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1.Time for clarity (The Hindu)

2.Capacity building for primary health care (The Hindu)

3.Natural Partners (The Indian Express)

 

1.Time for clarity (The Hindu)

Synoptic line: It throws light on the issue of recent concerns that China may be preparing for another standoff with India and the government must need to clear the air. (GS paper II)

Overview

  • Doklam is a narrow plateau lying in the tri-junction of India, China and Bhutan. The recent standoff at the Doklam plateau which lies at a tri-junction between the India, China, and Bhutan has gained much attention.
  • It has been five months after Doklam standoff came to an end, but the contours of the actual agreement and events that have followed remained a mystery.

Assessment

  • With diplomatic negotiations, India and China agreed to disengage from the standoff on the Doklam plateau, disputed between China and Bhutan, with a formula that saw China promise to make “necessary adjustments” to their troop deployments, after Indian troops withdrew back to their posts in Sikkim.
  • However, recently the Indian Army chief said that the Chinese troops are in parts of Doklam they had hitherto not manned, and while the People’s Liberation Army infrastructure development was “temporary” in nature, “tents remain, observation posts remain” in the disputed area.
  • The MEA, which had maintained that there was “no change” in the status quo, also appeared to shift position, saying that New Delhi was using “established mechanisms” to resolve misunderstandings over the Doklam issue.  There are divergence in public statements, which also fuels speculation that something deeper and more troubling exists on the ground.
  • During the meeting, on the sidelines of the BRICS summit in Xiamen in September, Chinese president said, “Actually, during the summit, the two leaders reached some consensus on improving bilateral relations and charting the course for future development… We hope relevant parties can earnestly follow through on the consensus reached by the two leaders, move in the same direction, jointly uphold the peace and stability of the border areas and stay committed for the comprehensive development of bilateral relations.”
  • Responding to the question on reports of Chinese military build-up in the area, the ministry in the statement mentioned that “the status quo at the faceoff site has not been altered; any suggestion to the contrary is inaccurate and mischievous.”
  • “We are of course keeping a constant vigil on developments which have a bearing on India’s national security and taking all necessary steps to safeguard it. The two sides do have, and have used established mechanisms to resolve any misunderstanding.
  • Speaking at the MEA’s annual Raisina Dialogue, Foreign Secretary S. Jaishankar put China’s rise first on a list of “major disruptors” in the region. General Rawat said that the “time has come” for India to “shift focus” from its western border with Pakistan to its northern border with China.
  • As the boundary with Pakistan has seen heavy shelling and rising military and civilian casualties in the past year, Beijing’s latest belligerent statements that all of Doklam belongs to China and is under its “effective jurisdiction” could be indicators that the agreement announced is unravelling.

Way ahead

  • “Peace and tranquillity in the border areas is an essential pre-requisite for further development of our bilateral relationship,” and it is imperative that the government proceed with caution in step and consistency in statement, and drop the ambiguity it has embraced since the Doklam stand-off.

Question: China’s reaction came amid reports that it was building a huge military complex close to the site of the Doklam standoff with India.” Discuss in the context of recently end of Doklam stand-off.

 

 

2.Capacity building for primary health care (The Hindu)

Synoptic line: It throws light on the issue for the need of integrated health care mechanism. (GS paper III)

Overview

  • National Medical Commission (NMC) Bill 2017 is an attempt to revamp the medical education system in India to ensure an adequate supply of quality medical professionals. It has been Section 49 that proposes a joint sitting of the Commission, the Central Council of Homoeopathy and the Central Council of Indian Medicine.
  • This sitting, may “decide on approving specific bridge course that may be introduced for the practitioners of Homoeopathy and of Indian Systems of Medicine to enable them to prescribe such modern medicines at such level as may be prescribed.”
  • The debates around this issue have been ranging from writing-off the ability of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners to cross-practise to highlighting current restrictions on allopathic practitioners from practising higher levels of care giving.

Assessment

  • Ongoing debates seems to miss the reality, which is a primary health system that is struggling with a below-par national physician-patient ratio (amongst the lowest in the world) due to a paucity of MBBS-trained primary-care physicians and the unwillingness of existing MBBS-trained physicians to serve remote or rural populations. Urban-rural disparities in physician availability in the face of an increasing burden of chronic diseases make health care in India both inequitable and expensive.
  • Therefore, there is an urgent need for a trained cadre to provide accessible primary-care services that cover minor ailments, health promotion services, risk screening for early disease detection and appropriate referral linkages, and ensure that people receive care at a community level when they need it.

Issues

  • There has been the issue of AYUSH cross-prescription, which has been a part of public health and policy discourse for over a decade, with the National Health Policy (NHP) 2017 calling for multi-dimensional mainstreaming of AYUSH physicians.
  • There were 7.7 lakh registered AYUSH practitioners in 2016, according to National Health Profile 2017 data. Their current academic training also includes a conventional biomedical syllabus covering anatomy, physiology, pathology and biochemistry. Efforts to gather evidence on the capacity of licensed and bridge-trained AYUSH physicians to function as primary-care physicians have been under way in diverse field settings, and the call for a structured, capacity-building mechanism is merely the next logical step.

Report’s findings

  • The 4th Common Review Mission Report 2010 of the National Health Mission reports the utilisation of AYUSH physicians as medical officers in primary health centres (PHCs), as a human resource rationalisation strategy. In some cases, it was noted that while the supply of AYUSH physicians was high, a lack of appropriate training in allopathic drug dispensation was a deterrent to their utilisation in primary-care settings.
  • The 2013 Shailaja Chandra report on the status of Indian medicine and folk healing, commissioned by the Ministry of Health and Family Welfare, noted several instances in States where National Rural Health Mission-recruited AYUSH physicians were the sole care providers in PHCs and called for the appropriate skilling of this cadre to meet the demand for acute and emergency care at the primary level.
  • There has been focus on deploying a capacity-building strategy using AYUSH physician’s upskilled through a bridge-training programme, and the use of evidence-based protocols, supported by technology, to deliver quality, standardised primary health care to rural populations.
  • Capacity-building of licensed AYUSH practitioners through bridge training to meet India’s primary care needs is only one of the multi-pronged efforts required to meet the objective of achieving universal health coverage set out in NHP 2017.
  • The existing practice of using AYUSH physicians as medical officers in guideline-based national health programmes, a location-specific availability of this cadre to ensure uninterrupted care provision in certain resource-limited settings, as well as their current academic training that has primed them for cross-disciplinary learning hold promise. These provide a sufficient basis to explore the proposal of bridging their training to “enable them to prescribe such modern medicines at such level as may be prescribed”.

Way ahead

  • In the long run, a pluralistic and integrated medical system for India remains a solution worth exploring for both effective primary-care delivery and prevention of chronic and infectious diseases.

Question Explain the issue related with the ‘National Medical Commission (NMC) Bill 2017’, also explain how a pluralistic and integrated medical system remains a solution worth exploring?

 

3.Natural Partners (The Indian Express)

Synoptic line: It throws light on the need to take India-EU relations to more ambitious levels. (GS paper II)

Overview

  • The challenges that the EU has faced recently have been a driver for greater integration. As the growth is picking up in the Euro zone, Unemployment is at its lowest in the past nine years. These points in the direction of a promising economic outlook for the European Union.
  • In the Elysee Treaty, Chancellor Angela Merkel and President Emmanuel Macron have expressed renewed ambitions for Europe to adapt it to today’s challenges in a rapidly-evolving world.

India and EU

  • There are various challenges to the globalised world, and it is common between India and EU, that is-Climate change and terrorism, as it knows no borders.
  • Fortunately, challenges are not the only commonality between India and Europe; both share the same basic principles and values. Both believe in multilateralism, cooperation and a rules-based international order rather than the unilateral use of force and coercion. Both believe democracy, human rights and the rule of law to be the best means to secure freedom and prosperity for our peoples. India and EU are natural partners.
  • The partnership between the EU and India is as old as the EU itself. Today, the EU is India’s largest trading partner and investor and this will not change after Brexit. European companies are actively involved in India, working hand-in-hand with Indian companies, contributing to shaping a new India by creating employment, sharing technical know-how and opening research and innovation centres in this country.
  • Reciprocally, highly-qualified Indian workers have been contributing to the European economy for decades. Indian investment flows towards Europe are also strong. In these disruptive times, the EU remains open to Indian talent and enterprise. Together, we are formulating innovative solutions for the 21st century in the fields of smart cities, renewable energy and clean transportation.
  • There is the growing significance of the EU-India security partnership for today’s world. For France and Germany, India has been a trusted security partner for many years. Based on this decades-old experience, we are convinced that the partnership between India and the EU as a whole has great potential as the EU has gradually, but surely emerged as a strategic actor on the global scene.

Way ahead.

  • Though there have been regular exchanges of views between Indian and European officials on a large number of foreign policy and security issues. The time is to take this partnership further and promote concrete cooperation in areas such as counter-terrorism, the Indian Ocean and cyber security.

Question: Briefly explain the India-EU relationship. And discuss the need for both the countries to deepen economic and strategic ties?