📰 Maldives President Abdulla Yameen concedes defeat in election
Ibrahim Solih pledges reforms, probe into missing journalist after his victory in presidential poll
•Much to the surprise of his critics and political rivals, Maldives President Abdulla Yameen on Monday conceded defeat in Sunday’s presidential election, making way for the joint Opposition candidate Ibrahim Mohamed Solih.
•Senior parliamentarian of the Maldivian Democratic Party (MDP) Mr. Solih secured 58.3% of the votes, while Mr. Yameen obtained 41.7%, according to preliminary results released by the Elections Commission. The final tally is expected within a week.
Will of the people
•“In front of the Maldivian people, my work was sincere. But yesterday the Maldivian people made their decision about me. So, I have decided to accept the results and stay in service to the people in any way I can,” Mr. Yameen said according to English translations of his televised speech, delivered in the local Dhivehi language. The 59-year-old outgoing President met Mr. Solih at the president’s office in Male on Monday evening and wished him.
•The election comes after the Indian Ocean Archipelago, home to over four lakh people, plunged into a political crisis, triggered by Mr. Yameen declaring an Emergency in February. About 2,60,000 voters were registered to vote in the presidential election that drew considerable international attention, amid concerns over the Yameen government's apparent retreat from democracy.
•Though preceded by the opposition’s accusations of attempts to rig the polls and and instigate violence, Sunday’s election — the third multi-party contest since the Maldives transitioned to a democracy in 2008 — was held peacefully, recording a near 90% turnout, with many voters braving long queues and several hours’ wait. “As has been in the past, the Maldives is capable of holding credible, free and fair elections,” Maldivian Ambassador to India Ahmed Mohamed told The Hindu.
•Unlike in parliamentary systems, a presidential term is fixed, and the President-elect Mr. Solih would be sworn in when Mr. Yameen’s term ends on November 17, he explained.
‘Difficult journey’
•Supporters of Mr. Solih celebrated all through Sunday night and Monday. A photograph of Mr. Solih jumping high in the air, flinging his arms and smiling wide, went viral on social media.
•In his first public address in the early hours of Monday, Mr. Solih said: “The will of the people has spoken.” “For many of us it has been a difficult journey. A journey that led to a prison cell, or years in exile. It’s been a journey that led to the complete politicisation and breakdown of public institutions. But it’s been a journey that has ended in the ballot box because the people willed it,” the 54-year-old said.
•Mr. Solih had earlier pledged to open investigations into the disappearance of journalist Ahmed Rilwan, and murder of dissident blogger Yameen Rashed, and promised press freedom.
•Countries that had strained relations with the Yameen administration were quick to welcome the poll outcome on Monday, before Mr. Yameen conceded and ahead of the Elections Commission’s official announcement. The U.S. said it looked forward to “a peaceful transition of power,” and pledged cooperation to Mr. Solih’s government.
📰 Missed opportunity or ill-timing?
The acrimony over the proposed Foreign Ministers’ meeting has set back India-Pakistan ties
•That was quick. A quick cool breeze turning into a scorching slap of hot wind of the desert. We had a rocky start when the routine congratulatory letter by Indian Prime Minister Narendra Modi to Pakistan’s Prime Minister Imran Khan calling for constructive engagement was translated as the signal for resumption of dialogue. The Indian Ministry of External Affairs (MEA) wasted no time to embarrass Pakistan’s Foreign Office for its lack of capacity to understand the diplomatic language. Despite another facepalm over the contents of U.S. Secretary of State Mike Pompeo’s phone call with Mr. Khan, the Pakistan Foreign Office put up a brave face to ease the tension between the U.S. and Pakistan on the eve of Mr. Pompeo’s five-hour visit on September 5.
•The pundits in Islamabad saw a prize for the patience. Besides the same ol’, same ol’ statements issued unilaterally from both sides, there was something special discussed on the sideline related to India and Pakistan. While the U.S. insisted on pulling the plug on India and Afghan-centric militants, Pakistan prodded the U.S. to push Delhi for positive engagement and a commitment to act positively should India accede to normalisation and finding mutually acceptable solutions to long-standing problems.
•On the heels of the U.S. visit to the region, Mr. Khan sent Mr. Modi a letter, presumably to respond to his congratulatory letter but actually to bring a thaw into the frozen relationship. The letter might not be rich on style but did offer something to both countries. It offered Pakistan a face saver by mentioning Kashmir, Siachen and Sir Creek, while it offered India the possibility of resumption of trade and the T word. Pakistan was willing to talk about terrorism, Indians have always wanted to talk about it as they have maintained it as the main hindrance in the resumption of the comprehensive dialogue.
Back and forth
•On Thursday, September 20, the MEA spokesperson acknowledged the letter from Mr. Khan, requesting a meeting of the two Foreign Ministers, Sushma Swaraj with Shah Mehmood Qureshi, and said a meeting would take place but should not be construed as the resumption of the dialogue process.
•The U.S. Department of State wasted no time by welcoming the scheduled meeting in an almost condescending tone. Within 24 hours, the very next day the MEA Spokesman made a U-turn, cancelling the meeting. Had it been just the cancellation, it would have been taken lightly, but the direct accusation against Mr. Khan by naming him created a new crisis.
•The Pakistan Tehreek-e-Insaf (PTI), the party now ruling Pakistan, had in the past used very harsh language against former Prime Minister Nawaz Sharif, who had contested the 2013 elections on the promise of improving relations with India. “Modi ka yaar gaddar (Modi’s friend is a traitor)” was a theme that ran for almost the entire campaign period against Mr. Sharif’s Pakistan Muslim League-Nawaz (PML-N) in the elections this summer. The PTI had accused the PML-N of establishing personal relations with Mr. Modi and doing personal business with him instead of promoting the national interests of Pakistan. The party had hit Mr. Sharif hard for Mr. Modi’s visit to Lahore in December 2015 and had blasted his government on an Indian businessman’s visit to Pakistan in April 2017.
•With the controversial elections of July 25 behind him, Mr. Khan turned the corner. His first informal acceptance speech offered the olive branch to India. “If India moves one step, we will move two,” he said.
•Islamabad was rife with rumours that he wanted to invite Mr. Modi besides his friends in Bollywood and cricket friends for his oath-taking ceremony on August 18.
•Somehow Mr. Khan was prevented from inviting Mr. Modi, but one of his cricket buddies, Navjot Singh Sidhu, did turn up. While his seating arrangement and the japha (bear hug) with the Chief of Army Staff, General Qamar Javed Bajwa, created quite a stir in India, Pakistan government circles were bullish on the offer to open the Kartarpur border crossing for Sikh pilgrims. While The New York Times even suggested that the Pakistani military had tried to reach out to the Indian side to discuss outstanding issues, a story never denied by the military, the very ambiguity created a positive atmosphere before the scheduled meeting between the top diplomats of both countries on September 27.
More fireworks
•All that changed on Friday, September 21, with the cancellation of the meeting that almost insulted the Pakistan PM. While the Pakistan Foreign Office and Mr. Qureshi expressed their disappointment, they stayed within the diplomatic ambit and did not attack the Indian side. That changed when Mr. Khan on Saturday, September 22, attacked Mr. Modi without naming him and chiding him as the small man holding a big office. As if that was not enough, the statement by the Indian Army Chief threatening Pakistan and the retaliatory statement by the Pakistan Army spokesperson has made the situation more toxic than the pre-election situation. We expect more fireworks in New York City during the UN General Assembly.
•Will the two men in Delhi and Islamabad find a way untangle the relations should Mr. Modi continue to rule after the upcoming elections in India is a question that hangs in the air in both countries now. Politics is the art of the possible, and thankfully both Mr. Modi and Mr. Khan are politicians.
📰 An indefensible ordinance
The triple talaq ordinance is bound to fail the test of judicial scrutiny on several grounds
•An ordinance is a constitutionally sanctioned ad hoc mechanism by which critically urgent situations are met when Parliament or a State Assembly (as the case may be) is not in session and the government cannot afford to wait till it reassembles for fear of things becoming unmanageable if not legislatively redressed immediately.
•Last week, the Union Cabinet, on the presumption that direful conditions prevail in the country due to the pervasiveness of instant triple talaq, convinced the President to promulgate the Muslim Women (Protection of Rights on Marriage) Ordinance, 2018. In the words of Union Law Minister Ravi Shankar Prasad, the “overpowering urgency and compelling necessity” that gave birth to this ordinance was that talaq-e-biddat continued unabated despite the Supreme Court’s order last year.
•The fact is, excluding isolated cases, there is no documentary evidence to show that the incidence of instant triple talaq had reached alarming levels to warrant the hasty promulgation of a presidential ordinance. And as Article 123 of the Constitution requires the President to ensure the existence of circumstances “which render it necessary for him to take immediate action”, the Centre, in the interest of a fair debate, must make public the evidence presented to the President.
Poorly conceived and drafted
•Nevertheless, the triple talaq ordinance is so poorly conceived and drafted that it is bound to fail the test of judicial scrutiny on several grounds. First, it could collapse under the weight of its internal contradictions. Section 2 (b) of the ordinance defines talaq-e-biddat as any form of talaq “having the effect of instantaneous and irrevocable divorce” but lays down in Section 3 that such a pronouncement in any form whatsoever “shall be void and illegal”. No explanation is offered as to how the pronouncement can be “void” and have “the effect of instantaneous and irrevocable divorce” at the same time. Besides, Section 4 mandates a three-year imprisonment and fine for this void act, and Section 7 declares it a cognisable and non-bailable offence. This fixation with talaq-e-biddat, even when it does not dissolve the marriage, is baffling.
•Second, barring constitutional amendments under Article 368, Parliament is not competent to enact any law which is inconsistent with the fundamental rights enshrined in Part III of the Constitution. Article 13 (2) states: “The State shall not make any law which takes away or abridges the rights conferred by this Part and any law made in contravention of this clause shall, to the extent of the contravention, be void.” Endorsing this, Article 123 (3) warns that if an ordinance “makes any provision which Parliament would not under this Constitution be competent to enact, it shall be void.”
•The ordinance, insofar as it arbitrarily curtails the personal liberty of a citizen without his having committed any offence, violates Part III of the Constitution, specifically Article 21 which states: “No person shall be deprived of his life or personal liberty except according to procedure established by law.” It also goes against Article 19 which inter alia allows all citizens “to move freely throughout the territory of India” and “practise any profession, or to carry on any occupation, trade or business.”
•Third, the Supreme Court in several cases, including Maneka Gandhi v. Union of India (1978) and Justice K.S. Puttaswamy v. Union of India (2017), had made it clear that “law” means reasonable law, not any enacted piece. And a procedure established by it has to be fair, just and reasonable to avoid being struck down as unconstitutional. The ordinance fails on all these counts.
•If by criminalising the mere pronouncement of the legally impotent formula talaq-talaq-talaq it violates the principle of substantive due process, the ordinance disregards procedural due process by laying down an iniquitous procedure for the “offender’s” imprisonment, bail, custody of his children and the amount he has to shell out as subsistence allowance to his wife even while serving a jail sentence. The unfairness, injustice and unreasonableness lie in the fact that the ordinance inflicts this torment on a citizen despite acknowledging the voidness of his pronouncement.
•Fourth, Article 123 empowers the President to promulgate an ordinance only when urgent situations arise during the recess of Parliament. In the case of triple talaq, no such emergency came to light after the monsoon session ended. In fact, the triple talaq Bill passed in the Lok Sabha was already being debated across the country when the Centre, citing the reason of lack of consensus among parties, decided not to table the amended version of it in the Rajya Sabha during the monsoon session. This indicates that the Bill did not have the approval of the Upper House of Parliament. If despite this an ordinance resembling the untabled Bill has been promulgated, it lends credence to accusations that the legislature was undemocratically circumvented to serve the political interests of the ruling party.
•The fact is, it makes no sense to bypass the parliamentary process because Article 123 (2) (a) demands that all ordinances be laid before both Houses of Parliament when Parliament reassembles. In Krishna Kumar Singh v. State of Bihar (2017), the Supreme Court ruled that tabling ordinances in Parliament (or a State Legislature) “is a mandatory constitutional obligation cast upon the government” because ultimately it is the legislature which determines “the need for, validity of and expediency to promulgate an ordinance.” And failure to table an ordinance before the legislature “is an abuse of the constitutional process” and a “serious dereliction of the constitutional obligation.” Therefore, one fails to understand the Union Cabinet’s wisdom in taking the ordinance route without discussing the triple talaq Bill in the Rajya Sabha. If it was due to the fear that the Bill would not have been approved, then the same fear exists for the ordinance because in all probability, the Rajya Sabha will reject it too, and the government would have achieved nothing except criminalising instant triple talaq for a short period of time till the winter session of Parliament starts.
A pointless ordinance
•In this context, the Supreme Court’s pronouncement on the re-promulgation of ordinances assumes significance. In Krishna Kumar Singh, criticising the State of Bihar for re-promulgating ordinances without placing them before the legislature, the court declared that “re-promulgation of ordinances is a fraud on the Constitution and a subversion of democratic legislative processes.” The power to promulgate ordinances is subject to legislative control, it said, and does not make the President or the Governor “a parallel source of law making or an independent legislative authority.” As is obvious, the pointlessness and the indefensibility of the triple talaq ordinance stands out from every coign of vantage. One hopes that the President will examine the legal infirmities that the ordinance suffers from and consider withdrawing it at the earliest.
📰 The power of a nudge
Including behavioural insights in policymaking is helpful
•According to the Organisation for Economic Cooperation and Development, 202 institutions around the world are applying behavioural insights to public policy. While most of them are found in the U.S., the U.K., Europe and Australia, some are found in developing countries in West Asia, Africa and Latin America. These institutions partner with behavioural and social scientists and combine psychology, sociology, anthropology, and politics to understand human behaviour to design effective public policies.
Understanding a paradox
•Why are governments including behavioural science in policymaking? Over the last few years, it has been observed that even the most well-intentioned public policy programmes fail to be adopted by people who would benefit from them the most. On the contrary, people repeatedly make decisions that serve neither their own interests nor of others. In India, for instance, despite access to toilets, open defecation remains a huge challenge. Finding answers to this paradox is where behavioural frameworks become relevant.
•Until recently, it was assumed that individuals make rational choices, and the right incentives determine the “right choices”. But evidence suggests otherwise. People’s choices and decisions are not rational but determined by a far more complex set of psychological, cognitive and behavioural factors. Given their limited attention and computational capacity, people gravitate towards the status quo, which often results in a gap between the policy’s intent and action. It’s therefore not surprising that people discount the risk of stroke and “choose” not to invest in health insurance. Decisions also tend to be clouded because of societal perceptions and adherence to norms — for instance, girls are still married young. Understanding these barriers is leading to recalibration of public policy design. By including ‘nudges’ — small, easy and timely suggestions to influence behaviour — we understand implementation outcomes better.
•There are a few aspects that could be considered while applying this science. One, the advantages of deploying these insights can only be reaped if national contexts and differences in socio-economic, cultural and political narratives are appreciated. So, while success stories from across the world showcase the potential of informed behavioural adjustments to policies, these can’t be simply emulated in developing countries. There first needs to be an analysis of social norms. One such effort is cognitive scientist Christine Legare’s work in Bihar, to improve the quality of health-care service delivery by front-line workers. It takes into account popular ‘rituals’, like keeping a baby away from the ground in a cot (palna), or marking decorations around her hearth (chulah), for transmitting messages that are culturally acceptable.
Improving health services
•Second, behavioural science can be applied to large-scale programmes. The very nature of the science being imbued in a social and cultural context enables it to generate effective and sustained results to public service programmes. PENN SoNG is collating the analyses of core social motivators for open defecation and related behaviours in Tamil Nadu and Bihar with culturally appropriate social measures to convert toilet usage into a sustained habit.
•Third, interventions that are designed using this science can reduce the intent-to-action gap. There is a plethora of tools like defaults, reminders, prompts, and incentives that can reduce poor adherence and increase compliance for sustained impact throughout the life of an intervention — for example, Kilkari, a mobile service by the government that delivers free, weekly and time-appropriate audio messages about pregnancy, childbirth and childcare directly to families’ mobile phones. It focuses on improving uptake of health services.
•Lastly, data collected and evaluated from a behavioural insights approach can be used for better management of programme performances. Rigorous evaluation of behaviour is often missed while measuring programme performances, and often this missing data can help explain the limited impact of well-intended government programmes. The impressive work done by the Ministry of Rural Development, on monitoring the implementation of national flagship schemes through DISHA dashboards, can be leveraged for evaluating behavioural change on the ground. While DISHA does not include measures on behaviour, it measures implementation of programmes. It shows how India can benefit from the use of behavioural insights in policy decision-making.
📰 Centre to issue warnings on lynchings
Tells Supreme Court that message against mob action will be run on TV and radio within a week
•The Centre on Monday assured the Supreme Court that the Union and State governments would, within a week, start broadcasting on radio and TV a stern message that mob lynchings and violence would invite the “wrath of law”. The Centre’s promise came in response to a query by a Bench led by Chief Justice of India Dipak Misra on whether the court’s directions on the matter had been complied with.
•On July 17, the Supreme Court had directed the Centre and the State governments to disseminate using radio, television and other media platforms, including the official websites of the Home Department and through State police, the message that “lynching and mob violence of any kind shall invite serious consequences under the law”.
•On Monday, senior advocate Indira Jaising, appearing for activist Tehseen Poonawala, drew the court’s attention to its more than two-month-old direction.
The gravity of the acts
•In her submission, Ms. Jaising said that nothing appeared to have been done on the ground. She said that people must be made to realise the gravity of their acts, and for this, they ought to dread the long arm of the law.
•When the court sought a response from Attorney-General K.K. Venugopal and Additional Solicitor-General Tushar Mehta, they replied that “the same shall be done, if not already done, within a week”. Mr. Venugopal informed the Bench that an empowered Group of Ministers was considering a specific law against lynchings.
•“It has to be borne in mind that the said direction was issued so that people would realise the gravity of their act and the effect on the law and order situation,” Chief Justice Misra observed in Monday’s order for the Bench, also comprising Justices A.M. Khanwilkar and D.Y. Chandrachud. “The said purpose has to be put on a high pedestal and people must realise that involving in such kind of activities will invite the wrath of law.”
•The court also directed the State governments to not lag in compliance and follow the direction “absolutely religiously within a week from today”. The court noted that eight States and Union Territories were yet to file reports indicating their compliance with the July 17 verdict. It asked them to file it in three days.
📰 SC to rule on barring accused in heinous crimes from polls
CJI had pointed out the urgency to keep criminals at bay
•A five-judge Constitution Bench, led by Chief Justice of India Dipak Misra, is on Tuesday scheduled to pronounce its judgment on petitions to bar politicians facing charges of heinous crimes, such as murder, rape and kidnapping, from contesting elections.
•Under the Representation of the People Act, convicted lawmakers are disqualified, but not those facing charges.
•The Bench, including Justices A.M. Khanwilkar, Rohinton Nariman, D.Y. Chandrachud and Indu Malhotra, had made it clear that the Supreme Court could not legislate for Parliament.
•“The court declares the law, the Parliament makes the law,” Justice Nariman had observed.
•But Chief Justice Misra had pointed out the urgency to do something “to keep criminals at bay and prevent them from contesting elections”.
•The Chief Justice had voiced the Supreme Court’s anguish at the helplessness of society to prevent criminalisation of politics at the very entry-point itself.
•The CJI had pointed out that Parliament was obliged under Article 102 (1) (e) to make a law. “As conscience-keepers of the Constitution, we [Supreme Court] can ask you [Parliament] to do it,” the CJI said.
•Attorney-General K.K. Venugopal had submitted that fast-track courts to try cases against politicians was “the only solution.”
📰 Sushma Swaraj to focus on climate change, South-South cooperation at U.N.
Ms. Swaraj will also attend a special meeting on climate change being convened by Secretary General António Guterres during her stay in New York.
•External Affairs Minister Sushma Swaraj kicked off her week-long diplomatic engagements at the United Nations General Assembly (UNGA) on Monday morning, attending a special meeting on drugs convened at the instance of U.S. President Donald Trump. Ms. Swaraj has several bilateral and multilateral meetings over the next few days. She will address the UNGA on Saturday.
•Ms. Swaraj will also attend a special meeting on climate change being convened by Secretary General António Guterres during her stay in New York.
•The 73rd UNGA is taking place against the backdrop of increased American hostility towards the world body in particular and multilateralism in general. Mr. Trump believes that multilateral global bodies and treaties function to the detriment and at the cost of the U.S.
•The U.S has reduced its funding for the U.N. and either withdrawn or threatened to withdraw from several U.N. bodies under the Trump presidency. Mr. Trump is, however, seeking more support for his combative stance against Iran, from member countries. As Mr. Trump pushes ahead with his America First agenda at the UNGA and on the sidelines, India will be trying to secure its interests and preserve its standing through several diplomatic initiatives this week, according to a senior official overseeing the Minister’s engagements.
•His stated scorn for the U.N. notwithstanding, Mr. Trump praised the body while addressing the special meeting on drugs. “..the scourge of drug addiction claims too many lives around the world. Today we commit to fight the drug problem together.. I’ve always said the United Nations has tremendous potential. Slowly but surely, it is being met,” he said. “If we take these steps together, we can save the lives of countless people in every corner of the world,” Mr. Trump said.
•With America rolling back its interest in global security and development, under the Trump administration, the Security Council’s prominence has diminished, an Indian official pointed out. While America is on retreat, no other country is stepping up to fill the leadership vacuum in the U.N., and Ms. Swaraj’s engagements will account for this situation. “The EAM’s meetings will focus on issues such as climate change, digital infrastructure, sustainability and South- South cooperation. These are areas that India has interests and expertise in,” said the official.
•Ms. Swaraj met Federica Maria Mogherini, High Representative of the EU for Foreign Affairs and Security Policy, and Morocco Foreign Minister, Nasser Bourita on Monday. She “discussed strengthening cooperation in areas of commerce, pharma, cybersecurity, defence and culture,” with Mr. Bourita, MEA spokesperson Raveesh Kumar said.
📰 Centre finalising tariffs on non-essential imports
The measure is aimed at shoring up the sliding rupee
•The government has finalised the list of non-essential items on which it will be imposing import tariffs, according to a senior official in the Finance Ministry.
•The official said the list, to be notified soon, would include electronics, gems, select items of steel that are also manufactured in India, imported apples, and almonds, among others.
•“There has been a discussion on the list for the last two weeks,” the official said, speaking on condition of anonymity since the list has not been notified yet. “The main issue under consideration was whether to include gold in it. The list has now been finalised and will include most of the non-essential items such as electronics, gems, some select items of steel that are manufactured in India, imported apples, and almonds.”
•The official, however, did not specify when the list would be notified, only saying that it would be “very soon.”
•Economic Affairs Secretary Subhash Chandra Garg had said a few days ago that the list would help in shoring up the rupee at about ₹68-70 to the U.S. dollar.
•The government had, earlier this month, announced the easing of overseas borrowing norms for manufacturing companies, removal of restrictions on foreign portfolio investment in corporate bonds and tax benefits on masala bonds.
•The imposition of tariffs on the import of non-essential items is expected to bolster these efforts in stabilising the rupee’s levels, according to the official.
📰 Panel approves nutrition norms
‘Severely wasted children must befed fresh food’
•India’s top nutrition panel has recommended that severely malnourished children must be fed freshly cooked food prepared from locally available cereals, pulses and vegetables, and distributed by anganwadi centres, as part of the country’s first-ever guidelines for nutritional management of children suffering from severe acute malnutrition (SAM).
•“The National Technical Board on Nutrition (NTBN) has approved guidelines proposed by our Ministry for severe acute malnutrition,” Secretary, Women and Child Development, R. K. Shrivastava told The Hindu .
•The measures are part of the community-based health management of children suffering from SAM. The government had, till now, only put in place guidelines for the hospitalisation of severely wasted children who develop medical complications. Those norms were made public in 2011.
•The norms were okayed by a scientific sub-committee under the NTBN, according to the minutes of the meeting issued last week.
Anganwadi workers
•The guidelines outline the role of anganwadi workers and auxillary nurse midwives (ANMs) in identifying severely wasted children, segregating those with oedema or medical complications and sending them to the nearest health facility or nutrition rehabilitation centres.
•The remaining children are enrolled into “community based management”, which includes provision of nutrition, continuous monitoring of growth, administration of antibiotics and micro-nutrients as well as counselling sessions and imparting of nutrition and health education.
•According to the recommendations, anganwadi workers have to provide modified morning snacks, hot cooked meals and take home ration for SAM children.
•The morning snacks and hot-cooked meals, which are served at anganwadis to children between the age of three to six years, should be “prepared freshly and served at the centralised kitchen/ anganwadi centres. Locally available cereals, pulses, green leafy vegetables and tubers, vitamin C rich fruits, as well as fresh milk and 3-4 eggs every week” have also been prescribed.
•Importantly, the government has also revised the method to be used to measure wasting and advised calculating weight based on the height of children instead of the mid-upper arm circumference.
📰 Long road ahead: on Ayushman Bharat scheme
Budgetary support must be strengthened to make Ayushman Bharat a success
•Ayushman Bharat has been rolled out as a health protection scheme that will provide guaranteed access to treatment that is free at the point of delivery to about 40% of the population selected on the basis of censused socio-economic indicators. It is the essential first step on the road to universal health coverage, although it has been launched by the NDA government quite late in its term, possibly with an eye on the 2019 general election. Since the Centre has announced that 10.74 crore families identified through Socio-Economic Caste Census data will be given an annual ₹5 lakh cover under the Pradhan Mantri Jan Arogya Yojana (the insurance component of the scheme), the question of eligibility appears settled. But the late start makes it virtually impossible for all those who are technically insured to avail of the services that state agencies must make available, within a reasonable time-frame. And, the allocation of just ₹2,000 crore during the current year to the PMJAY cannot provide the promised cover to the large population sought to be included. Not all States and Union Territories are in a position to raise their own share, and a few have not even joined the scheme. The challenge of funding, therefore, remains. And without adequate budgetary commitments, the implications of pooling the financial risk for such a large segment of the population through insurers or state-run trusts or societies make the outcomes uncertain.
•Guaranteeing health-care access using private or public facilities presumes tight cost control. In the case of the PMJAY, this is to be achieved using defined treatment packages for which rates are prescribed. Costs are a contested area between the care-providers and the Centre, and many for-profit hospitals see the government’s proposals as unviable. In the absence of adequate preparation, the Ayushman Bharat administration is talking of a rate review. More importantly, a lot of time has been lost in the NDA government’s tenure, when State governments should have been persuaded to regulate the hospital sector under the Clinical Establishments (Registration and Regulation) Act, which dates back to 2010. The law broadly provides for standardisation of facilities and reasonable rates for procedures. Apprehensions of fraud have prompted Ayushman Bharat administrators to announce that some key treatments should be availed through public sector institutions. But public facilities have been neglected for long. Going forward, there are some clear imperatives. It is essential to reduce the pressure on secondary and tertiary hospitals for expensive treatments by investing in preventive and primary care facilities. Here, the 150,000 health and wellness centres of the National Health Protection Mission can play a valuable role. The first-order priority should be to draw up a road map for universal health coverage, through continuous upgradation of the public sector infrastructure.
📰 Rethinking disaster management
The new climate reality is raising the bar on disaster resilience
•It is time to stop thinking of the extreme weather events hitting us with increasing frequency as bolts from the blue. Kerala bravely endured the monsoon storms, but it would be a mistake to think that disasters of this magnitude are “once in a hundred year” events.
•Weather disasters are being affected by climate change that is caused by humans. The devastation is worsened by the collective failure of governments and businesses to invest in building resilience despite the evidence on runaway climate change. The lesson from the Kerala floods, Hurricane Harvey (Houston, U.S., 2017) and Typhoon Haiyan (the Philippines, 2013) is that responses to disasters must be proactive, not just reactive.
•First, reconstruction efforts must involve rebuilding in a better way. Climate proofing in Kerala calls for structures to be built with wind- and water-resistant materials. The higher cost will be more than offset by avoided repairs. Second, people need to relocate out of harm’s way. After Haiyan’s storm surges, distances from coastlines that were considered safe for settling were extended. During the 2015 floods, Chennai illustrated the price of unrestricted urban development. Third, early warning is vital. Because of investments in these systems, Cyclone Phailin (2013) claimed less than 40 lives in Odisha, whereas a superclyclone in 1999 in the State had killed 10,000 people. In Kerala, there was no timely forecast from national weather services. The State needs a reliable flood forecasting capability. Fourth, there needs to be tougher implementation of logging and mining regulations in fragile ecologies. Deforestation worsened the effects of Kerala’s floods and mudslides, as the report of the Western Ghats ecology expert panel 2011 had warned. Lastly, there is the climate conundrum: Wayanad, which just saw record rainfall, is expecting a severe drought. Kerala by itself has a small carbon footprint, but it can have a voice in helping one of the world’s largest carbon emitters reduce its carbon footprint.
•The economic damage from global warming has global ramifications. The 2011 floods in Thailand’s economic heartland disrupted not just national, but global manufacturing value chains. The Kerala floods are estimated to have shaved off about 2.2% of the State’s GDP. Bolstering resilience must be central to recovery. Multilateral agencies including the World Bank and Asian Development Bank may be well-positioned to provide financing, which is vital when budgets are stretched, and, crucially, knowledge solutions to tackle climate disasters. Kerala gets high marks for its participatory approach to relief and rehabilitation. Invaluable as this is, the new climate reality is raising the bar on disaster resilience.
📰 A study of inter-generational mobility
Post-liberalisation, Muslims are worse off
•A good measure of progress in a household is inter-generational mobility — an improvement in social status from the previous generation. How has this varied across social groups and geographies across India since liberalisation? A recent paper, “Intergenerational Mobility in India: Estimates from New Methods and Administrative Data” by Sam Asher et al, tries to answer this by using a novel method to parse data from various India Human Development Surveys and the Socio-Economic Caste Census of 2012.
•The paper studies educational mobility from the 1950s to the 1980s birth cohorts instead of income mobility, as data on income mobility that link parent and child wages are rare and unavailable in a structured manner. The researchers find that there is rising mobility among the SCs and STs post-liberalisation, but among Muslims, except in J&K, there has been declining inter-generational mobility. This is a significant finding as Muslimsare not generally studied as marginalised in India.
•They find that urban areas are significantly more mobile than rural areas; “the mobility gap between urban and rural locations is about equal to today’s gap between higher caste Hindus and SCs”. Among the STs, the remote districts where they are present explain 59% of the upward mobility gap with the forward or other reference groups.
•The researchers also present estimates on mobility by geographic location by parsing data for sub-districts and towns on a high-resolution map. They find that upward mobility — the average education rank attained by sons born to fathers who are born in the bottom half of the father education distribution — is much higher in the southern States (except for pockets in Karnataka and Telangana), Maharashtra, Punjab, Haryana, Delhi, Himachal Pradesh and J&K. The north-central and eastern States of Uttar Pradesh, Madhya Pradesh, southern Chhattisgarh, Bihar, Jharkhand, parts of West Bengal and Odisha and the north-eastern States (barring Manipur) have relatively lower upward mobility.
•The average income and education in rural areas and the average education, size and low segregation in urban areas are the strongest predictors of upward mobility. The researchers find that on average, children are most successful in exiting the bottom of the education distribution in places that are in south India, are urban, or in general have higher average education levels.
📰 Tiny device may be effective in treatment of heart failure
MitraClip, inserted into the heart, sharply reduces death rates in patients: study
•For people with severe heart failure, even mundane tasks can be extraordinarily difficult.
•With blood flow impeded throughout their bodies, patients may become breathless simply walking across a room or up stairs. Some must sleep sitting up to avoid gasping for air.
•Drugs may help to control the symptoms, but the disease takes a relentless course, and most people with severe heart failure do not have long to live. Until now, there has been little doctors could do.
•But on Sunday, researchers reported that a tiny clip inserted into the heart sharply reduced death rates in patients with severe heart failure. In a large clinical trial, doctors found that these patients also avoided additional hospitalisation and described a drasticallyimproved quality of life with fewer symptoms.
•The results, reported at a medical meeting in San Diego and published simultaneously in the New England Journal of Medicine , were far more encouraging than heart specialists had expected.
•“It’s a huge advance,” said Dr. Howard Herrmann, director of interventional cardiology at the University of Pennsylvania, which enrolled a few patients in the study. “It shows we can treat and improve the outcomes of a disease in a way we never thought we could.”
•If the device is approved by the Food and Drug Administration for treatment of severe heart failure, as expected, then insurers, including Medicare, likely will cover it.
•In heart failure, the organ itself is damaged and flaccid, often as a consequence of a heart attack. The muscle pumps inefficiently, and in an attempt to compensate, the heart enlarges and becomes misshapen.
•The enlarged organ tugs apart the mitral valve, which controls blood flow from the left atrium into the left ventricle. The distorted valve functions poorly, its flaps swinging apart. Blood that is supposed to be pumped into the body backs up into the heart and lungs.
•A vicious cycle ensues: the heart enlarges, so the mitral valve leaks. The leaky mitral valve makes the heart enlarge even more, as it tries to compensate, and heart failure worsens.
•In the new study, a device called the MitraClip was used to repair the mitral valve by clipping its two flaps together in the middle.
•The result was to convert a valve that barely functioned into one able to regulate blood flow in and out of the heart.
📰 Mosquito population made extinct with genetic tweak
After eight generations, there were no females left to reproduce
•Scientists said on Monday they had succeeded for the first time in wiping out an entire population of malaria-carrying mosquitoes in the lab using a gene editing tool to programme their extinction.
•So-called gene drive technology works by forcing evolution’s hand, ensuring that an engineered trait is passed down to a higher proportion of offspring — across many generations — than would have occurred naturally.
•In experiments with the species Anopheles gambiae , scientists at Imperial College London tweaked a gene known as doublesex so that more females in each generation could no longer bite or reproduce.
•After only eight generations, there were no females left and the population collapsed due to lack of offspring. “This breakthrough shows that gene drive can work, providing hope in the fight against a disease that has plagued mankind for centuries,” said lead author Andrea Crisanti, a professor in Imperial’s Department of Life Sciences.
•Malaria affected more than 200 million people worldwide in 2016 and killed nearly 4,50,000. It remains one of the most deadly of infectious diseases.
•Previous attempts by the same team and others to induce the genetically programmed extinction of mosquitoes in the laboratory ran into “resistance” in the form of mutations that fought back against the high-tech engineering.
A timely breakthrough
•The next step will be to test the technology in a confined laboratory setting that mimics a tropical environment, said Mr. Crisanti.
•“It will be at least five-to-ten years before we consider testing any mosquitoes with gene drive in the wild,” he said.
•Scientists not involved in the study described it as a timely breakthrough.
