Editorials/Opinions Analyses For UPSC 25 October 2021

Contents

1. India’s Central Asian outreach
2. Ayushman Bharat Health Infrastructure Mission

India’s Central Asian outreach

Context:

The dramatic developments in Afghanistan have catalysed new geostrategic and geoeconomic concerns for the central-Asia region. The evolving situation has also thrown up renewed challenges for India’s regional and bilateral ties with Central Asia and the Caucasus, prompting India to recalibrate its rules of engagement with the region.

External Affairs Minister was in the Central Asia region in October 2021 – the third visit within a span of four months.

Relevance:

GS-II: International Relations (India’s Foreign policy, Foreign Policies, Treaties and Agreements affecting India’s Interests)

Dimensions of the Article:

1. What is Central Asia?
2. What is the genesis of India-Central Asia relations?
3. What are India’s strategic interests in Central Asia?
4. Recent ties between India and Central Asian countries
5. Significance and Conclusion

What is Central Asia?

• Central Asia is the central region of Asia, extending from the Caspian Sea in the west to the border of western China in the east.
• It is bounded on the north by Russia and on the south by Iran, Afghanistan, and China.
• The region consists of the former Soviet republics of Kazakhstan, Uzbekistan, Tajikistan, Kyrgyzstan, and Turkmenistan.
• All of these nations became independent in 1991 after the collapse of the USSR.
• On the east and south Central Asia is bounded by the western Altai and other high mountain ranges extending into Iran, Afghanistan, and western China.
• Central Asia’s landscape can be divided into the vast grassy steppes of Kazakhstan in the north and the Aral Sea drainage basin in the south. About 60 percent of the region consists of desert land, the principal deserts being the Karakum, occupying most of Turkmenistan, and the Kyzylkum, covering much of western Uzbekistan.
• The scarcity of water has led to a very uneven population distribution, with most people living along the fertile banks of the rivers or in fertile mountain foothills in the southeast; comparatively few live in the vast arid expanses of central and western Kazakhstan and western Uzbekistan and Turkmenistan.
• The five largest ethnic groups in Central Asia are, in descending order of size, the Uzbek, Kazakh, Tajik, Turkmen, and Kyrgyz.

What is the genesis of India-Central Asia relations?

• India’s relations with the Central Asian countries can be traced back to the ancient Silk Road, along which people, goods and ideas flowed.
• During the period of the Kushan Empire, which spanned across the territories of modern Central Asia and India, the people-to-people contact, cultural and economic ties were flourishing.
• The dissolution of the ancient Silk Road, the invasion of Central Asia by Russia and China and the Anglo-Russian rivalry has limited the exchanges between India and Central Asia.
• Immediately after independence, India maintained limited ties with Central Asian countries because of the former’s excessive focus on the immediate neighbourhood, major powers in the international arena and other Afro-Asian countries.
• This may be because of the lack of shared boundaries.
• Following the USSR dissolution, the five Central Asian countries gained independence and India started to improve ties with them.
• India was the only non-communist country with a diplomatic presence in the region.
• It was also one of the first to accord diplomatic recognition to the newly independent countries.
• Immediately after the formation of the Central Asian states, New Delhi signed agreements focusing on expanding Indian trade, investment and developmental assistance.
• At present, Central Asia is considered to be a part of India’s extended neighbourhood.

What are India’s strategic interests in Central Asia?

• Central Asia sits at the heart of Eurasia, making it strategically vital for countries like the US, China, Russia, Europe and India.
• This is because it serves as a pivot for geopolitical transformations within the international arena.
• Many countries are currently competing to increase influence and power over the region.
• Through this region, countries like India and China can expand their markets throughout Eurasia.
• Apart from its geostrategic position, Central Asia has been rich with natural resources – Turkmenistan with gas, Kazakhstan with gas and uranium, Tajikistan and Kyrgyzstan with hydropower.
• With a population of 33 million in the 1990s, this region is potentially a large market.

Recent ties between India and Central Asian countries

• In Kyrgyzstan, the External Affairs Minister extended a credit line of $200 million for the support of development projects and signed a memorandum of understanding (MoU) on High-Impact Community Development Projects (HICDP).
• In Kazakhstan, the External Affairs Minister attended the 6th Foreign Ministers’ Conference on Interaction and Confidence-Building Measures in Asia (CICA). At CICA, he targeted China’s Belt and Road Initiative (BRI). Admonishing China’s methods in promoting the BRI, he said while greater connectivity was essential for the promotion of regional stability, it must not be pursued for parochial interests. He also confronted Pakistan for its support towards cross-border terrorism.
• New Delhi signed the Strategic Partnership Agreements (SPA) with Kazakhstan, Tajikistan and Uzbekistan to stimulate defence cooperation and deepen trade relations.
• In 2012, New Delhi’s ‘Connect Central Asia’ policy aimed at furthering India’s political, economic, historical and cultural connections with the region. However, India’s efforts were stonewalled by Pakistan’s lack of willingness to allow India passage through its territory. China took advantage of the situation and unveiled the much-hyped BRI in Kazakhstan.
• Mr. Jaishankar has become the first Indian External Affairs Minister to visit Armenia. The two countries agreed to enhance trade and cultural exchanges to boost bilateral relations. India also supported efforts for a peaceful solution of the Nagorno-Karabakh conflict between Azerbaijan and Armenia under the Organization for Security and Cooperation in Europe’s (OSCE) Minsk group.

Significance and Conclusion

• Central Asian countries have been keen to have India as a partner as they have sought to diversify their strategic ties.
• Central Asian countries have admitted New Delhi into the Ashgabat Agreement, allowing India access to connectivity networks to facilitate trade and commercial interactions with both Central Asia and Eurasia, and also access the natural resources of the region.
• Rising anti-Chinese sentiments within the region and security threats from the Taliban allow New Delhi and Central Asia to reimagine their engagement. India cannot afford to lose any time in recalibrating its regional engagements.

-Source: The Hindu

Ayushman Bharat Health Infrastructure Mission

Context:

India’s Prime Minister is set to visit Uttar Pradesh  to inaugurate what is being touted as “India’s largest scheme to scale-up health infrastructure” – the  Ayushman Bharat Health Infrastructure Mission.

Relevance:

GS-II: Social Justice and Governance (Issues related to health, Welfare Schemes, Government Policies and interventions, Issues arising out of the design and implementation of policies)

Dimensions of the Article:

1. About the Ayushman Bharat Health Infrastructure Mission
2. Status of Healthcare in India
3. Improvement in Health infrastructure in India

About the Ayushman Bharat Health Infrastructure Mission

• The Ayushman Bharat Health Infrastructure Mission is expected to be one of the largest pan-India schemes for strengthening healthcare infrastructure across the country. It will be in addition to the National Health Mission.
• The primary objective of the Ayushman Bharat Health Infrastructure Mission is to fill critical gaps in public health infrastructure, especially in critical care facilities and primary care in both urban and rural areas.
• The mission will provide support for 17,788 rural Health and Wellness Centres in 10 High Focus States. Further, 11,024 urban Health and Wellness Centres will be established in all the States.
• Under the mission, critical care services will be available in all the districts of the country with more than 5 lakh population, through Exclusive Critical Care Hospital Blocks, while the remaining districts will be covered through referral services. Also, Integrated Public Health Labs will be set up in all the districts.
• The programme targets to build an IT enabled disease surveillance system by developing a network of surveillance laboratories at block, district, regional and national levels, in Metropolitan areas.
• The Integrated Health Information Portal will be expanded to all States/UTs to connect all public health labs.
• It also aims at operationalising 17 new Public Health Units and strengthening 33 existing Public Health Units at Points of Entry, for effectively detecting, investigating, preventing, and combating Public Health Emergencies and Disease Outbreaks.
• It will also work towards building up a trained frontline health workforce to respond to any public health emergency.
• Under the mission, the following would be set up:
  1. One National Institution for One Health
  2. Four New National Institutes for Virology
  3. One Regional Research Platform for WHO South East Asia Region
  4. Nine Biosafety Level III laboratories
  5. Five New Regional National Centres for Disease Control

Status of Healthcare in India

• Health expenditure:
  • General Government expenditure on health as percentage of GDP in 2019-20 was 1.6% (up from 1.5% in 2018-19.
  • Out-of-Pocket Expenditure (OOPE) as a percentage of Current Health Expenditure fell down to 58.7% in 2016-17 from 60.6% in 2015-16.
  • Population with health insurance coverage: About 14% of the rural population and 19% of the urban population had health expenditure coverage.
  • Source of hospitalisation expenditure: Rural households primarily depended on their ‘household income/savings’ (80%) and on ‘borrowings’ (13%) for financing expenditure on hospitalisation. The figure is 84% and 9% respectively for Urban households.
• Life Expectancy: As per the 2019 Human Development Report released by United Nations Development Programme (UNDP), between 1990 and 2018, life expectancy at birth increased by 11.6 years in India.
• Child Health: As per estimates developed by the UN Inter-agency Group for Child Mortality Estimation:
  • Under-five mortality rate (U5MR) (deaths of children less than 5 years per 1,000 live births) has declined from 126 in 1990 to 34 in 2019, with a Annual rate of reduction (ARR) of 4.5 per cent in the time period 1990-2019.
  • Infant mortality rate (deaths of children less than 1 year per 1,000 live births) has declined from 89 in 1990 to 28 in 2019. o Neonatal mortality rate (deaths of children within a month per 1,000 live births) has declined from 57 in 1990 to 22 in 2019.
• Status of Immunisation among children aged 0-5 years:
  • About 97% of children across the country received at least one vaccination — mostly BCG and/or the first dose of Oral Polio Vaccine at birth, but two out of five children (40%) do not complete their immunisation programme.
  • Among States, Manipur (75%), Andhra Pradesh (73.6%) and Mizoram (73.4%) recorded the highest rates of full immunisation.
  • In Nagaland, only 12% of children received all vaccinations, followed by Puducherry (34%) and Tripura (39.6%).
• Maternal Health:
  • Institutional deliveries: In rural areas, about 90% childbirths were institutional (in Government/private hospitals) and in urban areas it was about 96%.
  • Pre and Post Natal Care: Among women in the age-group 15-49 years, about 97% of women took pre-natal care and about 88% of women took post-natal care.
  • Maternal Mortality Rate (proportion of maternal deaths per 1,00,000 live births reported) of India has declined from 130 in 2014-2016 to 122 in 2015-17.
• Profile of ailments: About 31% of the hospitalised cases had infectious diseases followed by injuries (around 11%), cardio-vascular (around 10%) and gastro-intestinal (around 9%).

Improvement in Health infrastructure in India

• The Centre told the Supreme Court that the total ICU beds had increased by 45-fold from a baseline 2,500 to more than 1.1 lakh.
• The total isolation beds (excluding ICU beds) have climbed 42-fold from 41,000 to over 17 lakhs.
• The government said over 1.5 lakh health personnel have been engaged including medical officers, specialists, staff nurses, community volunteers, Accredited Social Health Activists (ASHA) and ASHA facilitators along with other support staffs.
• The affidavit said insurance coverage was given to more than 22 lakh heath workers, including ASHAs fighting COVID-19.
• The Centre had further enhanced the ceiling limit for expenditure of State Disaster Response Fund from 35% to 50% in 2020-21 for States to finance COVID-19 containment measures.

-Source: Indian Express