Editorials/Opinions Analyses For UPSC 4 October 2021

Contents

1. Ayushman Bharat Digital Mission (ABDM) Concerns
2. Reimagining food systems with lessons from India

Ayushman Bharat Digital Mission (ABDM) Concerns

Context:

The Ayushman Bharat Digital Mission (ABDM), launched in September 2021 will not only simplify processes of hospitals but also increase ease of living according to the Prime Minister.

Relevance:

GS-II: Social Justice and Governance (Issues Related to Health, Government Policies and Initiatives, Welfare Schemes)

Dimensions of the Article:

1. What is the Ayushman Bharat Digital Mission?
2. Some of the Key Facilities of Ayushman Bharat Digital Mission
3. Benefits of Ayushman Bharat Digital Mission
4. Key points regarding Digital Health ID card
5. Issues with the Digital Health ID
6. Other Issues with ABDM

What is the Ayushman Bharat Digital Mission?

• The Ayushman Bharat Digital Mission (ABDM) is a digital health ecosystem under which every Indian citizen will now have unique health IDs, digitised health records with identifiers for doctors and health facilities.
• Ayushman Bharat Digital Mission will create a seamless online platform through the provision of a wide-range of data, information, and infrastructure services, duly leveraging open, interoperable, standards-based digital systems.
• The Mission will ensure the security, confidentiality, and privacy of health-related personal information, and enable access and exchange of longitudinal health records of citizens with their consent.
• The Mission is based on the foundations laid down in the form of Jan Dhan, Aadhaar and Mobile (JAM) trinity, and other digital initiatives of the government.
• It aims to create interoperability within the digital health ecosystem, similar to the role played by the Unified Payments Interface in revolutionizing payments. Citizens will be a click away from accessing healthcare facilities.
• The ABDM will come under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
• The National Health Authority has been given the mandate to design, build, roll-out and implement the mission in the country.
• Private stakeholders will have an equal opportunity to integrate and create their own products for the market. The core activities and verifications, however, remain with the government.
• The pilot scheme is currently being implemented across 6 union territories namely Andaman & Nicobar Islands, Chandigarh, Dadra & Nagar Haveli, and Daman & Diu, Ladakh, Lakshadweep, and Puducherry.
• It comprises six key building blocks — HealthID, DigiDoctor, Health Facility Registry, Personal Health Records, e-Pharmacy and Telemedicine.
• The core building blocks of the mission is that the health ID, DigiDoctor and Health Facility Registry shall be owned, operated and maintained by the Government of India.

Some of the Key Facilities of Ayushman Bharat Digital Mission

• Health ID: Every citizen will be allotted a health ID that will be used as their health account. The personal health records of the citizen will be linked to their respective Health ID. These records can be viewed with the help of a mobile application.
• Healthcare Professionals Registry (HPR): A repository of registered nurses, doctors, paramedical with their qualifications, experience, and other relevant details.
• Healthcare Facilities Registry (HFR): A repository of all public and private healthcare facilities across both traditional and modern systems of medicine. This will ensure ease of doing business for doctors, hospitals, and other healthcare service providers.
• Personal Health Record Application: A self-managed health record of an individual linked to the Aarogya Setu App.

Benefits of Ayushman Bharat Digital Mission

1. Empowering citizens with a modern healthcare system
2. Easy access to health records of citizens and healthcare professionals
3. Enabling the private healthcare sector to participate
4. Making healthcare providers and doctors to be more accessible and accountable
5. Providing efficient healthcare services for the benefit of people
6. Help people with medical services in remote and urban areas
7. Provide affordable health facilities at the grassroots level
8. Giving highest importance to the privacy of the personal data of the citizens

Key points regarding Digital Health ID card

• Under National Digital Health Mission, every Indian will get a Health ID card that will work as a unique health account.
• The health ID will be completely technology-based and will include a unique 14-digit health identification number- for every citizen.
• The digital health ID card will work as a repository of all health-related information of the person such as the person’s past medical conditions, treatment and diagnosis.
• The digital Health ID will have details of every disease, every test and all doctor visits along with results of all diagnostic tests and prescribed medicines. Each time, a person will visit the doctor or a pharmacy, the details including prescriptions will be logged in the health ID card.
• The unique digital health IDs will enable Indian citizens to get hassle-free access to healthcare across the country.
• The digital health card will create interoperability within the digital health ecosystem. It will also create a seamless online platform that will also be secure and will protect the confidentiality and privacy of health-related personal information.
• The health ID will be voluntary and it will be free of cost. It is a hassle-free initiative as citizens will only be a click away from accessing healthcare facilities using it.
• The digital health id card will make all the health-related information portable and easily accessible even if the patient shifts to a new place or visits a new doctor. All person health records can be viewed with the help of a mobile app.
• The health ID can be used to access the health records of the citizens only with their consent. It cannot be accessed without their permission so it would be a reliable repository.

Issues with the Digital Health ID

• The absence of a privacy law and little public awareness and control over their data is one of the grave concerns plaguing the idea of Digital Health ID and ABDM. With the health ID storing personal data, concerns are being raised that it could be open to misuse.
• There is the danger that any large private insurance company could use sophisticated algorithms across the health and other databases to construct risk profiles for people and make access to affordable insurance difficult.
• Data mining can prioritise certain rich demographics for their services and direct public and private resources to people who can afford a high premium for their services rather than to the poor who need them.
• Despite provisions such as making citizen’s consent mandatory for sharing their information, such provisions can be easily manipulated by interested entities.

Other Issues with ABDM

• India faces structural issues like the acute shortage of healthcare professionals and healthcare facilities. The digital health mission will be rendered ineffective without such bare minimum resources.
• The fact that India has a huge population of which a large portion is rural population means that the cost of researching, finding and buying appropriate drugs and treatment, competing systems of medicine is challenging.
• The lack of access to technology, poverty and lack of understanding may hamper the mission.
• India’s previous experience with respect to similar attempts like the One Nation One Ration card, PM-JAY card, Aadhaar card, etc., had brought to light many issues such as errors. The DHM is also likely to face similar issues.

-Source: The Hindu

Reimagining food systems with lessons from India

Context:

The first and historic United Nations Food Systems Summit (UNFSS) 2021 which was held in September 2021 concluded after an intense ‘bottom-up’ process conceived in 2019 to find solutions and ‘catalyse momentum’ to transform the way the world produces, consumes, and thinks about food and help address rising hunger.

Relevance:

GS-II: Social Justice and Governance (Issues related to Hunger and Poverty, Government Policies and Interventions), GS-III: Indian Economy. Agriculture (Food Security, Types of Resources), GS-II: International Relations (Important International Institutions and their reports)

Dimensions of the Article:

1. What is Food Security?
2. About the U.N. report on Inequitable Food System
3. About the UN Food Systems Summit
4. Outcomes of the Summit
5. Safety nets in India
6. Challenges in India

What is Food Security?

Food security, as defined by the United Nations’ Committee on World Food Security, means that all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their food preferences and dietary needs for an active and healthy life.

Implications of Covid-19 on the six dimensions of food security

The dynamics outlined above affect food security and nutrition in complex ways. The HLPE Global Narrative report highlights six dimensions of food security, proposing to add agency and sustainability as key dimensions alongside the four traditional “pillars” of food availability, access, stability and utilization.

1. Availability: While world grain stocks were relatively high at the start of the pandemic and remain strong, this global situation masks local variability and could shift over time. Grain production in high-income countries tends to be highly mechanized and requires little labour, making it less vulnerable to disease outbreaks among farm workers.
2. Access: More than any other dimension of food security, food access has arguably been the most affected by the COVID-19 crisis. The global economic recession triggered by lockdowns has had a very negative impact on people’s ability to access food.
3. Utilization: Utilization and nutrition have been affected by the pandemic in important ways. Good nutrition is essential for supporting the human immune system and reducing the risk of infections. However, as people’s ability to access food diminished in the crisis, this had a negative impact on their ability to afford a healthy diet.
4. Stability: The severe disruptions to food supply chains noted above are affecting the stability of global food supply and access (Bene, 2020). The export restrictions placed on staples like wheat and rice led to higher world prices for those crops, compared to prices for other foods, which generally fell.
5. Agency: The most marginalized food system participants—including food producers and food system workers—have had little agency as the crisis has unfolded. As outlined above, food system producers and workers have been on the front lines and have suffered higher rates of disease and are affected by supply chain disruptions the most.
6. Sustainability: The pandemic is intertwined with the sustainability dimension of food security in complex ways. The expansion of industrial agriculture is associated with a rising prevalence of zoonoses—diseases that transmit from animals to humans—of which COVID-19 is a prime example.

About the U.N. report on Inequitable Food System

• Food systems are a complex web of activities involving production, processing, handling, preparation, storage, distribution, marketing, access, purchase, consumption, food loss and waste, as well as the outputs of these activities, including social, economic and environmental outcomes.
• Women farmers are disproportionately more affected by climate change and land degradation as they are less likely than men to receive key information on climate and agricultural information that would allow them to plan for climate concerns.
• Rural women accounting for nearly half the agricultural workforce in developing countries, face discrimination. They have very little land rights, face difficulties obtaining ownership, do not have access to credit and are engaged in unpaid work.
• Though indigenous women play a crucial role in eradicating hunger and malnutrition, they face high levels of obesity and are more susceptible to chronic diseases due to limitations in the recognition and exercise of rights that have hampered their access to equitable systems of food.
• Rural women were among the worst affected among the food insecure population of 821 million (as of 2017). As many as 31 African countries depended on external food aid till 2019.
• Migration among youths over the course of urban transition have had impacts on the gendered nature of economic roles. Such migration has entailed a growing gap between the location of food production and food consumption.
• A 2020 UN report had hinted how epidemics can significantly reduce women’s economic and livelihood activities, increasing poverty rates and exacerbating food insecurity.

About the UN Food Systems Summit

• The UN Food Systems Summit 2021 has brought together all UN Member States and constituencies around the world to bring about tangible, positive changes to the world’s food systems.
• It will seek to set the stage for global food systems transformation to achieve the Sustainable Development Goals by 2030.
• The UN Secretary-General will convene the Food Systems Summit with the aim of maximizing the co-benefits of a food systems approach across the entire 2030 Agenda and meeting the challenges of climate change.
• The Summit aims to provide a platform for ambitious new actions, innovative solutions, and plans to transform food systems and leverage these shifts to deliver progress across all of the SDGs.

Objectives of the UN Food Systems Summit

• Raise awareness of food systems’ centrality to the entire sustainable development agenda, and the urgency of transforming food systems, particularly in the wake of a global pandemic;
• Align stakeholders around a common understanding and narrative of a food system framework as a foundation for concerted action, making food and food systems a more widespread issue for advocacy and action to achieve the 2030 Agenda;
• Recognize the need for inclusivity and innovation in food systems governance and action;
• Motivate and empower stakeholders who support food systems transformation through the development of improved tools, measurement, and analysis; and
• Catalyze, accelerate, and enlarge bold action for the transformation of food systems by all communities, including countries, cities, companies, civil society, citizens, and food producers.

Outcomes of the Summit

• The summit created a mechanism for serious debates involving UN member states, civil society, non-governmental organisations, academics, researchers, individuals, and the private sector, which is to evolve transformative themes and ideas for reimagining food systems to enhance satisfaction of all stakeholders including future generations.
• The debate and response focused on five identified action tracks namely: Ensure access to safe and nutritious food for all; Shift to sustainable consumption patterns; Boost nature-positive production; Advance equitable livelihoods, and Build resilience to vulnerabilities, shocks, and stress.
• The summit provided a historic opportunity to empower all people to leverage the power of food systems to drive our recovery from the COVID-19 pandemic and get us back on track to achieve all 17 SDGs by 2030.
• The Statement of Action emerging from the summit offers a concise set of ambitious, high-level principles and areas for action to support the global call to “Build back better” after the COVID-19 pandemic.
• Several themes that have emerged in the discussions and dialogues leading up to the summit find resonance with India’s past and ongoing journey towards creating and improving food and livelihood security.

Safety nets in India

• One of India’s greatest contributions to equity in food is its National Food Security Act 2013 that anchors the Targeted Public Distribution System (TPDS), the Mid-Day meals (MDM), and the Integrated Child Development Services (ICDS) – through which India’s food safety nets collectively reach over a billion people.
• Food safety nets and inclusion are linked with public procurement and buffer stock policy in India – evident during the global food crises 2008-2012 and during the COVID-19 pandemic fallout, whereby vulnerable and marginalised families in India continued to be buffered against the food crisis by its robust TPDS and buffer stock of food grains.
• India has taken a bold decision to fortify rice supplied through the Public Distribution System with iron. Agricultural research institutes are about to release varieties of many crops having much higher nutrition as a long-term solution for undernutrition and malnutrition.

Challenges in India

• Climate change and unsustainable use of land and water resources are the most formidable challenges food systems face today.
• Dietary diversity, nutrition, and related health outcomes are another area of concern as a focus on rice and wheat has created nutritional challenges of its own.
• Reducing food wastage or loss of food is a mammoth challenge and is linked to the efficiency of the food supply chain. Food wastage in India exceeds ₹1-lakh crore.
• It is ironic that despite being a net exporter and food surplus country at the aggregate level, India has a 50% higher prevalence of undernutrition compared to the world average. (However, it is important to note that proportion of the undernourished population declined from 21.6% during 2004-06 to 15.4% during 2018-20.)

-Source: The Hindu