📰 Cabinet nod for setting up WHO Global Centre for Traditional Medicine
It is to be established under Ministry of Ayush in Jamnagar
•The Union Cabinet, chaired by Prime Minister Narendra Modi, on Wednesday approved the establishment of a WHO (World Health Organization) Global Centre for Traditional Medicine (WHO GCTM) at Jamnagar in Gujarat. An agreement was signed by the Government of India with the world body in this regard.
•The WHO GCTM, to be established under the Ministry of AYUSH ( Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy), will be the first and only global outposted centre (office) for traditional medicines.
•“The move will help to position AYUSH systems across the globe, provide leadership on global health matters pertaining to traditional medicine, ensure quality, safety and efficacy, accessibility and rational use of traditional medicine while developing specific capacity building and training programmes in the areas of relevance to the objectives and conduct training programmes in campus, residential, or web-based, and through partnerships with the WHO Academy and other strategic partners,’’ a government release said.
•The move would help develop norms, standards, and guidelines in relevant technical areas, tools and methodologies for collecting data undertaking analytics, and assess impact.
Other MoUs
•The other decisions the Cabinet was appraised of included a memorandum of understanding (MoU) signed between the Indian Council of Medical Research (ICMR) and Deutsche Forschungsgemeinschaft e.V. (DFG), Germany; MoU signed by the ICMR with the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Health of Department of Health and Human Services, U.S.; and the Council’s MoU with Oxford University, U.K.
•The objective of the MoU with Oxford University includes capacity-building for Indian scientists and researchers, collection of data compliant with international standards and regulatory requirements, development of India towards becoming a regional hub for capacity development using its own funds and following the principles of equity and sovereignty, and building partnership in and beyond data and skill-sharing with equity and transparency.
‘It will help government generate substantial revenues’
•The Union Cabinet on Wednesday approved the setting up of a new government-owned firm for pooling and monetising sovereign and public sector land assets. The National Land Monetisation Corporation (NLMC) is being formed with an initial authorised share capital of ₹5,000 crore and paid up capital of ₹150 crore.
•The government will appoint a chairman to head the NLMC through a ‘merit-based selection process’ and hire private sector professionals with the expertise required for asset monetisation in areas such as real estate market research, legal due diligence, valuation, master planning, investment banking and land management.
•The NLMC will undertake monetisation of surplus land and building assets of Central public sector enterprises (CPSEs) as well as government agencies. “With monetisation of non-core assets, the government would be able to generate substantial revenues by monetising unused and under-used assets,” an official statement said. The proposal is in pursuance of the Budget announcements for 2021-22, which included an ambitious National Monetisation Pipeline to garner revenues from public assets.
•The new corporation will also help carry out monetisation of assets belonging to public sector firms that have closed or are lined up for a strategic sale. As per the plan, the surplus land and building assets of such enterprises may be transferred to the NLMC, which will then manage and monetise them.
‘Hasten closure process’
•“This will speed up the closure process of the CPSEs and smoothen the strategic disinvestment process,” the statement said, noting that the CPSEs hold ‘considerable surplus, unused and under used non-core assets’ in the form of land and buildings.
•Apart from executing the monetisation plan, the NLMC will advise other government entities to identify their non-core surplus assets and ‘generate maximum value’ by monetising them ‘in a professional and efficient manner’.
•“…NLMC will undertake surplus land asset monetisation as an agency function. It is expected that NLMC will act as a repository of best practices in land monetisation, assist and provide technical advice to government in implementation of asset monetisation programme,” the official communique said.
📰 Water management needs a hydro-social approach
Freshwater resources are under stress, the principal driver being human activities in their various forms
•The Global Water System Project, which was launched in 2003 as a joint initiative of the Earth System Science Partnership (ESSP) and Global Environmental Change (GEC) programme, epitomises global concern about the human-induced transformation of fresh water and its impact on the earth system and society. The fact is that freshwater resources are under stress, the principal driver being human activities in their various forms.
Fresh water, water valuation
•In its fourth assessment report in 2007, the Intergovernmental Panel on Climate Change (IPCC) highlighted the link between societal vulnerability and modifications of water systems. It is globally estimated that the gap between demand for and supply of fresh water may reach up to 40% by 2030 if present practices continue.
•The formation of the 2030 Water Resource Group in 2008, at the instance of the World Economic Forum, and the World Bank’s promotion of the group’s activity since 2018, is in recognition of this problem and to help achieve the Sustainable Development Goal (SDG) on water availability and sanitation for all by 2030 (SDG 6). Formally, it is: “to ensure safe drinking water and sanitation for all, focusing on the sustainable management of water resources, wastewater and ecosystems....” The latest UN World Water Development Report, 2021, titled ‘Valuing Water’, has laid stress on the proper valuation of water by considering five interrelated perspectives: water sources; water infrastructure; water services; water as an input to production and socio-economic development, and sociocultural values of water.
•Designing a comprehensive mix of divergent views about water (along with ecological and environmental issues) held by stakeholder groups is necessary. In this context, a hydro-social cycle approach provides an appropriate framework. It repositions the natural hydrological cycle in a human-nature interactive structure and considers water and society as part of a historical and relational-dialectical process.
Inter-basin transfer projects
•The anthropogenic factors directly influencing a freshwater system are the engineering of river channels, irrigation and other consumptive use of water, widespread land use/land cover change, change in an aquatic habitat, and point and non-point source pollution affecting water quality. The intra- and inter-basin transfer (IBT) of water is a major hydrological intervention to rectify the imbalance in water availability due to naturally prevailing unequal distribution of water resources within a given territory.
•There are several IBT initiatives across the world. One recent document indicates that there are 110 water transfer mega projects that have either been executed (34 projects) or being planned/under construction (76 projects) across the world. The National River Linking Project of India is one of those under construction. These projects, if executed, will create artificial water courses that are more than twice the length of the earth’s equator and will transfer 1,910 km3 of water annually. They will reengineer the hydrological system with considerable local, regional and global ramifications. Based on a multi-country case study analysis, the World Wildlife Fund/World Wide Fund for Nature (2009) has suggested a cautious approach and the necessity to adhere to sustainability principles set out by the World Commission on Dams while taking up IBT projects.
Some of the key assumptions
•Recently, inter-basin transfer of water drew attention in India due to a provision made in Budget 2022 for the Ken Betwa river link project which is a part of the National River Linking project (mooted in 1970 and revived in 1999). This decision raises larger questions about hydrological assumptions and the use and the management of freshwater resources in the country. We shall ponder over some of them.
•First, the basic premise of IBT is to export water from the surplus basin to a deficit basin. However, there is contestation on the concept of the surplus and deficit basin itself as the exercise is substantially hydrological. Water demand within the donor basin by factoring present and future land use, especially cropping patterns, population growth, urbanisation, industrialisation, socio-economic development and environmental flow are hardly worked out. Besides this, rainfall in many surplus basins has been reported as declining. The status of the surplus basin may alter if these issues are considered.
•Second, there is concern about the present capacity utilisation of water resources created in the country. By 2016, India created an irrigation potential for 112 million hectares, but the gross irrigated area was 93 million hectares. There is a 19% gap, which is more in the case of canal irrigation. In 1950-51, canal irrigation used to contribute 40% of net irrigated area, but by 2014-15, the net irrigated area under canal irrigation came down to less than 24%. Ground water irrigation now covers 62.8% of net irrigated area. The average water use efficiency of irrigation projects in India is only 38% against 50%-60% in the case of developed countries.
Agriculture, grey water use
•Even at the crop level we consume more water than the global average. Rice and wheat, the two principal crops accounting for more than 75% of agricultural production use 2,850 m 3/tonnes and 1,654 m 3/tonnes of water, respectively, against the global average of 2,291m 3/tonnes and 1,334m 3/ tonnes in the same order. The agriculture sector uses a little over 90% of total water use in India. And in industrial plants, consumption is 2 times to 3.5 times higher per unit of production of similar plants in other countries. Similarly, the domestic sector experiences a 30% to 40% loss of water due to leakage.
•Third, grey water is hardly used in our country. It is estimated that 55% to 75% of domestic water use turns into grey water depending on its nature of use, people’s habits, climatic conditions, etc. At present, average water consumption in the domestic sector in urban areas is 135 litres to 196 litres a head a day. Given the size of India’s urban population (469 million estimated for 2021), the amount of grey water production can be well imagined. If grey water production in the rural areas is considered it will be a huge amount. The discharge of untreated grey water and industrial effluents into freshwater bodies is cause for concern. The situation will be further complicated if groundwater is affected.
•Apart from the inefficient use of water in all sectors, there is also a reduction in natural storage capacity and deterioration in catchment efficiency. The issues are source sustainability, renovation and maintenance of traditional water harvesting structures, grey water management infrastructure, groundwater recharge, increasing water use efficiency, and reuse of water.
Planning ahead
•Looking into these issues may not be adequate to address all the problems. Nevertheless, these measures will help to reduce demand supply gap in many places, and the remaining areas of scarcity can be catered to using small-scale projects. The axiom that today’s water system is co-evolving and the challenges are mainly management and governance has been globally well accepted. Water projects are politically charged and manifest an interplay of social relations, social power, and technology.
•It is important to include less predictable variables, revise binary ways of thinking of ‘either or’, and involve non-state actors in decision-making processes. A hybrid water management system is necessary, where (along with professionals and policy makers) the individual, a community and society have definite roles in the value chain. The challenge is not to be techno-centric but anthropogenic.
📰 A new vision for old age care
A formal approach to homes for the elderly is an important policy and planning issue for India
•As India becomes increasingly urbanised and families break up into smaller units, homes for the elderly have sprung up. The care of elderly people is managed by a set of professionals or voluntary organisations interested in geriatric services. The number of such care homes is rising rapidly in urban and semi-urban India. These homes are either paid for, or offer free or subsidised service. Typically, such homes are run by NGOs, religious or voluntary organisations with support from the government, or by local philanthropists. They provide accommodation, timely care, and a sense of security for their residents. However, the quality of service varies as these homes lack regulatory oversight. Many homes lack clearly established standard operating procedures, and their referral paths to health care are informal. There is an urgent need to understand the quality of life at such institutions, including the impact of these homes on the mental health of their residents.
A rapidly growing section
•A formal approach to homes for the elderly is an important policy and planning issue for India. The UN World Population Ageing Report notes that India’s ageing population (those aged 60 and above) is projected to increase to nearly 20% by 2050 from about 8% now. By 2050, the percentage of elderly people will increase by 326%, with those aged 80 years and above set to increase by 700%, making them the fastest-growing age group in India. With this future in mind, it is essential that our policy framework and social responses are geared to meet this reality.
•A recent set of research papers from Hyderabad focusing on the quality of health in homes for the elderly has some interesting insights. The papers highlight the fact that good intentions and a sense of charity are often inadequate when it comes to addressing the basic health needs of their elderly residents. These papers are outcomes of the Hyderabad Ocular Morbidity in Elderly Study (HOMES) by the L.V. Prasad Eye Institute that was primarily meant to understand the vision needs of elderly residents of such homes. About 30% of the residents who were part of the study (over 1,500 participants from 40 homes) had a vision impairment of some sort, but nearly 90% of this vision impairment could be addressed by simple, relatively low-cost health interventions: issuing better eye glasses or cataract surgery.
•The study also found some ‘unseen’ effects of vision impairment: many were prone to depression. In fact, those with both vision and hearing impairment had a rate of depression that was five times higher than those without. Our homes, buildings and social environment are not built keeping the elderly (or people with disabilities) in mind. As people age, and their motor skills weaken, they are at a greater risk of falling down and hurting themselves. Having an impairment increases this risk. Instead of planning for accessible and elderly-friendly structures that allow them to operate safely, we reduce their mobility. People with functional skills are asked to stay away from daily tasks like cooking, sewing, cleaning, or washing up. This reduces their sociability, their sense of independence and well-being — all leading up to mental health issues and depression.
•The state of homes for the elderly today offers us some low-hanging fruit we can address easily: build formal pathways for basic health screening between such homes and public health facilities. This can include screenings for blood sugar, blood pressure, periodic vision and hearing screening, and a simple questionnaire to assess mental health. Such interventions are inexpensive (think of all the motorcycle-operated screenings outside public grounds for morning-walkers) and could go a long way in identifying health issues and offering support. The next step would be to build formal pathways to address any health issues that such screenings identify. Many hospitals (public, NGO-run, and private care) can help.
Public policy support
•Crucial though will be the need for robust public policy to support homes for the elderly. Health institutions will also need to offer a comprehensive set of packages that are tailored for the elderly — not piecemeal solutions for diabetes, cardiology or cancer, for example. What happens once care is provided? Homes for the elderly must be guided, again by policy, to make their facilities, buildings and social environment elderly- and disabled-friendly. Design, architecture and civic facilities must be thought from the ground up — and these innovations must be available for all residents, not just those living in expensive ones. There are lessons here for society as a whole, but, as they say, let’s take one step at a time.
