector.

Aims and Significance of MITRA

• The Mega Investment Textiles Parks (MITRA) Scheme aims to enable the textile industry to become globally competitive and boost exports.
• The scheme also aims to boost employment generation within the textile sector and also attract large investment.
• The scheme was launched in addition to the Production Linked Incentive (PLI) Scheme.
• The scheme will create a level-playing field for domestic manufacturers in the international textiles market.
• It will also pave the way for India to become a global champion of textiles exports across all segments.
• MITRA will lead to increased investments and enhanced employment opportunities with the support from the Production Linked Incentive (PLI) scheme.

Significance of Textile Sector in India

• The Textile Sector accounts for 7% of India’s manufacturing output, 2% of GDP, 12% of exports and employs directly and indirectly about 10 crore people.
• Owing to the abundant supply of raw material and labour, India is the largest producer of cotton (accounting for 25% of the global output) and second-largest producer of textiles and garments and man-made fibres (polyester and viscose).
• The availability of a strong domestic market in India is a major reason that increases the importance of the sector.

-Source: The Hindu

Exercise Nomadic Elephant

Context:

A bilateral joint military exercise “NOMADIC ELEPHANT-23” is scheduled to be conducted between India and Mongolia at Ulaanbaatar from 17 to 31 July 2023.

Relevance:

GS III: Security Challenges

About Exercise Nomadic Elephant:

• Exercise Nomadic Elephant is the 15th edition of a bilateral joint military exercise.
• It is an annual training event conducted alternately in Mongolia and India.
• The exercise involves soldiers from the Mongolian Armed Forces Unit 084 and Indian Army soldiers from the JAMMU AND KASHMIR LIGHT INFANTRY Regiment.
• The aim of the exercise is to build positive military relations, exchange best practices, develop interoperability, and foster camaraderie and friendship between the two armies.
• The primary focus of the exercise is on counter-terrorism operations in mountainous terrain under the United Nations mandate.
• The exercise includes a platoon-level Field Training Exercise (FTX) in which Indian and Mongolian troops will participate.
• Training activities during the exercise will cover endurance training, reflex firing, room intervention, small team tactics, and rock craft training.
• The soldiers from both sides will have the opportunity to learn from each other’s operational experiences, enhancing their skills and capabilities.

-Source: The Hindu