Editorials/Opinions Analysis For UPSC 17 May 2023

Editorials/Opinions Analysis For UPSC 17 May 2023

Contents

1. High-quality clinical trials and Ayurveda and contemporary medicine
2. Spending for welfare has been routinely reduced

High-quality clinical trials and Ayurveda and contemporary medicine

Context

In a much-welcomed move, the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa, and Homoeopathy (AYUSH) and the Indian Council of Medical Research (ICMR) have at last teamed up to conduct high-quality human clinical trials to produce evidence on the advantages of using ayurveda in conjunction with modern medicine (evidence-based medicine) in treating certain disease Ayurveda will be the first AYUSH system to be included in the cooperation, which aims to provide evidence-based medicinal solutions.

Relevance:

GS Paper-3: Science and Technology

Mains Question

Discuss the advantages and difficulties of combining Ayurveda with contemporary medicine based on the partnership between AYUSH and ICMR, and explain the significance of an evidence-based approach in the field of alternative medicine in India. (250 Words)

Reasons for Working Together

• The use of AYUSH systems as a complement or alternative to Western medicine has been practised in India for many years. This is the basis for the collaboration.
• The inclusion of AYUSH in the conventional healthcare system has, however, been significantly hampered by the absence of scientific support.
• It is anticipated that the cooperation will close this gap by carrying out high-quality human clinical trials that produce data on the effectiveness of combining Ayurveda with contemporary medicine.
• The shortcomings of earlier investigations, which were anecdotal and lacked scientific validation, should be overcome thanks to the ICMR’s experience in running clinical trials.

The importance of the joint initiative between AYUSH and ICMR is as follows:

• Collaboration is a crucial step towards achieving high-quality human clinical studies, according to the established expertise of ICMR.
• Designing and executing high-quality trials that adhere to international standards is anticipated to be made possible by ICMR’s significant experience in carrying out human clinical trials.
  • The engagement of ICMR is an important benefit that can aid in overcoming the severe drawbacks of trials undertaken in the past.
    • Scientific Validation of Combined Therapy: Ayurveda and contemporary medicine being combined is scientifically supported, which is a crucial component of the effort.
  • The experiments carried out as part of this collaboration are anticipated to offer strong proof of the advantages of combining Ayurveda with modern treatment.
• A better patient experience may be possible with the development of integrated medical interventions with such validation.
  • Overcoming the Drawbacks of Prior studies: The project seeks to carry out rigorous clinical studies that adhere to global standards.
  • Previous trials were of poor quality, and the results were unreliable.
  • It’s a step in the direction of conducting high-quality clinical trials that follow international guidelines and guarantee the accuracy of the findings.

Implications for the Healthcare System:

• Integration of Traditional and Modern Medicine: The partnership may result in the creation of integrated medical therapies that incorporate the best aspects of both Traditional and Modern Medicine.
  • The creation of new medications and treatments that are more efficient and have fewer side effects may result from this combination.
  • It might also assist in closing the divide between the two medical systems.
• Better Patient Outcomes and Lower Healthcare Costs: o Integrated medical interventions can improve patient outcomes.
  • As a result, patients may need fewer hospital stays and surgical treatments, which can lower healthcare expenses.
  • Patients may get access to more affordable treatment alternatives through the development of novel therapies and treatments based on Ayurveda.
• Increased Acceptance of Alternative Medicine: The collaboration may also result in a rise in alternative medicine’s popularity among conventional doctors.
  • The scientific support for the advantages of merging Ayurveda with contemporary treatment can aid in removing the scepticism that some medical professionals have towards alternative medicine.
  • This might cause people to value conventional medicine and its place in the healthcare system more.
• The Development of New Therapies and Treatments Based on Ayurveda Can Lead to the Growth of Alternative Medicine Industry.
  • As a result, there may be more opportunities for research and innovation, which could result in the creation of brand-new goods and services.
  • New employment prospects and increased economic potential in the healthcare sector may result from the expansion of the alternative medicine industry.

Conclusion

• The collaboration between AYUSH and the ICMR to perform high-quality human clinical studies to research the advantages of mixing Ayurveda with contemporary medicine is a good move that may have significant effects on the Indian healthcare system.
• This collaboration is a step in the right direction and should be supported by all stakeholders in the healthcare system because it has the potential to provide scientific validation of alternative medical interventions and lead to the development of integrated medical interventions that can offer better outcomes to patients.

Spending for welfare has been routinely reduced

Context

Experts criticised the Union Budget of 2023 for reallocating less money for welfare programmes during the post-COVID-19 recovery, when welfare expenditure ought to have been a top priority.

Relevance:

GS Paper-2: Welfare Schemes for Vulnerable Sections of the population by the Centre and States and the Performance of these Schemes

Mains Question

What are the main causes of the ongoing decrease in spending on different welfare programmes? How can the government justify the money it spends on welfare programmes? (150 Words)

Key Takeaways:

• The analysis based on Budget papers shows that the trend of declining central government spending on critical social schemes is not new, having begun in 2014 with NDA Govt.
• Since then, central allocations for welfare schemes and sectors that ensure basic rights have declined as a result.

Redesigned, absorbed, or discontinued Welfare Scheme:

• Out of the 19 programmes offered by the Ministry of Women and Child Development, just three remain: Saksham Anganwadi, Poshan 2.0, Mission Shakti, and Mission Vatsalya. ‘Beti Bachao, Beti Padhao’ was one of 14 initiatives that Mission Shakti itself superseded.
• The Saksham Anganwadi and Poshan 2.0 programme aims to combat hunger and malnutrition among children.
• The Anganwadi project (ICDS) was combined with POSHAN Abhiyaan and a nutrition initiative for teenage girls starting in 2021–2022.
• Despite the addition of new components, its allocation decreased from 0.13% of GDP in 2014–15 to 0.07% of GDP in 2023–24, or about half of what it was.
  • The percentage of anaemic, underweight, and stunted children in India is 67%, 32%, and 36%, respectively, according to statistics from the National Family Health Survey (NFHS)-5, ranking it among the worst in the world.
• Yet money allocated to combat malnutrition is being cut carelessly.
  • There are now three out of 20 programmes run by the Ministry of Agriculture and Farmers’ Welfare (Krishonnati Yojana, Integrated Scheme on Agricultural Cooperatives, and Rashtriya Krishi Vikas Yojana).
  • Out of the 12 programmes offered by the Ministry of Animal Husbandry and Dairy, just two are still in effect.
• The Ministry has discontinued three programmes, including the National Dairy Plan II and cooperative dairying.

Malnutrition

• About: o Malnutrition is characterised by inadequate or excessive food intake, an unbalanced intake of vital nutrients, or poor nutrient utilisation.
• Malnutrition signs and symptoms
• Low height for age is referred to as stunting.
• It is the outcome of persistent or recurring undernutrition, which is frequently linked to poverty, poor maternal health and nutrition, recurrent illness, and/or insufficient feeding and care during infancy.
• Stunting keeps kids from developing to their full physical and intellectual potential.
• Low weight-for-height is referred to as wasting.
• It typically happens when a person hasn’t eaten enough food, both in terms of quality and quantity, or when they’ve been sick frequently or for a long time.
• If left untreated, wasting in children is linked to a higher risk of mortality.
  • Low weight-for-age is the definition of underweight.
• An underweight child could be wasted, stunted, or both.
  • Deficiencies in micronutrients
• Micronutrient deficiencies occur when there is a deficiency in vitamins and minerals that the body needs to produce enzymes, hormones, and other compounds necessary for growth and development.
• The NFHS-5’s Malnutrition and Migration Key Highlights include:
  • While there have been some improvements in the previous ten years in the fight against malnutrition among women and children, they have been at best modest.
• The number of stunted children has increased since NFHS-4 in 13 States or Union Territories, including Gujarat, Maharashtra, West Bengal, and Kerala, despite a slight decline in the rate of stunting (35.5% from 38.4% in NFHS-4).
• The poorest households in India have traditionally relied on seasonal migrations as a means of obtaining food and cash through temporary labour; nevertheless, children and women are the most affected, suffering from deprivation throughout migrations that negatively affects their health.

Allocation for the Schemes is Reduced:

• The mid-day meal (MDM) programme is a nutrition programme that serves nearly 12 crore youngsters.
• Evidence suggests that the programme has improved learning outcomes, reduced stunting in children, and improved nutritional outcomes.
• However, the budgetary allotment for MDM dropped from 0.08% in 2014–15 to 0.04% in 2023–2024, a 50% reduction as a percentage of GDP.
• A breakfast at school programme was rejected by the Ministry of Finance in 2021 due to a lack of funding, despite Tamil Nadu seeing positive results from the programme within the first year.
• MGNREGA and NFSA: o Since 2014, the GDP share of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) and the NFSA (Food Subsidy) has decreased.
  • The NFSA offers subsidised grains to more than 80 crore people, whilst MGNREGA promises 100 days of employment to every rural household.
  • The amount spent on MGNREGA as a percentage of GDP decreased from 0.26% in 2014–15 to 0.20% in 2023–24.
• For NFSA, it decreased from 0.94% in 2014–15 to 0.65% this year.
• The Economic Survey 2022–23 has noted that as rural suffering persists, demand for the programme is larger than it was prior to the epidemic.
• Anecdotal evidence suggests that actual funding disbursement for MGNREGA has frequently been delayed, which has lowered trust in the programme.
  • As experts have noted, the Public Distribution System and MGNREGA were crucial in preventing a catastrophe during the pandemic.
• Both programmes had record demand in 2020–21; MGNREGA provided employment to 8.55 crore households, while PDS grain offtake was 93 million tonnes, resulting in expenditures for NFSA and MGNREGA of 2.73% and 0.56% of GDP, respectively.
• However, since 2020–21, the share of GDP allocated to NFSA and MGNREGA has quickly decreased.
• National Social Assistance Programme (NSAP): The NSAP is a programme that offers pensions to the aged, widowed and disabled people who are below the poverty line as well as financial aid to families who have lost a breadwinner.
  • Its allocations as a percentage of GDP decreased from 0.06% in 2014–15 to 0.03% in 2023–24.
• With the exception of 2020–21, when it was 0.21% and COVID relief in cash was included in the NSAP, the share continuously decreased during this time.
• PM Matru Vandana Yojana (PMMVY): It offers women in the unorganised sector maternity benefits in the form of a 5,000 rupee conditional cash transfer.
  • The National Food Security Act (NFSA) requires the scheme to cover all women and babies; nevertheless, the PMMVY Budget has not yet exceeded 3,000 crore.

Reasons for the Actions:

• There are difficulties, including funding reductions, disbursement, and use of funds.
  • As of June 2022, banks holding funds for central government-sponsored programmes held 1.2 lakh crore in deposits, generating interest income for the government.
• Another factor is the non-use of granted funds:
  • One intriguing example is the Nirbhaya fund (2013), which aims to support initiatives that increase women’s safety in public areas and promote their involvement in economic and social activities.
• The fund received an annual allocation of 1 billion rupees (2013–16), most of which went unused.
• Since the Nirbhaya fund’s founding, roughly 6,214 crore have been allocated to it, however only 4,138 crore have been distributed as of FY2122.

Way Forward:

• According to data from the Reserve Bank of India, real salaries of casual employees increased at a rate of less than 1% per year from 2014–15 to 2021–22, as recently noted by economist Jean Drèze.
  • Professor Drèze contends that this unsettling tendency necessitates a reorientation of economic strategies with a stronger emphasis on factors influencing wage growth.
• We need fewer data entry clerks in our public services and more doctors, teachers, and engineers.
  • To address the difficulties of today, such as offering a welfare system free from corruption, managing a contemporary economy, and offering improved public goods, we need to increase the capability of an effective civil service.

Conclusion:

Improving public service delivery should be the goal, not cutting back on government programmes and funding for them.