📰 Pakistan’s Jadhav dilemma
•As officials of the Foreign Office, the Law Ministry, the Interior Ministry and the military met in the office of Attorney-General Ashtar Ausaf last month, they had two proposals on their hands. One was to allow consular access for Kulbhushan Jadhav, the Indian national sentenced to death on spying charges, and the other was to grant permission to Jadhav’s wife for a meeting with him.
•After much deliberation, it was decided that as a goodwill gesture, Jadhav’s wife will be allowed to meet him. The diplomatic note in this regard was sent to the Indian High Commission on November 10.
•The proposal to allow consular access was hotly debated, a participant at the meeting told The Hindu, requesting anonymity. “It was argued that if consular access is allowed, it will destroy India’s case at the International Court of Justice (ICJ), which is based on the premise that Pakistan was not granting consular access,” he said. “But a military representative opposed it by saying that the matter is of national security and granting consular access to the Indian government will not be a wise decision.”
•The ICJ ordered in May not to carry out Jadhav’s execution, pending a final decision.
•Jadhav was arrested by Pakistani authorities in March last year. His video-taped confessional statement was released by the military in which Jadhav stated that he was working for the Indian intelligence agency Research and Analysis Wing. He was subsequently tried for espionage and conspiracy against Pakistan in a military court and sentenced to death. India dismisses the charges and insists that Jadhav was a retired Navy officer.
•Allah Nazar, chief of the Balochistan Liberation Front (BLF), was accused of working with Jadhav. Nazar is reportedly hiding in Afghanistan. His family was briefly detained on the Afghan frontier last month while attempting to cross the border. The BLF has claimed several attacks on security forces and civilians. In the latest, 15 people were killed in an attack in Turbat on November 15. Pakistan has also asked Iran to investigate how Jadhav operated out of its territories for a few years.
•As Pakistan prepares its case for the ICJ, scheduled to begin in January, the execution of Jadhav seems unlikely in the near future. “Even if Army Chief General [Qamar Javed] Bajwa rejects Jadhav’s mercy petition, he can appeal in High Court. After that, he can also file a mercy plea with the President,” a member of Pakistan’s legal team at the ICJ said. Pakistan will submit its “counter-memorial” to the ICJ by mid-December. The Pakistani side is relying on its argument that the case is a matter of national security and should not be seen as a bilateral diplomatic issue.
Weak point
•The Pakistani side fears that the trial of Jadhav by the military court remains one of the weak points in its case. Pakistan claims that Jadhav was a serving naval officer in contradiction to India’s stand that he had retired much earlier. “If India manages to prove in the ICJ that Jadhav was not a serving naval officer, then our case becomes weak. We will have to grant consular access to him,” an official associated with preparing the ‘counter-memorial’ said.
•In Pakistan, Jadhav has also become a political issue. Opposition parties have accused the government of being soft on the case. The government dismisses such criticism. Foreign Minister Khawaja Asif made a sensational claim in September during his visit to the U.S. that Afghanistan offered Pakistan to exchange Jadhav with the mastermind of the 2014 Army Public School attack in Peshawar in which 144 people, mostly children, were killed. However, he said Pakistan refused the offer.
📰 Manmohan wins Indira Gandhi Prize
Jury led by Pranab makes the choice
•Former Prime Minister Manmohan Singh will be the recipient of this year’s Indira Gandhi Prize for Peace, Disarmament and Development.
•A jury headed by former President Pranab Mukherjee made the decision on the award given out annually to individuals and organisations in recognition of creative efforts toward promoting international peace, development and a new international economic order, ensuring that scientific discoveries are used for the larger good of humanity, and enlarging the scope of freedom.
•The award, comprising a cash prize of ₹25 lakh and a citation, was instituted by the Indira Gandhi Memorial trust in 1986 and previous recipients include the former Soviet leader Mikhail Gorbachev, former U.S. President Jimmy Carter, former President of the Czech Republic Vaclav Havel, and organisations such as the United Nation’s Human High Commissioner for Refugees and ISRO.
📰 ‘Any government borrowing will impact fiscal deficit’
But, recapitalisation bonds will spur credit growth; higher RoE will compensate for interest cost, says IIM-A professor
•Prof. T. T. Ram Mohan, a professor of finance and accounting at the Indian Institute of Management, Ahmedabad, has welcomed the government’s initiative to infuse funds into banks through the use of recapitalisation bonds. Opining that the NDA administration was remiss in not opting for recapitalisation as soon as it came to power, he has earlier written that infusing funds into banks was not tantamount to money ‘going down the drain’ but that it allowed for banks to use capital for lending, which would improve their profitability. The higher return on equity should more than compensate for the government’s interest cost, he said. Excerpts from an email interview:
Should the government opt for perpetual bonds or should there be a tenure?
•Perpetual bonds would saddle the government with a permanent debt obligation. A fixed tenure bond would impose a certain fiscal discipline on the government. Moreover, we do expect the growth outlook will improve in the coming years and hence repayment should not pose a problem. As to tenure, a 10-year bond should be okay.
What lessons should be taken from the recap exercise undertaken in 1993-95?
•The amount involved then was much smaller. Following the recap, PSBs started improving their performance. Partly, this was because of improved growth but also it was because of a better focus on commercial performance all around. The government can take an optimistic view based on the earlier experience. Wherever large banks fail, governments tend to recapitalise as quickly as possible to avoid disruption to the economy.
•The Government of India should, of course, seek to improve governance and management at PSBs so as to minimise the probability of recurrence of large NPAs or losses.
Why haven’t governments used it more often? How does it work elsewhere?
•Well, it involves use of tax payer money, so you have to be careful. Governments the world over have used recapitalisation to cope with banking failures and crises — an IMF study has documented 140 episodes of banking crises in 115 economies in the period 1970-2011, which involved substantial use of tax payer money for recapitalisation of banks.
You have said that factors such as the 2008 crisis contributed to bank NPAs rising. What steps are needed to prevent high NPAs, low capital adequacy and banks returning with a begging bowl?
•Not just the 2008 financial crisis and the resultant global slowdown but events such as the glut in steel created by China and adverse court judgements in 2G, coal block allocation, iron ore mining etc. have contributed to the problem.
•The fact that it’s not just a PSB problem is borne out by the high NPA level at ICICI Bank.
•Gross NPA at ICICI Bank is 8% — not very different from SBI’s 10%. ICICI Bank has all the talent and credit risk appraisal skills you can think of, management has incentives and the bank has an independent board !
•It’s hard to argue, therefore, that public ownership is the crucial factor in the high level of NPAs at public sector banks.
•We do need better risk management at banks in general, including limiting exposures to long-term finance such as infrastructure. We also need to be more rigorous in selecting CEOs at PSBs and focus on the nuts and bolts of HR such as succession planning.
But aren’t infrastructure projects predominantly dependent on bank funding?
•Being of long duration, these are best financed by the bond market. Banks are not well-suited for such financing as it tends to create a mismatch between their short-term liabilities and long-term assets. It is not that banks should avoid such funding but it should be subject to prudential limits.
Is ₹9,000 crore in annual interest, which is bandied about, all that the government would be faced with?
•Yes
Opinions differ on whether there would be an impact on fiscal deficit.
•Any government borrowing means an impact on the fiscal deficit. It’s a different matter that the IMF allows an accounting fudge in this respect and doesn’t count borrowing for bank capital as fiscal deficit.
Is there an estimate of how much more fiscal deficit would expand, from the targeted 3.2%?
•That depends on whether the amount is infused at one go or in more than one budget. If done at one go, it would add approximately one percentage point to the fiscal deficit.
What benefits, versus the cost of a larger fiscal deficit, do you see in this recapitalisation exercise?
•We need to get credit flows going so that private production and investment pick up. The need for a fiscal stimulus is recognised by many but economists don’t think that government consumption spending or public investment is the best answer. I would argue that bank recap is the right stimulus at the present time.
If banks invest in government bonds that convert idle deposits into equity, isn’t it dangerous to convert depositors’ money into equity for the government?
•Banks are investing in government recapitalisation bonds. So, depositors’ funds are going into safe government bonds instead of going into risky loans. When the government uses the proceeds to invest in banks’ equity, on the liabilities side of the balance sheet, deposits or borrowings decrease and equity increases. This means leverage is going down and capital adequacy is increasing. Thus, PSBs become safer as a result of the capital infusion. This is one reason PSB stocks have risen after the announcement of recapitalisation, the other being the fact that they can grow loans faster than before on the strength of higher capital.
What else must the government be committed to?
•We could certainly use better boards and the finance ministry must express its views through its board representatives instead of giving instructions “offline”. This would strengthen the functioning of PSB boards.
•The government must bring quality professionals on to the boards of Public Sector Banks — this would require government to improve compensation for independent directors.
•However, talk of political interference coming in the way of PSB performance is overblown.
•Most PSB CEOs will tell you that in recent years, they have faced little interference on the whole.
•RBI must provide a guiding hand when it comes to risk management. Their draft for Large Exposure Framework is a good one and should be pursued.
Has the Banks Board Bureau lived up to expectations?
•The BBB, in my view, is an ill-conceived creation. It is unrealistic to expect the government as the majority owner of PSBs to be distanced from key appointments to PSBs. The creation of the BBB has just added one more layer to the appointment process. The BBB has understandably failed to live up to its ambitious mandate. It should be wound up.
📰 Smart cities project financially unsustainable: Expert
•MYSURU: “A rupee saved is a rupee generated.” That is how Ravikanth Joshi, a public finance expert with two decades of experience managing budgets for the Baroda Municipal Corporation previously, sums up the lessons he learnt on the job.
•Referring to some of the development proposals submitted by cities as part of the Centre’s flagship Smart Cities project, Mr. Joshi told The Hindu that the extravagant costs of the proposals, amounting to ₹9 lakh to ₹12 lakh per capita in cities such as Chandigarh, were financially unsustainable. He was speaking on the sidelines of the international conference on the U.N. Sustainable Development Goals (SDGs) at St. Philomena’s College here. Goal 11 of the SDGs pertains to sustainable cities.
•“The Area Development Component takes up 75% of the money intended for the project. This will be used to develop only specific areas of the city, with amenities like 24x7 water supply, nicely-paved roads, well-laid pavements, etc. Based on an analysis of 60 cities’ proposals under the project, I found hardly 4% of the physical area of the city would be developed this way. That way, retrofitting the infrastructure for entire cities would remain a dream for over 20 years,” he said.
•Under the project, Special Purpose Vehicles (SPVs) are registered under the Companies Act with the state and the Centre investing equally. Private capital could be injected into the project comprising up to 48% as equity, he explained. However, in the process urban local bodies got sidelined. The constitution of board members to the SPVs fell short of local representatives; only the city commissioner was represented, he said.
•“Neither the local communities nor the local officials are involved in framing project proposals, and the decision-making is dominated by top bureaucrats,” he said, adding that this could be corrected. “In Maharashtra, the state ordinance for constituting SPV under Smart Cities project appointed 15 board members, with six local officers and representatives from both the ruling party and the opposition party. This was achieved after local politicians raised their voices.”
•Addressing the current paradox in cities where on one side there is a proliferation of energy-guzzling glass exterior buildings and malls, and green buildings on the other side, he said that one welcoming aspect of the Smart Cities project was its emphasis on sustainability by ensuring 10% of electricity needs of cities to be met by non-conventional sources of energy.
•At the concluding session of the conference on Saturday, Lawrence Surendra, chairman of The Sustainability Platform, one of the organisers, spoke about the need to use the ongoing crisis in higher education in India as an opportunity to develop knowledge partnerships on matters such implementing SDGs to reinvigorate the university as spaces of learning and intellectual advancement.
•Dr. K. Ganapathy, a neurosurgeon with decades of experience with Apollo Hospitals, Chennai, spoke about bridging the urban-rural gap in healthcare access with the use of technology, such as telemedicine.
📰 Electric fences killing tigers in Maharashtra
•The electrocution of a tigress in the Chimur forest range in Chandrapur district of Maharashtra on November 7 brings the tiger death toll due to electrocution in the Vidarbha area alone to five this year.
Why are tigers dying?
•In a desperate attempt to prevent herbivores like nilgai (blue bulls) and wild boar from destroying their crops, farmers often set up illegal high-voltage electrical fences around their fields drawing power from electrical lines meant for home or agricultural use. Tigers, which use human-dominated landscapes including agricultural fields to move about, die when they come in contact with these fences. In some places, poachers erect live wiretraps using overhead 11 kv lines to kill animals, says Nitin Desai, director (central India) of the Wildlife Protection Society of India, an NGO that operates in the area. “This is fatal to any animal that comes in contact with it and is generally done at night,” he points out.
Why are there more incidents now?
•This year, seven tigers have been electrocuted in Maharashtra and Madhya Pradesh alone, says Bilal Habib, a scientist at the Wildlife Institute of India. Habib’s team had radio-collared four tigers to study their movement outside protected areas in the landscape; three of them died due to electrocution this year. “The radio collars highlighted the threat and helped us understand what is happening,” he adds. “Electrocution could be a major problem in other landscapes too, but we are probably not aware of it.”
•Though the last tiger death due to electrocution in the adjoining Telengana-Andhra Pradesh belt (parts of which are contiguous to the central Indian landscape) was reported from Andhra’s Chennur in December last year, electrocution of wildlife is a problem in these States too, says wildlife biologist Imran Siddiqui who studies tigers at the Kawal Wildlife Sanctuary in Telangana.
Why is this a problem?
•These tiger deaths are just the tip of the iceberg and point to a larger problem, says Milind Pariwakam, wildlife biologist with the Wildlife Conservation Trust’s Central Indian Programme. “Many uncollared animals may be dying of electrocution. Rampant and illegal use of high-voltage electric fences and traps is making the agricultural matrix more hostile to tiger movement, raising the importance of unbroken forest corridors,” he says.
•Experts admit that electrocution is one of the major threats to tiger conservation in central India. The resulting tiger mortality could be a problem for the 50,000-sq km central Indian area — consisting of protected areas, reserved forests, agricultural land and villages in Maharashtra, Madhya Pradesh and Andhra Pradesh — which supports one of India’s largest tiger populations and has been identified as a global tiger conservation landscape.
What are authorities saying?
•The threat of electrocution seems to be higher in villages near the core regions of the protected areas where crop raids by wild animals are more frequent, prompting farmers to put up high-voltage fences. With Maharashtra’s Electricity and Forest Departments, Habib’s team has identified nearly 200 villages that are prone to such a conflict and where tiger electrocutions are also highly probable. In these areas, the government hopes to initiate awareness campaigns to prevent the use of electric fences. The campaigns will also highlight the illegal use of such fences for crop protection: stealing power from overhead lines amounts to theft, and animal deaths that result from the erection of these fences are offences under the Wildlife (Protection) Act, 1972. “Solar fencing has been going on in the buffer zone of parks nearby for the past three years and we find that it is successful,” says Bandu Dothre, Honorary Wildlife Warden of Chandrapur district. “We have requested for it in the non-buffer areas also.”
📰 Delay in the protection of corridors threatens tiger population
•It is not just poaching or habitat loss that threatens India’s tiger population. Delayed action to protect crucial wildlife corridors — despite the availability of relevant ecological knowledge — is also killing these big cats, shows a study published in conservation journal Oryx.
•For species like tigers which move across large distances, wildlife corridors, protected patches of land connecting two habitats, are crucial. Uttarakhand's Chilla–Motichur corridor is one such patch connecting the eastern and western tracts of the Rajaji Tiger Reserve. It is the only way tigers from the eastern tract (part of a larger, more connected landscape) can colonise the isolated western one. Over the years, however, the corridor has been deteriorating due to reasons including the expansion of nearby townships and the construction of a national highway and rail line.
Multi-pronged approach
•Scientists at the Panthera, Nature Conservation Foundation and the University of Kent, U.K., used a multi-pronged approach to study the status of the Chilla–Motichur corridor. First, they studied tiger presence in the area using presence–absence surveys of tiger signs, assessing change in tiger presence from data gathered between 2002 and 2009. While the eastern tract showed a high presence of tigers, the western one showed a distinct decline in tiger numbers and presence.
•Second, the team studied the corridor’s connectivity using remotely-sensed night-time lighting as an indicator of urbanisation.
•They found that since 1993, urbanisation had decreased opportunities to restore the effectiveness of the corridor considerably.
•The team compiled 31 research articles on the corridor and made 14 distinct recommendations to restore corridor connectivity. Only five recommendations have been incorporated into government management plans, and delays in mobilising funds and approvals from state departments followed by the lack of deadlines to implement these actions exacerbated the problems.
•“Institutional failings are mirrored in the inability of many state and central departments to work together for the restoration of Chilla-Motichur; this case typifies what happens with most wildlife corridors across the country,” says lead author Abishek Harihar (Panthera and Nature Conservation Foundation). “If immediate action is not taken, the population in the western tract could go extinct.”
📰 Plant emissions higher than believed
•Carbon released by plant respiration may be around 30% higher than previously predicted, a new study claims. The study, published in the journal Nature Communications, suggests that as the mean global temperature increases, respiration will increase significantly.
Future prospects
•Such increases may lower the future ability of global vegetation to offset carbon dioxide emissions caused by burning fossil fuels. “Plants both capture carbon dioxide and then release it by respiration. Changes to either of these processes in response to climate change have profound implications for how much ecosystems soak up carbon dioxide emissions from burning fossil fuels,” said lead author Chris Huntingford of Britain’s Centre for Ecology and Hydrology.
•“In fact, this study provides the most up-to-date accounting of respiratory carbon releases from plants in terrestrial systems,” Peter Reich, Professor at University of Minnesota College of Food, Agricultural and Natural Resource Sciences in the US, said. The findings are based on the comprehensive GlobResp database, which is comprised of more than 10,000 measurements of carbon dioxide plant respiration from plant species around the globe.
Computer models
•Merging this data with existing computer models of global land carbon cycling showed plant respiration has been a potentially underestimated source of carbon dioxide release.
•“Once we incorporate this data into state-of-the-art carbon cycling models, we are much closer to being able to accurately model carbon cycle feedbacks for climates across the globe,” Reich said.
📰 In Asia, a path to cleaner air
•Cancer. Stroke. Heart Disease. Asthma.
•These are some of the life-threatening diseases caused by air pollution, a problem that kills more than six million people worldwide every year, and also the most pressing environmental health risk humanity faces. In 98% of cities in low- and middle-income countries, air quality exceeds World Health Organisation safe levels and is having a severe impact on peoples’ health. The youngest, the oldest and the poorest among them are most affected.
•For urban residents across the South-East Asia region, the situation is dire. As urbanisation proceeds, inadequate planning is compounding an already fraught scenario. Every day, more and more people are exposed to the deadly particulate matter from motor vehicles, diesel generators, smokestacks and power plants. And every day, those particulates are having a devastating impact on our immediate and long-term health.
Small but key steps
•Despite the magnitude of the problem, change is possible. Each one of us can do our part.
•Choosing to use public transport over driving a private vehicle is a good way to make an immediate difference that not only decreases emissions but also saves money and encourages physical activity. Similarly, if and when we do use a private vehicle, we can ensure that its engine is well-tuned and running efficiently, thereby decreasing emissions and maximising fuel mileage. Though these steps are simple, they can have a wide-ranging impact. Private vehicle use remains a significant contributor to urban air pollution across the region. In and around the house we can also make small but important changes. For example, instead of burning wood and other biomass fuels for cooking or heating, we can switch to using natural gas or liquefied petroleum gas (LPG). The household use of wood and other biomass fuels (including kerosene) is the cause of approximately 1.69 million deaths in the region every year — each one of them preventable. Importantly, we can also make concerted efforts to cut down on and have better disposal of waste, including ending open burning.
From the top
•In aiding private citizens’ actions, government interventions can be of crucial importance.
•It is now being seen across the region that from the municipal level up, governments are aiming to provide the infrastructure needed to provide healthier environments and taking steps to encourage public forms of transport. This is being done by building quality bus and rail systems, and making cities pedestrian- and bicycle-friendly through the provision of footpaths and bicycle lanes. Schemes are being implemented to provide incentives for households to switch to cleaner energy sources that are benefiting the poor and the vulnerable. Biomass continues to be burned largely as a result of cost incentives and there is a realisation now that demand can be shifted to other forms of household energy through subsidies and other innovative pricing mechanisms.
•Empowering and engaging the health sector is also important. Not only can the health sector identify and assist vulnerable groups to prevent exposure to air pollution, thereby mitigating its effects but it can also provide critical support to the society-wide struggle for clean air. Health institutions and workers have the power to raise awareness and promote change at the personal and policy levels — a role that should be encouraged and, where possible, supported. As a part of this wider push, city administrators ought to mobilise individuals and the cities they live in to take action against air pollution. Though air pollution represents a massive moral and practical challenge, it also represents a chance to chart a bold new path — one where clean air is an integral part of healthy economic development and growth. Indeed, as countries across the South-East Asia region develop and prosper, they needn’t repeat the development tropes of a bygone era. They can and must write a different history.
📰 It has white flowers, but a covetous heart
Parasitic plant found in Nagaland has no chlorophyll of its own, survives by stealing food from its host
•Scientists have discovered a new species of parasitic flowering plant that has no chlorophyll, and survives by feeding on another species of plant that does (chlorophyll helps a plant make its own food using sunlight).
•The species, named Gleadovia konyakianorum, in honour of the Konyak tribe of Nagas, was identified during a botanical exploration earlier this year near Tobu town of Mon district in eastern Nagaland.
•“It is a holoparasite [complete parasite] that derives its entire nutritional requirement from the host plant, which is a Strobilanthes species. The plant was found in the semi-evergreen forest at an altitude of 1,500-1,600 metres,” said Dilip Kumar Roy, a scientist with the Botanical Survey of India (BSI).
•Along with Mr. Roy, two others – N Odoyo, also from the BSI, and a Russian scientist, Leonid V. Averyanov – have published the details of the newly discovered species in the journal Phytotaxa.
•Though it is has no chlorophyll, the plant has a vascular system and extracts its nutrition from the host plant with the help of a haustorium, the scientists said. A haustorium is a specialised structure with which plant parasites attach themselves to the tissue of host plants and derive nutrition.
•Gleadovia konyakianorum is a root parasite that grows up to 10 cm in height, and bears white, tubular flowers. Interestingly, this is only the fourth species from the genus Gleadovia to be found in the world. The other three are Gleadovia banerjiana (discovered in Manipur), Gleadovia mupinense (found in China) and Gleadovia ruborum (discovered in Uttarakhand and also reported from China).
•The white flowering parasite was found in a group of 15-20 plants, and since the species hasn’t been reported anywhere else, scientists have described its status as ‘data deficient’ as per the International Union for Conservation of Nature Red List of Threatened Species Criteria.
•“Parasitic plants are often referred to as curious plants as they steal their entire nutritional requirement from the host. Not only are they rare but they are crucial evolutionary links in the plant kingdom that attest to Darwin’s theory of survival of the fittest,” said Rajib Gogoi, a scientist from BSI’s central national herbarium.
•Plant parasites are differentiated as stem and root parasites. Common stem parasites found in India are Loranthus sp, on Mango trees, and Cuscuta reflexa, a climber. Among the root parasites are Sapria himalayana, a rare holoparasitic flowering plant found in Arunachal Pradesh and Meghalaya.
📰 The lowdown on the dengue epidemic
What is it?
•The National Vector Borne Disease Control Programme (NVBDCP) records show that 1,29,329 people fell sick with dengue this year, while 200 died. India’s official numbers are well known to be gross underestimates, with private hospitals often not reporting the disease.
•In fact, a 2014 study calculated that the actual number of cases between 2006 and 2012 was 282 times the NVBDCP number.
•But even if one were to factor in the undercounting, 2017 is an extraordinary year. This is due to three reasons. First, India is getting better each year at reporting dengue, leading to more cases being counted. Second, dengue itself is becoming more endemic due to urbanisation.
•The dengue mosquito thrives in urban habitats, in water pooled under a flower pot for example. As population explodes in rural areas, what was initially an urban disease has moved to these regions too, says Arunkumar Govindakarnavar, a virologist at the Manipal Centre for Virus Research who runs a surveillance project for febrile illnesses in 10 States. Third, dengue epidemics follow a natural cycle as population immunity waxes and wanes. But given our patchy data collection, it has been hard to glean out such cycles.
How did it come about?
•As dengue burden rises in the country, says Mr. Arunkumar, the likelihood of more people becoming severely ill grows.
•This is because more infections raise the chances of the virus mutating to a more virulent form. It also raises the risk of a phenomenon called antibody-dependent enhancement.
•The dengue virus has four serotypes, or types that are classified by the type of antigen (a molecule on the viral surface which human antibodies recognise) they have.
•These serotypes are DENV-1, DENV2, DENV-3 and DENV-4. When a person is affected by one dengue serotype, she develops antibodies against it, which protect her for the rest of her life. If the same person is then infected by a different serotype, she is likely to develop severe disease.
•This is because, in some cases, antibodies against the first serotype worsen the second infection, instead of protecting against it.
•This phenomenon is called antibody-dependent enhancement (ADE) and results in a more dangerous illness called dengue haemorrhagic fever (DHF).
Why does it matter?
•Severe dengue haemorrhagic fever causes blood vessels to leak, which leads to a loss of blood pressure. If this isn’t treated quickly by replacing bodily fluids, the person can go into shock and can die. But treating a patient of DHF is a delicate balance, and hard to do in the high-pressure environment of an outbreak, says Mr Arunkumar. First, doctors must learn to spot severe cases and avoid indiscriminate admission of mild cases. For this, they need to look beyond easily-measured parameters like platelet counts, to symptoms that need careful observation. Haemorrhagic fever shows up as a puffy face, loss of blood pressure, low pulse rate and a range of other symptoms. Once it develops, fluids need to be given with care. It often happens, says Mr Arunkumar,that doctors give patients too much fluid, which too has dangerous consequences.
What next?
•Given the burden of dengue, the economic cost for India is huge. One calculation based on data from Madurai estimated the 2012 medical cost of dengue for India to be $548 million. According to the study, a hospitalised person spent an average of $235.20, usually out of her own pocket. Costs like this are a blow to daily-wage earners, because hospitalisation also means a loss of income. The good news is that, across the world, early treatment keeps mortality levels as low as 2%. India is still pondering over introducing the world’s first dengue vaccine, Dengvaxia, and for good reason. Studies show that people who have never been exposed to dengue can develop severe disease if they get dengue a few years after vaccination. This is thought to be due to ADE. So, for vaccination to be helpful, between 50 and 70% of the population needs to have been exposed to the virus. India is conducting seroprevalence studies to calculate exposure rates before it takes a call.
