Current Affairs 24 August 2024

CONTENTS

1. Passive Euthanasia
2. U.S. Urges India to Halt Dual-Use Exports to Russia
3. India Bans Certain Fixed Dose Combination Medications
4. Vaccine-Derived Polio
5. World’s Second-Largest Diamond in Botswana
6. Gongronema Sasidharanii

Passive Euthanasia

Context:

Recently, the Supreme Court of India denied a petition from an elderly couple seeking “passive euthanasia” for their comatose (deeply unconscious) son, who has been bedridden for 11 years following a fall. 

Relevance:

GS II: Health

Dimensions of the Article:

1. What is euthanasia, and what is a living will?
2. SC rule in 2018
3. Changes to Living Will Guidelines in India

What is euthanasia, and what is a living will?

• Euthanasia refers to the practice of an individual deliberately ending their life, oftentimes to get relief from an incurable condition, or intolerable pain and suffering.
• Euthanasia, which can be administered only by a physician, can be either ‘active’ or ‘passive’.
  • Active euthanasia involves an active intervention to end a person’s life with substances or external force, such as administering a lethal injection.
  • Passive euthanasia refers to withdrawing life support or treatment that is essential to keep a terminally ill person alive.
• Passive euthanasia was legalised in India by the Supreme Court in 2018, contingent upon the person having a ‘living will’ or a written document that specifies what actions should be taken if the person is unable to make their own medical decisions in the future.
• In case a person does not have a living will, members of their family can make a plea before the High Court to seek permission for passive euthanasia.

SC rule in 2018

• The Supreme Court allowed passive euthanasia while recognising the living wills of terminally-ill patients who could go into a permanent vegetative state, and issued guidelines regulating this procedure.
• A five-judge Constitution Bench headed by then Chief Justice of India (CJI) Dipak Misra said that the guidelines would be in force until Parliament passed legislation on this.
• However, this has not happened, and the absence of a law on this subject has rendered the 2018 judgment the last conclusive set of directions on euthanasia.
• The guidelines pertained to questions such as who would execute the living will, and the process by which approval could be granted by the medical board.
• “We declare that an adult human being having mental capacity to take an informed decision has right to refuse medical treatment including withdrawal from life-saving devices,” the court said in the 2018 ruling.

Changes to Living Will Guidelines in India

The 2018 Guidelines

• A living will was required to be signed by an executor in the presence of two attesting witnesses, countersigned by a Judicial Magistrate of First Class
• The treating physician was required to constitute a board comprising three expert medical practitioners with at least 20 years of experience to decide whether to carry out the living will or not
• If the medical board granted permission, the will had to be forwarded to the District Collector for his approval
• The Collector was to then form another medical board of three expert doctors, including the Chief District Medical Officer
• Only if this second board agreed with the hospital board’s findings would the decision be forwarded to the JMFC, who would then visit the patient and examine whether to accord approval

Changes Made by the Supreme Court

• Instead of the hospital and Collector forming the two medical boards, both boards will now be formed by the hospital
• The requirement of 20 years of experience for the doctors has been relaxed to five years
• The requirement for the Magistrate’s approval has been replaced by an intimation to the Magistrate
• The medical board must communicate its decision within 48 hours
• The 2018 guidelines required two witnesses and a signature by the Magistrate; now a notary or gazetted officer can sign the living will in the presence of two witnesses instead of the Magistrate’s countersign
• In case the medical boards set up by the hospital refuses permission, it will now be open to the kin to approach the High Court which will form a fresh medical team.

Different countries, different laws

• NETHERLANDS, LUXEMBOURG, BELGIUM allow both euthanasia and assisted suicide for anyone who faces “unbearable suffering” that has no chance of improvement.
• SWITZERLAND bans euthanasia but allows assisted dying in the presence of a doctor or physician.
• CANADA had announced that euthanasia and assisted dying would be allowed for mentally ill patients by March 2023; however, the decision has been widely criticised, and the move may be delayed.
• UNITED STATES has different laws in different states. Euthanasia is allowed in some states like Washington, Oregon, and Montana.
• UNITED KINGDOM considers it illegal and equivalent to manslaughter.

-Source: Indian Express

U.S. Urges India to Halt Dual-Use Exports to Russia

Context:

Recent initiatives by the United States involve advising Indian companies and exporters against supplying dual-use technologies to Russia. Such exports, which include chemicals and aeronautic components potentially applicable in defense equipment, could lead to Western sanctions.

Relevance:

GS II: International Relations

Dimensions of the Article:

1. Dual Use Goods and Technologies
2. Dual-Use Technology Developments Concerning Russia:
3. Conclusion

Dual Use Goods and Technologies

• Definition and Examples:
  • Dual-use goods are items applicable in both civilian and military settings.
  • Examples include global positioning satellites, missiles, nuclear technologies, and night vision devices.
• Specific Technologies:
  • Hypersonics: Systems capable of flight at speeds five times greater than the speed of sound, useful for satellite launches and defense applications.
  • Integrated Network Systems-of-Systems: Enhances the integration of various mission systems, bolstering networked command and control.
  • Microelectronics: Fundamental in both civilian tech like smartphones and military equipment.
• Regulatory Frameworks:
  • Governed by international dual-use export control regimes aiming to prevent misuse while allowing legitimate trade.

Global Export Control Regimes:

• Wassenaar Arrangement (WA): Promotes transparency and responsibility in arms and dual-use goods transfers; India joined as the 42nd member in 2017.
• Nuclear Suppliers Group (NSG): Focuses on curtailing nuclear arms proliferation; India is not a member but follows voluntary non-proliferation practices.
• Australia Group: Ensures that exports do not contribute to chemical or biological weapons development; India became a member in 2018.
• Missile Technology Control Regime (MTCR): Aims to prevent missile proliferation capable of delivering large payloads; India joined in 2016.
• Chemical Weapons Convention (CWC) and Biological and Toxin Weapons Convention (BWC): India is a signatory, committing to non-proliferation of chemical and biological weapons.

UN and Dual-Use Goods:

• UN Security Council Resolution 1540: Mandates member nations to regulate exports that could harm global peace or security.

Dual-Use Technology Developments Concerning Russia:

• Sanctions Risk: Indian companies face potential U.S. sanctions under CAATSA for dealings with Russia’s military-industrial sectors.
• Trade Insights: Indian exports to Russia surged by 40% in 2023, emphasizing the significant role of engineering goods.
• Global Supply Chains: The U.S. has flagged China as a major supplier of critical items like machine tools and microelectronics to Russia, impacting global defense manufacturing networks.

Conclusion:

India faces the intricate task of regulating the export of dual-use items, balancing between adhering to international norms and protecting its economic sovereignty. In the delicate geopolitical landscape, particularly concerning Russia, it is vital for India to conform to global regulations to evade sanctions while preserving its strategic autonomy. By enhancing regulatory oversight and raising industry awareness, India can ensure its export practices meet global standards, thus supporting both innovation and national security.

-Source: Indian Express

India Bans Certain Fixed Dose Combination Medications

Context:

The Union Health Ministry has prohibited the use of 156 fixed dose combination (FDC) medications, noting a lack of therapeutic justification and potential risks to patient health. These medications, which blend multiple active ingredients, are often used for treating conditions such as tuberculosis and diabetes. However, concerns arise because they may also introduce unnecessary or harmful components to patients.

Relevance:

GS II: Health

Dimensions of the Article:

1. Ban on 156 Fixed-Dose Combination Drugs
2. Fixed Dose Combination (FDC) Drugs
3. Challenges and Criticisms of FDC Drugs

Ban on 156 Fixed-Dose Combination Drugs

• Overview:
  • The Indian government has banned 156 fixed-dose combination (FDC) medications citing health risks. These include antibiotics, painkillers, and multivitamins.
• Legislative Action:
  • The Union Health Ministry has issued a gazette notification under Section 26 A of the Drugs and Cosmetics Act of 1940 to halt the production, sale, and distribution of these drugs.
• Regulatory Insight:
  • The decision is backed by recommendations from the Drugs Technical Advisory Board (DTAB) and an expert committee, which concluded that the ingredients in these FDCs lack therapeutic justification.
• Specifics of the Ban:
  • Drugs affected include combinations such as anti-allergics with decongestants, antibiotics with acne creams, and migraine treatments paired with anti-nausea medications.
  • Noteworthy inclusions in the ban are drugs like the mefenamic acid-tranexamic acid combo and sildenafil with vascular relaxants.
• Historical Context:
  • This action marks the most extensive ban since 2016, when 344 drugs were prohibited—a decision upheld in 2018 for 328 of those drugs.
• Industry Impact:
  • The ban extends to some drugs that were previously exempt, specifically those introduced before 1988, causing surprise and concern among pharmaceutical manufacturers regarding the sudden removal of these long-standing products from the market.

Fixed Dose Combination (FDC) Drugs

• Definition and Concept:
  • FDC drugs combine two or more active pharmaceutical ingredients into a single dosage form, commonly known as cocktail drugs.
  • The FDA defines a combination product as any product made up of a drug and a device, or a drug and a biological product, or all three combined.
• Formulation Guidelines:
  • Most medications are typically formulated as single compounds.
  • FDCs are deemed acceptable only if each component’s dosage meets specific population needs and offers clear advantages in efficacy, safety, or compliance over separate administration.
• Benefits of FDCs:
  • These include a synergistic mechanism of action, enhanced drug tolerability, extended product lifecycle, and potential cost savings.
  • FDCs aim to optimize therapeutic outcomes while reducing the number of pills a patient must take.

Challenges and Criticisms of FDC Drugs

• Increased Risks:
  • FDCs may heighten the likelihood of adverse drug reactions and interactions compared to administering drugs individually.
• Controversy and Irrational Use:
  • Many FDCs introduced in India lack rational justification, posing unnecessary health risks and increasing the potential for adverse reactions.
• Economic and Legal Concerns:
  • Irrational FDCs can place a financial burden on consumers.
  • Healthcare providers who recommend these combinations may face legal challenges, especially if the combinations are not recognized in authoritative medical texts or journals.
• Pharmaceutical Practices:
  • Despite these issues, pharmaceutical companies continue to aggressively market FDCs due to their substantial profit margins.

-Source: Indian Express

Vaccine-Derived Polio

Context:

Recently, a child from Meghalaya was diagnosed with vaccine-derived polio (VDP).

Relevance:

GS II- Health

Dimensions of the Article:

1. Vaccine-Derived Polio
2. What is Polio?
3. Polio in India
4. India’s Pulse Polio Programme
5. Steps taken by the Government to maintain polio free status in India

Vaccine-Derived Polio

• Vaccine-derived polio (VDP) occurs when the attenuated (weakened) poliovirus in the oral polio vaccine (OPV) mutates and regains the ability to cause paralysis.
• VDP is more likely in regions with low immunization coverage, poor sanitation, or among immunocompromised individuals. Over 90% of VDP outbreaks are linked to the Wild Poliovirus Type 2 (WPV2) present in OPV.
• Vaccine-Associated Paralytic Poliomyelitis (VAPP): This is a rare condition linked to the OPV but is not classified as polio by the Indian government due to its sporadic nature and minimal threat to the broader population.
• Polio Status in India: The WHO declared India polio-free in 2014, a status not undermined by the presence of VAPP.
• Types of Poliovirus:
  • WPV1, WPV2, WPV3: These are wild strains of the poliovirus with the same symptoms but distinct genetic makeups. WPV2 and WPV3 have been eradicated as of 2015 and 2019, respectively.
• Polio Endemic Regions: Wild poliovirus remains endemic in regions like Pakistan and Afghanistan.
• Polio Vaccines:
  • Inactivated Polio Vaccine (IPV): Developed by Jonas Salk, this vaccine uses an inactivated virus.
  • Oral Polio Vaccine (OPV): Developed by Albert Sabin, this vaccine contains a live, attenuated virus.

What is Polio?

• The World Health Organization (WHO) defines polio or poliomyelitis as “a highly infectious viral disease, which mainly affects young children.”
• The virus is transmitted by person-to-person, spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g., contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
• Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs.
• In a small proportion of cases, the disease causes paralysis, which is often permanent.
• There is no cure for polio, it can only be prevented by immunization.
• There are three individual and immunologically distinct wild poliovirus strains:
  1. Wild Poliovirus type 1 (WPV1)
  2. Wild Poliovirus type 2 (WPV2)
  3. Wild Poliovirus type 3 (WPV3)
• Symptomatically, all three strains are identical, in that they cause irreversible paralysis or even death.
• However, there are genetic and virological differences, which make these three strains separate viruses which must each be eradicated individually.

Polio in India

• India received polio-free certification by the WHO in 2014, after three years of zero cases.
• This achievement has been spurred by the successful pulse polio campaign in which all children were administered polio drops.
• The last case due to wild poliovirus in the country was detected on 13th January 2011.

India’s Pulse Polio Programme

• With the global initiative of eradication of polio in 1988 following World Health Assembly resolution in 1988, Pulse Polio Immunization programme was launched in India in 1995. Children in the age group of 0-5 years administered polio drops during National and Sub-national immunization rounds (in high-risk areas) every year.
• The Pulse Polio Initiative was started with an objective of achieving hundred per cent coverage under Oral Polio Vaccine.
• It aimed to immunize children through improved social mobilization, plan mop-up operations in areas where poliovirus has almost disappeared and maintain high level of morale among the public.

Steps taken by the Government to maintain polio free status in India

• Maintaining community immunity through high quality National and Sub National polio rounds each year.
• An extremely high level of vigilance through surveillance across the country for any importation or circulation of poliovirus and VDPV is being maintained.
• All States and Union Territories in the country have developed a Rapid Response Team (RRT) to respond to any polio outbreak in the country.
• To reduce risk of importation from neighbouring countries, international border vaccination is being provided through continuous vaccination teams (CVT) to all eligible children round the clock.
• Government of India has issued guidelines for mandatory requirement of polio vaccination to all international travelers before their departure from India to polio affected countries namely:  Afghanistan, Nigeria, Pakistan, Ethiopia, Kenya, Somalia, Syria and Cameroon.

-Source: Indian Express

World’s Second-Largest Diamond in Botswana

Context:

A 2,492-carat raw diamond discovered in Botswana is believed to be the world’s second-largest, behind only the famed Cullinan diamond.

Relevance:

Facts for Prelims

Exploring Recent Developments and Global Dynamics of Diamond Production

• A recently unearthed diamond has emerged as a close second to the famed 3,106-carat Cullinan Diamond discovered in South Africa over a century ago.
• Advanced X-ray transmission technology facilitated its extraction, minimizing damage and preserving the integrity of the large stone.
•  The full assessment of the diamond’s quality and potential is pending.

Diamond Characteristics:

• Formation: Diamonds originate from the Earth’s mantle and reach the surface through volcanic activities, specifically within dykes and sills.
• Utility: Their exceptional hardness makes them ideal for various applications including jewelry, industrial cutting tools, and polishing.

Diamonds in India:

• Key Locations:
  • Panna belt in Madhya Pradesh
  • Wajrakarur Kimberlite pipe in Anantapur district, Andhra Pradesh
  • Krishna River basin gravels in Andhra Pradesh
• Recent Discoveries: Notable are the new kimberlite fields in Raichur-Gulbarga districts, Karnataka.
• Processing Hubs: Major cutting and polishing operations are centered in Surat, Navasari, Ahmedabad, and Palampur.

-Source: Hindustan Times

Gongronema Sasidharanii

Context:

A plant with smooth stems and small urn-shaped flowers spotted in Idukki district has been identified as an entirely new species of the genus Gongronema. Equally importantly, this is the first time Gongronema has been reported from south India.

Relevance:

Facts for Prelims

New Botanical Discovery: Gongronema Sasidharanii

• A new plant species found in Pampadum Shola National Park, Kerala.
• Characterized by smooth stems and small urn-shaped flowers transitioning from creamy white to purplish-green.
• Marks the first report of the genus Gongronema in South India, expanding its known range beyond northeastern states and parts of North India.

Overview of Pampadum Shola National Park

• Situated in the eastern Southern Western Ghats, Idukki District, Kerala.
• Covers approximately 12 square kilometers.
• The name translates to ‘the forest where the snake dances,’ reflecting the park’s dynamic landscape.
• Features undulating terrain with hillocks, with elevations ranging from 1600 to 2400 meters.
• Characterized by a misty and cloudy atmosphere year-round, with significant rainfall during the North-East monsoon.

Ecological Attributes

• Vegetation: Comprises a diverse assembly of evergreen forests, moist deciduous forests, shola grasslands, and semi-evergreen formations.
• Flora: Hosts an array of 22 tree species, 74 herb species, and 16 climber species.
• Fauna:
  • Mammals: Inhabited by tigers, leopards, giant gizzard squirrels, rare flying squirrels, Nilgiri Tahr, and spotted deer.
  • Special Mention: The Nilgiri marten, unique to South India, is a notable inhabitant.
  • Butterflies: Home to approximately 100 butterfly species, highlighting its rich biodiversity.

-Source: The Hindu